Author Archives: Brian Trabulsi

I Can’t STAND to Stand!

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.

I frequently come across patients with low back pain whose biggest challenge is standing in place. They can walk for an hour but really struggle to stand for just a couple of minutes. This makes standing in line to check out of a store or washing dishes particularly challenging. So, one of the best tips I’ve learned over the years to help patients is to harness their inner ballerina.

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By placing the back heel of one foot against the instep of your other foot (Third position in ballet) it forces your gluteus muscles to contract. The contraction helps take some of the compression off the lumbar facet joints and lessen the strain of the low back muscles. Standing for an extended amount of time at a cocktail party, you can subtly switch back and forth between right and left.

If you think it sounds crazy, try it. Stand with your feet shoulder width as you normally would. Now move the back heel of one foot into the instep of the other making sure they touch. I promise you’ll notice a little “lift” in the low back as the gluteus muscles activate.

So, give it a try the next time you’re stuck in line at Harris Teeter while the shopper in front of you goes through an endless collection of coupons. Just don’t curtsy after you checkout.

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Tape isn’t just for wrapping Christmas gifts

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.

Kinesio Tape

What’s the most colorfully wrapped item under your tree this year? If you suffer from any type of muscle pain, then it could be your own leg!
(…or your shoulder …or your back …) ;)

Kinesio tape was developed in Japan in 1996 by Dr Kenzo Kase. It differs from other forms of therapeutic tape due to its elasticity. Kinesio tape is capable of stretching to 140% of its resting length. The purpose of Kinesio taping differs depending on the type of deficits you are trying to address. Depending on the tape’s direction and amount of stretch, therapists are able to either decrease muscle spasms or enhance muscle contractions. Kinesio tape is effective at reducing inflammation, swelling, and pain by lifting the skin to create space allowing for drainage and a cooling effect in the subcutaneous tissue. To address biomechanical faults such as poor patellar-femoral tracking, the tape is applied with a vigorous stretch to correct alignment and improve function within the joint/muscle.

Kinesio tape is latex free and only stretches in a longitudinal direction. The elasticity of the tape when applied properly provides a unique combination of stability without sacrificing mobility. This combination makes it a great option for athletes trying to remain competitive despite acute or chronic injuries. Physical therapists can use Kinesio tape to extend the effects of their treatment. Ideally, it works as an extension of the therapist’s hands from one treatment to the next to minimize setbacks and speed up recovery. Oh, and it makes a great stocking stuffer for the “sore” athlete in your family!

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Rising Heat

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.
 

As the 2013 Major League Baseball season kicks off this month, a record number of pitchers will be hitting triple digits. A recent article in the Wall Street Journal reported on the increasing number of pitchers throwing 100+ mph. “In 2003, there was only one pitcher who threw 25 pitches 100 mph or faster (Billy Wagner).” Since then, the number has quickly increased to seven. For years, experts believed 100 mph was the physiologic limit for throwing velocity based on bio-mechanical stressors placed on the shoulder. Power pitchers can exert as much as 7,000 degrees of rotation per second through his throwing shoulder. While the top speed has only increased marginally over the years, the number of pitchers near the physiologic limit has increased sharply.

Experts suspect the rise is likely due to both economics and technology factors. As pitchers salaries continue trending upwards, more top players are gravitating towards that position. Secondly, radar guns have become smaller and more accurate with most MLB stadium displaying the velocity with every pitch. Coaches specializing in the development of young pitchers are maximizing velocity by emphasizing posterior chain strengthening to optimize power from the legs. They’ve also started modeling some specific training techniques from successful Caribbean and Latin America players.

So as spring turns to summer and the thermometer starts to rise, be sure to take notice of the handful of players that are really bringing the heat.

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Surgery for RG3

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.
 

Triangle Redskins fans’ worst nightmare has come true. After watching Robert Griffin III (RGIII) leave the field on Sunday, speculations regarding the extent of his knee injury have been confirmed. Redskins’ team physician, Dr. James Andrews, reports that RGIII has torn his LCL (Lateral Collateral Ligament) and his ACL (Anterior Cruciate Ligament). Tests regarding the integrity of his previously repaired ACL were inconclusive until now. Read more…

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A Different Kind Of Physical Therapy…

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.
 

Physical therapists (PT) treat a wide variety of patients. While most people are familiar with therapists helping patients with low back pain or recovering from a stroke, doctors are increasing referrals to PTs for pelvic floor dysfunction (PFD). The pelvic floor is comprised of close to 10 muscles that provide “sling-like” support to the bottom of the pelvis. These muscles are vital to allow the internal organs of the pelvis to work efficiently and for pelvic stability with activities. Poor function of the pelvic floor muscles can lead to abdominal/pelvic pain, low back pain, incontinence, constipation/voiding dysfunction, or sexual dysfunction. Read more…

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Help!…My Computer is Killing Me!

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.
 

We all know that computers make our lives easier. Unfortunately, spending several hours a day looking at one can be more harmful then helpful. Computer oriented jobs can place workers at risk of developing Cumulative Trauma Disorders (CTD) if their workplace/computer is set up incorrectly. This can lead to excessive strain and fatigue possibly leading to injury over time. Read more…

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What a Pain in the……Jaw!!

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.
 

According to the National Institutes of Health, upwards of 10 million Americans suffer from a common diagnosis of TMJ. Various types of jaw or facial pain are often grouped as TMJ. The temporomandibular joint is comprised of the temporal bone (in front of the ear) and the top of the mandible (jaw). This joint is actually quite complex consisting of an upper and lower compartment. When you open your mouth, the lower compartment spins or rotates followed by a gliding or sliding motion in the upper compartment as you continue to open. Read more…

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Is Strength Training Good For Golfers?

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.
 

Are Kettlebells and Callaways a good combo?

For a few lucky individuals, the golf swing is a thing of beauty. They make the complex look simple. You can see some of these perfect swings on display this week at the Rex Hospital Open.

For millions of others, it’s an exercise in futility mixed with occasional moments of brilliance. It’s those fleeting moments of brilliance that keep most golfers coming back for more. The swing is comprised of complex motions that require precise timing, coordination, and strength, to maximize club head speed and transfer optimal force through the ball. In the simplest terms, it can be broken down into backswing, downswing, impact, and follow through. Read more…

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Swinging at Cancer

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.
 

The Nationwide Tour returns to TPC Wakefield this week for the 2012 Rex Hospital Open. Over the past several years, the Rex Open has donated more than $6 million to support programs and services at the hospital. Funds raised from the 2012 Open will directly benefit Rex Cancer Care.

Fighting cancer can be the toughest battle a person can face in their lifetime. Cancer treatments often include some combination of surgery, radiation, and or chemotherapy. While these treatments are necessary for survival, they can frequently take a tremendous toll on the body. Read more…

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Squats Are Bad For My Knees …Says Who?

Brian TrabulsiBrian Trabulsi, MPT, ATC is a physical therapist at Rex Hospital Outpatient Rehabilitation in Raleigh.
 

Squats are one of the most basic human movements performed daily by billions of people. You wake up in the morning, kick your feet out of bed, stand up and there it is, the first squat of the day and you’ve only been awake for 15 seconds. Despite worldwide participation, if you talk to most anyone who even dabbles in exercise they won’t hesitate to share their HATRED for squats. Reasons for this hatred will vary from naive “I walk so that strengthens my legs” to misinformed “squats are bad for my knees”. Well, both reasons couldn’t be any further from the truth. Read more…

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