Dr. Abbate Physical Therapy

07/17/2025

High & Low risk Stress fractures

The majority of stress fracture injuries are uncomplicated, and heal predictably with a period of rest

High risk stress fractures often have delayed healing or concomitant complications like AVN (avascular necrosis)

⚠️Low risk

👉Less likely to progress to a complete fracture and because they generally heal quite predictably

👉relatively short period of weight-bearing rest

👉Typically low risk: Metatarsal stress fractures often the 2nd & 3rd rays, posterior tibia

⛔️High risk

👉Require additional intervention (surgery)

👉longer period of non-weight bearing

👉longer time off

What can help bone healing?

1️⃣Bisphosphonate treatment for stress fractures in young female athletes with female athlete triad disorders is not established and there is little evidence for its effectiveness in the literature

2️⃣oral contraceptive treatment is not effective in increasing bone mineral density or reducing stress fractures

3️⃣avoid the use of oral non-steroidal anti-inflammatory medications as these may impair bone healing

4️⃣low-intensity pulsed ultrasound stimulates bone healing in fresh fractures

5️⃣orthoses or assistive devices are used to help try to limit the amount of load to the injured structure

6️⃣surgery is indicated in the treatment of some stress fractures

07/14/2025

Here are two progressive exercises I often prescribe dancers
Adding resistance (medicine balls) and dynamic movements (trunk rotation) can create sport specific challenges
Try these two exercises for your lower body days!
Jake makes it look EZ

06/30/2025

Athletes with bone stress injuries typically complain of an insidious onset of pain that is worse with activity and repeated loading
Biggest risk factors:
* Rapid increases in bone loading as a result of significant changes in training regime
* Large imbalances between energy (calorie) intake and energy expenditure, particularly amongst female football players, which can leave them vulnerable to hormonal dysfunctions

Intrinsic risk factors:
* Female gender
* Younger female players who have primary amenorrhea risk compromised peak bone mass; menstrual disturbances
* Low bone density
* Poor joint flexibility (hip ER & ankle DF)
* Poor nutrition status
* Low vitamin D

Extrinsic risk factors:
* A sudden or rapid increase in training loads
* Hard surfaces or surfaces which are less compliant
* Very young/old
* Previous history of fracture

Examination

Primary S&S: Localised tenderness at the site of injury followed by swelling

X-ray: stress fractures are rarely demonstrated on x-ray images; late presentation

CT scan: required to visualise cortical fractures such as the navicular and pars interarticularis

Bone scan: very sensitive for detecting increased bony remodelling

MRI: similar to CT scan in sensitivity, no radiation

DEXA: to assess their bone mineral density; important for longer term (observation) treatment

06/13/2025

Beet benefits 🫜

💪Enhanced Endurance: Beetroot juice supplementation has been shown to improve aerobic capacity. For instance, a study involving female endurance athletes reported a 4.82% increase in VO, max after consuming beetroot juice concentrate containing approximately 6.2 mmol of nitrate

🫁🫀Improved Cardiovascular Function: Acute intake of nitrate-rich beetroot juice before submaximal exercise led to reductions in diastolic and mean arterial pressure, and increased flow-mediated dilation, indicating better vascular function. mdpi.com +5
• Better Oxygen Utilization: Athletes consuming beetroot juice demonstrated decreased oxygen consumption during submaximal exercise, suggesting enhanced efficiency in oxygen utilization.

🤸Recovery Benefits: Beetroot juice may aid in recovery post-exercise by improving cardiovascular responses, as observed in studies with postmenopausal women with hypertension

05/29/2025

♻️Bone is a dynamic tissue.

📉📈The process of remodelling involves action of the osteoblasts and osteoclasts.

♨️Forces may result in micro-damage to the bone architecture.

🔃Stress fractures result from recurrent and repetitive loading of bone, where micro-damage occurs at a rate faster than can be remodelled

⤴️Too much load, loading too soon or low bone density or osteoporosis contribute to stress fractures
Stress fractures are one of the most common overuse injuries in professional dancers, with incidence rates ranging from 4.7% to 15.8% depending on training intensity and discipline.

They most frequently affect the foot, tibia, and metatarsals.

Recovery often requires 6–12 weeks of rest or modified activity, with longer downtime if misdiagnosed or untreated.

Early detection and load management are crucial to avoid prolonged time off stage. 💃🩰

05/12/2025

Metabolism and injuries

Metabolic deconditioning shows up fast — even before you notice it.

For performers, it affects energy, recovery, mood, and long-term body composition.
You don’t need a full workout. You just need momentum.

↓ Glucose uptake (less sugar moves into muscle)

↓ Insulin sensitivity (your body needs more insulin to do the same job)

↑ Fat storage, especially around the midsection

↓ Mitochondrial activity (energy engines slow down)

↑ Cortisol (stress + storage)

↓ Leptin & Ghrelin balance (hunger & fullness)

↓ Myokines (muscle-based messengers that protect your body)

This isn’t just about looks — it’s about energy, mood, and performance.

05/05/2025

🫀What Happens to an Athlete’s Heart With Time Off?

When athletes stop training, the heart feels it fast — and hard.

Even within 72 hours of inactivity, your plasma volume drops, leading to:
⬆️ Resting heart rate
⬇️ Stroke volume
⬇️ Maximal cardiac output
⬇️ VO₂ max

In just 2 weeks, elite athletes can lose up to 10–15% of their VO₂ max, and vascular function (how well your arteries expand and contract) can decline. This means slower oxygen delivery, quicker fatigue, and reduced work capacity.

How to defend your cardio system in recovery:

1️⃣ Add light aerobic work (bike, row, incline walk) even during deloads

2️⃣Use intervals or short-duration zone 2 work to preserve output

3️⃣Move frequently, even if it’s just 2–3 minutes per hour during sedentary days

🫀📉Your heart loves consistency. Don’t let it untrain itself.

05/02/2025

Deconditioning refers to the complex physiological and functional decline that results from reduced physical activity or immobilization.

Recent literature demonstrates that athletes may be uniquely susceptible to these effects due to their elevated baseline levels of fitness and metabolic function, which begin to regress rapidly when unable to exercise

Muscle atrophy and strength loss are among the earliest and most prominent consequences of reduced use.

Muscle strength may drop by 10-20% within two weeks, depending on the injury and rest protocols.

Athletes with high baseline performance often experience faster losses and longer recovery periods.

04/29/2025

🛋️➡️📉 What Happens When Athletes Stop Moving?

Even the most conditioned bodies begin to decondition when movement stops.
Whether you’re recovering from injury, taking time off, or just stuck in a sedentary routine — your systems feel it fast.

📊 picture 1 shows what happens internally when sedentary time increases — vs. what happens when we interrupt it.
🧠💪🫀 Every system gets hit: metabolism, brain function, fat distribution, muscle integrity, blood flow.

📉 picture 2 shows the rate of decline in athletes. In just 1–2 weeks:
* 🔥 VO2 Max drops
* 🧬 Muscle strength declines
* 🦴 Bone density weakens
* 🧠 Cognitive sharpness decreases
*
✅ Good news? Small, intentional activity breaks throughout the day — even while recovering — protect your edge

You don’t need to “go hard” to avoid falling behind. You just need to keep moving smart.

04/14/2025

Performance anxiety 😱

6 tips to overcome performance anxiety:
🪧
1️⃣Recognize the signs (e.g., increased heart rate, worry) to address them early.
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2️⃣Dedicate 5 minutes daily to mental practice to prepare for high-pressure moments.
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3️⃣Before practice or competition, repeat a positive phrase like “I’m strong, I’m ready” 3-5 times
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4️⃣Close your eyes for 2-3 minutes before training and visualize executing your routine perfectly
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5️⃣Inhale for 4 seconds, hold for 4, exhale for 4. Repeat 5 times before a game or performance.
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6️⃣Create a 10-minute weekly routine combining one self-talk phrase, one imagery session, and one mindfulness exercise.

04/07/2025

Struggling with balance or nagging injuries?
😵‍💫
Research reveals how leg dominance and muscle asymmetries can throw off dancers and active folks, raising fall and pain risks.
⚖️
From smaller multifidus muscles in ballet dancers with low back pain to sway differences in rotational tasks, these studies unpack the science of stability.
🎨
The fix? Targeted training like single-leg stances and style-specific strength work—think hip abductors for ballet or trunk power for hip-hop.
🧐
Physiotherapy steps in to assess, correct, and prevent, boosting symmetry and performance.
👉
Swipe through to see how science meets solutions for safer, stronger moves!

04/04/2025