Tag Archives: Glassboro physical therapy

A Parent’s Nightmare: Teenage Concussion

ON THE LEVEL FALL 2015
A Quarterly Newsletter of the Vestibular Disorders Association
TherasportPhysicalTherapy
          Concussion Therapy

By Dr. Jennifer Liss (with Sherron Laurrell)

Corinne Santana, age 13, is the picture of what makes a parent proud. Her parents, Jennifer MacDermott and Eric Santana, have watched with love and awe as their daughter has handled a medical emergency that introduced the family to the overwhelming topic of teenage concussion.

Corinne is an 8th grader and a cheerleader. On September 20, 2014, she was participating in a cheerleading stunt where she was in the second tier lifting another cheerleader to the top of a pyramid. The girl on the bottom lost her hold because of a weakened wrist that was wrapped in a brace. As the top girl fell, Corinne was clobbered in the back of the head. A few minutes later, Corinne hit her chin on another girl’s forehead. Both Corinne’s mom and her coach knew quickly that something was wrong. She was acting strangely and was unresponsive to questions. Her head was bobbing.

Her mom rushed her to the ER. After a CT scan, she was admitted to the hospital and eventually taken by ambulance to the Regional Trauma Center in Atlantic City, New Jersey. Suffering with intense head and neck pain, the doctors prescribed medications that required heart monitoring. For more than a week, Corinne zoned in and out. She remembers nothing of the accident or the days after. The on-call doctor at their family practice, although very sympathetic, did not have much knowledge about concussion. She recommended Corinne be seen by a Sports Medicine Specialist.

Corinne’s school was even less informed about concussions than the family doctor. The middle school just didn’t know what to do, including the school nurse. On October 2, 2014, Corinne was evaluated by a Rothman Institute Sports Medicine Specialist. Although Corinne’s specialist gave her a 504 (academic) Accommodation Plan, some of her teachers would not cooperate. A few were openly critical of her, saying that she was ”exaggerating” and ” faking” her symptoms. Corinne was depressed, full of anxiety, mentally confused, dizzy and in pain. She first came to see me on October 13th.

As a Certified Specialist in Vestibular Rehabilitation I had begun getting numerous referrals to treat postconcussive syndrome. When I initially started treating these patients four years ago I quickly realized they were different from the Traumatic Brain Injury (TBI)/ neurological and vestibular populations. They often have a combination of central and peripheral abnormalities. VOR (vestibulo-ocular reflex) retraining, even with extensive modification, did not progress the way my vestibular patients progressed. Many times the patients seemed to have trouble focusing on a target even with their heads still.

After spending extensive amounts of time with concussion specialists, vision therapists, and attending as much continuing education in this area that I could find, I realized that in order to normalize impaired vestibular reflexes, concussion patients first had to be able to clearly focus on a target.

Corinne’s main symptoms upon examination included headache, dizziness, fatigue, and neck pain. Her symptoms increased with reading, copying from the board, math class (always her hardest) and exertion. Instead of beginning my clinical concussion exam with the standard oculomotor exam, I began with monocular accommodative focus (the ability of an individual eye to focus clearly on a target) and found a significant difference between her two eyes. I then assessed for a convergence insufficiency (normal is 4-6 cm) and found that the same eye that had weaker accommodative focus had more difficulty moving medially and maintaining convergence on a target. This affected saccadic eye movement speed, and endurance strongly impacts reading ability. Copying from the board was even more difficult because it involves repetitive head movement combined with visual accommodation between near and far targets.

I treated Corinne twice a week for five months. Her recovery was slow but consistent. 13-year old girls are the slowest youth population to recover from concussion due to their dramatic hormonal changes. However, thanks to Corinne’s consistent efforts in therapy, she successfully graduated on February 5, 2015. She has returned to her middle school life and her cheerleading!

When Corinne’s mom was asked what she has learned from this experience she was very clear. “Speak up if you see something that looks out of place.” After the fact, she remembers seeing the wrist brace on the girl who was supporting her daughter in the pyramid and wondering why she was performing a cheerleading stunt if her wrist was injured. She also feels residual frustration about the lack of school system knowledge about concussions and how to treat patients. She tries hard to strike a balance between letting Corinne be independent and overprotecting her. This is an understandable reaction from a mom who has seen her daughter through such a powerful event. Corinne’s mom plans to educate those around them about the importance of treating teenage concussions seriously and immediately.
Sports Medicine

Jennifer Liss is certified in Vestibular Rehabilitation. She is an Adjunct Professor of Kinesiology at Rowan University in Glassboro, NJ. TheraSport Physical Therapy offices are located in New Jersey, where she has practiced for 16 years. She can be reached at JenLiss@Therasport.org. Sherron Laurrell is a vestibular patient who has been treated by Dr.Liss. They now collaborate on case studies to educate and help others.

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Catastrophe Averted – A Concussion Story

On The Level
A Quarterly Newsletter of the Vestibular Disorders Association
By Jennifer Liss (with Sherron Laurrell)

There are all kinds of events that have the potential for disrupting our lives. A near fatal car accident certainly fits that description. A resulting concussion interrupts life for both the sufferer and for those who love them.

That is exactly what Deana Leonard faced on a December afternoon in 2014. As she and her mother were on their way Christmas shopping, a man “late to work” blew through a red light and hit their car on the driver’s side, demolishing the front end. Deana’s mom was injured by the seat belt and fortunately healed without issue. Deana, however, was not so lucky.

After the collision, Deana jumped out of the car and instantly felt nauseous. Her head was hurting. Her focus was on her mom. And she was scared! The police wanted her to go to the hospital. She said “no.” She was terrified, she thought, but not hurt. She just wanted to go home and go to bed.

Two days later she was “talking crazy” and not making any sense. Her husband and her twin sister began insisting that she go to the hospital but she continued to resist. Finally they didn’t offer her the choice. When they arrived at the ER the doctors asked why she had waited. They ran tests and did a CT scan and then told her, “You have concussion like symptoms. You need to follow up with a neurologist.”

On December 19th, Deana saw a concussion specialist at The Children’s Hospital of Philadelphia (CHOP), who confirmed that Deana had a concussion. “Time is your friend Deana, but vestibular rehabilitation therapy will help you recover more quickly.”

Jennifer Liss with concussion patientWhen Deana came to see me, she felt like her head was in constant motion. Clinically she presented with motion sensitivity, dizziness, imbalance, light sensitivity, head pressure and cervical stiffness. Her injuries were the result of the air bag deployment. During the balance exam her BESS (Balance Error Scoring System) score was a 22 (normal is 10 or less); her timed heel/toe walk (10 feet with turn) was 21 seconds (normal is less than 14 seconds without losing balance). Her MSQ (motion sensitivity quotient) showed a severe handicap at 52 percent. All other tests supported the finding of concussion. Her first appointment with me was December 31, 2014, seventeen days after her accident.

She had continual dizziness and balance issues over the holidays, but being a mom she didn’t want to spoil the Christmas season for her two children, Megan, age 14 and Brett, age 9, by starting VRT. For many years before her accident, Deana had suffered from moderate to severe car sickness. Concussions can exacerbate previously existing conditions. After a thorough examination and case history I was able to say to Deana, “I have good news for you. After you complete VRT, you will feel better from the concussion and your long standing motion sickness issues may subside too!”

Deana began VRT twice a week at my office with homework she did on her own. It was a struggle at first. She continued to have severe headaches for the first few weeks. As her vestibular rehab progressed she began to feel better. When
she went for her check-in with the concussion specialist at CHOP in early February she was able to report that she felt much better – fewer headaches, more balanced.

As a middle school guidance counselor, Deana tried not to miss too much work. In total she missed only six days. Her principal was very supportive of her situation. Her students were terrific! In her role, she had always handled accommodations of concussion cases for students but now she has a deeper appreciation of how to coach teachers who “resist” the reality that a concussion is serious business.
JenLiss2
Her advice to others? If you are in a car accident, GO TO THE HOSPITAL! Don’t wait. Concussions are no joke!

Deana graduated from VRT on April 30. She is doing well and is grateful that her fear that she would never be normal again has been replaced with regained balance and no car sickness!


Jennifer Liss is “Susan Herdman certified” in Vestibular Rehabilitation. She is an Adjunct Professor of Kinesiology at Rowan University in Glassboro, NJ. TheraSport Physical Therapy offices are located in New Jersey, where she has practiced for 16 years. She can be reached at JenLiss@Therasport.org.

Sherron Laurrell is a vestibular patient who has been treated by Dr.Liss. They now collaborate on case studies to educate and help others.

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Knowlegde. Experience. Results. Let Our Expertise Expedite Your Recovery!

What is Physical Therapy?

Physical therapy is a form of treatment for when health issues make it hard to move around and do everyday tasks. Physical Therapy regularly helps you move better and may relieve pain that you have from an injury or illness. It also helps improve or restore your physical function and your fitness level to get back to your daily activities.

The goal of physical therapy is to make daily activities easier after surgery or ease the issues of a chronic illness. For example, physical therapy may help with walking, going up stairs, or getting in and out of bed.

Physical therapy can help with recovery after some surgeries. Your doctor may suggest physical therapy for injuries or long-term health problems such as:

•  Back pain or injuries/illnesses of the Back such as a herniated disc.
•  Tendon or ligament problems, an example would be an anterior cruciate
ligament (ACL) injury, a meniscus tear, or plantar fasciitis.
•  Arthritis conditions such as Osteoarthritis and rheumatoid arthritis.
•  Injuries of the spine such as Spinal stenosis
•  Neurological disorders such as Parkinson’s disease
•  Vestibular issues such as vertigo or post concussion syndrome

What does a physical therapist do?

At TheraSport Physical Therapy, our highly skilled physical therapists will examine you and create a treatment plan. Depending on your health and condition, your therapist will help you with flexibility, strength, endurance, coordination, and/or balance.

If you have an injury or complication from an illness, your therapist will first reduce your pain and swelling if you have any. Then he or she will work with you to increase your flexibility, strength, and endurance.

Physical therapy almost always includes some form of exercise. Stretching, core exercises, moderated weight lifting, and walking are some physical therapy methods we use at our facilities. Your physical therapist will also construct an individual exercise program so you can keep up with your therapy at home.

Our therapists may use manual therapy, and techniques such as heat, cold, massage, ultrasound, and electrical stimulation during your therapy program.

Contact TheraSport Physical Therapy for a consultation at one of our two New Jersey locations.

TSPT WASHINGTON TWP.
14 Parke Place Blvd Ste D
Sewell, NJ 08080
(856) 256-8393

TSPT MERCHANTVILLE
30 W Maple Ave
Merchantville, NJ 08109
(856) 661-0200

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Let TSPT Help Keep Your New Years Resolution!

People try to get a jump start on their fitness as the New Year rings, however, many of are going about it the wrong way. Unfortunately some injuries don’t get better with just working out, or without a proper physical therapy routine. The main reason for most injuries lingering, of this nature: too much repetition or stress to the injury in too short of time. At TheraSport Physical Therapy, we know it is important to communicate to the individual how crucial it is to build up a fitness routine slowly and carefully, keeping in mind proper nutrition and adequate rest.

Keep your New Years Resolutions with these tips:

Eat Well. Stay Hydrated. After the holidays you may be reaching for cold weather comfort food, but eating fruits and vegetables while drinking water throughout the day can provide you with improved energy. Proper nutrition will also give your muscles the right nutrients they need to limit inflammation and facilitate increased metabolism.

Warm Up. Stretch. Give yourself at least 10-15 minutes prior to your workout to warm-up your body. Dynamic stretches are also a great way to start a workout and get your blood flowing before you move into your cardio or workout routine.

Build Resistance. Recover. If you are sore for more than 3 days following a workout than you probably went a little too hard a little too much. To avoid injury you must build up your routine and recover properly. At TheraSport Physical Therapy we provide a proper exercise program that will give your body exactly what it needs to build strength, stamina, with time for recovery.

Call TheraSport Physical Therapy today, to make an appointment with our skilled physical therapists. Our therapy team will discuss a program that is suitable for you to keep those New Year’s Resolutions! Even if you aren’t prone to injury, your therapist can give you some education on proper technique and form in order to keep you injury-free.

Let TSPT help you with your fitness New Year’s Resolution plan. Call one of our two conveniently located New Jersey facilities now, to get you started! Ring in the New Year by being healthy and injury-free and let us help you every step of the way!

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2014 Back-To-School Tips from TheraSport Physical Therapy!

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Do you know how much your child’s backpack weighs? According to the APTA if it’s more than 15 percent of his or her body weight, then it could hurt your child’s back. Millions of students in the United States carry backpacks to and from school, often overloaded with books, supplies and equipment.  Weight of the backpack and improper use can result in injury to the skeletally immature child.

During adolescence kids are going through growth spurts and so their bones and posture are vulnerable to injury.  Injury can result when a child carrying a heavy backpack uses bad posture or shifts there weight abnormally to adapt a heavy load.  These adaptations can cause pain from disk injury, improper spinal alignment and deformity.  In addition, the muscles of neck, shoulder region and lower back can be strained leading to injury.  In more advanced cases, a child may even experience nerve compression and damage.

Some of the warning signs that a problem may be arising include back pain, fatigue, red marks on the shoulders, tingling or numbness in the arms and a shift or leaning in one direction.

The American Physical Therapy Association has set forth guidelines that should be used with backpacks to reduce the risks associated with them.  These recommendations include:

–       Backpacks should be worn on both shoulders for equal weight distribution, and the height  should fall two inches below the shoulder blades and sit at waist level.

–       It should have padded shoulder straps, which distribute the weight in the bag evenly over his/her shoulders.

–       Shoulder straps should fit comfortably on the shoulder and under the arms, so the arms can move freely.

–       The bottom of the pack should rest in the contour of the lower back.

–       Keep the load 10-15% or less of the child’s body-weight.

–       Organize the contents of the backpack by placing the heaviest items closest to the back

–       Carry only those items that are required for the day

TheraSport Physical Therapy can help you and your child choose a proper backpack that fits your child properly.  Additionally, our physical therapists can help your child improve their posture, correct muscle imbalances and manage the pain from improper backpack use.  TheraSport has two board-certified McKenzie credentialed practitioners to help with all spinal related problems.

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TheraSport Physical Therapy – Merchantville, NJ and Washington Twp, NJ

TheraSport Physical Therapy is motivated to provide patients with successful rehabilitation goals. We want our patients to reach optimal overall function in work, sports, home and recreational activities.

After we evaluate the patient’s need of physical therapy due to sports injury, surgery, or other impairments, we develop treatment programs that are unique to each individual.

Besides treatment, TheraSport Physical Therapy develops fitness and wellness programs for healthier and more active lifestyles.

For more information about TheraSport Physical Therapy: http://www.therasport.org

Like us on Facebook:
https://www.facebook.com/pages/TheraSport-Physical-Therapy/190490151268

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Put a little Spring in your step at TheraSport Physical Therapy!

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Spring is right around the corner, which means it’s time to tend to that garden! However, getting down on your hands and knees to plant can be difficult and hard on your back.

If you experience this kind of trouble, try warming up before you start gardening by walking or stretching. Don’t do the same task in the same position for too long as that can lead to muscle and joint pain or repetitive-motion injuries.

At TheraSport Physical Therapy, we can show you stretching techniques that address stiffness. We also teach core-strengthening exercises that can help reduce low back pain, common in prolonged kneeling and bent over positions.

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