Monthly Archives: September 2012

Palm Beach County Nature Trails

With fall right around the corner, it is time to dust off the walking shoes and enjoy the local nature trails for your daily walk.  Palm Beach County offers a variety of locations that will provide a change of scenery from the typical morning routine.

Green Cay Nature Center:

12800 Hagen Ranch Road, Boynton Beach.  Open Sunrise to Sunset.  Cos t- Free.

1.5 miles of elevated boardwalk through 100 acres of wetlands.  The trails are wheelchair and stroller accessible, and there are benches on the boardwalk.


John Prince Park, Custard Apple Trail:

4759 S. Congress Ave, Lake Worth.  Open Sunrise to Sunset.  Cost – Free.

Paved trail around the waterways of JohnPrincePark.


Okeeheelee Nature Center:

7715 Forest Hill Blvd, West Palm Beach.  Open Sunrise to Sunset.  Cost – Free.

2.5 miles of paved and non-paved trails through 90 acres of pine flatwoods and wetlands.


Riverbend Park:

9060 Indiantown Road, Jupiter.  Open Sunrise to Sunset.  Cost – Free.

15 miles of nature trails that offers a variety of flora fauna and wildlife.  The trail system is mostly flat unpaved hard pack with occasional boardwalks.


South County Regional Park, Daggerwing Nature Center:

11200 Park Access Road, Boca Raton.  Open Sunrise to Sunset.  Cost – Free.

Two 1/3 mile boardwalk trails through natural swampland.  The trails are wheelchair and stroller accessible and there are benches on the boardwalk.



Tendonitis or Tendonosis

So has the outside or lateral region of your elbow started to hurt or maybe the front of your knee has a jabbing pain after going up and down stairs frequently, maybe squatting repeatedly? You tried to give it a week but it still hasn’t gone away, you should see the doctor for a diagnosis before it gets progressively worse, however, stay proactive with your treatment and knowledge before and after the doctor visit.

When we hear that we have an overuse injury or that we need to rest and be patient, that is when an individual does not live up to their “patient” status. There are two similar conditions that are treated in different fashions but should not be taken lightly or disregarded.


This condition is caused by an overuse (i.e. lateral epicondylitis, street name: tennis elbow) of a muscle or muscle groups, leading to inflammation of the connecting tendon. When the tendons become strained and their function is impaired they will become irritated and inflamed. Signs of inflammation are pain, redness, increased temperature in the region and possible swelling.


Sometimes mistaken for tendonitis, tendonosis is associated more with the degeneration of the tendons or a trauma/ contusion from the past. The degeneration of collagen, in the tendon, causes fibrous tissue to become soft and jelly like. Function then suffers as a result inadequate strength. Unlike tendonitis, this condition is sometimes difficult to detect because it is not always accompanied by inflammation.

Treatments of these conditions are different. For tendonitis, it is important to give the affected area adequate time to rest. This means putting a freeze on the physical activity that may have caused the problem. Ice should be applied at the first hint of an issue, possibly with assistance from an anti-inflammatory. Next step, see the doctor. On the other hand, for tendonosis, try to avoid the movements that cause excessive pain but do try to use and move the muscles with the affected tendon. The usage will help reduce the degeneration of collagen. Massage the area with ice or using ice packs can help ease the pain.

In any case do not ignore the pain. By physically exerting damaged tendons can further aggravate symptoms. Always seek a doctor’s advice for proper treatment and diagnosis.

By: Rocco Ferraiolo PTA, NASM certified, SPARQ certified

Little League Elbow

Recently orthopedists and physical therapists have seen an increasing number of younger athletes with elbow pain. As a nation we are becoming more involved in athletics at an earlier age. Increased single-sport participation with year-round training, higher intensities at young ages, and longer competitive seasons are contributing factors to the increased injury rates seen in pediatric athletes. These injuries can occur in multiple compartments of the elbow including the medial, lateral and posterior compartments.

Little league elbow syndrome entails injuries to the medial compartment of the elbow. During a throwing motion there is a stress placed on the inside of the elbow during the cocking or “wind up phase” and “deceleration phase” after release of the ball. This stress usually causes micro trauma to the inside of the elbow that can result in injuries. Injuries usually are precipitated by pain in the medial elbow, decreased throwing effectiveness and decreased throwing distance.

In the medial compartment of the elbow, 3 types of injuries are usually seen with repetitive throwing.  One, stress fractures to the medial epicondyle with possible damage to the epiphysis can lead to delayed or accelerated growth to this area of the elbow. This is usually found in athletes less than 13 years of age with skeletal systems that have yet to mature. A second type of injury is acute avulsion fractures that usually come from one traumatic event. They usually are identified by point tenderness at the medial epicondyle and the inability to completely straighten the elbow.  Lastly, there can be soft tissue injuries to the ulnar collateral ligament from repetitive stress of throwing. These repeated events usually lead to instability where the athlete is unable to sustain the forces placed on the elbow during throwing. These injuries usually occur in teenagers who have fully developed skeletal systems placing most of the stress on soft tissue.

Regardless of the type of injury, when one of these younger athletes are experiencing medial elbow pain, immediate action needs to be taken. Coaches, parents, and health professionals need to educate the athlete to refrain from all throwing activity to avoid serious injury to the body that would require surgery or delays in the maturation of the athlete’s body. X-rays along with a full evaluation by a medical doctor should be performed to ensure a prosperous future for the athlete.

Written by: Chris Athos, MPT COMT

Training for an Obstacle Mud Run

One of the most popular activities that continue to grow among weekend warriors and athletes of all varieties is obstacle mud runs. The names that you will hear are Spartan Race, Warrior Dash, Tough Mudder and Muddy Buddy, all of which are similar. They all require participants to show both strength and endurance to negociate obstalces, which are spread out over the course. Courses range form 3-12 miles to days.. Anaerobic athletes will excel at the obstacles and the aerobic athlete can complete the distance but both may struggle with the opposite. Here are some strategies to maybe help excel at your mud run vs. just surviving.

1. Train as specific to the race

Expected the unexpected! Athletes will never know what kind of obstacle lies around the next turn. There is a good chance that it will be a pushing or pulling activity after a half-mile to a two mile run. So when training for an event, vary the mileage and challenges. For example, run for 1 mile and then stop and perform 20 push-ups, 10 pull-ups, bear crawls (20-40 yards) or 15 burpees, then repeat that sequence for the remainder of your training session. Time your circuits or intervals and remember never sacrafice quality for quantity.

2.  Work up to Race Distance

Anyone who has trained for a distance event knows the importance of the progression for the specified distance. A three mile obstacle run is more time efficient to train for where the treacherous 13 mile mudder will take more time. Just like the challenges above but now the distance, the repetitions, difficulty of obstacles or time of your intervals will have to be increased. So now, the distance for running can be about 2 miles followed by rope climbs or farmer carries with a 400 meter (approximately ¼ mile) backpedal.

3. Don’t forget the distance

High-intensity, anaerobic athletes can lack the aerobic base for the distance. Long and slow runs should be incorporated into their training for the “over and over” effort that will be used. The endurance runner needs to add more intervals.

4. Get Dirty

Whether an athlete is covered in mud or running through freezing cold water, these races are known for making athletes uncomfortable. The better the race situation can be duplicated, the better the training. Jump in the pool fully clothed for some activities then climb out of the pool into bear or tiger crawls. Have someone hose you down or throw buckets of dirty/cold water on you while you perform tire flips or push-ups.

Your average athlete cannot just show up and hope to complete these races. Proper training should be performed as well as acclimation to uncontrollable events (i.e. wet clothes, being covered in mud). The proper training with as many variables will also help your mental toughness, which is required for these races. During the recovery, post-training, take an ice cold shower (see how long you can stay under the water).

By: Rocco Ferraiolo PTA, NASM certified, SPARQ certified