Some of you know how I came into South Bend without knowing more than two physicians. Some of you may also already know some of this story from the first day McDonald Physical Therapy opened. If you have heard or read some of our story, please consider reading this, regardless. I do a better job of showing how unaware I was in starting my practice with no clear goal or understanding of what it would take to keep a private practice growing over time.

As I sat thinking about the past 35 years of bringing our physical therapy care to the Michiana area, I can’t help but remember the first day in South Bend walking into the office. This was in the basement of 416 East Monroe Street. The workers were still two days shy of finishing our clinic area - about the size of a 2 1/2 car garage. I had two areas for examinations: one small treatment room and a slightly larger room with three pieces of workout equipment.

I brought to the clinic a strong belief that I would make a difference. My belief came in large part from what I learned through my mom, dad, brothers, and sisters, and the training of Beverly Stewart, P.T. of Buffalo, N.Y. Beverly was demanding and sensitive, and as good a coach as I have known in any sport. I learned how (and why) to treat people with concern and hospitality from my family. But Bev taught me a unique way to evaluate a patient thoroughly among other things.

On a rainy January 12 in 1989, my first patient walked in. I asked the construction workers to leave so I could evaluate him. After they left, I offered apologies for our unfinished space and then asked my first patient about his injury. He had had a back problem for years. His physician had told him about this new physical therapist in town who might be able to help. I evaluated his problem, treated him, and gave him some exercises he had never done before. When his treatment was completed, I faced my greatest weakness as a businessperson. I was, and still am, not good at asking for payment for my services. As luck would have it, he asked me if I needed to be paid. I answered, “Yes.” He had no money with him, but he would write me a check at his office. He asked me if I had any other patients that day. I told him I was free and walked with him to his office. We talked about life and Notre Dame football. He paid me, and I went home.

That was my first of about almost 13,000 workdays – just over 35 years of physical therapy service in the Michiana area. I could not have imagined at that time that the clinic would grow from our 2 1/2 car garage-sized space to our present facility, and that we would have treated over 95,000 patients.

What successes we have known would never have happened without the loyalty of our patients, the confidence of physicians and the dedication of our staff, those who have worked and continue to work in our clinic. People continually praise our staff. They ask me how we have found so many happy and caring people. My response has always been: “We hire people who enjoy others.” I am thankful we have been able to find so many special people. I would also like all of our families and friends to know how grateful I am for their support!

I am thankful that my first patient thought enough of my “one man shop” to ask about paying me. I am also thankful to all of you who continue to share your loyalty with us by asking your physicians to send you back to us when you are in need.

Thanks for believing in us and what we do!

Enjoy the journey,

Fran McDonald President/CEO

Physical Therapy Guide to Groin Strain

A groin strain is an injury to the area of the body where the abdomen meets the leg and the inner thigh muscles (adductors) attach to the pubic bone. Typically, groin strains occur in the muscles of the upper inner thigh near the pubic bone or in the front of the hip. This injury is more common in athletes and men, but certain activities can increase the risk of groin strain for anyone.

Groin strains can occur during sprinting or with any type of activity requiring forceful movement of the leg. These can include jumping, kicking the leg up, or changing directions while running. Groin strains account for 10% of all hockey injuries and 5% of all soccer injuries. Physical therapists treat groin strains by reducing pain and helping patients improve muscle strength and leg motion. Physical therapy can also help to reduce recovery time.

What Is a Groin Strain?

A groin strain is an overstretching or tearing injury to the muscles of the inner thigh or front of the hip. Groin strains make certain activities hard to do and painful. These can include walking, lifting the knee, or moving the leg away from or toward the body. Groin strains can occur from overuse of the muscles. They also can result from a sudden contraction (such as tightening) of the muscles.



Injury occurs when the muscles are either too forcefully contracted or too forcefully overstretched. There are several grades of groin strains based on the amount of muscle damage that occurs. They are:

• Grade 1. Mild or partial stretch, or a tear of a few muscle fibers. The muscle is tender and painful but maintains its normal strength. Use of the leg is not impaired, and walking is normal.
• Grade 2. Moderate stretch or tearing of a greater percentage of the muscle fibers. There is more tenderness and pain, noticeable loss of strength, and sometimes bruising. Use of the leg is noticeably impaired, and limping when walking is common.
• Grade 3. Severe tear of the muscle fibers, sometimes a complete muscle tear. A "popping" sound may be heard or felt when the injury occurs. Bruising is apparent. A "dent" in the muscle may be seen under the skin at the site of the tear. Use of the leg is very difficult, and putting weight on the leg is very painful.

Groin strains most often occur in athletic activities such as football, soccer, and dance. They also can occur during everyday activities, such as lifting heavy items or slipping while walking. With a groin strain or tear, muscle fibers and other cells are disrupted. Bleeding can occur, which causes bruising. Within a few minutes to a few hours after the injury, swelling can occur. This can cause the injured area to expand and feel tight and stiff.

How Does It Feel?

A groin strain causes sharp pain or spasms in the groin area or lower abdominal region. The pain can quickly resolve, or it can last. It can become a throbbing pain at rest with sharp stabs of pain when you try to move your leg or walk.

A lower-grade strain can be relatively pain free with everyday activities and walking. However, it can become aggravated with quick movements of the legs. These can include cutting, kicking, performing sit-ups, or sprinting/running.

Higher-grade strains can cause the muscles to feel tight or weak. Simple movements that involve lifting the leg or knee or bringing the knees together can provoke pain. This can even cause the groin muscles to spasm. With a Grade 3 injury, using the leg at all can be extremely painful.

Signs and Symptoms

With a groin strain, you may experience one or more of the following symptoms in the groin area or lower abdomen:

• Pain, a deep ache, and/or spasms.
• Swelling.
• Bruising.
• Tightness.

Additional symptoms that you may experience include:

• Weakness in the leg when trying to walk, climb stairs, or move the leg.
• Limping when walking.
• Difficulty performing daily activities that require standing and walking.

How Can a Physical Therapist Help?

Your physical therapist will design a treatment program for your specific needs to speed your recovery. The program will include exercises and treatments you can do at home to help you return to your normal lifestyle and activities. Your physical therapist will personalize a treatment plan for you based on your unique condition and goals.

During the First 24 to 48 Hours After Injury

Your physical therapist may advise you to:

• Rest the area. This may include avoiding walking or any activity that causes pain. They may recommend crutches to reduce further strain on the muscles when walking.
• Apply ice packs to the area.
• Compress the area with an elastic bandage wrap.
• Consult with another health care provider for further services. These may include medication or diagnostic tests.

As you continue with recovery from your groin strain, your individualized plan may include treatments to:

Reduce pain. Your physical therapist may use different treatments for pain. These may include ice, heat, ultrasound, electrical stimulation, taping, exercises, and hands-on therapy such as massage. These treatments can lessen the need for pain medication, including opioids.

Improve motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in the leg and hip. These might begin with "passive" motions that they perform for you to gently move your leg and hip joint. They will help you progress to doing active exercises and stretches that you perform yourself.

Improve strength. Certain exercises will benefit healing at each stage of recovery. Your physical therapist will teach you the appropriate exercises to restore your strength and agility. These may include using cuff weights, elastic bands, weight-lifting equipment, and cardio-exercise equipment, such as treadmills or stationary bicycles.

Speed recovery time. Your physical therapist is trained and experienced in choosing the right treatments and exercises to help you heal. They can help you return to your normal lifestyle and reach your goals faster than you are likely to do on your own.

Promote a safe return to activities. Your physical therapist will work with you to decide on your recovery goals, including your return to work or sport. They will design your treatment program to help you reach those goals in the safest, fastest, and most effective way possible. Your physical therapist can teach you work retraining activities. They also may teach you sport-specific techniques and drills to help you achieve any sport-specific goals.

Prevent future reinjury. Your physical therapist can recommend a home exercise program to strengthen and stretch the muscles around your hip, upper leg, and abdomen. Doing these prescribed exercises can help prevent future reinjury of your groin. These may include strength and flexibility exercises for the leg, hip, and core muscles.

If Surgery Is Necessary

Surgery is rarely needed for a groin strain. If a groin muscle fully tears and requires surgical repair, your physical therapist will help you minimize pain, restore motion and strength, and return to normal activities safely and as soon as possible after surgery.

 **choosept.com

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