Blog | NeuroSport Physical Therapy

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New Year, New Variant

As COVID-19 has taught us, we must take nothing for granted and be ready to constantly adapt. Here are a few changes we are making this month.

We are in the process of shifting schedules (yet again!) in order to spread out therapists and patients to limit overall numbers in the clinic.

Secondly, it’s time for a mask upgrade. We are kindly requesting that each person who comes to NeuroSport wear a properly fitting N95, KN95 or 3-ply surgical mask over their nose and mouth. A surgical mask can be work under a cloth mask, but a cloth mask alone does not offer sufficient protection for you or others. We have surgical masks available at the front desk if needed.

As health care providers we have a duty to provide care to all, regardless of vaccination status. However, we do require all staff to be fully vaccinated and up to date with boosters and encourage our community to do the same.

Lastly, a friendly reminder to arrive on time to your appointment (not early) to limit traffic in the waiting room. Also, please have family members or caregivers not involved in the session wait outside of the clinic while you are in physical therapy.

We are still offering telemedicine so please reach out if this is something that you are interested in doing.

We keep the health of our patients and staff at the front our our minds every step of the way. Wishing our entire NeuroSport community a happy and healthy 2022.

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COVID-19 Update

In light of tomorrow’s much anticipated date, we wanted to keep our NeuroSport family informed of our COVID-19 policy. Please do not toss aside your mask quite yet! LA County Department of Public Health and the CDC has mandated the continued use of masks for all health care settings. In an effort to protect others who may be immunocompromised or for younger patients who have not yet been vaccinated, please continue to wear a mask over your mouth and nose when visiting NeuroSport regardless of vaccination status. We understand that there is mask fatigue, but please continue the practices we have successfully followed over the past 15 months to ensure that everyone who enters our doors feels comfortable and safe. Thank you for your help on this!

Reminders when visiting NeuroSport:

  • Face coverings must be worn over mouth and nose at all times.

  • Wash or sanitize hands upon entering and leaving clinic.

  • Arrive at the time of your appointment, not early.

  • Family members and/or caregivers not involved in session should wait outside.

  • Maintain distance from other patients when possible.

If you have any of the following symptoms, please do not attend PT and call to reschedule your appointment:

  • chills or fever of 100 degrees or higher;

  • loss of taste or smell;

  • muscle soreness or headaches or fatigue;

  • cough or runny nose or sore throat or congestion;

  • difficulty breathing or shortness of breath;

  • conjunctivitis (inflammation of the eye including redness, itching and tearing) along with feeling feverish;

  • gastrointestinal symptoms (stomach upset, such as abdominal pain or diarrhea or nausea or vomiting).

Please reach out if you have any questions or concerns!

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COVID-19 Reminders and Updates

We hope all of you are feeling well and staying safe as we dive into the holiday season. We wanted to reach out since Los Angeles County Department of Public Health has issued a temporary safer at home order.

We are open and continue to limit overall number of people in the clinic as we have done since March. We are dedicated to serving our patients who need physical therapy while following all of the guidelines and recommendations.

Reminders when visiting NeuroSport:

  • Face coverings must be worn over mouth and nose at all times.

  • Wash or sanitize hands upon entering and leaving clinic.

  • Arrive at the time of your appointment, not early.

  • Family members and/or caregivers not involved in session should wait outside.

  • Maintain 6 feet of distance from other patients.

If you have any of the following symptoms, please do not attend PT and call to reschedule your appointment:

  • chills or fever of 100 degrees or higher;

  • loss of taste or smell;

  • muscle soreness or headaches or fatigue;

  • cough or runny nose or sore throat or congestion;

  • difficulty breathing or shortness of breath;

  • conjunctivitis (inflammation of the eye including redness, itching and tearing) along with feeling feverish;

  • gastrointestinal symptoms (stomach upset, such as abdominal pain or diarrhea or nausea or vomiting).

    ***Please self-monitor for these symptoms and be aware that we serve many high risk individuals.

Can I do telehealth?

Yes! We are still providing telehealth appointments (also referred to as eVisits). We can use secure video conferencing to answer any questions and review or update your exercises at home. Contact us if you are interested.

The health of our NeuroSport community continues remain at the forefront of our minds as we open our doors each day. Please reach out if you have any questions or concerns.

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Questions Answered: Selecting Running Shoes

It’s never a bad time to take up or get back into running. A lot of people lately are doing just that. As a runner, your running shoes are the most important equipment purchase you’ll make in the sport.

Picking running shoes, however, can be a labyrinth – there are many different types; subtle differences in construction can vastly alter how the shoe feels for you; and the terminology can be inconsistent, too. A little fundamental knowledge about picking running shoes can help you have a more informed and helpful discussion when you walk into the store, so that your purchase is the best one for you.

Let’s look at some things to consider.

What kind of running do you do?

Do you run road? Do you trail run? Are you running a few miles to stay in shape, or are you working on a marathon, or something in-between? Also, are there injuries or issues you’ve dealt with in the past, or are you currently trying to run while dealing with an injury?

 Properties of running shoes & what they mean for you

Shoe type 

  • Road shoes – these are constructed with soles designed for thousands upon thousands of strides on a hard, uniform surface (asphalt, concrete). They have flexible upper sections designed to give your foot more airflow but won’t protect your foot from rocks or debris.

  • Trail shoes – these have harder, directional tread for running on low-grip dirt and rocks, especially on hills. As a result, they often do not feel as good when running on asphalt for any prolonged period. These shoes most often focus less on cushioning, and they’re reinforced to protect your feet from the trail itself. They have stiffer upper portions, trading airflow for rigidity and stability on the uneven terrain.

Cushioning

People who are unable to dissipate shock absorption with their own feet (e.g. stiff feet, history of bone issues, etc.) must rely on the shoe to perform that task.  Cushioning is the major way that running shoes can help these runners.  People who benefit from more cushioning often use running descriptors such as “pounding,” “compressing,” or “vibration.”  The trade-off is that cushioning places softer material between your foot and the ground, which can lead to less feedback of the running surface, and it may be slightly easier to injure your ankle if you misstep or slip off a curb.

Drop

This refers to how much higher the heel is than the toe. A “zero drop” shoe is the same height at the front and back, and can work well for somebody who runs near the front or middle of their feet. A shoe with more drop, or a higher heel, may work better if you land near your heel when you run or need your ankles and calves to do less work. More drop may also affect how your lower back feels, so pay attention to any new sensations in your body when you try a shoe with more drop.

Support type

Simply put, this refers to the overarching goal of the shoe. It’s a deep enough topic that we had to make a separate video about it. Broadly speaking, there are three types of shoe support:

  • Cushioned – these shoes prioritize cushioning above all else. They often have a softer or thicker sole. They work well for people for whom the force of impacting the ground may be a concern.

  • Motion control – these shoes attempt to control how much your foot and arch flatten (often referred to as “pronation”) when you land. They are much stiffer in the middle and especially inside edges of the sole, and may even visibly angle your heel off to one side. They work well for people with more pliable feet, for whom excessive or too-rapid flattening may cause problems.

  • Stability/Neutral – nowadays these terms are often synonymous. These shoes are for people who don’t need either of the above. They have thinner cushioning and are overall pretty pliable throughout (the exception is trail shoes, which are typically built this way but without being so flexible).

There are two things to consider here. First, because motion control shoes have to be slightly stiffer to do their job, they may absorb less shock for you; cushioned shoes, on the other hand, sacrifice some amount of foot control to gain better shock attenuation. If you need both, some cushioned shoes are now built with a little extra stiffness in the middle. Second, the shoe generally affects how your foot behaves when you run. Some people need more specific foot control, or need more cushioning or some space accommodation in specific spots. This is where a shoe insert orthotic may be of help.

Sole Width and Shape 

Shoes are rarely classified by how wide their soles are. The sole will almost always be wider than your foot. However, the width of the shoe’s contact patch with the ground can have a big impact on your running. A wider sole near the back of the shoe will exert more leverage on your foot as it strikes the ground. For example, if you land near the outside rear of your foot (as is the case for most runners), a wider sole will cause the shoe (and your foot) to flatten more quickly. This may further stress the ankle of a runner who already has pain from or problems relating to “over-pronation” (which in common use refers to excessive flattening of the foot).

Similarly, the further rearward a sole extends, the more it will encourage you to strike the ground with your heel, and simultaneously “throw” the front of your foot to the ground. This may further stress the ankle or shins of any runner.

 Bear in mind that both of these effects – excessively rapid flattening of the foot in either direction – can affect not just a runner’s feet or ankles, but also the knees, hips, and lower back.

Take-Aways

Be picky. Your shoes should be comfortable immediately. Your feet will “know” when they’re in the right shoe, be it the first pair or the tenth pair.

Return policy matters. Your first run may reveal more than when you tried shoes at the store.

Bring insoles or orthotics. They too need space in your shoe, and shoes and orthotics affect each other.  Try them on together when in the store.

Written by Ari Baquet, PT, DPT, OCS, CSCS

Imperium Boxing - Part 3

In Imperium Boxing, Part 3, Dr. Reman Rajab and Dr. Ari Baquet will demonstrate the exercises in both sitting and standing with the addition of flows to take it to the next level and challenge your brain! Talk to your physical therapist to determine if seated or standing is best for you. Please ensure you are near a stable object or chair to use for support, have a friend or family member nearby for safety, go at your own pace, and take breaks as needed.

Disclaimer: This video is informational and does not substitute for professional medical advice, which should always be sought prior to attempting any exercise or lifestyle activities. NeuroSport Physical Therapy is not responsible for any loss or injury that may arise from or relate to action taken as a result of viewing videos we post.

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Imperium Boxing - Part 2

In Imperium Boxing, Part 2, Dr. Reman Rajab will guide you through a work out demonstrated in both sitting and standing.  Talk to your physical therapist about which option is best for you. Please ensure you are near a stable object or chair to use for support, have a friend or family member nearby for safety, go at your own pace, and take breaks as needed. Keep an eye out for part three coming soon! 

Disclaimer: This video is informational and does not substitute for professional medical advice, which should always be sought prior to attempting any exercise or lifestyle activities. NeuroSport Physical Therapy is not responsible for any loss or injury that may arise from or relate to action taken as a result of viewing videos we post.

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Imperium Boxing - Part 1

Imperium Boxing is here! At NeuroSport Physical Therapy, we are challenging the expectation that a person with Parkinson's Disease or other neurologic conditions should expect to decline or lose mobility. We have seen over the years that individuals participating in regular exercise can defy those expectations. Research shows that intense, frequent exercise and physical therapy is important for your brain and body!

As a physical therapist and boxing enthusiast, Dr. Reman Rajab has created a three-part Imperium Boxing series which incorporates large movements and punches to help you exercise at home.  Imperium means “power” in Latin. With Imperium Boxing, we want to empower people with Parkinson’s and other neurologic conditions. 

We will be releasing a three-part video to help keep your brain and body active — especially during this uncertain time while many of us are moving less and spending more time at home. 

In Imperium Boxing, Part 1, Dr. Reman Rajab will guide you through a seated workout. Just a reminder — make sure you are using a stable chair, have a friend or family member nearby for safety, go at your own pace, and take breaks as needed. Keep an eye out for parts two and three coming soon for more advanced options!

Disclaimer: This video is informational and does not substitute for professional medical advice, which should always be sought prior to attempting any exercise or lifestyle activities. NeuroSport Physical Therapy is not responsible for any loss or injury that may arise from or relate to action taken as a result of viewing videos we post.

Questions About: Bike Fit (at the Gym)

Do you wish the bikes at the gym felt as good as your own setup? You may have a great bike fit out on the road or trails, but setting up a gym bike can be hit-or-miss. Dr. Ari Baquet, with NeuroSport Physical Therapy, takes the bike fit discussion indoors with some pointers for quickly setting up a gym spin bike to suit your needs. We want to help you move better and live more — please reach out with questions if we can help!

Questions About: Bike Fit

Your bike should fit like a glove! Have you wondered if riding a bike could feel even better? Have you just picked up riding, or been having discomfort on the bike? NeuroSport Physical Therapy’s Dr. Ari Baquet hops on the trainer to discuss bike fit – what it is, and how to go about getting one. A bike fit should be collaborative, detailed, dependent as much on your feedback as on the fitter’s expertise, and should leave you more knowledgeable about your body. We want to help you move better and live more — please reach out with questions if we can help!

Questions Answered: Running Analysis

“Should I get my running looked at?” is a common question we get from patients who are almost ready to get back out on the roads or trails. The short answer is usually “yes”, but there is a lot behind that.

In understanding whether you should get your running looked at, especially if you are recovering from, have previously dealt with, or are trying to prevent problems or pain, it’s helpful to look under the hood of running analyses. We should also address another common question – “is there a right way to run?”

The “right” way to run

What is the right way to run? However you need to. Your running should feel efficient, pain-free, and suitable for your body and running environment.  The answer is that it depends on many factors, but it most importantly depends on your goals and reason you want to run.

What is a running analysis?

A good running analysis must include, of course, running – preferably after a warm-up, and potentially after you’ve already been in motion for some time if there are issues which arise later in your runs. Research has shown that your running form settles in after about six minutes on the go.

The person working with you will watch for the quality, symmetry, alignment, and timing of how you run, as well as keep an eye out for any “problem movements” relating to any issues you may be having.  They may also suggest small form changes, or “cues”, to try, to help you both learn more about how you run. Sometimes, this may include filming you, both to replay in slow-motion and to show you how you run as well as the effects of any changes to your form.  And, finally there should be a thorough assessment that will include at a minimum a shoewear assessment, history of running, flexibility and strength testing - all to better understand the reason why you run with your particular strategy.

Why get one?

  1. If your running does not altogether feel efficient, pain-free, and suitable for your body and environment

  2. If you want to improve performance, minimize injury (or re-injury) risk, or even educate yourself

At minimum, a good running analysis will help you understand how you move. You will learn about how your body behaves in motion, rather than just at rest. People often tell us that the running analysis done when, for example, shopping for running shoes (check back soon for our video on this) consisted of standing still or, at most, walking – in actuality, what happens in flight while running is usually different.

A good running analysis will also be interactive, enabling you to learn about your movement in the context of what you actually feel when you run. Ultimately, the better you understand your body’s behavior, the more you can troubleshoot if problems arise later.

Who should I see for one?

A running analysis is at its heart a learning tool. Thus, go to somebody interested in helping you learn. A good running coach can be very helpful, as they’ll have worked with and studied a high number of individuals, as can a physical therapist who works with runners, as they’ll have good training in biomechanics and how different parts of the body affect each other.

Whoever you work with, their primary interest should be to help you identify what your goals are for the analysis, and to help you achieve them in that session.

In summary

A running analysis is a great way to learn more about how you move and how your body behaves on the run. There’s no right way to run, but there are sub-optimal ways, so the analysis should look at your unique patterns, symmetries or asymmetries, and alignments, in the context of your personal history and goals. Work with somebody who will tailor the running analysis to meet your needs, and who’s primary interest is in helping you learn.

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