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How to Protect and Strengthen the Knee (and Foot)

How to Protect and Strengthen the Knee (and Foot)

Knee and foot injuries are common for people of all ages. They tend to occur during day-to-day activities such as walking, climbing stairs and running. In most cases, people tend to ignore the pain and just 'carry on', leading to more injury and pain. Rest and medication help reduce pain. However, the residual effects of knee and foot injuries (loss of strength and mobility) are best treated with physical therapy.

The knee joint is a complex, weight-bearing structure and the ankle, in particular, is protected by ligaments on the inside, outside and the front. Sudden twisting movements can lead to tendon and ligament tears, and in some cases, fractures. Also, a myriad of injuries including strains, sprains, plantar fasciitis, fractures, meniscal tears and ligament tears can lead to impaired mobility and severe pain. These conditions can make it difficult, if not impossible for the individual to walk until the injury heals.

Depending on the severity of the injury, surgery may be required. With or without surgery, physical therapy plays a vital role in recovery from knee and ankle injuries.

Time to Heal

Due to the sensitive, weight-bearing nature of the hip and knee joint, it is critical to allow sufficient time for the healing process. Once healing is complete, physical therapy can begin.

The healing process typically results in

-    Weaker muscles
-    Tighter ligaments
-    Reduced blood flow
-    Scar tissue formation
-    Joint restrictions

Pain and discomfort is experienced during movement and weight bearing.

Physical therapy will increase strength and mobility to prepare the knee and ankle for active, daily life. Exercises and techniques used by physical therapists include, but are not limited to:

-    Therapeutic exercises to strengthen the muscles in the hip, knee, and ankle
-    Manual techniques to increase mobility of underlying joints, improve blood circulation and break down scar tissue (when indicated)
-    Balance exercises to improve posture and biomechanics while sitting, standing and walking
-    Weight control, as needed, to reduce weight bearing stress on the hip, knee and ankle
-    Identification of appropriate assistive devices and footwear to facilitate mobility.

Time to Take a Stand!

Physical therapists use sound, scientifically proven principles of human anatomy, physiology, movement and psychology to help patients lead healthy, pain-free lives.

The therapist will conduct an initial evaluation followed by several progress notes to document progress over time. A comprehensive analysis establishes a 'clinical baseline' and identifies muscle imbalances, causes of pain and joint alignments. This is the foundation for short and long-term goals designed to help individuals recover completely. In fact, physical therapy can address every aspect of recovery including:
-    Gait
-    Biomechanical aspects like spine/hip/foot alignments
-    Lower back strength
-    Pain levels
-    Functional capability

As your physical therapist, we will get you back on your feet as soon as possible. Call us today to learn more. You deserve the right kind of care. It's time to take a stand. Let's do it together. We are here to help.

Specialized Physical Therapy, LLC 1919 Greentree Road Suite B Cherry Hill NewJersey 08003 Phone: 856-424-0993

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How to Deal with Chronic Joint and Muscle Pain

All of us have experienced pain and discomfort in the muscles and joints at some point, especially with age. In most cases, the use of over the counter medications, hot/cold packs and rest help resolve the problem.
Muscle and joint pain can be extremely troublesome to say the least. Some cases start with mild discomfort while others can become so severe that simple things like sitting, standing and walking become extremely painful, limiting day to day activities.

Although physical therapy can improve any condition involving muscle and joint pain, certain conditions make ongoing ongoing physical therapy a necessity. These include:

- Osteoarthritis
- Rheumatoid arthritis
- Peripheral neuropathy and neuropathic pain
- Fibromyalgia

Step by Step Improvement

For people suffering from chronic pain and discomfort, physical therapy improves quality of life. Physical therapists design treatment plans to increase range of motion, flexibility and strength, while reducing pain in the muscles and joints.

Relieving pain in the muscles and joints is the primary goal. A careful designed exercise program helps improve blood flow to the affected areas.

The first thing a physical therapist will do is to help you understand your limits, so you don't hurt yourself by doing too much too soon. Physical therapists using a variety of procedures and modalities to relieve chronic pain in the muscles and the joints. This also helps patients to safely increase strength and mobility while reducing pain.

Procedures include therapeutic exercise, manual therapy and neuromuscular reeducation. Modalities include electrical stimulation, ultrasound and hot / cold therapy. The therapist will use his / her clinical judgement to identify, design and implement the right protocol based on the needs of the patient.

A Scientific, Proven Solution

Physical therapy is a proven solution to chronic muscle and joint problems. This condition can affect individuals of all ages, and has the potential to impact every aspect of life.

Patients require emotional and physical support since the condition can become severely limiting in nature. Patients may experience anxiety, depression, and potential disability as the condition advances.

The good news is - we can teach you what to do, and we are here to help you. Physical therapists dedicate their lives to helping individuals get better, stronger and live life without pain. We want you to experience the full benefits of strength and mobility. We strive to achieve life changing improvements in all our clients. Nothing makes us happier. We want to see that smile on your face when you walk out of our clinic. It's why we do what we do.

Physical therapy can empower patients with chronic joint/muscle pain and improve the quality of life. Let us show you what we can do or you. To get started, call us today to discover how we can help you deal with chronic joint and muscle pain.

Specialized Physical Therapy, LLC 1919 Greentree Road Suite B Cherry Hill NewJersey 08003 Phone: 856-424-0993

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What Do Insects Do in Winter? Some Come Inside Your Home . . .

Insects are naturally cold-blooded creatures and in order to survive the cold winters in New Jersey and Pennsylvania, they must find a way to adapt. Some bugs such as the monarch butterfly simply migrate before it gets too cold, while other insects overwinter in your home. But what exactly does overwinter mean?

To escape the winter, certain types of bugs seek the comfort of your home in insulated areas. Overwintering bugs will traditionally seek south-facing walls since they offer the greatest warmth due to sun radiation during the winter and will seek to "shutdown" in order to survive the coldest months. The bugs will also not eat, grow, or reproduce, which is why they are generally not considered an infestation.

Although the living space inside your home is nice and cozy, entering your house is actually an accident for these bugs since they typically enter your home through imperfections in your home's exterior. Once they are overwintering, often times they can wake up prematurely when it is too cold to go back outside which is when you typically see the bugs as they are exploring your home.

Some insects that have been known to overwinter are: Stink Bugs Paper Wasp Queens Elm Leaf and Lady Beetles Box Elder Bugs Leaf Footed Bugs In order to prevent the bugs from entering your home, listed below are some good preventative measures to keep overwintering bugs outside.

Caulk or seal all openings near doors and windows; around pipes, outlets, and vents.

Caulk any splits in siding and cracks in foundations and walls.

Seal cracks or openings under eaves and along roofs.

In addition to the preventative measures listed above, proactive pesticide applications by Cooper Pest Solutions can help to eliminate the invasion before it starts."

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Benefits of Physical Therapy for Kids

Having a physical therapist as a part of the team providing treatment to children is extremely valuable. Their input into the care of the child provides valuable insights into what the long term outlooks are, and how parents themselves can work with their children to help in treatment and rehabilitation. Physical therapists provide a roadmap that helps parents to promote their child's independence along with enhancing their motor ability and function. This overall care allows the parents to be actively involved, with the additional benefit of increasing the confidence of the child to try more activities. Parents also more assured that the care provided is improving their child's overall health.

What are the goals of pediatric physical therapists?

They are committed to ensuring the holistic development of the child by improving motor function and coordination, increasing confidence and promoting independence on the part of the child. They collaborate with parents, physicians, other healthcare providers and child-centric organizations to ensure that the care and treatment provided is consistently delivered to the child.

After all, every child deserves to be independent and have the ability to pursue and achieve their dreams. Pediatric physical therapists help achieve that goal.

Let Us Help You Take Care of Your Child

A pediatric physical therapist can make a substantial contribution to the development of a child. Their thoughtful insights and valuable input in shaping a child's care may be under-recognized by the community at large, but healthcare professionals have realized their importance and now actively involve them in their multi-disciplinary teams tasked with looking after children.
Call us today and we will show you what physical therapy can do for you and your children.
Specialized Physical Therapy, LLC
Our Princeton location: 1000 Herrontown Rd, Building 2, Floor 2, Princeton, NJ 08540

P: 609-497-1000

F: 609-497-1005

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Bell's Palsy - What it is and What You Can Do

The 43 Muscles in the Face

Did you know the face has 43 muscles? These are tiny muscles that control facial expressions like smiling, smirking and frowning. In fact, there is a condition called Bell's palsy that affects facial muscles, as a direct result of nerve damage.

The dysfunction affects a primary cranial nerve that controls facial muscles, resulting in temporary paralysis for some, but others experience lingering effects that can last several years.

Causes include a brain tumor, stroke or Lyme disease. Other causes include viral infections like herpes simplex 1, chickenpox, German measles and mononucleosis. In some patients, no definitive cause can be found contributing to Bell's palsy.

Patient's may experience difficulty blinking and closing the eyes, raising their eyebrows, and smiling and frowning. This can also affect taste. Individuals may also experience balance problems, tingling of the face, memory problems and weak muscles. Bell's palsy can appear as a single condition or as part of a larger neurological dysfunction.

Some patients achieve a spontaneous recovery and regain near-normal function. Patients may have lingering problems such as the inability to close one or both eyes, necessitating protection to prevent the eye(s) from drying out. Hearing loss is also common. Men and women are affected, and those with diabetes or upper respiratory ailments face additional risk.

Let's Face This Together

Various physical therapy methods can be used to help patients with Bell's palsy. It's essential to begin physical therapy as soon as possible. Options include:

Acupuncture/Dry Needling – Used to stimulate specific nerve and muscle sets to maintain facial tone, ease pain, and release stress. Reduces the potential for further neurological damage.

Electrical Stimulation – Stimulation of muscle and nerve groups to maintain tone and improve function. Reduces muscle 'wasting' or atrophy.

Facial Muscle Exercise – Mild facial exercises maintain facial tone and reduce muscle weakness. Activities are tailored to each individual. Improves coordination and maintains 'muscle memory'.

Clinical Pilates – A loss of balance and coordination can be treated with a specialized exercise program that focuses on small movements to build strength and regain balance.

Heat Therapy – Supervised application of hot packs helps circulation around nerves and muscles.

Biofeedback – Helps individuals regain movement control by identifying and isolating the pertinent muscles. Helps increase patient awareness of facial muscles.

Time to Face the World

The face is the most recognizable part of the human anatomy.

It provides others with insight into our feelings. The muscles of the face allow verbal and non-verbal communication.

The loss of control over facial muscles (or any injury to the face) can be extremely intimidating, but we are here to help. A physical therapist is a specialist in movement control for all joints and muscles in the body. We can help you regain function and control. We can also help prevent potential complications.

If you suspect you may be suffering from Bell's palsy or know someone who is, don't hesitate to call us. We treat a wide variety of diseases, syndromes and conditions to alleviate pain and restore functionality. The sooner you begin, the better. Call us today, and together, we'll help you face the world.

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Why The Shop Local Movement Matters

Greenleaf Painters is in its 10th year of operating as a successful, local and independent business. Serving the community around us is our thing. When local businesses gathered together to create the Independent Business Alliance (IBA) last year— part of the Princeton Regional Chamber of Commerce—we got super excited!

IBA is part of a larger, national movement to “Shop Local.”

Why does shopping local matter? Check this out from IBA’s website:

—For every $100 spent, a locally-owned independent business generates $68 in local economic activity. 

Each dollar you spend at independent businesses returns three times more money to your local economy than one spent on the Internet.

—If the people of an average American city were to shift 10% of their spending to local, independent businesses, it would bring an additional $235 million per year to the community’s economy.


Greenleaf’s roots are in the West Windsor / Princeton Junction community, where owner Jonathan Shenk lives with his wife and son. Word of mouth by people we’ve done work for in the region (and online) has been the fuel for our growth. This summer, we have been able to employ 20 people, including our managers and local craftsmen. All of these employees are local and participate in the local economy.

In addition, we give business to painting suppliers locally, as well as other contractors in the area. These are also employers and participants in the local economy. So you see how it can work!

As a member of IBA, we have had the pleasure of getting to know many Independent business owners. We work directly with some and simply commend others because of their values and work ethic. A small handful of these include:

— Rees Powell Custom Floors, owned by Rees Powell

— Real Possibilities, owned by Rose Fisher,

— Asenka Interactive, owned by Brian Hasenkamp,

—StimulusBrand, owned by Tom McManimon,

Shenk has been on the Ambassador committee of the Princeton Chamber of Commerce since 2013 and is now on the IBA Regional Planning Committee which organizes events. Shenk’s participation in the Chamber has helped to increase awareness of our presence in the community and thus accelerate our growth. We have a lot of faith that the IBA will contribute to this kind of growth for others–and by extension the entire region.

Shout out to Local Businesses! 

If you are a local business and are interested in joining in, the next IBA event will be “10 Best Practices for Growing Your Business,” held September 25, 7:30 AM TO 9:30 AM, with Jeff Dorman of JDA International Leadership. Visit for details and registration.

Why The Shop Local Movement Matters

Greenleaf Painters is in its 10th year of operating as a successful, local and independent business. Serving the community around us is our thing. When local businesses gathered together to create the Independent Business Alliance (IBA) last year— part of the Princeton Regional Chamber of Commerce—we got super excited!

IBA is part of a larger, national movement to “Shop Local.”

Why does shopping local matter? Check this out from IBA’s website:

—For every $100 spent, a locally-owned independent business generates $68 in local economic activity. 

Each dollar you spend at independent businesses returns three times more money to your local economy than one spent on the Internet.

—If the people of an average American city were to shift 10% of their spending to local, independent businesses, it would bring an additional $235 million per year to the community’s economy.


Greenleaf’s roots are in the West Windsor / Princeton Junction community, where owner Jonathan Shenk lives with his wife and son. Word of mouth by people we’ve done work for in the region (and online) has been the fuel for our growth. This summer, we have been able to employ 20 people, including our managers and local craftsmen. All of these employees are local and participate in the local economy.

In addition, we give business to painting suppliers locally, as well as other contractors in the area. These are also employers and participants in the local economy. So you see how it can work!

As a member of IBA, we have had the pleasure of getting to know many Independent business owners. We work directly with some and simply commend others because of their values and work ethic. A small handful of these include:

— Rees Powell Custom Floors, owned by Rees Powell

— Real Possibilities, owned by Rose Fisher,

— Asenka Interactive, owned by Brian Hasenkamp,

—StimulusBrand, owned by Tom McManimon,

Shenk has been on the Ambassador committee of the Princeton Chamber of Commerce since 2013 and is now on the IBA Regional Planning Committee which organizes events. Shenk’s participation in the Chamber has helped to increase awareness of our presence in the community and thus accelerate our growth. We have a lot of faith that the IBA will contribute to this kind of growth for others–and by extension the entire region.

Shout out to Local Businesses! 

If you are a local business and are interested in joining in, the next IBA event will be “10 Best Practices for Growing Your Business,” held September 25, 7:30 AM TO 9:30 AM, with Jeff Dorman of JDA International Leadership. Visit for details and registration.

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Why You Shouldn't Over Do It . . .

Why You Shouldn't Overdo It...

We have all heard the phrase 'No pain, no gain'. When it comes to the human body, discomfort is acceptable, but pain is not. In fact, there is a threshold of pain tolerance that is unique to each individual.

It's important to understand and respect this limit. When the body is pushed past this 'breaking point', injuries and long-term damage can occur. On the other hand, the right approach towards exercise, nutrition and rest can actually increase this limit at any age. When you exercise in a gradual and progressive manner under the supervision of a physical therapist, the body becomes stronger, and injuries are avoided.

Overtraining syndrome occurs when an individual participates in new activities that the body is unaccustomed to. It also occurs when an individual does the same actions for a prolonged period, or in the absence of warm up and stretching routines. Sometimes, a specific area of the body hurts, and the individual will notice impairments in movement, coordination and performance. Athletes with overtraining injuries may display fatigue, disturbances in sleep patterns and appetite suppression in severe cases.

The Physical Therapy Arsenal

If left unchecked, overtraining can lead to long-term pain and disability. Physical therapy goes a long way in the prevention of overtraining. A variety of physical therapy techniques can be used to evaluate, prevent and treat overtraining injuries. These include:

Therapeutic Massage – Relaxation of soft tissue and increased blood circulation to affected areas is a great way to relieve pain and inflammation associated with overtraining.

Clinical Pilates – The specialized exercise programs of Clinical Pilates help improve flexibility and build core and pelvic floor strength.

Aquatic Therapy–The buoyancy of water provides gentle support, allowing patients to perform movements that might not otherwise be possible. The soothing effect of water allows the body to gain strength, coordination and flexibility in a gradual manner.

Dry Needling – Similar to acupuncture, dry needling is used to release muscle tension, alleviate pain and stimulate the body's natural healing abilities.

Manual Manipulation and Mobilization – Using a combination of specialized active and passive techniques to facilitate motion between joints, a physical therapist can increase joint mobility and facilitate a return to full function.

When Less is More

Overtraining injuries can happen suddenly or develop over time. With the proper precautions and supervision from a physical therapist, you can enjoy an active lifestyle without pain and discomfort. Little things go a long way in the prevention of overtraining syndrome.

Simple ways to prevent overtraining include gradual, progressive exercise, appropriate footwear and adequate warm up and stretching. A physical therapist will teach you to use the right technique, range of motion and breathing when you exercise.

The therapist will also build a training program with the appropriate degree of intensity and frequency. The goal is to challenge, but not overwhelm you. When you remain within your 'threshold', expect to significant improvements in strength, flexibility and mobility over a period.

If you or someone you know has complained of pain or discomfort after swimming, cycling, running or any activity, give us a call. We will look for signs of overtraining and take action accordingly. We are committed to helping you live a happy and healthy lifestyle. We will make sure you don't overdo it, and we will teach you how to work smart and not just work hard. Sometimes, less is more.

Specialized Physical Therapy, LLC 1919 Greentree Road Suite B Cherry Hill NewJersey 08003 Phone: 856-424-0993

Yes! Physical Therapy Can Help Urinary Incontinence

Incontinence is an embarrassing condition that affects men, women and children of all ages. A common symptom is the loss of bladder control when coughing, sneezing, lifting and laughing.

Incontinence can be temporary or persistent. Temporary loss of bladder control is related to diet, alcohol, caffeine and prescription medications. Underlying medical conditions such as urinary tract infections and chronic constipation also play a role.

Persistent loss of bladder control may be related to pregnancy, age-related changes in the bladder, menopause and enlarged prostate. Disorders of the brain and spinal cord like stroke and Parkinson's disease can also cause loss of bladder control.

This has vast social implications for patients, who turn to adult diapers, medications and even surgical interventions.

Getting Back the 'Mind-Muscle' Link

Incontinence can be treated effectively with a variety of physical therapy techniques including, but not limited to:

Kegel Exercises – This involves controlled contractions of the pelvic floor muscles, using a hold and release pattern for a designated number of repetitions and sets. The frequency and intensity is gradually increased over time.

Clinical Pilates – These specialized exercises help strengthen the core and pelvic floor muscles.

Electrical Stimulation – The use of mild electrical currents to stimulate the pelvic floor muscles tends to mimic the 'hold and relax' pattern of Kegel exercises.

Biofeedback – A technique used to build the 'mind-body' connection between the brain and the muscles of the pelvic floor. This helps patients identify, contract and control specific muscles surrounding the urinary tract.

Your physical therapist may use a combination of techniques, and may design a home exercise program to help you achieve results as quickly as possible.

Regaining Control of your Life..

Incontinence can take an emotional toll on a patient. Social implications include feeling of guilt, shame, and depression in some cases. Family members and physical therapists must work together to support and help the patient prepare for 'accidents' by planning ahead prior to outdoor activities.

Incontinence is more prevelent than most people realize. It can be treated with a combination of traditional medicine and physical therapy. Mental health counselling may be required in some cases.

Physical therapy, in particular, plays an important role in the strengthening and retraining of the pelvic floor muscles. Therapy can also strengthen the lower back and realign posture to dramatically improve the quality of life.

If you or someone you know is suffering from incontinence, schedule a consult with us. Physical therapy will help you regain control of your life in more ways than one.

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A Solid Musical Foundation Paves the Way for Many Musical Successes

When I was younger, studying classical music, I really had to put in the time. Three hours a day is not even nice - you have to put in six.

--Alicia Keys

Earlier this year, I was watching television and came across the presentation of the Gershwin Prize, honoring Billy Joel.  The Gershwin Prize is a newly established award by the United States Library of Congress, honoring a songwriter who has made significant contributions to the popular American song.  ( Previous honorees have included Carole King, Paul Simon, and Stevie Wonder. 


The award is aptly named for George and Ira Gershwin, American songwriters of the Tin Pan Alley era, whose songs such as "Embraceable You" and "I Got Rhythm" are still well-known today. 


The award is given during a concert in Washington D.C. each year featuring the songs of the honoree, often performed by other well-known artists.  The concert honoring Billy Joel was a real treat—the band tightly wove wonderful arrangements of the well-known hits, the singers executed the vocals beautifully.  The highlight of the concert was when Billy Joel himself came to the stage and played several numbers with the group.  I was so impressed with his technical prowess at the piano and his musically sensitivity to the songs.  After the concert, the 2013 concert honoring Carole King was aire, and I was glued to the television.  Again, I was moved and inspired by Carole King's effortless piano technique and ease at the instrument.  An added bonus was the pleasure of hearing so many familiar songs from the 60s-80s.


As one does these days, I began researching these artists online.  I learned that both Billy Joel and Carole King had an extensive background in classical music.  Joel comes from a musical family—his half brother is a classical conductor in Europe—and studied classical piano from an early age.  He also is a composer of classical music, and released a classical album in 2001.  Likewise, Carole King studied the piano since age four and had early experiences in conducting.


As I enjoyed these concerts, I couldn't help but think about my own students.  As I work with young people, I have no idea what the future holds for them.  They may become a professional musician in a variety of musical styles or genres, or they may be  professionals in another field, enjoying music for life.  Regardless of my students' future career path, I found myself wanting to give them the following messages:


1.     Work to be the best musician you can be in all areas—don't limit yourself!  I doubt that when Billy Joel was a young piano student, studying Mozart and Beethoven, that he imagined himself playing "Piano Man" every night.  Maybe he did, we don't know!  However, I do know that he worked to master his instrument.  He likely spent many hours at the piano practicing scales and arpeggios—his technical facility at the piano proves it.  He is also deeply familiar with a wide variety of styles and genres.  If he had limited himself as a youngster, determined to focus only on one certain style, he likely wouldn't be the amazing musician we know him to be today. 

2.     Challenge yourself.  We all have areas of music that come more easily than others.  Some students have wonderful ears, but need to work harder to read music effortlessly.  Others are the exact opposite.  Some students compose and improvise readily, while others shy away from these activities.  Some students transpose without giving it much thought, while others have to work much harder at it.  Cultivate your strengths, but don't neglect a focus on the musical elements that are your weakness.  Commit to a steady, diligent practice in these areas, set regular goals for yourself and hold yourself accountable.

3.     Explore ALL musical styles and genres.  We all have our preferences for certain styles of music.  Some prefer major pieces to minor ones, or vice versa; others may be drawn to music of the Romantic Period, popular styles, or Bach Inventions.  It is common to want to focus on the styles of music that are our favorites.  Again, we can learn from Billy Joel.  As a young musician, he immersed himself in a variety of musical styles.  I want my students to immerse themselves in all kinds of music.  Listen to classical piano music, symphonies, opera, and chamber music, as well as popular music—both current and past—folk music, and any genre you can! This vast musical knowledge has certainly helped Billy Joel throughout his career, and it will do the same for every piano student. 


So, to today's students I say: listen to every type of music you can get your hands on—Beethoven, opera, and Billy Joel; focus on your weaknesses and challenge yourself to improve on the areas of musical skills that are hard for you.  In addition, always strive to be the best musician that you can be to set yourself up well for a lifetime of enjoying and experiencing the transformative power of music!



Rebecca Mergen Pennington has been on the faculty of The New School for Music Study since 2007, and currently serves as the Administrative Director.  Dr. Pennington holds a doctorate from the University of Kansas, where she studied with Jack Winerock.  Dr. Pennington performs as a solo and collaborative artist and enjoys teaching students of all ages and levels.  

 The New School for Music Study is one of the country's leading centers in piano education and provides a variety of programs and classes for piano students. Our school is conveniently located in the Princeton area of central New Jersey, offering piano lessons for students from Princeton, Plainsboro, East Windsor, West Windsor, Kingston and other surrounding communities.


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Drive Revenue & Profitability by Measuring ROMI

On Friday, June 12th, Rick Verbanas, of Creative Marketing Alliance, presented “Driving Revenue and Profitability by Measuring Return on Marketing Investment.” How do you know if your customers are engaging with or buying in on your marketing efforts if you don’t track them. As we learned from Rick, knowing something about your ROMI (Return on Marketing Investment) is better than nothing at all. Below are some of the highlights from the meeting:

  • ROMI demands marketing and sales team alignment. The two should meet regularly to review current/upcoming efforts and sales leads. The result is a win-win: improved marketing performance that delivers more leads.
  • ROMI allows you to identify tactics that are under-performing so you improve or drop, and then reallocate budget to programs that are delivering results. 
  • Design ROMI metrics that speak directly to the bottom line; avoid soft metrics (Facebook "likes") that have difficulty defining impact on financial performance. 
  • Focus on metrics that demonstrate change and growth in revenue and profitability, e.g. raw leads, Sales Qualified Leads (SQL) & Marketing Qualified Leads (MQL), conversion rate, time-to-conversion rate, email marketing open rates and click-through rates, website visits and conversions, website form completions, response to mass/direct media. 
  • Develop an actionable barometer of brand perception. One way to do that is through online pre- and post-marketing surveys. 
  • Remember that the objective of ROMI is to measurement of economic value, but the goal is improvement -- of the company revenue and quality and effectiveness of your marketing programs. 
Learn more about CMA and how you can work with them on your marketing efforts at Follow CMA on Twitter at @CMAmarketing and follow Rick at @RickVerbanas

Never Ignore Hip and Thigh Pain (Here's Why)

The hip is an important weight bearing joint in the human body. Repetitive stress to the femur (thigh bone) over time can lead to the formation of cracks in the hip joint, which is the junction of the pelvis and the femur. For most individuals, simple cracks can heal over time without the need for surgical intervention. For others, it may escalate into a fracture.

A fracture can occur in one of three possible locations – at the top near where the femur joins the pelvis, in the middle of the thigh bone, or the bottom near the knee joint. The femur reaches a breaking with a fall (a particular risk for seniors), vehicle accident, or during competitive sports.

Regardless of the location of the fracture, an individual will experience extreme pain and movement restriction. Tingling or numbness in the area may accompany the pain, along with swelling and the inability to walk, stand or tolerate pressure on the leg. If left untreated, complications may include uncontrolled bleeding, blot clots, infection and pneumonia.

The femur is a major weight-bearing bone and the rate at which it heals is dependent on factors such as age and underlying medical conditions such as diabetes. Full recovery can take approximately 12 weeks to several months and may require surgical intervention.

Get Treatment Immediately... Time is of the Essence

Thomas Edison once said, "There is time for everything". We live in a very busy world, and it's easy to 'ignore the pain' and just carry on. But as your physical therapists, we can tell you that it's important to make time for a physical therapy evaluation if you have any pain or discomfort.

If you have hip pain, it's important to rule out a fracture in the hip joint and seek physical therapy right away. This will protect your balance, ability to walk unhindered, eliminate pain and improve bone strength.

Depending upon the severity of the injury and the stage of recovery, physical therapy may involve a combination of exercise, stretching, balance training and pain relief modalities.

When the correct movement pattern is reinforced in the muscles and joints, the process of recovery begins. This is called 'neuromuscular re-education' and includes a variety of advanced techniques to speed up recovery.

The use of water as a medium to reduce pain and swelling, increase strength and improve mobility is also helpful. Massage under the guidance of the physical therapist also helps relieve pain and improve mobility. Several exercise programs can be prescribed to build core and pelvic floor strength to aid in balance and prevent falls. In some cases, the therapist may recommend mobility devices such as crutches and canes.

Hip Hip Hurray!

Let's face it - no one wants to be in crutches or have to struggle to walk. Hip pain can impact every aspect of life, from getting out of bed in the morning to driving and walking. The good news is that physical therapy has two significant benefits for anyone with hip pain:

- Improve healing so you have less pain and can get back to doing the things you enjoy doing.

- Prevent further damage to the hop joint and reduce your risk of falls.

The benefit of physical therapy extends beyond strength improvement in the hip joint and pelvic muscles. This can also help reduce or treat low back pain, improve posture and boost the quality of life.

Hip Hip Hurray to that!

If you or someone you know is experiencing hip discomfort, please have them contact our office. You can also call our office and request us to call them on your behalf, and we will reach out to them. We are committed to serving your needs and improve the health and well-being of everyone in our community. Thank you for the opportunity to assist you.

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Understand Your Eyeglass Prescription

How To Read Your Prescription

What does OD and OS Mean? The first step to understanding your eyeglass prescription is knowing what "OD" and "OS" mean. They are abbreviations for Oculus Dexter and Oculus Sinister, which are Latin terms for right eye and left eye. Your eyeglass prescription also may have a column labeled "OU." This is the abbreviation for the Latin term OculusUterque, which means "both eyes."

Sphere (SPH). This indicates the amount of lens power, measured in diopters (D), prescribed to correct nearsightedness or farsightedness.

If the number appearing under this heading has a minus sign (-), you are nearsighted; if the number has a plus sign (+) or is not preceded by a plus sign or a minus sign, you are farsighted.

The term "sphere" means that the correction for nearsightedness or farsightedness is "spherical," or equal in all meridians of the eye.

Imagine cutting a slice off a glass ball. The slice would be shaped like a dome, with the same curve in all meridians of the dome. The original shape from which you cut the slice was a ball or "sphere", which gives this component of a lens prescription its name.

Cylinder (CYL). This indicates the amount of lens power for astigmatism. If nothing appears in this column, you have no astigmatism. Imagine cutting a slice from a glass rod, along its length. The slice would resemble a long "domed" glass ruler. The original shape from which you cut the slice was a rod or "cylinder", which gives this component of a lens prescription its name.

The number in the cylinder column is the "power" of the cylinder. It may be preceded with a minus sign (for the correction of nearsighted astigmatism) or a plus sign (for farsighted astigmatism). Cylinder power always follows sphere power in an eyeglass prescription.

Meridians of the eye are determined by superimposing a protractor scale on the eye's front surface. The 90-degree meridian is the vertical meridian of the eye, and the 180-degree meridian is the horizontal meridian. The cylinder "axis" of a prescription specifies in degrees how the cylinder component should be oriented in front of the eye.

Multifocal Add. This is the magnifying power "added" to the bottom part of multifocal lenses to aid near vision. The number appearing in this section of the prescription is always a "plus" power, even if it is not preceded by a plus sign. Generally it will range from +0.75 to +3.00 D and will be the same power for both eyes. Adds are normally prescribed for lens wearers over age 40 but (in special cases) they may be prescribed for younger wearers as well.

An Example of an Eyeglass Prescription

OD -2.00 SPH +2.00 add OS -1.00 -0.50 x 180 +2.00 add

In this case, the eye doctor has prescribed -2.00 D sphere for the correction of myopia in the right eye (OD). There is no astigmatism correction for this eye, so no cylinder power or axis is noted. This doctor has elected to add "SPH," to confirm the right eye is being prescribed only spherical power. (Some doctors will add "DS" for "diopters sphere;" others will leave this area blank.)

The left eye (OS) is being prescribed -1.00 D sphere for myopia, combined with -0.50 D cylinder for the correction of astigmatism. The cylinder power has its axis at the 180 meridian. Both eyes are being prescribed an "add power" of +2.00 D to aid near vision.

An Eyeglass Prescription Is Not a Contact Lens Prescription

In addition to the information in an eyeglass prescription, a contact lens prescription must specify the base (central) curve of the back surface of the contact lens, the lens diameter, and the specific manufacturer and brand name of the lens. In stronger prescriptions, the power of the prescription can even be different for contacts than for glasses.

An accurate contact lens prescription can be written only after a contact lens fitting has been performed and the prescribing doctor has evaluated your eyes' response to the lenses and to contact lens wear in general.

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Pot or plot? 'Right-size' Plant Picks for Gardening Success

(BPT) - Have you ever walked into a room that was so full of over-sized furniture it made an already small space feel miniscule and unusable? Or tricked your tummy into being satisfied with less food by using a small plate to make a modest portion look huge? Scale makes a decided difference in many aspects of life, and gardening is no different.

Whether you’re gardening in containers or have a big plot in your backyard, right-sizing your plant picks to coincide with your available garden space can yield a more productive and pleasurable gardening experience. More than a third of all American households now grow some type of food themselves, making food gardening the third largest yard activity after landscaping and lawn care, the National Gardening Survey shows.

Whether you aim to trim grocery bills by growing your own produce, add your own fresh herbs to your summer cooking, or just plain love to garden, choosing the right plants for your gardening space – pot or plot – is your best bet for great success.

Get your garden growing

Veggie and herb gardens need plenty of sunshine and water, no matter what you’re planting, or growing them in. Six to eight hours of bright light every day is best, so choose a sun-drenched spot in your yard for raised beds or larger gardens, and place pots and containers on sunny porches, decks or patios.

Use a good potting mix for containers and raised beds; it should be light weight and provide fast drainage. For garden plots, till soil, test for quality and work any necessary amendments into the soil before planting. All food plants need to be fed. Consistent and frequent watering, good drainage and a quality plant food such as Bonnie Plant Food are needed for good plant health and harvest.

Cultivating in containers and raised beds

Gardening doesn’t require a huge plot of land for hefty harvests and good success. Planting in containers can solve space problems and raised beds allow you to enjoy a garden if you’re short on space or have poor soil quality in your yard. Place containers in a sunny spot, whether it’s an apartment balcony or backyard patio. Make sure the pots are large enough for the plants you’ll put in them and have good drainage holes. Consider container color; dark containers will absorb more heat, so try using lighter colored containers.

Plants suited for containers include:

* All herbs.

* All greens. Add flowers to the same pot for an ornamental touch.

* Tomatoes like Bonnie Plants’ popular Husky Cherry Red, Patio, Bush Early Girl, Bush Goliath and Better Bush. For larger varieties, use a large pot, at least 5 gallons for each plant and support plants with a cage.

* Smaller eggplants such as Patio Baby Mini Eggplants.

* Peppers, like Lunchbox Sweet Snacking Peppers, that are smaller in size and high in yield.

* Cucumbers if you add a trellis to the pot and train them to climb.

Raised beds can host bigger veggies like Beefmaster Tomatoes, or varieties that require more room to spread on the ground like zucchini. They’re also great for greens like collards, lettuce, mustard and Swiss chard, and a variety of peppers, beans and eggplants.

Planting plots

In-ground gardens allow you much more room for larger plants. Even if your plot isn’t huge, it can accommodate plants that require more room, like watermelon and corn. In addition to staples for your table like greens, tomatoes and peppers, a garden plot allows you to incorporate a greater variety of veggies, like beans, peas and squash, in your garden plans.

No matter where you live or how much or little space you might have, you can enjoy growing your own food. Be sure to right-size, according to your space and need. Once you get growing, you’ll love the homegrown flavor of your harvest and the enjoyment gardening brings.

For more gardening tips, how to’s, trouble shooting and to learn about plants that fit your garden environment, visit


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What To Do When That Shoulder Pops...

The shoulder joint is subject to a great deal of motion, more so than other large joints in the body. This makes the shoulder susceptible to dislocation. Anyone who has experienced a dislocated shoulder knows how painful it can be. In fact, a dislocation can lead to a condition called multidirectional instability of the shoulder (MDI). The joint dislocation can result in an excessive forward, backward or downward motion relative to its normal position. MDI is often seen as a result of a sports-related injury, but it can develop over time with repetitive use of the shoulder joint.

Surrounding soft tissues are also affected. Ligaments and muscles in the arm and shoulder region can become stretched or torn. At times, a genetic abnormality of the joint can be an underlying cause. Repetitive motions, shoulder sprains and sudden  muscle contractions can result in MDI. Individuals with below average fitness levels and 'loose joints' are also at risk.

Multidirectional instability leads to weakness in the rotator cuff muscles, which become fatigued and overworked. The surrounding bursa (fluid filled protective sacs), tendons and nerves may also get affected.

Pain in the shoulder at rest and with motion is a common symptom. MDI may be associated with numbness, paralysis and weakness in the shoulder. Some patients report a crackling feeling or sound in the shoulder area during motion.

Physical therapy plays a crucial role in recovery from any dislocation.

Your therapist will help position the shoulder joint in the right position and immobilize it to promote healing and prevent further damage. A sling may be used for three to eight weeks, depending upon the severity of the injury. Once healing is complete, physical therapy will facilitate recovery. Rehabilitation treatments can include:

Heat and Cold Therapy – Used to manage pain and reduce swelling.

Exercise – A customized program of gentle exercise to build stability, strength and muscle control helps offset muscle weakness after weeks in a sling. Patients will be provided with a strength and mobility program that can be implemented at home and work.

Clinical Pilates – At times, a specialized exercise program can be designed to regain muscle strength, tone, and control. Exercises may be performed with specialized equipment or independently.

Electrical Stimulation – The technique is used to improve muscle and ligament tone. This is a useful method to control pain and inflammation.

Water Therapy – Water relieves stress on joints and encourages patients to relax and move with relative ease. An aqueous environment provides support for weak muscles and joints and supports 'relearning' of muscle strength and control.


Meeting the Challenges of MDI

Multi-dimensional instability of the shoulder must be evaluated carefully to determine the best course of treatment. As your physical therapists, we will do everything possible to relieve your pain, prevent further damage, and provide the rehabilitation framework to help you recover quickly.

In fact, physical therapy can help with any pain or discomfort in any joint in the human body. If you or a loved one is experiencing stiffness, tingling or loss of joint function, give us a call. In particular, MDI is a complex condition, and it is often overlooked. The underlying cause for simple 'aches and pains' can be easy to ignore and lead to further pain and injury. Therefore, we encourage you to reach out to us as quickly as possible.

Once joint healing is complete, we put you through a routine of specialized exercises and therapies to help you regain strength, stability, and functionality. Give us a call to discover how physical therapy can help heal your shoulder and every joint in your body.

Specialized Physical Therapy, LLC, 1000 Herrontown Rd, Building 2, Floor 2, Princeton, NJ 08540

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Garage Trend 2015 - Carriage House Garage Doors

(BPT) - The carriage house garage door is to your house what the little black dress and strand of pearls are to your wardrobe; classic style elements that never go out of fashion.

At the dawn of the automobile age, those who were affluent enough to own a car kept it in the carriage house, where the horses and buggy would have been stored. But this cohabitation became a little, well, smelly, and the need for separate storing structures was soon realized.

Enter, the garage. Built in the style of the original carriage house, the garage’s sole intent was to store the car away from the animals and elements. The word garage actually comes from the French word, garer, which means to shelter and protect. Naturally, the garage needed a door to offer protection to the automobile. The ensuing “carriage house door” was a hinged, double door that swung outwards, and can be considered the original garage door.

In the early 1920s, the kickout door was invented and progress continued from there, bringing homeowners the modern convenience of today’s overhead garage doors. Today’s carriage house sectional garage doors open overhead and continue to gain in popularity, constituting 35 percent of the volume in the garage door industry with projections to remain a huge trend.

When it comes to the style of garage door chosen, most homeowners want something classic, that won’t fade in popularity over the years and will also enhance curb appeal. This is especially true if home resale is a factor.

The carriage house door also offers a myriad of design elements. For example, the Classica Collection by Amarr offers a dual-directional wood grain design that provides the realistic look of wood with the practicality and low-maintenance upkeep of steel. With a three-section design and the option of larger windows, this door offers a more authentic carriage house look with the benefit of additional natural light flow into your garage. Two-tone looks are also available with many color combinations and panel designs, and hardware and window choices are plentiful. These different design options can be tailored specifically to your home’s façade and will further enhance curb appeal.

If you’re thinking of replacing a tired garage door in an effort to boost your home’s curb appeal, consider the classic carriage house door whose popularity has only continued to grow over the last century. With a timeless design that can be specifically tailored to your house, it’s a choice that both you – and future owners of your home – can happily live with for a long time.

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Degenerative Disc Disease and Physical Therapy

Degenerative disc disease (DDD), despite the name, is not a disease but a deterioration of the discs of the spine. It occurs over a period of time, resulting in neck or back pain and other musculoskeletal and neurological symptoms. It is common in adults, especially with aging.

Types of degenerative disc disease

  1. Cervical: affects the neck and is referred to as cervical degenerative disc disease
  2. Lumbar: affects the lower back and is called lumbar degenerative disc disease

The cervical and lumbar regions of the spine are susceptible to damage due to increased movement capabilities. Constant motion over time results in the wear and tear of the discs.  The signs and symptoms of DDD can negatively impact a person’s ability to function throughout the day.  This can lead to decreased participation in recreational activity, lost time at work, difficulty performing household chores, and decreased quality of life. 

Signs and Symptoms of DDD

Most patients report one or more of the following symptoms.

  • Pain is triggered by an activity
  • Pain flares up periodically and then settles to a low-grade pain/discomfort
  • Sitting or standing for long periods of time worsen the pain
  • Relief upon changing body position
  • Muscle spasms
  • Tingling sensations in the extremities

Consult with your healthcare provider if you are having neck or back pain. Early intervention could save you from further damage to the disc, muscles and ligaments.

Management of Degenerative Disc Disease 

Physical therapy helps treat the underlying factors such as stiffness in joints, weak muscles, lack of flexibility, and poor posture. Your physician may recommend prescription medication to provide relief. Specialized physical therapy techniques, specific to each patient, are utilized to achieve lasting relief.  Treatment may include:

  • Manual therapy to stretch joints and muscles and relieve pain
  • Core stabilization exercises to help strengthen the spine
  • Aerobic activity to promote movement and fitness
  • Postural advice to help decrease stress on the spine during daily activities
  • Home exercises to facilitate long term success

Take Action

Don’t let neck and back pain slow you down.  Talk with your healthcare provider so you can start feeling better today!  To learn more about how physical therapy can help you, visit


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Spicing Up a Room with Cultural Flavor

Interior designer Monique Duarte, owner of Duarte Decor, shares her ideas about design and how she works with clients to spice up a room based on their cultural background and tastes.

Tell us aboutDuarte how you integrate a home-owner’s background with interior design?

I start with preferences, then take into consideration an individual’s cultural influences. I like to push the envelope sometimes. A client might like green and not have a preference on hue, but I may give them three different hues to choose from to get a better sense of their style and how adventurous we can go. I do think color adds so much character to a space.

Even if you just paint, it makes a whole world of difference. It can make a room look like a whole new room. I do accent walls, and really push the envelope in those areas.

During the first consultation, I always like to tell them a little about myself, not only my experience in interior design but also my background. I studied abroad, in London, England for over four years and lived in Italy for about two years, working in international business and marketing. I like to share that with my clients because it influences how I work.

For example, I can relate with clients of West Indian culture, because from the age of 15, I was going to Trinidad and Tobago every year to visit family of West Indian culture. Also, having lived in Europe for many years, I was surrounded with people of all cultures from Italian, French, African, Asian, Indian, Russian, Latin and more.  So through life experiences I had an opportunity to learn about these cultures and what makes the people and their preferences in life so unique.  Through traveling and being exposed to different cultures, it has taught me how culture influences who we are. A lot of time it naturally comes out.

How do you put together a room when you have furnishings from different cultures or eras?

With interior design, there really are no rules. That is the art of design. You can mix themes. It’s taking the time to think through what is aesthetically pleasing to them and will also function well.

Some clients will say that they want an Indian feel throughout our home, because that is their culture. Or there may be a specific room, such as a children’s room, that is themed.

I have a current client who is Indian and wants that theme in their living areas, but their son loves soccer, and so his room will be reflective of that.

When you do design for a family who wants a certain cultural look, do you mix in modern colors—or do you stick with traditional colors?

We talk about what are the must-haves. What is the ultimate design look that they want.

What happens when you have two individuals from two completely different backgrounds? 

I do get that a lot. The husband loves contemporary design. The wife is more on the traditional side. Usually in that situation, I will sit down and give them some visuals, going through magazines and catalogues. There are certain aspects that they can actually come to a compromise on. They might like Provencal furniture with a French flavor.

New Jersey is very interesting because we are right near New York and Philadelphia and Delaware, all with unique pockets of clients and homes. It’s a diverse area. My experience in working with different types of clients, there’s a lot of Indian, and a mix of caucasian and Asian. We get a lot of clients from India, and want to infuse those characteristics into their interior design.

We also get Toms River area. And those are closer to the water, and want a coastal design. Those are always fun to designer, because my family’s from the Carribean, and I love the beach and the water.

Tell us about your background and how you got into design?

My mother is from Trinidad, which was an English colony. My great-grandmother was Indian. My father is African-American, from Atlanta, Georgia. My mother has her own design company in quilting and fabric arts. She was and still is an amazing artist, having won many awards, and work shown in art galleries in Virginia. My grandmother by trade had a degree in interior design & all her life made porcelain dolls, jewelry, and clothes for a living. So I naturally come from a creative family.

However, It took me longer to realize that I had a creative calling for my work in life. When I bought my first home, I was working in advertising, and decorating the house became my little baby and stress reliever. It had all white walls, and I took my time and designed it the way I wanted my home to be. I got so much joy out of doing it, and when I finally finished it, friends would come over and ask if I hired an interior designer. That’s when I knew I had a knack for this. I then went back to school to study Interior Decorating at Penn Foster University. And then I went full-force and started my business in 2012, at age 30. I’m serving mainly Central New Jersey, and I’ve been venturing out into boroughs of New York as well. In 2015, we will be launching our expansion into the Caribbean and Latin Market (Dominican Republic), focusing on coastal interior decorating, which I am super excited about. I’m looking forward to expanding into those markets.

What is a favorite project that you have done?

I worked on a project last year, and it was a challenging but rewarding project. I was working with a single professional woman, who lived alone and spent a lot of time at work. When she came home, she didn’t have a lot of organization. A lack of good systems in place to keep track of things. Things would pile up. She wanted design, but also organization.

I brought in an organizing team first, before doing any design. We helped her create systems for organizing and even helped her purge old items that she no longer needed. And then, completely redesigned the home.

She said she was so grateful that her home was transformed. It’s peaceful and conducive to her life. We did more than just design her home, it helped transform her life.

A part of design is making sure the things in your space are the things that belong there. From a functional standpoint and also aesthetically.

Sometimes people don’t realize clutter has an impact on your emotions and mindset. We trained her to put mail into a specific place, a consul by the doorway, with a basket for her mail.

And now she can use her dining room table, which she can now use for dining with her friends and family. Design changes how you can use your home.

In this project, the client’s cultural preference was more based on her behaviors and being very close to her family. She always had her aunts, nieces and mom visiting her home, because family time was very important to her. So to ensure that the design of her home was in-line with this cultural characteristic, we made sure that all the design elements we proposed kept in mind that she would have family over often.  We incorporated a sofa bed into the living room, as well as a nice, plush reading chair in her guest bedroom for when her mother comes to visit. So, cultural characteristics can be infused in many different ways. It’s all about getting to know your clients and delivering on their specific needs and wants, something in-line with who they truly are.

And when you can make that kind of difference, it’s very rewarding.

Have you always combined organizing and design?

We didn’t initially offer organizing. But we saw that sometimes it was difficult designing a home without organizing first. The home has to be functional. The company we use is Honeybee Organizing. All of my clients who have done this organizing piece first have been 100% satisfied.

For ideas and inspiration, visit Monique’s website,


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What to Know About Shoulder Pain/Rotator Cuff Injury

Shoulder Pain?

By: Paul Vidal, DPT

Specialized Physical Therapy, LLC

Princeton, NJ


Do you experience shoulder pain?  Do you have difficulty reaching above your head or behind your back?  Is it difficult to put on your jacket or sleep on your side?  Answering “yes” to questions like these may be a clue that you have a problem with your rotator cuff.


What is the rotator cuff?


The "rotator cuff" is a group of 4 muscles and their tendons (which attach them to the bone). These muscles connect the upper-arm bone, or humerus, to the shoulder blade. The important job of the rotator cuff is to keep the shoulder joint stable. Sometimes, the rotator cuff becomes inflamed or irritated due to heavy lifting, repetitive arm movements, or a fall. A rotator cuff tear occurs when injuries to the muscles or tendons cause tissue damage or disruption.  An injury to the rotator cuff can be from a fall or lifting a heavy object.  Other times a rotator cuff tear can develop over time such as from repetitive activity or motion.


What are common symptoms of a rotator cuff injury?


People with rotator cuff tears can feel:

  • Pain over the shoulder that may extend down the side of the arm
  • Shoulder weakness
  • Loss of shoulder motioin


How is it diagnosed?


A review of your health history, a thorough examination, and a series of clinical tests are performed specifically to help pinpoint the cause of the shoulder pain.  Diagnostic imaging tests such as MRI or CTscan may be needed to help to make the diagnosis. 


How can physical therapy help?


Physical therapy can help you to restore your range of motion, muscle strength, and coordination, so that you can return to your regular activities. In some cases, your physical therapist may help you learn to modify your physical activity so that you put less stress on your shoulder. If orthopedic surgery is the best course of action, your therapist can help you both before and after the procedure.


A physical therapist can help you decrease your risk of developing or worsening a rotator cuff tear, especially if you seek assistance at the first sign of shoulder pain or discomfort.


To make an appointment to see a physical therapist at Specialized Physical Therapy, please call 609-497-1000. 




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