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Physician Update – October 2022

On July 26, New York Yankees fans shook their fists when the Yankees lost 3–6 to their rivals, the New York Mets. Some fans blamed the loss on the absence of Giancarlo Stanton, the team’s all-star MVP. Stanton didn’t simply take the day off — he was missing from the baseball field due to Achilles tendinitis. Although the team expected him back in just 2–3 weeks, his injury may still have cost the Yankees the game.

Stanton’s situation illustrates why it’s so crucial for athletes to quickly return to the field after an injury. Every game they miss negatively impacts their team and their career. Though this is less important for high school, college, and recreational athletes than MLB players, it’s still a vital concern. Injuries can have a similarly disastrous effect on nonathletes. If a person who works a physical job is injured and forced to take time off, they’ll lose PTO or wages for every day they miss work.

As a physician, one of the best things you can do to speed up the recovery of a patient with a sports injury or other injury type is refer them to a physical therapist. Thanks to advances in the field, PT before, after, or in place of surgery can reduce “return to sport” time for injuries like Stanton’s. It is a recommended treatment for acute Achilles tendon overuse injuries, for example, when paired with stretching, strengthening exercises, and other non-surgical treatment options.

Post-surgery, a PT can prescribe key “range of motion,” stretching, and strengthening exercises for an efficient recovery. Physical therapy can also speed the rehabilitation process after other sports injuries, including anterior cruciate ligament (ACL) sprains and tears, plantar fasciitis, tennis and golfer’s elbow, concussions, and more. In fact, PT is key during three of the five stages of the process of care for an athlete returning to play (medical treatment, rehabilitation, and end-stage rehabilitation). A skilled PT can even aid in the psychological aspect of recovery, which is gaining attention right now in rehabilitation and return-to-sport literature.

In many sports injury cases, PT can postpone or even replace surgery. One randomized controlled trial of 121 active adults with acute ACL injuries, for example, found that when the subjects were split into two groups — one receiving structured rehabilitation plus early ACL reconstruction and the other structured rehabilitation with the option of later ACL reconstruction if needed — “a strategy of rehabilitation plus early ACL reconstruction was not superior to a strategy of rehabilitation plus optional delayed ACL reconstruction.”
In fact, the latter “substantially reduced the frequency of surgical reconstructions.”

That is fantastic news for athletes eager to return to play, as surgery substantially prolongs the recovery process. Anecdotal evidence also supports the vital role of PT in injury recovery and return to sport. Olympic figure skater Bradie Tennell, for example, credits a combination of physical therapy and Pilates for helping her return to the ice after she fractured two of her lumbar vertebrae in 2015 and 2016. After rehabilitation, Tennell went on to win a bronze medal in the 2018 Olympic Games.

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Julian Manrique

Focus Physical Therapy

"We Help Adults Get Back To Their Normal Active Lifestyles Naturally...While Avoiding Medications, Injections, And Surgeries"