Learn How to Remedy Plantar Fasciitis

Learn How to Remedy Plantar Fasciitis

planters fasciitis physical therapy miami boca raton

Do You Have Plantar Fasciitis?

Learn how these 4 simple at-home exercises can help you remedy the pain caused by Plantar Fasciitis.

By: Stephanie Beckel, DPT and Eric Alexander, DPT, OCS, Cert. MDT

If pain occurs with your first steps in the morning, chances are you may have plantar fasciitis. In fact, plantar fasciitis is the single most common foot condition treated by healthcare practitioners, affecting about 2 million Americans each year. This type of injury is especially prevalent in runners, as studies have found that over 30% of runners struggle with this condition. The good news is that greater than 95% of cases will heal non-surgically with the correct application of skilled physical therapy by a state licensed doctor (DPT).

So what exactly is the plantar fascia?

The plantar fascia consists of three bands of dense connective tissue that run along the bottom of the foot. All three bands originate from the calcaneus (heel bone) and then spread out as they run forward to connect to the base of each phalynx (toes). This fascia is responsible for tightening during the push-off phase of walking to elevate and support the medial arch, so that the foot may become a rigid lever propelling the body forward.

Plantar Fasciitis describes a condition that is often associated with overuse, resulting in a chronic degenerative process. The condition begins with repetitive strain, which leads to microtears ultimately inducing an inflammatory response. Over time, this leads to degeneration of the plantar fascia, primarily at its attachment site to the heel. When looked at under a microscope, there is evident thickening and fibrosis as well as damaged collagen and calcification of the fascia.

Plantar Fasciitis Symptoms:

Symptoms include pain in the medial heel, usually most noticeable with first steps out of bed in the morning, standing after a period of inactivity, and also after prolonged weight-bearing. Pain is also present with deep palpation of the heel at the insertion of the plantar fascia.

While 80% of heel pain stems from plantar fascia, several other conditions can mimic this pain and may need to be ruled out. In one retrospective study of 250 individuals with plantar heel pain, the majority were diagnosed with plantar fasciitis. The next most common diagnosis was fat pad atrophy (approximately 15%). Those with fat pad atrophy were more likely to have pain primarily after long periods of standing, pain at night, and lacked the characteristic first-step pain in the morning. Les common conditions include Ankylosing spondylitis, Reiter’s syndrome, and osteoarthritis. If symptoms are in both heels, rheumatoid arthritis becomes a likely culprit in women, while ankylosing spondylitis or Reiter’s is more common in men. For patients with a history of diabetes, an abscess in soft tissue must be ruled out. Rarely the condition may be caused by entrapment of nerves (usually the first branch of the lateral plantar nerve or the medial calcaneal nerve), proximal plantar fibroma, lumbar herniation causing S1 radiculopathy, or a hidden fracture. These conditions can be ruled out during the evaluation process with your physical therapist.

Risk Factors:

There are several categories of risk factors, some of which can be mediated and others which are more difficult to change. Anatomic risk factors are those that are inherent characteristics that you may be born with. These include flat feet, high arches, or a shortened Achilles tendon. Limitations in hamstring flexibility and the difference in leg length have also been associated with this condition. Biomechanical risk factors are those that describe faulty movement patterns. These include an inward roll of the foot (overpronation), poor alignment of the lower extremity, limitations in ankle dorsiflexion, and weak plantar flexor and intrinsic muscles of the foot. The condition also frequently occurs after a recent increase in activity, such as a recent increase in walking mileage or training for a run, so make sure to increase activity slowly. Lastly, there are environmental risk factors, which are often the easiest to eliminate. These include poor footwear, walking barefoot, hard surfaces, unusually long weight-bearing, lack of stretching, and being deconditioned/ overweight.

How can physical therapy help?

A full biomechanical evaluation is warranted in all cases of plantar fasciitis. Often times it is not the tissue at the bottom of the foot that is faulty, but something up the chain that is driving increased or aberrant forces through the fascia on the bottom of the foot. What is often seen clinically is dysfunction in the calf musculature, weak stabilizers in the lateral hip preventing proper control of the femur, and stiffness through the thoracic and lumbar spine driving aberrant forces through the chain from a top-down fashion. These are just a few examples of biomechanical faults that may be present. Failure in addressing the cause of the biomechanical dysfunction and only treating the irritated tissue will lead to failed treatment. Addressing deficits of the entire lower extremity often result in improved biomechanics and correction of the underlying cause of dysfunction. Some of these interventions include correction of gait mechanics, joint mobilizations to improve the mobility of the first metatarsalphalangeal joint (big toe), talocalcaneal/talocrural (ankle), knee, and hip, as well as stretching to restore optimal muscle length to the calf, thigh, and hip. Important areas to strengthen in order to limit pronation and reduce impact when the foot hits the ground include the tibialis posterior and fibularis longus (directly limit midtarsal pronation via eccentric contraction), tibialis anterior (eccentrically controls ankle plantarflexion), quadriceps femoris (eccentrically limits knee flexion), gluteus medius (eccentric control of hip adduction and internal rotation). At Fox Physical Therapy all of our board certified Doctors of Physical Therapy will help to identify the true cause of your pain and teach you how to prevent it from ever coming back.

Here are a few home treatments you can start right now. Many of these techniques will treat the painful site at the heel directly. Remember that to truly rid yourself of this issue work up and down the chain is needed as well. This is where a visit to a skilled Doctor of Physical Therapy can get the help you need.

Tips for at Home Treatment

Tip #1: Calf and arch stretch with a towel. Perform 3 sets pulling back on the foot for 30 seconds before going to sleep and before first steps in the morning.

Tip #2: Stretch of the plantar fascia stretch with cross-friction massage. Stretch the big toe up and massage bottom of the foot for 1 minute, 3 times before taking first steps. This can also be done throughout the day by placing the heel on the ground and the ball of the foot on the wall and leaning forward.

Tip #3: Roll plantar fascia over a can or ball. Perform for 1 minute (3 times with 30 rest in between) before going to sleep and before first steps in the morning. You can also roll over a frozen water bottle as needed for control of pain and inflammation.



Tip 4:
Use the toes of the painful foot to pick up a dry paper towel, drop and repeat for 2 minutes. Also, scrunch a towel using only your toes.

Contact us today and let us get you back on your feet!

If you or someone you know is suffering from foot pain, the board-certified Doctors of Physical Therapy at Fox Physical Therapy can provide a complete evaluation, including biomechanical screening to identify deficits and underlying causes. No two people are the same and therefore it is essential to have a plan of care that is specific to your needs. Individualized treatment programs can help to relieve plantar fasciitis and prevent it from coming back.

New Physical Therapy Office Location Boca Raton

fox-physical-therapy-boca-raton-florida

Fox Physical Therapy Boca Raton

Fox Physical Therapy to Open New Office in Boca Raton, Florida May 1st, 2017

Fox Physical Therapy, Miami’s premier orthopedic and sports physical therapy center, is proud to announce that we are expanding north with the opening of our newest clinic in Boca Raton Florida on May 1. Conveniently located in the Twin Lakes Professional Center at 2900 North Military Trail, Suite 220, the new Boca Raton location will offer patients a hands-on, results-based approach to addressing a wide range of work, auto, orthopedic, and sports related injuries or post-surgery therapy.

“I am excited to now offer our patients in Broward and Palm Beach County the same specialized and innovative physical therapy services our Miami patients have come to love,” said Owner and Licensed Physical Therapist Dr. Brett Fox PT, DPT, OCS, COMT. “We look forward to becoming a part of the fabric of this great community as we work together with patients to develop a holistic, cost-effective approach to managing their aches and pains.”

Fox Physical Therapy opened its flagship Miami facility in 2014. Along with an experienced team of therapists, he has grown it into one of the top physical therapy centers in South Florida. Fox Physical Therapy received the 2015 Patients’ Choice Award as one of the Top Physical Therapists in Miami.

Fox Physical Therapy Boca Raton will accept all major insurance carriers and offers those without insurance a self-pay rate. To book an appointment, please call 561-923-8292.

Do You Have Pain in Your Knee Cap? It Could be Patellofemoral Pain Syndrome

knee-injury-physical-therapist-wynwood-miami-fox-physical-therapy

Patellofemoral Pain Syndrome is Causing Major Issues for Athletes Living in Miami

Read our  physical therapy tips for overcoming knee pain caused from Patellofemoral Pain Syndrome

By: Eric Alexander DPT,OCS,MDT,CSCS

If you are an active individual there is a good chance at some point in your life you have experienced knee pain. In one report, over the past 30 days, at least 1 in 5 adults in the United States have cited some form of knee pain¹. One of the more common types of knee pain is called patellofemoral pain syndrome (PFPS). This is basically an umbrella term for knee pain that occurs at and around the patella, also known as the knee cap.

The knee cap is a bone contained within a tendon that facilitates movement at the knee. The knee cap slides within a groove in the femur during flexion and extension at the knee. It is thought that pain originates when the patella begins to ‘mal-track’ through this patellar groove in the femur and causes uneven forces through the bony surfaces. The mal-tracking is commonly attributed to muscular imbalances in the hips, thigh, and lower leg. Common populations presenting with PFPS include runners, bicyclists, and young athletes. Pain can typically intensify by sports, walking, running, stair climbing, or sitting for a long time, often called the “Movie-Goers Sign.”

One research article, in particular, has demonstrated the importance of lateral hip strength in relation to knee alignment with activity². College athletes were followed over the course of an athletic season. The athletes who experienced knee and ankle injuries throughout the season all shared two things in common: a weakness of the hip abductors and external rotators of the hip. Any weakness of these muscles during activity can allow your knee to drop-in towards the midline during motion, known as genu valgum, facilitating mal-tracking of the patella and PAIN.

The muscles in question are the gluteus medius, piriformis, and smaller external rotators of the hip. There are a few key exercises that you can add to your normal exercise routine that will help strengthen these muscles in question. These exercises include:

Side-lying Leg Raises

Hip External Rotation Clamshells

Side Planks

Three sets of fifteen reps (3×15) of the side-lying leg raises and clamshells coupled with two sets of thirty to sixty-second holds (2×30-60”) in the side plank position will target these muscles and assist in strengthening. Perform these exercises three to four times a week for six to eight weeks to allow for appropriate strength gains.

If you are experiencing knee pain or know someone who does, Fox Physical Therapy board-certified therapists deliver full biomechanical screens during the evaluation process to specifically identify which structures are at fault. Schedule you consultation today at 305-735-890 or click here.

Resources:

1. Centers for Disease Control and Prevention. QuickStats: Percentage of Adults Reporting Joint Pain or Stiffness, — National Health Interview Survey, United States, 2006. MMWR 2008:57(17);467.
2. Leetun, DT, et al. Core Stability Measures as Risk Factors for Lower Extremity Injury in Athletes. Medicine & Science in Sports & Exercise. Vol. 36, No. 6, pp. 926–934, 2004.

Speed up Your Recovery Time with Direct Access to Physical Therpay

direct-access-physical-therapy-miami-fox-physical-therapy

New law makes it easier for patients to seek treatment from a Physical Therapist without a referral from an MD.

Direct Access to Physical Therapy can speed up the time it takes patients to receive treatment during the vital first few weeks after an injury.

By: Dr. Alexander PT,DPT,OCS,MDT,CSCS

In the state of Florida, it is no longer necessary to see a Medical Doctor to initially prescribe treatment for Physical Therapy. This law was passed to directly benefit you, the patient, in getting speedy treatment for whatever musculoskeletal injury or dysfunction you may have. As a consumer, you can directly access Physical Therapy services for up to 30 days without a prescription. This speeds up the time it takes to get you the treatment you need during the vital first few weeks after injury.

I consistently see patients who are 6+ weeks removed from an injury before they finally get a chance to get in for therapy. When I ask them why it took so long I hear stories of three-week waits for initial appointments with the physician, followed by an additional one to two-week wait period to receive an MRI. When the patient finally returns to the physician following the MRI they are often prescribed a pill and told to try Physical Therapy. Why would one wait this long?! This long wait cuts out on vital stages of the healing and remodeling process after an injury where Physical Therapy is key.

Your Doctor of Physical Therapy is the best-equipped health care practitioner to provide the treatment you need for a musculoskeletal injury. We specialize in ensuring a full return to function without lingering issues. The majority of patients we see at Fox Physical Therapy start to see positive results within the first two weeks of treatment. If you have not been to Physical Therapy recently or have been left with disappointing results in the past I challenge you to give Fox Physical Therapy a try. Dr. Fox and I, Dr. Alexander, are Board-Certified Orthopedic Specialists and our passion is getting you back to the pain-free life you want as quickly as possible.

They say Health is Wealth. After working with an entire spectrum of patients ranging from the ages of two months to 106 years I couldn’t agree more. Don’t put off an injury until it becomes a chronic issue because you don’t want to deal with the hassle of waiting weeks to see an MD only to be prescribed a pill and an MRI. At Fox Physical Therapy you will receive personalized treatment that directly addresses the root cause of the problem.

To take advantage of Direct Access give us a call today. We will set up an initial evaluation and figure out exactly what is causing your pain. If you have a Primary Care Physician or favorite MD that you are concerned about being left out of your treatment, worry not. You provide us the name and we will ensure that our initial evaluation is faxed over to them in order to maintain lines of communication and a complete medical record. We look forward to seeing you soon.

Has direct access to physical therapy benefited you or a friend? We would love to hear about your success stories. Leave a comment below, call us at 305-735-8901, or click here to schedule an appointment.

Learn How this Ancient form of Alternative Medicine Can Help You Heal Faster

cupping-therapy-miami-fox-physical-therapy

Heal Your Injuries Faster with the Ancient Form of Alternative Medicine known as Cupping Therapy

By Tim Alemi

Cupping Therapy originated in ancient Egyptian and Chinese medicine, however, it has since made its way into the world of western orthopedic medicine. It is commonly used today in orthopedic physical therapy for the treatment of pain, trigger points, and myofascial adhesions. Cupping therapy has seen a dramatic rise in popularity recently due to increased media exposure secondary to an increase in athletes and celebrities supporting this ancient form of alternative medicine. Cupping therapy describes the act of placing a plastic, glass, or bamboo “cups” onto the body to create negative pressure, or a vacuum, to pull the skin away from the affected area. Once the cup is placed on the skin, the “vacuum” is created by suctioning the air out from the cup. The underlying tissue is pulled away from the body, resulting in improved perfusion to the affected area. Cups can be fixed on one localized area or moving to drag cups across a larger area to create a skin-rolling, massage-like effect. Treatments typically last for about 5-15 minutes before cups are removed from the skin. Cupping therapy in the orthopedic physical therapy setting typically uses suction, but it is common in other professions to use fire as a modality to create a negative pressure vacuum. Prior to treatment, it is crucial to ensure that your patient is aware of circular bruising and mild discomfort that may occur as a side effect of this treatment.

Cupping Therapy Benefits

Cupping therapy in the orthopedic setting has contributed to beneficial outcomes for the reduction of pain. It helps to remove toxins, decreasing the presence of adhesions, mobilize subcutaneous connective tissue, stimulate the autonomic nervous system, and provide improved circulation to affected area. Regulation of the immune system and reduction of high blood pressure are two other benefits that have also been proposed as a result of this treatment. Cupping is an ideal alternative for patients who have soft-tissue dysfunction but do not tolerate palpation, soft-tissue mobilization, instrument-assisted soft tissue mobilization, or cross-fiber massage.

Much of the research and evidence on cupping therapy is unreliable due to high risk of bias (84.44% of 135 RCTs)1. However, the results of a systematic review performed by Cao et al found that cupping may be an effective treatment for herpes zoster, acne, facial paralysis, and cervical spondylosis. An overview of systematic reviews performed by Lee et al suggests that cupping may be an effective alternative treatment for the reduction of pain.2 Cupping therapy is a good alternative to reduce pain in patients who cannot tolerate palpation or soft-tissue mobilization.

Patient Testimonial:

“ I was experiencing right hip pain that would increase each time I ran. Dr. Fox worked on my hip with manual therapy and cupping which reduced my symptoms 50% the first 2 visits”.

Have you used Cupping Therapy in the past? Tell us about your experience and tips you can share in the comments section below.

Kinesiotape Helping Athletes in Miami Recover Faster

Learn How Kinesiotape Helps Athletes to Recover Faster

By: Tim Alemi

Kinesiotape is a type of elastic taping technique that has increasingly become more popular since the widespread use by Olympic athletes during the 2008 Summer Olympics. Now, it is common to see professional athletes, cross-fit enthusiasts, weekend warriors, and general population patients wearing brightly colored kinesiotape for both function and fashion. The application of kinesiotape technique is designed to help enhance the body’s healing process, improve stability, and decrease stress load on tissues. It is similar to a brace in that it may provide support to the surrounding structures to decrease the load of impact activities, also, the tape does not restrict the range of motion like a brace typically would. According to RockTape which is a different brand of tape, pathologies commonly treated with tape include achilles tendonitis, plantar fasciitis, jumpers knee (PFS), ACL/MCL issues, rotator cuff injuries, groin and hamstring pulls, lower back issues, shin splints, tennis and golf elbow, pain associated with pregnancy, postural corrections, and skin abrasion protection.

Taping can be used for various reasons, and depending on the application it may have several different proposed benefits. According to RockTape, it is able to decrease the sensation of pain by raising the threshold required for nerve fibers to send an impulse to the brain4. Also, it can decompress an area of swelling, bruising, or inflammation by lifting the skin away from underlying tissues resulting in vasodilation. It is widely proposed that tape can normalize tone by activating or inhibiting appropriate corresponding musculature; as well as support tissues by absorbing and properly distributing stress forces. Patients often prefer this method of treatment because of ease of application, comfort, convenience, and longer wear times (2-7 days) with decreased pain and no loss of range of motion2.

Further research needs to be assessed to make an appropriate determination on the effectiveness of kinesiotape versus alternative taping techniques. However, experts suggest that the application of kinesiotape may provide the immediate short-term reduction in pain2. There is limited moderate level evidence that suggests kinesiotape is no more effective than sham tape or other modalities, but it is difficult to make any definitive conclusions due to a limited number of RCTs included in reviews2, 3. This does not mean that kinesiotape is ineffective, but it does suggest that it may not be more effective than other alternatives. However, kinesiotape is beneficial compared to other modalities because it may provide a safe and immediate reduction in pain for short periods of time2.

Testimonial:
“ I had shoulder instability that would not allow me to workout. The taping helped support my arm while I did my stability exercises until I was able to gain enough strength from the physical therapy”
— Sandra S.

For More Info

Contact us today and schedule a complimentary consultation for Kinesiotape taping at 305-735-8901 or click here.

Why You Want Instrument-Assisted Soft Tissue Mobilization Therapy

  • Instrument-Assisted-Soft-Tissue-Therapy-Miami

Heal Faster With Instrument-Assisted Soft Tissue Mobilization Therapy

By: Tim Alemi – Fox Physical Therapy

Patients experiencing soft-tissue dysfunction such as the formation of scar tissue, trigger points, or sprains/strains are often treated with manual therapy techniques such as Instrument-Assisted Soft Tissue Mobilization (IASTM), manual soft-tissue mobilization, or many other types of massage techniques. These techniques are used to help stimulate the healing response, promote correct realignment of collagen fibers, and decrease pain. Instrument-Assisted Soft Tissue Mobilization is a manual therapy technique that utilizes specifically designed concave/convex tools to identify and breakdown myofascial restrictions, soft tissue fibrosis, scar tissue adhesions, and chronic inflammation, which should result in improved outcomes for both the patient and the physical therapist when compared to other manual therapy techniques. The shape of the tools allow for ease of use, swift and comfortable adjustment to contours of the body, minimal stress on the PT’s hands, and maximal penetration into soft tissue.

Patients that are typically treated with IASTM include those diagnosed with soft-tissue dysfunctions such as tendinopathies, ligament sprains, muscular strains, and scar tissue adhesions. Further examples of common injuries treated with this technique include Achilles tendinitis, plantar fasciitis, IT band syndrome, medial and lateral epicondylitis, cervical/lumbar sprains/strains, patellofemoral disorders, rotator cuff tendinosis, shin splints, and carpal tunnel syndrome. Further research needs to be completed to appropriately determine which pathologies are most effectively treated with IASTM.

The proposed mechanism of IASTM utilizes controlled microtrauma resulting in increased fibroblast production to the treatment area, stimulating an inflammatory response triggering the healing process of affected tissues. Also, this technique is believed to increase blood flow to the area, as well as facilitate the breakdown of cross-link adhesions found in collagen fibers of myofascial soft tissues and scar tissue. However, perhaps the greatest proposed advantages of IASTM is that the tool helps to protect the PT’s hands from injury, and provide the clinician with greater palpation skill to specifically identify an area that needs to be treated.

Although further research needs to be completed to determine if IASTM is truly any more beneficial than other manual therapy techniques, much of the evidence supports IASTM as an effective treatment to determine. Burke et al proposed that the primary benefit of IASTM over other manual therapy techniques may only be the decreased stress on the hands of the physical therapist2. However, according to Loghmani et al, injured ligaments treated with instrument-assisted soft tissue mobilization were “43% stronger, 40% stiffer, and 57% more able to absorb energy” than the untreated contralateral injured side3.

The jury is still out if this is a more effective treatment than traditional manual therapy, IASTM continues to make a strong case to be greatly beneficial for both the patient and the clinician. In our clinic, we have seen great results with patients that have soft tissue restrictions. Within one treatment session patients are able to move better after use of IASTM. Some common areas we see great results with are low back, knee, neck, and ankle.

For more information on IASTM Therapy and to schedule your free consultation contact us at 305-735-8901 or click here.

AlterG® Anti-Gravity Treadmill®

  • alter-g-anti-gravity-treadmill-miami-florida

Get Faster and Safer Results with the AlterG Anti-Gravity Treadmill

Fox Physical Therapy in Miami, Florida is proud to announced the arrival of our newest rehabilitation technology, the AlterG Anti-Gravity Treadmill, the world’s first and only treadmill using NASA based anti-gravity technology, has been installed to help patients in their short-term rehabilitation programs.

The AlterG treadmill will be a huge asset to our facility and our patients will benefit the most. Patient’s recovering from all lower extremity injuries, surgeries, and back pain will get relief with the Alter-G treadmill.

AlterG Anti-Gravity Treadmills enable faster rehabilitation, safer conditioning for the geriatric population, and weight loss, which can help remove major obstacles associated with these activities. Impact on the body and the pain of recovery are reduced, which helps people achieve better results. Patients at Fox Physical Therapy can now rehab better, train smarter, and exercise safer with the AlterG.

With the AlterG, patients can run and walk without bearing their entire weight, reducing the impact on the body to optimize rehabilitation and physical therapy outcomes. Its Differential Air Pressure (DAP) technology applies a lifting force to the body that reduces weight on the lower extremities and allows precise unweighting – up to 80% of a person’s body weight, so people can find exactly where the pain stops and natural movement feels good again.

There are a multitude of benefits when training and rehabilitating on the AlterG. Patients can use the AlterG Anti-Gravity Treadmill to recover from injury and surgery and it allows them to immediately do partial weight bearing exercises. Patients with neurological disorders maintain, and in some cases even regain functionality and mobility working with the AlterG. It is also used as a motivational tool for obese patients, as users can immediately experience what it would feel like to weigh less, exercise with less joint impact and stress, and improve their cardiovascular health.

“With AlterG you get all the gain, without the pain,” says Steve Basta, CEO of AlterG. Adopted initially by nationally renowned hospitals and rehabilitation facilities, most recently nursing facilities are seeing the benefits the AlterG can provide for their patients. “We are pleased that Fox Physical Therapy is one of those pioneers,” he said. “Our unique approach to unweighted physical therapy preserves natural body movement, helps with fall prevention and benefits a broad range of medical conditions.”

AlterG Anti-Gravity Treadmills are designed to be used for lower body injury and surgery rehabilitation, aerobic conditioning, weight control and reduction, sport specific conditioning programs, neurologic retraining, and geriatric strength and conditioning.

Contact us today to schedule a consultation with Dr. Fox and learn if the AlterG Anti-Gravity Treadmill is right for your rehab. Call 305-735-8901 or click here.

Welcome To Our Website

  • fox-physcial-therapist-miami-design-district-wynwood

Fox Physical Therapy Miami

Thank you for stopping by our new website. We are excited to open our physical therapy office in Miami, Florida in January 2015. Join our mailing list to stay up to date with important news around the office and tips for improving your rehabilitation experience.

Fox Physical Therapy is a premier Orthopedic and Sports Injury Rehabilitation Center located in downtown Miami at the 25 Mirage Building inside Miami Performance Sports Institute, owned by licensed physical therapist Dr. Brett Fox PT, DPT,OCS, COMT.

Our modern Physical Therapy facility and outstanding team can provide the best environment for patient success. Combined with our hands-on, results-based approach, Fox Physical Therapy creates an enjoyable and motivating atmosphere to address a wide range of work, auto, orthopedic, and sports related injuries.

We look forward to working and serving the Miami community.

Fox PT –