Is Barista Elbow the New Tennis Elbow?

Posted by | Posted in Blurbs, Our Therapists, SPEAR in the media, Tips & Favorites | Posted on 07-05-2014

The New York Post recently asked SPEAR’s Certified Hand Specialist and Physical Therapist, Phaeleau Cunneen, to weigh in on a new ailment they’re dubbing, “Barista Elbow.”

According to the article, the injuries suffered by “java slingers” are the result of repetitive use (lifting gallons of milk and grinding coffee on a daily basis), similar to golfers elbow and tennis elbow.

“Treatment for RSI ranges from physical therapy to cortisone shots to surgery, Cunneen says. There are also preventive measures, including exercise to build muscle and better posture.”

Click here to find out more about how SPEAR’s hand specialist gets NYC back to life:

Pilates-based Physical Therapy

Posted by | Posted in Education, Our Therapists, Tips & Favorites | Posted on 28-04-2014

In this entry, SPEAR’s Kasey Johnson, Physical Therapist and licensed Pilates Instructor, writes about the benefits of Pilates-based treatment and the impact of poor posture on musculoskeletal health.

By Kasey Johnson, PT DPT

I initially discovered Pilates, a method of core strengthening and exercise created by Joseph H. Pilates, as a method of recovery from my own dance injuries and have been practicing for over 10 years. Since becoming a physical therapist I started incorporating the Pilates method of strengthening into treatment sessions after noticing how many patients have difficulty contracting their abdominal muscles correctly and how many musculoskeletal problems are truly caused by poor posture.

Pilates has a strong emphasis on lengthening as you strengthen, specifically in elongating the spine. Since most of us work at full-time desk jobs, we end up sitting in a flexed and compressed posture all day long. We then go to the gym and reinforce this posture by performing crunches and abdominal exercises with a strong emphasis on shortening. This always seemed counter-intuitive to me and Pilates is an excellent method for reversing all of those compressive forces and creating the length and strength necessary for proper posture.

Since initiating the Pilates program at SPEAR I have been able to incorporate Pilates into treatment sessions for a wide variety of injuries and the equipment has given all of our therapists at 56th street a new tool to help patients reach their goals faster and more efficiently.

A Brief History of Pilates
Pilates is a method of core strengthening and exercise created by Joseph H. Pilates. After growing up in Germany with many illnesses leading to muscular weakness he dedicated his life to physical fitness and overcoming these struggles. He studied yoga, martial arts, meditation and Greek and Roman exercises to come up with his own unique program originally named Contrology.

He brought his exercise method to the United States in 1923 and it became a popular recovery method among injured dancers in the 1930s and 1940s. Pilates continued to gain recognition and become well known in the rehab world in the 1990s.

Pilates exercises are performed on a mat, reformer, chair or cadillac apparatus that utilizes springs to assist and resist injured individuals to regain motion and increase strength. It has a strong focus in strengthening the deep stabilizers of the core musculature and improving posture.

Pilates proved to be effective in rehabilitation by allowing for reintroduction of movement very early on in the healing process from injury by minimizing the gravitational effect on the body and minimizing the degrees of freedom within a movement. As a therapeutic exercise Pilates has been found to be useful with patients of all ages and impairments ranging from low back pain to osteoporosis to stroke recovery.

Marathon Recovery

Posted by | Posted in Inspiration, Our Therapists, Running, Tips & Favorites | Posted on 13-11-2013

Last Sunday’s ING NYC Marathon has come and gone, but for most runners the journey isn’t over. Recovering from a marathon requires just as much mindfulness as training for one.  We spoke to 44th Street‘s Abby Karpinksi, PT DPT and 56th Street‘s Sarah Tabia, PT DPT for some tips to help you maintain a balanced and replenishing marathon recovery.

The Weeks After:  Rest, Flush, Massage, and Stretch

When 56th Street‘s Sarah Tabia, PT DPT crossed the finish line on November 3rd, she was gently guided by marathon volunteers to keep walking.  As she slowly made it a mile deeper into the park, heat sleeves and the ubiquitous mylar blanket were draped over her shivering body.  “They make you do this to flush out the lactic acid,” Sarah explained when we spoke to her about her recovery game plan earlier this week.  “They ask you to walk slowly and to keep your legs moving.  When the [volunteer] wrapped the warm blanket around me I remember looking up at her, just so vulnerable and cold and she put the hood over me and it was the best moment of my life.”

Running 26.2 miles certainly takes it’s toll on the body.  According to a study cited by, “both the ‘intensive training for, and the marathon itself, induce inflammation and muscle fiber necrosis that significantly impaired muscle power and durability.’”  This means that taking the time to rest and recover your muscles before returning to training full-time is absolutely necessary.

Sarah’s recovery game plan for the days immediately following the marathon made rest her first priority.  “First and foremost I did no running for at least a week.  People who love running typically want to get back to running as soon as possible, but I was in full recovery-mode all week.”

44th Street‘s Abby Karpinski, PT DPT, who along with 16th Street‘s Jason Kang, PT DPT and Lisa Yirce, PT DPT, volunteered at the marathon medical tents last Sunday, also recommends mixing in a little gentle cross-training (walking, biking, elliptical) to continue to flush out the lactic acid that has pooled into the muscles.

“10-20 minutes of light cardio or elliptical a few times a week is all you need during your recovery period.  I also tell my patients to get up every hour or so, especially if they return to a sedentary job immediately after the marathon.  Being idle is bad for your muscles so you’re going to want to move around regularly,” advises Abby.

Both Sarah and Abby also recommend a soft massage from a licensed massage therapist after a day or two of rest from the marathon.

Says Sarah, “I got a massage on the Tuesday after the race with Laura Mirabella and it was incredible.  I noticed that my walking was significantly better after that.  She worked on my legs and my lower back and that helped a lot, because before that I was actually limping.”

Make sure to let your massage therapist know you are recovering from a marathon.  Your massage therapist should avoid any deep tissue work, and will instead gently roll out your muscles to help you with your range of motion and soreness.

Finally, Abby recommends constant gentle stretching to keep your muscles loose and from spasming.  For this, she highly recommends consulting a physical therapist first in order to learn proper form.  “While there’s no such thing as too much stretching, there is such a thing as over stretching.  If you stretch too far or pull too hard you’ll injure yourself,” cautions Abby.  “Daily stretching is vital, but make sure you’re being good to your body.  You’re asking a lot of it by running a marathon, so you need to be good to it in return.”

Run This City

Posted by | Posted in Inspiration, Running, Tips & Favorites | Posted on 01-11-2013

For the last two weeks SPEAR has been spotlighting our patients who are running this year’s ING NYC Marathon on November 3rd. Today’s installment features Vishal Desai, who sees Abby Karpinski, PT DPT at our 44th Street facility.  Vishal’s story of triumph over cancer and paying it forward via the American Cancer Society’s DetermiNation team is truly inspiring and we are honored to have been able to help him prepare for his first NYC Marathon.

Vishal Desai

Why do you run? My reasons are twofold. When I first started, I was looking for a way to get into better health, and for a way to give back to charity. I survived cancer when I was a teenager and I received assistance from the American Cancer Society. I figured I would try to run the NYC Half Marathon in 2012, and thought the perfect way to do it was by training and fundraising with the American Cancer Society’s DetermiNation team. I loved every minute of running with the team and I’ve been running ever since. I’ve been able to complete 7 half-marathons and 1 marathon.

How long have you been running marathons? I did my first marathon in Philadelphia last year when the NYC Marathon was cancelled due to Superstorm Sandy, and thanks to Abby and SPEAR, I’m getting ready to finally run the NYC Marathon this coming weekend!

Which physical therapist do you see at SPEAR and what treatments have you been doing for training? After having to stop training early in the summer due to shin splints and foot pain, I began seeing Abby Karpinski. I’ve learned quite a few strengthening, stretching and balance exercises. Abby helped me realize that I was pounding the ground and compounding my problems with my running style. After a few weeks of working together, and with a fair bit of ice, I was able to start running lighter, and reduce my pain. I was able to get back to training in September and now I’m ready to run my race!

Do you have any words of wisdom or training tips for anyone thinking about doing their first marathon? The biggest thing is to take the race and training seriously. Stay disciplined, make sure you stretch and get time on your feet so you become mentally ready for 26.2. And if you can, try to find a team to run with. Nothing to keep you going like a little peer pressure.

Run This City

Posted by | Posted in Inspiration, Running, Tips & Favorites | Posted on 28-10-2013

For the next two weeks SPEAR is spotlighting our patients who are running this year’s ING NYC Marathon on November 3rd.  Today’s installment features husband and wife runners Adam and Elizabeth Brill, both patients of Jason Kang, PT DPT at our 16th Street facility.

Adam and Elizabeth Brill

Why do you run?
Adam: Running makes me feel free. Just a pair of sneakers and I’m on my way. It’s my favorite way to explore new places. I also run because I love food, and there’s nothing more satisfying than cooking and eating a meal with your lungs still burning from a hard workout. Running is a great way to stay in shape and learn about yourself and your surroundings.

Elizabeth: I was never that into sports – and definitely not into running – but I started running when we moved to New York six years ago. It was a great way to get to know the City and spend more time outside. (I also didn’t have to pay for a gym membership.) I kept running because I loved it. I was training for my first half marathon when we got engaged – Adam designed these “bride” sneakers for me with our wedding date – by far the best running gear/pair of shoes I’ve ever owned!

How long have you been running marathons?
Adam: The 2013 race will be the fourth race I’ve trained for, and the third one I’ve run. I finished NYC in 2008, Chicago in 2009, and then got “Sandy’d” in 2012. I think I’ll always wear that asterisk.

Elizabeth: This will be the second marathon that I’ve trained for, but the first one I’ll actually get to run because of Hurricane Sandy. Since I started training for the 2012 race last spring, I’ve run more than 1,300 miles or roughly the distance from New York to Florida.

Which physical therapist do you see at SPEAR and what treatments have you been doing for training?
Adam: I work with Jason, and he’s been an integral part of my training. My IT band has been a trouble spot for me throughout the years, but with Jason’s help, I’m able to run with more confidence. We do exercises to strengthen and stretch my glutes, quads and hamstrings as well as massage to loosen my IT band.

Elizabeth: I also work with Jason, and the experience has helped me improve both physically and mentally. I first started coming to SPEAR to get some knots in my legs worked out. At my first appointment, Jason put me in front of the mirror and asked me to do a one-legged squat. Looking at my reflection, I was shocked by how little strength and control I had to keep my knee from caving inwards. I thought I was doing enough by covering the long distances, practicing on hills and doing interval work, but Jason showed me how to train smarter. Since that first appointment, I’ve worked on strengthening my glutes and quads, stretching out my hamstrings and have also had Jason work on the knots in my muscles. I know that I am physically stronger than I was this time last year, and that gives me the confidence to be mentally stronger, too. Jason and the SPEAR team have been all-around fantastic, and I know I’m as prepared as I can be to face whatever the marathon throws my way.

Runaway bride? Elizabeth's "Bride" running shoes, designed for her by then-fiancé Adam.

Do you have any words of wisdom or training tips for anyone thinking about doing their first marathon?
Adam: Go for it. If you’ve thought about doing one, chances are you’re the type of person who has the tenacity and commitment to realize your goal. Before I started training for my first race, I had never run more than five or six miles. You learn a lot about yourself, and it’s a great sport. And as race day approaches, don’t over think it. Trust your training!

Elizabeth: It is an amazing experience – and you should do it! Be committed but have fun. Listen to and take care of your body. Ask for help before you need it. Eat dessert. It’s OK to get nervous, but don’t let yourself or anyone else talk you into thinking that you can’t do it. You will be astonished by what you can achieve.