As flowers bloom and the days get longer, it’s natural to want to get outside. Whether you’re digging in your garden, hitting the trails, or playing sports, spring brings new energy. But if you were inactive this winter, your body might not be ready for a sudden burst of activity.
What Are Overuse Injuries?

Overuse injuries happen when we do too much, too soon, or too often. These aren’t injuries from a fall or sudden twist. Instead, they build up slowly from repeating the same movements over and over. Common symptoms of overuse injuries include:

● Muscle soreness that doesn’t go away
● Painful joints that ache when moving
● Tendons that feel tender to touch
● Swelling that doesn’t go down

Why Spring Can Be Risky

After winter, many of us jump back into activities at full speed. Our bodies aren’t prepared for this sudden change. Think about it:

● We’ve been less active during cold months
● Muscles might be weaker or tighter
● Our stamina isn’t what it was last fall
● We’re excited about the nicer weather and may do too much at once

5 Simple Ways to Prevent Injuries

1. Start Slow
Begin with just 15-30 minutes of your activity.
Add a little more time each week – 10% is a good guideline. Your body needs time to adjust!

2. Warm Up Right
Never skip your warm up.
Take 5-10 minutes to walk, do gentle stretching, and move your joints before any activity.

3. Mix It Up
Don’t do the same activity every day.
Trying different things will let you use new muscle groups and give others rest.

4. Listen to Your Body
Pain is a warning sign.
If something hurts, stop and rest. A little muscle soreness is normal, but sharp pain isn’t.

5. Use Good Tools and Form
For gardening, use tools with padded handles and kneel instead of bending. For sports, make sure your gear fits well and learn proper form.

Your Physical Therapist Can Help

Your PT is your body’s best friend when getting active again. We can:

● Check your movement patterns to spot problems before they cause pain
● Create a safe plan to build strength and flexibility
● Teach you specific exercises for your favorite activities
● Show you proper form to prevent strain
● Help you recover if you do get hurt

Don’t let an injury stop you from enjoying spring! With a little care and the right help, you can stay active and pain-free all season long.

Call our office today to schedule a spring check-up – your body will thank you! Dr. David Bertone, PT, DPT, OCS is the founder and owner of db OrthoPT with offices in Red Bank and Manalapan. NJ. We have hundreds of 5 star reviews making us the premiere physical therapy practice in Monmouth County. Appointments can be made at 732-747-1262 or online at www.dborthopt.com.

So, why would you choose Physical Therapy for your ailments over orthopedists, pain management doctors or chiropractors?

I vividly remember going through years of Physical Therapy Graduate School and entering my practice fully expecting to “fix” everyone who came through our door. As I evolved as a clinician, I began to understand the full scope and complexity of the problems our patients face. And trust me, we as humans are complicated, and the solutions to our breakdowns aren’t always simple or straightforward. The “fix” may mean completely resolving ones symptoms and returning the body to a normal musculoskeletal/neuromuscular state. But it may be a bit more complicated and focus more on education, modification, compensation, and some level of restoration in order maximize functional mobility and improve their quality of life.

I typically categorize patients with orthopedic and neuromuscular problems into 2 distinct categories. Individuals with a relatively healthy, normal structure and function of the musculoskeletal and neuromuscular systems, who just so happen to get injured. Those injuries can range from sprains and strains, to broken bones, or even herniated/bulging discs in their neck or low back. These individuals typically require Physical Therapy for proper guidance post-operatively or post injury, and they often recover fully. The second category is one that we see more frequently in our clinic. These are individuals who may already have degenerative changes, spinal/skeletal changes, biomechanical and postural abnormalities, and often years of improper form or habit. These individuals may come to our clinic with a specific and isolated site of pain, or a problem, however the evaluation, and course of treatment may be more comprehensive, and not only require addressing the body part in question, but also perhaps the adjacent joints, and maybe even the lumbar or cervical spine. Treatment plans for these individuals are more in-depth.

This is a big distinguishing factor between our profession and some others. We as Physical Therapists tend to look more globally at the whole picture. Not isolating to the site of the most obvious impairments and pain, but rather diving a little deeper to identify whether there are other contributing, or predominating factors. These factors can be things like limitations of the joints above or below the affected area, chronic degenerative changes, postural and habitual abnormalities, or lumbar or cervical spine factors just to name a few. Establishing a relationship with a patient and really understanding the history of their condition is key. Developing a plan of care that not only addresses the impairments that we as clinicians identify, but more importantly addressing the needs and goals of our clients will likely lead to a more engaged and satisfied client, with better overall outcomes. Please consider seeing your physical therapist as a primary point of contact for any musculoskeletal conditions you may have.

Dr. Moczerniuk is a Doctor of Physical Therapy, Board Certified Orthopedic Clinical Specialist, and a member of American Physical Therapy Association. He is also an Associate Partner/Clinical Director of db OrthoPT – Manalapan and can be reached via email at jerry@dborthopt.com or by calling 732-462-2162.

With spring season upon us it is finally time to shed those heavy jackets, hats and gloves and enjoy more outdoor time. This is also the time of the year that many people begin to exercise outdoors. Whether it’s picking up road running, playing soccer, basketball or baseball, hamstring injuries are a fairly common occurrence, especially early in the season.

Hamstring injuries typically occur when the hamstring muscle (the muscle in the back of the upper thigh) is stretched quickly and excessively. Usually, there is a sensation of a pull, or even a pop in the back of the thigh. Pain, loss of flexibility, swelling, and bruising may follow, as well as difficulty walking and performing daily activities.

The severity of the injury dictates the length of recovery. Typically, most hamstring injuries will fully resolve within 6-8 weeks. This timeframe can be slowed by a more severe injury, but may also be sped up by proper guidance and rehabilitation, allowing an individual to return to their favorite activities sooner.

In the first 1-2 weeks after injury, there may be bruising in the back of the thigh and calf, and there may be swelling. There will be pain with activities that flex your hamstring, and often times with walking. This is the time to focus on reducing swelling and bruising, and restoring normal walking. Using ice, elevating, and massaging the muscle can help speed up the process. During this phase, isometric exercises, bicycle, and strengthening exercises for other lower extremity muscles may be initiated, as long as they are not excessively irritable to the hamstring.

Once swelling, bruising and pain are improved, the focus shifts towards restoring flexibility and progressive strengthening of the hamstring. There are many exercises that do a great job at loading and strengthening the hamstring, bridges with heel digs, bridges with alternating marching, and bridges with walkouts are three of my favorite exercises to start with after a hamstring injury. During this phase, one should also be mindful of proper loading and avoiding excess irritability of the hamstring.

When strength and mobility of the hamstring are restored, and pain is no longer a factor, progression toward return to sport may be initiated. This typically consists of increasing cardiovascular endurance, increasing running distance/speed, plyometric training, and sport specific training.

In 6-8 weeks your recovery should be complete, but remember this may vary from individual to individual. Consider consulting your Physical Therapist if you suspect a hamstring injury. Early physical therapy interventions in treatment of hamstring injurie results in quicker and safer return to sport, and other activities.

Dr. Moczerniuk is a Doctor of Physical Therapy, Board Certified Orthopedic Clinical Specialist, and a member of American Physical Therapy Association. He is also an Associate partner and Clinical Director of db OrthoPT – Manalapan and can be reached via email at jerry@dborthopt.com or calling 732-462-2162.

Congratulations to Dr. Alyssa Baez, PT, DPT, a physical therapist in our Manalapan office on becoming a Certified Kinesiotaping Practitioner (CTKP).

What is a Certified Kinesio Taping Practitioner (CKTP):

The letters CKTP stand for Certified Kinesio Taping Practitioner. In earning and maintaining your CKTP status you are demonstrating your commitment to the highest standards of patient care within the only globally recognized modality for health professionals. Those letters “CKTP” after a name ensure confidence that the practitioner has undergone the necessary training to integrate Kinesio Taping in to their practice.

Want to learn more about Kinesiotaping? Click here

Have you noticed Kinesiology Tape on athletes at the Olympics? Football? Tennis? Have you wondered if it “really does anything?”

As a Certified Kinesio Taping Instructor and Practitioner, I can attest to the fact that it is not “just tape.” Elastic therapeutic Taping was invented in the late 1970’s by Dr. Kenzo Kase, an American-trained Chiropractor and Naturopathic Clinician from Japan. He experimented with different taping materials to provide his patients with more lasting therapeutic effects between treatments. Fast forward to the 2008 Beijing Olympics, and everyone wondered what the tape was doing for athletes from the volleyball court, to diving platforms and even in the sumo wrestling ring.

Kinesio Tape is used to provide mechanical and neurological cues to the body for pain, circulation, posture, and overall improvement in function. Practitioners manipulate the shape, tension, direction, and placement of the tape to provide unique therapeutic outcomes for patients of all ages and conditions. Although Kinesio Tape may be most visible on athletes, more than 85% of applications can be found on patients from the NICU to Nursing homes, in the work place, and in Rehab facilities all around the globe.

Kinesio Taping applications can be used for joint pain, ligament sprains, post surgical swelling, neurological pain from trauma or injury, supporting unstable joints, tendonitis, back pain, muscle strains…. I could go on. At db Ortho PT, trained physical therapists use their examination skills to identify symptoms and conditions that will benefit from Kinesio Taping, and customize the applications to address specific needs. Kinesio Taping offers a non-invasive, non-addictive alternative to managing pain, and relieving acute and chronic symptoms. We look forward to using this modality as a part of your recovery. If you would like to learn more about Kinesiotaping and how it could help you, email Dr. Scarano Ward at Cward@dborthopt.com or call the office at 732-747-1262 to schedule an appointment.

Frozen shoulder, also known as adhesive capsulitis, is a condition where the shoulder becomes painful and stiff. Do not be fooled with the name of “frozen” shoulder, because this condition can occur at any time throughout the year. Frozen shoulder can occur after a minor injury to the shoulder but often occurs out of nowhere. Risk factors for developing frozen shoulder include the following: having thyroid disease or diabetes mellitus, age 40-65 years old, female sex, and having a previous episode of frozen shoulder in the other arm. In an MRI, some components of frozen shoulder can include thickening of some of the shoulder structures, joint volume reduction, and proliferative synovitis surrounding the shoulder ligaments.

The pain and stiffness caused by frozen shoulder can affect your ability to perform everyday activities such as getting dressed, brushing your hair, reaching to a shelf or cabinet, driving, cleaning, and so forth. For women, a main complaint is having difficulty with putting on/taking off a bra. There may be pain at rest as well, including difficulty with sleeping at night. The problem usually lasts 1 to 2 years; however, physical therapy has been shown to help decrease the pain and improve the motion and function of your shoulder.

The timeline of frozen shoulder has been nicely broken down into four phases:
• Phase 1: 0-3 months, “Pre-Freezing Stage”: In this stage you may have sharp pain at end ranges of shoulder motion, achy pain at rest, and your sleep may start to be disturbed. Range of motion is not significantly affected yet.
• Phase 2: 3-9 months, “Freezing Stage”: You may start to notice that your shoulder range of motion is starting to become more limited because of pain.
• Phase 3: 9-15 months, “Frozen Stage”: In this stage, there is moderate pain and loss of shoulder range of motion.
• Phase 4: 15-24 months, “Thawing Stage”: Shoulder pain will begin to resolve, but significant stiffness may persist.

These phases of frozen shoulder are not a “one size fits all” categorization, and many people will see improvement in pain levels and range of motion once initiating in a physical therapy program. A thorough evaluation will help determine an individualized treatment approach for your shoulder. Education on the condition in addition to what phase you are currently in will be discussed. Once this is determined, your physical therapist will help decide what intensity of stretching, mobility exercises and joint mobilizations are appropriate for you. It is important to note that with this condition, although the shoulder may be stiff and painful, you should continue to move the shoulder and stretch, as this will help speed up your healing. Furthermore, it has been found that a corticosteroid injection in combination with physical therapy may help to reduce the inflammatory response and reduce pain.
These exercises/stretches below can be attempted to loosen the shoulder capsule.

1) Pendulums: Setup: Begin in a standing position with your trunk bent forward, one arm resting on a table for support and your other arm hanging toward the ground. Movement: Slowly shift your body weight in a circular motion, letting your hanging arm swing in a circle at the same time.

2) Internal Rotation Towel Stretch: Setup: Begin in a standing position, holding both ends of a towel in each hand, with one arm behind your head and the other behind your mid to low back. Movement: Slowly straighten your upper arm, gently pulling upward on the towel, and hold when you feel a stretch.

Frozen shoulder can sound like a daunting diagnosis, especially with the amount of time that it may take to fully recover. However, a patient once told me, “Motion is lotion,” and this could not be more applicable to this diagnosis. Knowing what exercises/stretches to perform will be integral to your recovery. For more information on the treatment of frozen shoulder, contact us at either of our offices or send an email to me at jfilzen@dborthopt.com

References:
Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, Godges JJ, McClure PW. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013 May;43(5):A1-31. doi: 10.2519/jospt.2013.0302. Epub 2013 Apr 30. PMID: 23636125.

Declining reimbursement rates for healthcare providers are expected to impact patients, especially those relying on private practices and specialized care. As insurers cut payments, providers may reduce services, cut staff, or even close, leaving patients with fewer options, longer wait times, and less access to specialists. In some cases, practices may shift to higher-volume models, leading to shorter, less personalized appointments.

These financial pressures could also lead providers to raise out-of-pocket costs or adopt cash-only models, which could burden patients with high-deductible plans, limited insurance and/or limited income. This may reduce access to care for many, particularly those who cannot afford the increased costs.

Additionally, as reimbursement rates fail to keep up with inflation, providers may struggle to attract new healthcare workers due to an inability to offer competitive salaries, offer adequate annual raises, potentially leading to a shortage of providers in the future as it may not be a fiscally feasible career choice in the future. Many providers are saddled with a significantly lopsided debt-to-income ratio due to these reductions in reimbursement and it is only getting worse as tuition continues to rise, but starting salaries remain stagnant.

With life expectancy continuing to increase, the demand for healthcare providers will only increase, but at this rate, the supply of healthcare providers may decrease significantly.
This is why it is important for you to reach out to your local state and federal representatives and advocate for your healthcare rights and providers before it becomes a larger issue! You deserve good quality healthcare; do not let it get taken away from you.

Dr. Matt Duncan, PT, DPT

Happy New Year! Sincere wishes for a positive start to 2025. For many people, me included, that positive start includes an exercise routine. For some that routine is already well established and being tackled with a sort of post-Holiday vigor. Others find themselves beginning a totally new fitness journey, the most common of which are walking, running, and gym routines. I find myself returning to running in a way that I haven’t attempted to undertake in several years, and my biggest take away is this: My feet hurt.

I know, I know, as a Physical Therapist I am in a prime position to respond to a little ache and pain with the appropriate level of activity modification, rehabilitative exercises, and general stretching that should keep my goals within reach. On the other hand, hitting a roadblock this early is just plain frustrating. If you have had any sort of similar experience, the following breakdown of the What, Why, and How might just help you (and me) stave off that frustration and keep the resolutions going strong.

What exactly hurts? It’s difficult to know without a thorough evaluation (like the kind the clinicians at db Ortho PT pride themselves on), but there are a few likely culprits. Plantar Fasciitis is a term that gets its fair share of the conversation, as it’s practically synonymous with foot pain. There’s also Achilles Tendinitis, which may not affect just the back of the ankle but the heel as well. Somewhat less commonly discussed is what I have been combating, namely Posterior Tibialis Tendinitis, or inflammation of the insertion of a relatively small foot and ankle muscle on the arch of the foot and just behind the ankle bone.

What do we do about it? Regardless of the specific irritation, the result is the same; something hurts. In the presence of pain, the body’s natural reaction is to try to promote healing by sending blood and nutrients to the affected area. This is a good thing, but part of the process typically reduces the flexibility and strength of the muscles in the area to protect them from load and stress. More than just speeding up the arduous process of the body healing itself, stretching and strengthening of the feet and ankles can help build the strength you need to continue your exercise routine without succumbing to this type of overuse injury in the first place.

What, specifically, do we do about it? The following three exercises can be effective, when implemented daily, at building foot strength and improving pain with running and walking.

The Runner’s Stretch – Place your hands on the wall and extend one leg straight backward, bending your front leg, until you feel a stretch in the calf of your back leg and hold.

Towel Scrunches – Spread out your toes, then scrunch the towel with your toes, and repeat.

Ankle Inversion – Move the foot with the resistance band away from the other foot by rotating your ankle inward, then slowly return to the starting position and repeat.

This is by no means an exhaustive list, but it is a great place to start. Depending on the severity of your pain, and the intensity of your exercise, there are more tricks and tools available to us at db OrthoPT to get you back to full health. Because we could all use a helping hand to work off the December snacking.

Medicare Advantage is not the same as traditional Medicare! There are real differences that can have an impact on the medical care you receive. United Healthcare is the only Medicare Advantage plan that requires prior authorization for physical therapy that you may require. Here is a comparison of Medicare vs Medicare Advantage Plans – click the file below:

ConsumerCollateral_KnowtheDifference

The head shake immediate after a head injury is now correlated with the diagnosis of concussion in this latest study.

Watch story here on You Tube

New study published in the Oct. 2024 Journal of Orthopedic and Sports Physical Therapy breaks down the concussion rates by sport, sex, and practice/game. The data reveals the following:
Highest incidence rate: rugby, snowboarding, ice hockey and football.
Higher incidence in softball/baseball, basketball and soccer in females compared to males.
Higher incidence during games compared to practice for football, soccer, ice hockey and rugby.
db OrthoPT is the recognized leader of baseline concussion testing and post injury concussion rehabilitation in Monmouth County. Call us today to schedule your child’s baseline concussion test or your child has not recovered following a head injury.

You will start to see construction in the coming weeks to expand out Manalapan office an additional 500+sqft to adding the space of an adjacent office into our layout. Most of the work will be done in the evenings or on the weekend to avoid any disruption to patient care. We are excited for the additional space to better serve our patients. It will allow for a private evaluation room and more open treatment area. Dr. Moczerniuk, Dr. Filzen, Dr. Baez and the rest of the Manalapan staff are excited for the new space!

Please be patient during the construction process.