- Orthopedics, Physical Therapy, WellnessGeneral Page Tier 3BlogTennis is a great sport that offers a cardiovascular challenge, a test of skill and strategy. Proper tennis warmups and strengthening exercises can help prevent muscle and tendon strains and tears. Below are some tips to help get you tennis ready and help prevent injuries. The warmup Start with a light jog, jump rope, do burpees or do a combination of all three. The point is to get your blood flowing. In five minutes you should feel loose and have your heart pumping. Dynamic warmup The goal of the dynamic warm up is not just to stretch, but to make sure you are able to take your joints their full range. Frankenstein’s Kick – You can do this statically in one position or walk around. Keep your hips and pelvis pointing straight ahead and kick your right foot while reaching out with your left hand, then alternate with your left foot and your right hand. Do this for 30 seconds or go 30 yards. Butt Kicks – The ideal athlete should be able to kick his or her own butt. Stand tall, keep your tail bone tucked and kick your right foot back while reaching back with your left hand to touch it. Now alternate with your left foot kicking back with your right hand reaching back to touch it. Do this for 30 seconds or go 30 yards. Side Shuffles – We move in one direction most of the day: forward. Get in an athletic stance, like someone was going to knock you over. Side shuffle each direction for 30 yards. Keep your body squared and hips forward. Grapevines – This is the same as the side shuffle except you have to open up your hips, bring the push off leg in front of the lead leg, shuffle laterally and then bring the push off leg behind the lead leg. Repeat for 30 yards each way. The stretching Now that your body is warmed up, it is time to stretch. For tennis players and all overhead athletes, due to the repetitive nature of the sport, certain things tend to tighten. Cross body shoulder stretch – Keeping your shoulders low, bring your arm across your chest. Grab onto your elbow with your opposite hand and pull. Hold 20-30 seconds and repeat three times. Now repeat on the other side. Prayer stretch and reverse prayer stretch – Bring your palms together as if you are going to pray. Place your elbows out and feel the stretch of the muscles of your forearm. Now alternate with bringing the back of the palms together. Keep elbows out and hold each stretch for 20 seconds. Repeat twice. Sleeper stretch – Lying on your side, bring your arm that you are laying on out at a 90-degree angle from your body. Now bend your elbow to 90 degrees with your palm facing the direction in which you would arm wrestle someone. Use your top arm and push your hand down towards the floor/bed/mat. You should feel a nice stretch in the back of your shoulder. Hold for 20-30 seconds and repeat three times. Thoracic mobility – A stiff rib cage and thoracic spine can cause your whole shoulder girdle to overstress itself. Lying on your side, keeping your knees together, open up your trunk like a book. Your top arm is going to reach away from the direction that your knees are pointing. Turn your head facing your reach hand, as well. Hold 2-3 seconds, and repeat 10 times. Now try the other side. Rotator cuff strengthening There are many ways to approach rotator cuff strengthening. These are a few of my favorites: Neutral external rotation (NERT) – Using a resistance band, keep your arms by your side with your arms bent at 90 degrees, like you are holding a pizza box. Palms up, thumbs out. Grip the resistance band and pull it apart while keeping your elbows tucked into your rib cage. Squeeze the shoulder blades together. Repeat 15 times. Do 2-3 sets twice a week. Plank and rotate with a band – Hold a plank on your elbows while holding a resistance band with light tension between your hands. Now rotate your body so all your weight is through one elbow. Extend the free hand towards the ceiling while pulling the band. Rotate and repeat 10 reps to each side. Do two sets at least once a week. The reverse throw – Set a band or a pulley system to waist height and stand centered to it. Grab onto the band with your throwing arm and cock your arm back as if you were to throw a football. You should be able to do 20 reps. Repeat for three sets and alternate arms. ABC plank – Plank on a Swiss ball with elbows on the ball. Now draw the whole alphabet with the ball, keeping a tight plank. Do one set with capital letters and one set with lower-case letters at least once a week. Other general upper body strengthening to help the shoulder girdle that should be part of any strengthening program include: Pushups Dips Pull ups Rows Knee stability The knee needs balance between all the muscle behind the knee, above the knee, and below the knee. Knee range of motion – Make sure you have full range of both knees. Can they bend all the way equally, and can they not only extend, but hyperextend equally? If not, stretch them or make an appointment with your physical therapist to figure out why. Squat – Feet should be shoulder width apart. Keep your knees behind your toes and squat down. You can add resistance with a barbell, kettle bell, dumbbell, etc. Find a trainer to make sure your form looks good. Single-leg dead lift – Stand tall holding a dumbbell or kettle bell. Hinge forward with one leg kicking back. Bring the weight down towards the floor keeping the three curves of the back. Allow the stance leg’s knee to bend. Now bring it back to position one. It is okay to do a standard dead lift with a barbell, as well. Form is everything when trying to prevent injuries in this exercise. Overhead reverse lunge – Holding a weight over your head with your right hand, step back with your left leg and sit in a lunge with the left knee close, but not touching the ground. Return to start. Repeat 8-10 times for two sets and switch legs. Side plank clams and hip abduction – Holding a side plank, try 20 reps of clams. The top leg should be bent at 90 degrees. Open the hips just enough before your trunk starts to rotate. For hip abduction, return to the side plank position. Keeping the hips and toes pointing forward, lift your top leg away from the bottom leg, leading with the heel. Repeat 20. The leg exercises not only give you the strength needed to compete, but also improve the power of your swing. Proprioception Proprioception is your body’s ability to perceive its position in space. Simply balancing and standing on one leg can challenge your proprioception. Exercises like yoga and the practice of martial arts help you develop the balance, strength and skill to master your body awareness. At a gym or at home use a Bosu ball or wobble board with your exercise routine to help you challenge your proprioception and improve your core activation. Simply standing on a BOSU while doing arm curls can help improve proprioception. Stand-up paddleboarding is also a great way to challenge your balance, proprioception and core strength for tennis players looking for a way to cross train. Plyometrics Plyometrics is a type of activity that involves explosion and using a muscle in a way that creates a quick stretch and response. Jumping rope – Keeping your body relatively stiff, jump rope. Variations include single leg, alternating skips and side-to-side jumping. Box jumps – Finding a box at an appropriate height for your level of skill is important. This is an explosive exercise. Keeping your legs parallel, hop up on to the box, landing as softly as possible. Then step down. The point is to explode and react with strong stability. Do reps of five for a set of five. Depth jumps – It is also important to learn how to react quickly with plyometrics. Set up two boxes at difference heights or a box and a hurdle. Start at the higher box and jump down. Now explode as fast as you can onto the second box. The cue is “attack the ground.” Again, repeat for five reps for a set of five. Other activities that can help you train plyometrics include basketball, high-intensity interval training (HIIT) classes and wind sprints. If you’d like help developing a training routine specific for your needs or help recovering from a sports injury, AAMG Physical Therapy can help. Call 443-481-1140 for an appointment or more information. Author Dat Quach, PT, is a senior physical therapist at AAMG Physical Therapy and supervisor at the Bowie Pavilion clinic. To reach his practice, call 443-481-1140. Originally published June 6, 2017. Last updated June 11, 2018.0
- News & Press Releases, Stroke CareGeneral Page Tier 3BlogAnne Arundel Medical Center (AAMC) has received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes AAMC’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized evidence-based guidelines. AAMC earned the award by meeting specific quality measures for the diagnosis and treatment of stroke patients. These measures include the proper use of medications and other stroke treatments with the goal of speeding recovery, and reducing death and disability for stroke patients. READ MORE: Reducing stroke risks This year, AAMC also achieved the next level of Chest Pain Center with Primary PCI Accreditation by the American College of Cardiology (ACC). AAMC earned the higher-level accreditation for continuing to show exceptional competency in treating patients with heart attack symptoms, and for streamlined systems from admission to evaluation to diagnosis and treatment to appropriate post-discharge care. AAMC exceeded an array of stringent criteria. The ACC also acknowledged that the hospital’s team of doctors, nurses, clinicians, and other administrative staff support the efforts leading to better patient education and improved outcomes. READ MORE: The heart of the matter: Lowering your risk of heart disease “This recognition is testament to our culture of quality and the people behind our carefully designed systems of care to deliver the best possible outcomes for our patients,” said Jerome Segal, MD, medical director of Cardiovascular Services at AAMC. “We are proud to be recognized for our efforts by the industry’s most leading organizations.” To learn more about AAMC’s stroke services, visit www.askAAMC.org/stroke, and for more information about AAMC’s heart services, visit www.askAAMC.org/heart.0
- Men's Health, Senior Care, Women's Health, UncategorizedGeneral Page Tier 3BlogWhile death is a natural part of life, many people find it hard to bring up end-of-life discussions with their loved ones and even their doctors. More than 90 percent of people think these conversations are important, yet fewer than 30 percent have actually had them with their families. It may seem impossible to plan for the end of life, but Patricia Czapp, MD, chair of clinical integration at Anne Arundel Medical Center, explains death isn’t a surprise for most people. “You need a general plan,” she says. “It should involve really good conversations about what’s important to you in your life and, more importantly, who will make decisions for you if you can’t speak for yourself.” Dr. Czapp says your spokesperson should be someone you trust, whether that’s a relative or close friend. It’s important to identify someone and have a conversation about your wishes, even though bringing it up can be uncomfortable. AAMC is proud to partner with The Conversation Project, a group that recognizes the difficulty and importance of these conversations. The Conversation Project offers resources like the Conversation Starter Kit that breaks down the discussion process into four easy steps: get ready, get set, go and keep going. “They guide you through the things you should be thinking about: What level of quality of life would you like? Are you willing to go to a nursing home if you might never come home? What would it be like if you couldn’t talk or you couldn’t recognize your family members anymore?,” says Dr. Czapp. “Those are things you’ve got to have a conversation about. If you wait until it’s too late and you’re in the emergency room it doesn’t always go very well. You don’t have time to process it all.” READ MORE: The Conversation Project: Sharing your wishes for end-of-life care Advance directives are also important. They are written instructions that explain your healthcare decisions if you are no longer able to speak for yourself. However, the decisions you make when preparing the advance directive may be different than the ones you would make when you become ill. This is why Dr. Czapp recommends having a spokesperson to make decisions for you. A spokesperson can talk to your doctor and help apply the decisions you made in your advance directive to your current health status. Just as you have end-of-life conversations with your loved ones, you should also have them with your doctor. It is important that your doctor understands your wishes and beliefs in order to help you. Medicare now pays for these face-to-face meetings about end-of-life care. “Eventually, everybody’s life comes to an end and if we can stop denying that then we can say, ‘How do I plan for the best ending?’” concludes Dr. Czapp. What is palliative care? Here are the top three things you need to know about palliative care from Dr. Czapp: Palliative medicine focuses on quality of life, symptom management, care planning and skillful decision-making that involve the body, mind and spirit. Palliative care is reserved for people who have a serious illness that can be life-threatening. Palliative care and hospice care share a similar whole-person, comprehensive approach. However, hospice is reserved for people who have a short life expectancy. Learn more about The Conversation Project, and how it can help you and your family. Contributor Patrica Czapp, MD, is the chair of clinical integration at Anne Arundel Medical Center. Originally published Dec. 23, 2015. Last updated June 7, 2018.0
- Orthopedics, Physical Therapy, WellnessGeneral Page Tier 3BlogRunning: It’s a form of exercise that doesn’t require spending money on fancy gear, and can be done anywhere, alone or with friends. Some scientists say it can even make you feel happier and live longer. Best of all? You only need the right pair of shoes to get started. But, whether you’re a seasoned runner or just working up to your first mile, it may not be as simple as lacing up your running shoes. While research shows that runners’ joints and bones are actually healthier than the average person’s, some runners do get injured. A growing number of doctors and physical therapists (including myself) believe people can prevent running-related injuries by fixing how they run. Evaluating how you run can help identify the root cause of an injury or identify a bad habit that may lead to injury. For example: Runners with long strides tend to develop knee pain. Runners with a narrow gait are prone to shin splints and IT Band syndrome. Runners with an excessive bounce are prone to Achilles tendonitis and plantar fasciitis. Muscle weakness is another frequent cause of injury. For example, weakness in your hips may lead to pain in your knees. A physical therapist can perform a professional running assessment, which usually takes place at a hospital or sports center and lasts about an hour. During a running assessment your physical therapist will analyze your readiness to run, injury history, running goals and training and race schedule. The therapist can also assess your form by looking at balance, strength and flexibility as well as how your joints move. To do this, the therapist may take a look at how the small joints in your foot move while sitting and what changes when your foot bears weight as you stand, walk or run. Is your foot stiff, flexible, flat or high-arched? Do your toes have enough motion when pushing off? How does the ankle joint move when you squat? The physical therapist may also record your running with a high speed camera to collect information about your gait. The therapist slows the footage down to study your movement closely, looking at the runner from head to toe to make any necessary corrections. By slowing the video down, the therapist has a detailed view of the different running stages at various angles and can see what could be triggering injuries or affecting your running efficiency. A video evaluation can also help runners find the right shoe with the right support. The physical therapist can look at your current running shoe and wear pattern to see how they fit to give suggestions and a plan that works for you. If you experience pain while running or want to improve your form and efficiency, a professional running assessment can really help. Running shouldn’t lead to injuries. AAMG Physical Therapy’s Running Program offers running gait assessments at most outpatient rehab clinics. To schedule your exam with a physical therapist, call 443-481-1140. Author By Dat Quach, PT, a senior physical therapist at AAMG Physical Therapy and supervisor at the Bowie Pavilion clinic. Originally published June 22, 2016. Last updated June 4, 2018.0
- Women's HealthGeneral Page Tier 3BlogWhen Roxanne Walsh’s son Van was born in October 2016, it could have been a difficult delivery. The Pasadena woman was more than a week overdue when she gave birth to the nearly 10-pound boy after 64 hours of labor. But there was someone by her side who helped make things much easier – her midwife Maria Mayzel, MSN, CNM, with Anne Arundel Medical Group (AAMG) Bay Area Midwifery. “I felt like she just had a gentle, guiding hand,” says Roxanne, 30, a hairstylist at Studio Salon in Annapolis. “I loved my experience. I wouldn’t change it for anything.” AAMG Bay Area Midwifery is a freestanding birth center located on Anne Arundel Medical Center’s (AAMC) Annapolis campus. Staffed by seven certified nurse-midwives, the midwifery team takes a holistic, individualized approach to pregnancy. “Just having a freestanding birth center in the state of Maryland is unique. We’re one of only two in the state,” says Maria, who has worked at AAMG Bay Area Midwifery for four years. While moms-to-be can opt for unmedicated births in the birthing center, AAMG Bay Area Midwifery is still an active part of the hospital. Clients, like those who want pain management such as an epidural, can choose between giving birth in the hospital or in the birth center. Clients who have high-risk pregnancies receive care from both the midwives and a team of specialists at AAMC. A seamless transfer system between the birth center and the hospital adds an extra layer of safety. “Safety is always our number one priority,” Maria says. READ MORE: The rising popularity of birth centers Roxanne learned about AAMG Bay Area Midwifery from her sister, who delivered three of her four children there. She liked the birth center’s attitude toward pregnancy, especially the close interactions all patients have with their midwives. Roxanne’s husband, Shane, also liked the idea of a natural birth for their first child. She remembers counting down the days until her first appointment, when she was eight weeks pregnant. But five weeks later, when she had her first sonogram, she learned some surprising news. Roxanne has a bicornuate, or heart-shaped, uterus, a condition that affects about 1 percent of women and frequently causes complications during childbirth. Risks can include a higher risk of miscarriage, improper attachment of the baby’s placenta, excessive bleeding and premature birth. Though Roxanne and Shane were concerned, the team at AAMG Bay Area Midwifery was reassuring. “Our plan was to just take it as it came,” Roxanne says. “I felt very confident.” As her pregnancy progressed, Roxanne held out hope that she would be able to have her baby in the birth center. But shortly after the 30-week mark, midwives told her she would be a better candidate for delivery in the hospital’s birth center, due to potential risks during labor. “At this point, we didn’t know how far my uterus could expand,” Roxanne says. Though she was disappointed, the partnership between the midwives and the hospital team comforted her. Plus, she would still be able to have one of the midwives by her side. Maria says the goal is always to honor the family’s wishes, which is why it is important to start talking about their birth plan early on. Those conversations include the entire family, Maria says. “The client’s family is the most important part of the birth team,” she says. Shane said his main concern was the safety of his wife and child, and was happy with the decision to deliver in the hospital. “It was just a change of scenery,” he says. The birth Roxanne went into labor at around 5 pm on a Saturday night, just as she and Shane were leaving a movie. At that point, she was more than 41 weeks pregnant. She called Maria, who told her to call back when the contractions were five minutes apart. A day later, the pain was intense and the contractions were holding steady. She made an appointment for Monday, when she had a stress test and learned her cervix was just four centimeters dilated. Maria says Roxanne was experiencing prodromal labor, which is when contractions happen for hours, even days, with no cervical change. After a day of therapeutic rest, Roxanne’s labor began to slowly progress. She returned to AAMC on Tuesday, and Maria — who happened to be on call that day — made a plan with Roxanne to proceed with labor induction. Roxanne was still in labor when Maria’s shift ended. “I was ready to lose it,” Roxanne says with a laugh. But Maria stayed an hour and a half past the end of her shift to help bring Van into the world — an example of the close relationship the midwives develop with their clients. “One of the biggest things we can offer our clients is more time,” Maria says. Roxanne says she had the experience she always envisioned, complete with essential oils, flameless candles and music — lots of Alice Coltrane in particular, she recalls. Shane, a musician who plays in several Annapolis-area bands, used special headphones to play Alice Coltrane for the baby when Roxanne was pregnant. Van came into the world happy and healthy, weighing nine pounds, 14 ounces. An ongoing relationship Today, Van is an active 18-month-old who loves to bang on his dad’s drums and play with blocks. And his parents couldn’t be happier with their family’s experience at AAMG Bay Area Midwifery. “She was a calm force of wonderful energy,” Roxanne says of Maria. “I feel like a lot of people would have talked me into doing other things, but I had a midwife who advocated for me.” Roxanne’s relationship with AAMG Bay Area Midwifery now continues through annual well woman visits. “At my six-week checkup, I was so sad I was leaving,” she said. “So I was thrilled to learn that I could still receive all my wellness care from the midwives.” AAMG Bay Area Midwifery midwives provide well woman and primary care for women throughout their life span, including family planning, Pap smears, screening and treatment for sexually transmitted infections, breast exams and referrals for mammograms, referrals for mental health services, and menopausal care. Roxanne says she will always remember the sense of community she felt throughout her pregnancy. She encourages any mom-to-be who wants a personalized birth experience to consider AAMG Bay Area Midwifery. “You couldn’t make a better choice,” she says.0
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