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Read Our Blog

Welcome to the Midwood Physical Therapy blog. Visit this page often for updates on the clinic, the latest developments in physical therapy, as well as inspiring stories from our patients all over New York.

Meniscus Tears - do I need surgery?

November 2019

There are many types of Meniscus tears of the knee. The Meniscus is the cushion that your upper leg rests upon. It can tear by normal wear and tear or traumatic - usually with a quick twist of the knee. There are many types of tears -  from small tears in the middle of the cartilage to flap tears where it can get caught in your knee joint and lock your knee. The body has a natural healing and scarring process that will occur. The type of tear, the location of the tear and overall health of the joint usually dictate how well the healing will occur. Most Meniscus tears do not need surgery. A good stretching and strengthening program after an initial period of healing and "calming down" the pain and inflammation often times takes care of the injury.

Avi Kleinman has over 18 years experience in Physical Therapy treating all forms of foot pain in his Brooklyn and Hewlett offices.

Why Does My Foot Hurt? Part 3

March 17, 2018

If you experience pain under your inside (medial) ankle you may be experiencing Posterior Tibial Tendon Dysfunction (PTTD). Poor arch support is a common cause as it changes the positioning of the Posterior Tibialis muscle. Symptoms may include severe pain and even burning from standing, walking and stair climbing. I often perform a K taping technique to immediately raise and support the arch followed by electrical stimulation, ultrasound treatments, gentle massage and stretch to the affected muscle and tendon. I usually recommend purchase of an arch to insert into the shoe. Most patients are successfully treated in a short period of time.

Avi Kleinman has over 18 years experience in Physical Therapy treating all forms of foot pain in his Brooklyn and Hewlett offices.

Why Does My Foot Hurt? Part 2

Feb 5, 2018

If you experience pain behind your heel or below your calf muscle you are probably experiencing Achilles tendon pain. More often the injury is tendonitis and requires some combination of ice initially followed by periods of heat and gentle stretch. A primary cause is over use and insufficient stretching. Do not return to sports or activity too soon as this may also be a precursor to a larger injury including an Achilles tendon tear or rupture. Focus on stretching your calf and separately your Achilles tendon several times a day towards return to sports. Maintain and pre and post workout stretch routine once you return to sports.

Avi Kleinman has over 18 years experience in Physical Therapy treating all forms of foot pain in his Brooklyn and Hewlett offices.

Why Does My Foot Hurt? Part 1

Feb 5, 2018

There are many orthopedic injuries that can cause foot pain. Today I will focus on Plantar Fasciitis. It's a term everyone has heard and most mispronounce. The Plantar Fascia is a thick tissue at the bottom of the foot that is situated from the heel to where your toes begin. A hallmark of this condition is a stabbing sharp pain in the foot when you take your first steps of the day getting out of bed. Flat feet and shoes with poor arch support are common causes as well as tight calves/Achilles behind the heel. Simple home remedies include: Frequent calf and Achilles stretch, rolling the foot over a golf ball or frozen water bottle, early morning warmth (bath) and the use of K Tape to create arch support. Physical Therapy will add Electrical stimulation and Ultrasound treatment as well as massage and manual stretch throughout the bottom of the foot. When treated early Plantar Fasciitis can be relieved 100% within a few days to a few weeks. If it is more progressed and painful, shoe arches and nighttime Plantar Fascia socks are also recommended.

Avi Kleinman has over 18 years experience treating all forms of foot pain in his Brooklyn and Hewlett offices.

What is causing my dizziness?

Feb 5, 2018

Differentiating if the cause of dizziness is coming from the inner ear or from the brain requires a simple initial test called the Hallpike-Dix Maneuver. If this test is positive, at the very least we can say there is an issue coming from the inner ear. There may also be other factors but this is where we start the treatment. If the test is negative, we can now focus on the many other factors that may cause dizziness but with the confidence that the ear is not a factor.

Avi Kleinman has over 17 years experience diagnosing and treating all forms of dizziness and vertigo

Recent sports injuries

Jan 28, 2018

Demarcus Cousins has a complete rupture of his Achilles Tendon. He is scheduled for surgery. This is in my opinion a tougher rehab and return than an ACL injury. Most recent star athletes with this injury have been Kobe Bryant and Wes Matthews. I wouldnot expect him to be ready until next years All Star Break.

Avi Kleinman has over 17 years experience treating young adults and athletes with various knee and ankle injuries. He also works on injury prevention and sports performance.

Tommy John Surgery and young pitchers

Jan 28, 2018

The "epidemic" of ulnar collateral ligament (UCL) injuries leading to Tommy John surgeries has been the talk of baseball the past few years. The topic has been addressed constantly in the past few months. It has recently been a hot topic in New York as Mets Pitchers Matt Harvey and Steven Matz as well as well as Yankee’s pitching ace, Masahiro Tanaka who was coming from the lauded Japanese pitching system, have all injured their UCL. My experience treating injuries in adolescent boys and young adults with sports injuries has led me to see this "epidemic" as a simple and straight forward orthopedic injury. The UCL is stressed when throwing breaking balls (curves, sliders, splitters...). A developing elbow with its muscles and ligaments has less ability to tolerate these forces, becoming weakened and injured. The stress put on the elbow and the UCL only increases as the pitcher matures and throws with greater force and torque. This creates a perfect storm- a compromised UCL on a pitcher who only increases the stress on it as his fastball and breaking balls increase in speed movement. The fact that it happens to some of the best pitchers at a young age is more proof to this theory. A young pitcher with exceptional arm strength will continue to pitch long games several times a week and will be more inclined to develop and throw breaking balls at a young age. As he gets older and develops, he will become a star due to his “great breaking ball" which is accomplished by being able to create even greater torque and force on the elbow. The straight forward fastball pitcher or the pitcher who came to pitching late in his high school or college career will be less likely to develop a UCL injury while the youth star who continues to work and improve his breaking ball will be more likely to have Tommy John surgery. My advice: the kids with the best "arms" should not pitch in youth baseball. Those who choose to pitch should not throw any breaking balls. No one signs a pro contract from a great little league game, but a future pro career can be ruined from it.

Avi Kleinman has over 17 years experience treating young adults and athletes with elbow and shoulder injuries. He also works on injury prevention and sports performance.

"Carson Wentz says 'He also tore his LCL' "

Jan 26, 2018

Most ACL tears will also have an affect on one of the collateral ligaments - the ligaments that are directly on the side of the knee. There is a medial (inner) and lateral (outer) collateral ligament referred to as MCL or LCL. There are essentially rubber bands that help keep the knee joint intact by connecting the Femur (thigh bone) to the Tibia (shin bone). They help prevent the knee from bending sideways - MCL prevents an inward bend while the LCL prevents an outward bend. It is uncommon to have an injury that exclusively tears one of these ligaments. Football, with players propensity for tackling low in clean sideways angles, has a higher propensity for these injuries. Picture a cornerback going directly into the side of a running back's knee, which would cause an MCL injury. Generally, one of these ligaments would tear along with an ACL injury Almost exclusively the ligament involved is the MCL. In most cases the ACL tears from a planting of the foot and twisting the knee (basketball guards "making a quick move" or wide receivers "making a cut"). Carson Wentz's ACL injury was unique in the actual mechanism of injury. He was airborne and had a lineman come across from the inside of his knee. This caused for the more unique ACL and LCL tears instead of ACL and MCL tears. 

Kawhi Leonard's knee

Jan 25, 2018

I am always asked to give my opinion on basketball injuries as it pertains to fantasy teams. Recently I was asked my opinion regarding someone's top draft pick - Kawhi Leonard - nd my thoughts on his knee injury - Patellar Tendonosis. This is a common injury in weekend athletes, runners, cross fit ... Understand that your huge, powerful Quadricep muscles ultimately forms this small tendon under your knee cap. Overuse or stress on the Quadricep will cause this point to slightly tear thereby creating pain with any activation of the Quadricep muscle. Generally rest, heat/ice, gentle stretch and use of a tendon band (if needed) allows for return within a few weeks. Tendonosis, however, is a catch term that encompasses a large spectrum of injury. The Spurs have been comparing his rehab to that of teammate Tony Parker, who completely tore this tendon. In some cases, though, a complete tear and surgery allows for a more predictable recovery than a Tendonosis. My response to a patient with Patellar Tendonosis often times is to let the pain and inflammation calm down down and slowly increase resistance exercises. Some respond quickly, others more slowly. What I do always stress however is that uncertainty. The same uncertainty that Kawhi Leonard is experiencing

Sports Performance for Children

Jan 15, 2018

I am approached by many parents asking what are the best exercises to make my child a better basketball player. My reply usually focuses more on "what they should not do" more than what they should. A few basic ABCs about youth sports performance training.

A. Always stretch! Before... during... after. Stressing the muscles and tendons requires those said muscles and tendons are at maximal tension at all times.

B. Never perform an activity that requires landing on one leg. If you are performing any one leg exercise - power jump, lateral jump ... land on both feet. The only exception would be quick hopping forward.

C. Keep the routine to no more than 2-3 times a week. And Ice up after each workout.


Dec 15, 2017

I always stress the importance of stretching. I recommend a pre workout AND post workout stretch. Spend at least 1 minute on each muscle group pre workout and 30 seconds post workout.The longer you stretch the better. 

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Don’t hesitate to contact us and ask about our services. We serve clients in Brooklyn and surrounding areas.

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