James Jowdy wrote...

About the benefits of Athletic Trainers, appropriate stretching and pool running

“I was disappointed when you mentioned that a sufferer of ITB should directly seek out a physical therapist. By Law in all 50 states, patients are unable to directly see a P.T. because they need a referral from a physician in order to evaluate and treat them. The educational background of physical therapy and population which they treat is broad, and such they don't commonly specialize in sports related injuries, where the education and training of Athletic Trainers has this specific focus. You may find information about athletic trainers at www.nata.org Athletic trainers are health allied professionals such the same as P.T.'s & nurses are. Their difference lies in their sports specific rehabilitation training. A better recommendation for your website may be to seek out therapy by an athletic trainer (ATC - initials after their name) or a physical therapist who is dual educated (ie Joe Smith P.T., ATC). The experience and training of an ATC will far surpass that of PT b/c of their population and treatment focus which is to return the patient to their highest level of activity.

“Something to keep in mind about the acute phase and why people are not able to heal this injury quickly: Similar to tendonitis, the acute phase is when there is microtrauma to the connective tissue of the tendon and/or tendon sheath. As a result, inflammation is present. The acute phase of healing should squelch this inflammation.

“The one BIG mistake that many athletes, teams/coaches w/out athletic trainers , PT's, ATC's & Dr's make is the use of stretching in the acute phase. Stretching provides axial loading of healing tissue, such in the same way that varying grades of exercise provides this loading. So it is necessary to allow this tissue to heal before you start yanking on it again. Even cautionary low grade stretching in the sub-acute phase is important factor in the healing process. I've done some radiological research on an in-vitro rabbit tendonitis model that has displayed the intracacies of tendonitis. Additionally, my clinical experience at an athletic trainer has allowed me to apply this methodology to my patients that have ITB and other forms of tendon inflammatory injury. As a result, I've been able to reduce their treatment time on a consistent bases by greater than 50%. So basically, their back to their activity in half the time as when my peers or fellow P.T.'s treat their similar patients.

“Such in the same way that we use a 'night-splint' for the healing of achilles tendonitis or plantar fascitis to promote healing and achieve correct anatomical tissue length, a pillow between the knee for someone who sleeps on their side will aid in the healing of the ITB.

“Supported slow pool running may be used in the later sub-acute phase utilizing an aqua belt or a couple of kick boards. Non-supported slow to moderate pool running may be used in the recovery phase. An 'egg-beater' style kick can be incorp. to enhance balanced hip rotational strength. When swimming during the acute, subacute and recovery phases, attention and care must be made to push off from the wall in order not to preturb the ITB. Therefore, a very soft push-off with the unaffected side is recommended. “

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