Preventing Injuries for Football – Knee Injuries

If you’re getting injured, you’re not on the field. If you’re not on the field playing, you’re not getting better. If you’re not getting better, Nick Saban and Bo Pelini aren’t sending you letters asking you to have dinner with them and their family, their football family that is. Make sure your doing everything you can to prevent those football injuries. They can happen after a huge hit or from making a cut. Although either one can knock you out of the game or season, non-contact injuries are some of the most frustrating injuries. These occur due to poor mechanics or weakness in a muscle group that stabilizes a joint. We’ll touch on a couple ways to help prevent these injuries from happening.

Preventing Knee Injuries

Take a look at a running back taking a cut as he’s changing direction. Is he using his outside or inside leg to push off with? In most cases its his outside leg that he’s using to make the initial cut with. If its the inside leg, chances are he’s not running anymore. Many non-contact knee injuries occur this was as the knee is put under more force and torque than it could handle when its under the body.

As you go through drills, focus on pushing with your outside leg. This puts your knee in its strongest and most powerful position, protecting it from possible ligament damage.

EP-706079875There are several prehab exercises that will help prevent injury by activating the muscles that support the knee. One exercise is the terminal knee extension (TKE), which targets the vastus medialis oblique (VMO). Other exercises such as a single leg hop and hold the landing will help target the quadriceps and increase stabilization. While performing any of the knee exercises, keep your knee tracking in the direction of your foot and don’t allow it to fall inward or outward. This facilitates proper mechanics trains the muscles to perform this movement when needed most, in the game.

Injuries that occur from contact are hard to prevent from the prehab exercises above but the severity of the injury can be decreased.

What Supports the Knee

The ligaments that support the knee include two (medial and lateral) collateral ligaments and two (anterior and posterior) cruciate ligaments. The medial and lateral collateral ligaments prevent the knee from buckling inward and outwards and is often injured from being hit from the outside of the knee. As for the anterior and posterior cruciate ligaments, they prevent rotation and front to back movement of the tibia under the femur and are located with in the joint.

The knee joint moves over two menisci that act as a cushion for your upper leg (or femur) on top of the shin (tibia). Injuries and complications to the meniscus often occur with rotation of the tibia under the femur as with ACL and PCL injuries and often at the same time. Some symptoms might include the feeling of instability, swelling and stiffness.

Decreasing Recovery Time

Recovery from injuries to these ligaments often take 6-12 months. Going through physical therapy prior to surgery greatly decreases the length of therapy after surgery. It increases range of motion and prepares your quad for post-surgery strengthening. Through out the process, rest, ice, and elevation will help decrease the swelling that will also help decrease the recovery time, getting you back to the playing field faster.

Don’t assume the time you put in at physical therapy is all you need. Be sure to follow the home exercise program your physical therapist has prescribed to stay on track.

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Balance problems or at risk of falling?

Balance in Every Day Life

Has it been hard to stand or walk without feeling like you’re going to fall? Do moving objects in your visual field mess with your balance? We often take our balance for granted until we experience trouble getting out of a chair, walking, bending over to tie your shoes, or holding your kids or grandkids.

There are a few different systems that help tell us where our body is in relation to our environment that gives us a stable stance whether we’re standing or walking. We like to think of these systems as the three legs of a tripod. They all work together to keep us from falling or feeling like our balance is off.

Feel like you could benefit from physical therapy just for symptoms like these? Visit us at

Visual System

One of them includes our visual system (our eyes) and tells us what the environment around us is like and what obstacles we may encounter. Often taken for granted, the eyes provide a large amount of information and takes into account what we are focused on as well as what is in our peripheral field (ambient vision).

Proprioception/Somatosensory System

Another system includes the proprioceptive/somatosensory system that tells us where our body is in space. The proprioceptive system uses sensory information that come from within the body. For example, if we hold our right arm above our head and close our eyes, we still know that the right arm is raised from information sent to our brains from sensory nerves. So if you think about walking or standing, we don’t really look at our legs when we’re walking but rely on the proprioceptive information from our legs to tell us where they are.

Vestibular System

The third one is the vestibular system, which has a lot to do with balance portion of our movements or stance. This system resides within our inner ear and as our head moves (along with our body) we receive information as to what direction and how fast or slow we’re moving. It doesn’t just help us with posture or stance but tells our eyes what they should be looking at and where to look next. Can you imagine how this might affect our balance if it were somehow “off” or not working right?

Typically these three systems are healthy as we’re young and can diminish in acuity as we grow old. Injuries to the head that we might sustain during sporting events or car accidents can also have an impact on these systems. These injuries are known as traumatic brain injuries (TBI) and sometimes can be tough to diagnose as they may not present themselves right away.

Balance and Vestibular Therapy

Some of the conditions that may be treated by balance and vestibular therapy include:

  • Movement Disorders
  • Chronic Mobility Disorders
  • Neuro Degenerative Disease
  • Fall Risk Identification
  • Dizziness/Disequilibrium/Vertigo
  • Vestibular Disorders
  • Orthopedic Injuries
  • Cerebral Vascular Accident (CVA)
  • Migraines
  • Head Injury/Concussion
  • Spinal Cord Injury
  • Worker’s Compensation

If you feel that you could benefit from physical therapy that is designed to treat these problems in balance then please give us a call or stop by any one of our locations below. Ask for Erin Bryant as she is one of our physical therapists that specializes in the different balance and falling disorders.


Location: 4201 North 90th Street
Omaha, NE 68134
Phone: 402.934.0045
Fax: 402.934.6562
Click here for directions.


Monday through Friday
7:00 am – 6:00 pm


Location: 3830 North 167th Court
(northeast corner of 168th and Maple)
Omaha, NE 68116
Phone: 402.502.2290
Fax: 402.505.3922
Click here for directions.


Monday through Friday
7:00 am – 6:00 pm


Location: 8419 S. 73rd Plaza, Suite 104
Papillion, NE 68046
Phone: 402.991.2745
Fax: 402.991.2748
Click here for directions.


Monday through Friday
7:00 am – 6:00 pm


Location: 1021 S. 178th Street, Suite 101
Omaha, NE 68118
Phone: 402.933.3036
Fax: 402.933.3163
Click here for directions.


Monday through Friday
7:00 am – 6:00 pm


Location: 6909 S. 157th Street, Suite E
Omaha, NE 68136
Phone: 402.933.5448
Fax: 402.933.5449
Click here for directions.


Monday through Friday
7:00 am – 6:00 pm

Treating Little League Elbow

What is Little League Elbow?

Injuries in baseball can often occur from repeated movements are preventable, such as the throwing motion. These injuries usually influence the shoulder and elbow joints while limiting the athletes’ playing time.

Now that the baseball season is reaching its halfway mark, aches, pains, and injuries might begin to limit playing time or performance. The goal is to prevent the aches and pains from becoming long-term or season-ending injuries. If an injury does arise, you want to be sure to treat it as soon as possible, limiting the amount of game time missed.

How to treat Little League Elbow

As hard as it is, initial treatment for Little League Elbow is to rest. That prohibits a throwing  motion of any kind for a minimum of 4-6 weeks, or until the player is pain free. Icing the elbow 1-2x a day for 15-20 minutes at a time will help decrease the pain and inflammation. During this time, core strengthening exercises and cardiovascular exercise would be beneficial in maintaining strength as the amount of practice and activity has decreased. Increasing the strength of the muscles that make of the “core” can help improve throwing motions as many adolescents have poorly developed core muscles.

Physical therapy is the most important part of treatment for little league elbow syndrome.” – Range-of-motion exercises may be prescribed by the therapist to help in the healing process. When the player is pain free, your physical therapist might begin strengthening exercises to prevent further injury.

Always remember that until the pain is gone, the player is constantly in danger of injuring the elbow again, which means more time away from the field.



How to shop for running/walking shoes.

Shopping Tips:

  1. Look at the general workmanship of the shoe (loose or uneven stitching, sloppy glue, etc.).
  2. Heel counter, the back of the shoe that cups the heel should be stiff and firmly attached.
  3. Run your hand along the inside to feel for any rough edges.
  4. Nylon material is the best for the upper portion of the shoe as it allows the foot to “breathe”.
  5. The weight of the shoe is overrated, do not use as a factor for shoe selection.

Fitting Tips:

  1. Even if the shoe is highly recommended, do not buy it if it does not fit correctly. A shoe that does not fit correctly will not work correctly.
  2. The heel counter should fit snug and firm, but does not dig into your heel. If not, check the width of the shoe.
  3. Allow at least one quarter inch up to a thumb nail beyond the end of your toes.
  4. Feet swell while running so do not choose a shoe that is too tight across the widest area of the forefoot.
  5. Put both shoes on, lace them up, and try them out. If they fit correctly, wear them.
  6. When trying shoes on, wear the socks that you would normally use when running or walking in them. Also, be sure to put the inserts or orthotics in that you would use to be sure they fit correctly.

– Scott Keenan, PT, DPT, OCS, CSCS

Makovicka Physical Therapy

Why choose aquatic therapy?

Aquatic therapy is the use of an aquatic environment to perform exercises, manual therapy, sensory integration, and gait training.  Aquatic therapy utilizes the properties of water to provide a safe, functional, and challenging atmosphere to restore normal movement.  The benefits of aquatic therapy include, but are not limited to:

Buoyancy:  Buoyancy is the property of water that reduces the force of gravity on the body.  The body can be relieved of gravity by up to 80% at chest-high level.  This allows a person to practice walking without the stress of a land setting.  Buoyancy can also be used to decrease the compression of gravity on the spine.  Finally, buoyancy can be used to improve range of motion for any body part by reducing the force gravity exerts.

Hydrostatic Pressure:  Hydrostatic pressure is the force that water applies to the body.  It can aid in the reduction of edema, improve circulation, and decrease blood pressure.  This pressure can also be utilized for resistance to improve breathing capacity, allowing the chest muscles to expand more on land.

Temperature:  At Makovicka Physical Therapy we utilize an aquatic temperature of 92-95 degrees.  This allows the tissues to relax and improve flexibility.  It also provides a more comfortable experience for the patient to focus on their movement.

By employing these characteristics physical therapists are able to create a challenging, yet safe setting for patients to begin, progress, or finalize their rehabilitation.  The versatility of aquatic environment has been shown to benefit patients who suffer from:

ACL reconstruction


Rotator cuff injury

Adhesive capsulitis (Frozen Shoulder)

Gait dysfunction

Various foot injuries, including plantar fasciitis, post-surgical conditions, and ankle sprains

Chronic and acute low back pain

Complex Regional Pain Syndrome

And many others


For a video demonstration of the Hydroworx pool: &


Visit, call (402) 933-3036, or come see us at 178th and Pacific at Makovicka Physical Therapy for more details.

Dan McCutchen, PT, DPT, OCS