Along the way, we’ve seen athletes surpass expectations and we’ve seen several wipe outs, injuries and even death.  I’m particularly struck by the athletes who suffer what looks like a debilitating injury only to be on the course the next day, racing for another chance at an Olympic medal.  How do they recover so quickly?

While Olympic athletes are in far better shape than the rest of us, they too must go through the same physical therapy exercises and rehabilitation.  The primary focus is usually physical therapy; however, mental rehabilitation is also key in helping to get an athlete back in the game.

We recently had the opportunity to speak with Felix Raytsin, Sports Psychology / Mental Game Coach and founder of Soccer Mental Coach, based in Springfield, NJ.  He was able to shed some light into some of the mental challenges athletes face when injured and some of the steps they can take to help get back on the field, in the game or on the slopes faster.  It is his belief that physical therapy and mental rehabilitation go hand in hand.

Athletes are often under intense pressure to get back on the playing field after injury.  Studies have shown that there is a decline in self confidence after an injury.  Anger, guilt, feelings of isolation, fear of re-injury, depression and difficulty watching others perform are often common sources of stress for injured athletes.  A body/mind approach allows athletes to focus their energy and emotions on getting back to their sport instead of focusing on the negative aspects of their injury.

Athletes who recognize the mental side of the injury are more compliant with their home exercise programs.  They also experience less re-injury, fear, anxiety and less pain during rehabilitation.  For optimum recovery, patients should understand their plan for physical therapy and what it entails.  More knowledge increases a person’s feeling of “control” and they are better able to cope with the rehabilitation process.  To help cope with the emotional struggle, goal setting, visualization, relaxation training and positive self talk all help people heal faster.

After speaking with Felix, I have no doubt that Olympic Athletes are using both physical therapy and mental rehabilitation.  It seems that we injured “weekend warriors,” can also benefit from physical therapy and mental skills training.

To read the entire article, “Injury Rehabilitation and Psychology”, please click on the link below.

For more information about Felix Raytsin, please visit: http://www.soccermentalcoach.com/

Erik has more than twelve years experience as a physical therapist and practiced at Columbia Presbyterian Hospital and several orthopaedic prviate practices in Manhattan and Westchester. To enhance his clinical skills, in 2003, he received an Advanced Masters in Musculoskeletal Physiotherapy from the University of Queensland in Australia, a world renowned institution for manual therapy. This training involves mastering highly refined assessment and evidence based manual techniques. There are only a handful of therapists in New York with this degree.

As a manual therapy specialist, he treats musculoskeletal pain of the spine and extremities with various advanced techniques including muscle energy, joint and neural mobilization, specific muscular releases and stretches. He also provides specific postural reeducation exercises to alleviate and prevent pain.

Erik is an active member of the APTA (American Physical Therapy Association) Orthopedic, Sports and Private Practice sections and AAOMPT (American Academy of Orthopedic Manual Physical Therapists). Erik has lectured on current manual therapy topics at various clinics and universities in the NY area. Erik is married to a pediatric occupational therapist and they live in Westchester. He enjoys fishing, kayaking, and hiking in his spare time.

Marivic joined RPT in 2006 and received her MPT degree from Hunter College and her BS from St John’s University. Prior to practicing physical therapy, she was a dental assistant for 5 years.

In her spare time, Marivic enjoys trying out new restaurants and attending concerts.

Sara joined RPT in 2006. She received her MSPT and DPT degrees from Boston University and has been practicing physical therapy for six years.

Sara is a talented athlete and plays many sports including; touch football, soccer, boxing, golf, and snowboarding. She is also an avid Red Sox fan.

There are many reported cases where the patient co-pay is $50 and the allowable charges by contract with the provider were actually less ($45); the actual insurance cost for the visit is $0 and the patient pays the full amount. This impacts the patient by limiting access due to the excessive financial burden placed on them, and challenges the therapist with unrealistic expectations for optimal outcomes as a result of too few treatment sessions.

While recognizing the unfairness of this practice, Legislators have been encouraged to eliminate the “specialist co-pay” loophole and bills have been introduced in both the NYS Assembly (Kevin Cahill- A8171) and Senate (Neil Breslin- S4321). In fact, on Lobby Day this past May, Legislators themselves shared their own stories about family and friends who have been adversely affected by high co-pays; limiting access to care. Both bills sit in committee, not considered the most pressing issue before the Legislature, and we need continued pressure to push the issue to the forefront and demand action.

We’d like these bills passed on or before 2010. Please contact your legislator and let them know you want this change, of an unfair insurance practice, to happen.

In 1999, we began with one small New York City office, and two employees.  Now we have twelve offices spanning the NYC metro area, with more than 45 physical therapists. 

Anniversaries are a time to look back – at the choices we’ve made and reflect on the good decisions and the mistakes.  It is also time to plan for the future.

If you look back to the beginning, why Recovery Physical Therapy even came into business, you’ll see the first good decision in a long line of great choices.  RPT started on the premise that this would be a company owned and managed by physical therapists.  Each Director has ownership in their facility which means that decisions are made from a clinical perspective and not by an accountant crunching numbers in a back office. 

Additionally, our President and CEO, practiced physical therapy in NYC for more than 20 years and understood that when patients are treated by licensed physical therapists patients heal faster with better overall outcomes.  He made the decision that licensed physical therapists would treat our patients.  Quality of care comes first. 

When I first came to work for RPT in 2003, our CFO took me on a tour of all six of our facilities.  As the day wore on, I started to panic, thinking I had made a big mistake. Each office was only treating a few patients at a time.  In my mind, clearly RPT was not doing well.  You see, I had previously worked at a competitor and physical therapists were constantly being pushed to see more patients in an hour, so I was used to offices loaded with patients. But not RPT.  It was quiet and calm in each office, one patient per physical therapist at a time.  It was just a different way of doing business.

We’ve also expanded with the same, “take our time” approach.   Each of our offices is strategically placed, based upon physician and patient feedback, as well as extensive research.  Instead of just blanketing the metro area with offices in order to “grow”, we’ve made decisions that make sense – such as, opening our Wall St office at 6 AM to accommodate our financial district patients to offering weekend hours at many of our “neighborhood” facilities.

Have there been missteps along the way?  Absolutely.  We’ve made some wrong hiring decisions, opened an office in an area that didn’t work out, and had to deal with our share of growing pains. Are their downsides to our philosophy?  In terms of volume, sure.  There are some insurance plans that we can’t participate with in-network simply because we can’t handle the number of patients that could potentially come our way. All in all though, the good far outweighs the bad.  We are blessed with a great leader, fabulous people, and loyal patients. 

Jim Cardone, our President and CEO, brings not only experience and expertise to the table; he has integrity and is an amazing leader.  He gives people what they need to succeed; he’s open to new ideas and supports our staff in all ways.

Our physical therapists are the best.  They are not only highly skilled practitioners, but they care about their patients’ recovery and treat them with highest level of attention. 

Our front desk staff greets our patients with a smile while untangling ever-changing insurance coverage and issues.  Kudos too, to our corporate staff who keep it all together behind the scenes.

Most of all, we are most grateful to all of our patients who have become like family to us.  We’ve watched many of you go on to achieve amazing things, like running a marathon after a debilitating injury or climbing to Mt Everest’s base camp.  Thank you for coming back again and again and for referring your friends and family to us. 

And to our physician partners, we look forward to continuing to provide the highest level of care that you’ve come to expect from us.  Thank you for believing in us.

 As we look ahead to the future, there will be bumps and bruises along the way but as long as we stay true to our core values, the future is limitless.

First, my recommendations are offered as a general scientific based suggestion to succeed as one training design may work for one runner, but may be a huge mistake for another.  We are all different.  Runners come in all shapes and sizes and our body mass, aerobic capacity, muscle strength, frequency of training availability, surfaces we run on, cross-training background, and general nutrition are all variables that will enable us to run with a smile, or make us vulnerable to ‘break down’, resulting in injury.  Many problems can be prevented if identified early and adjustments made.  Your program may only need to be tweaked and alternatively, it may need to be tailored a great deal.

Let’s start with rest, a subject one doesn’t think about when considering running 26.2 miles.  Admit it, runners are an obsessive group and you have to be somewhat to do this.  No one wants to stop running, but sometimes this is needed.  Do you run everyday, every other day, do slow long runs on weekends?  The thing to keep in mind is that your runs need to be of a specific intensity (speed), frequency, and duration to promote a physiological change. 

You may have started slow (hopefully approximately four month ago for your first marathon), but too tentatively.  Eventually, but gradually, you are going to have to get out and do some more ’substantial’ runs to build you aerobic capacity and anaerobic threshold.  It doesn’t mean you have to run a marathon distance before as I’ve met many runners who trained at distances no greater than 16 miles before their first marathon. (I did however have the experience of meeting an experienced runner in the starting line medical tent of a marathon who had run a marathon the day before.  He was attempting to run a marathon in every state in one year.  Surprisingly, he was complaining of shinsplints and it’s not something I would recommend.) 

It is possible to run without completing a 22 mile run before, but you need to set realistic goals and give yourself time to make these changes.  Sometimes, these shorter training runs may be beneficial as your body type may not allow you to complete the run without risk.  Make the changes in training first and give your body time to adapt.  This includes rest periods when you’re tired, ill, or are suffering from injuries.  Physiological changes actually occur during the rest periods and you need to give your body ample rest to promote this. 

Questions to ask yourself may be, “Am I so exhausted towards the end of a run that I am compensating or losing form?”  Are you developing pain or experiencing pain that is beyond the common muscle fatigue you get with running? This is different than being ’stale’ or bored with the training, that can occur also.  You shouldn’t be doing only hills or interval runs and you may need to consult with a professional.  All marathons of notoriety offer links to groups or lectures way in advance that provide specific recommendations to help.  Some have groups that are charity based, but also train together, insuring consistency and will counsel you how to finish and enjoy the experience. 

Generally, you should be running about 40 miles per week about one month prior to the race.  You also need to taper this distance as you approach the last week.  Try running the last 10 miles of the course about two weeks before to familiarize you with it.  You can study the elevation on most websites to prepare for hills.  Along those lines, you can train on hills, but this should not be the only route you do.  Vary the pattern you run and avoid the pitch of a road.  Hard cement, the pitch of a road, and uneven surfaces can all lead to bio mechanical errors that may irritate structures in the legs.  Running just 1/2 mile on an irregular path can lead to tendinitis, strains, sprains, or poor form, leading up to stress reactions over time.  I will talk more in the future about specific problems you may encounter from dehydration to black toe-nails, Yucchh!   Have a good day and enjoy the nice weather.