Category Archives: Balance & Vestibular Rehab

FOOSH

FOOSH – Silly Name, Serious Injury

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

FOOSH

One of the most common mechanism of injury from falls is called a FOOSH (Fall on an Out Stretched Hand) injury. Don’t let the funny name fool you. A FOOSH injury is one of the most debilitating ways to injure your upper extremity and cause a significant loss of function. A Foosh occurs when a person is on their way down during a fall and tries to brace for impact using their hands. This is a natural response to falling and is difficult to try and prevent. The resulting impact of the hand and wrist on the ground can cause varying types of injuries from strains and sprains to fractures of the hand, wrist, elbow or shoulder.

What to look for if you experience a FOOSH Injury

1. Fractures: Typically, the fractures of the forearm from a FOOSH are the easiest to spot. They become swollen and bruised very rapidly and are associated with a lot of pain. Often times they produce a visible bulging of the skin of the forearm which can even protrude outside of the body. Fractures of the wrist and forearm will need to be evaluated and often times re-set and casted. Following casting the person must regain strength and range of motion through a guided exercise program before normal function can return. These injuries may take as long as 12 weeks to heal, but as many as 20 weeks for return to normalcy. This process can be expedited significantly by a referral to a well-trained physical therapist.

2. Sprains: Sprains from a FOOSH are much more difficult to spot. A sprain is a common injury to a ligament that normally holds one bone to another as a part of a joint. It most likely causes moderate to severe swelling, bruising, and pain. The pain may occur both by moving the joint yourself or having someone else move the joint while you are relaxed. During a sprain, a non-contractile piece of tissue becomes torn partially or completely. The result is a joint that is too lax to allow proper joint stability. This can cause problems for years following the initial injury. Think of the brake system on your bicycle. If the brake cable becomes elongated the brake does not function correctly until it is repaired. An evaluation by a physical therapist is necessary to diagnose and treat a sprain correctly and to prevent further injury to the injury site as well as allow for speedy recovery.

3. Strains: Strains are also difficult to spot following a FOOSH. A strain differs from a sprain in that it occurs as a tearing of the tendon instead of a ligament. This can present like a sprain with swelling and bruising, but will have a few different characteristics. Tendons attach to bone on one side and a muscle on the other. Tendons therefore hurt with both passive motion, but also with active motion. Strains of the wrist and hand can cause a significant loss in function with things like writing, typing, or even just holding an object in your hand. Without intervention, this can lead to progressively worsening problems like tendonitis and carpal tunnel syndrome which may need surgical intervention if not attended to quickly.

No matter your age or fitness level please use caution to avoid these types of debilitating injuries. If you do fall, it is important to consult your health care provider. During rehabilitation we can help you reduce pain, increase strength and regain function. Please feel free to call us for more information or to schedule an appointment.

fall prevention physical therapy

Fall Prevention Programs Can Keep You On Your Feet!

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

 

One in every three adults 65 and older fall each year in the United States – WWW.CDC.GOV

The numbers are staggering. Apparently not only does the eyesight go, but balance along with it. The two could be seen as going hand in hand since the worse your vision gets, the more likely you are to bump into or trip on something unnoticed. Fear not worried reader. Physical therapy may not improve vision, but it does improve the ability to manage and reduce the likelihood of a fall and even more importantly, a resulting hip fracture.

Fall prevention physical therapy conditioning programs offered by physical therapists are designed to increase independence with functional activities, functional mobility, and safety awareness while decreasing fall risk. Research has shown that a successful fall prevention program must be multi-dimensional. A program must address all underlying factors in addition to strength and balance. Physical therapists use valid and reliable assessments to determine all the factors affecting each individual’s fall risk. Therapy focuses on reducing the factors and decreasing fall risk. This is consistent with the protocols recommended by: The American Geriatrics Society and the American Academy of Orthopedic Surgeons’ Panel on Fall Prevention Guidelines.

THE MAIN GOALS OF THE FALL PREVENTION PHYSICAL THERAPY CONDITIONING PROGRAM ARE:

  • Increase independence with Activities of Daily Living (ADLs)
  • Increase independence with functional mobility
  • Decrease fall risk
  • Prevent future fall
  • Increase safety
  • Patient education

Still on the fence?
Don’t take our word for it. We have included an adapted Tinetti Balance Assessment Tool to help assess the likelihood of a fall. The Tinetti tool is the oldest clinical balance assessment tool and the widest used among older people (Yelnik, Bonan 2008). The advantages of Tinetti’s balance assessment tool are its inclusion of both balance and gait and its good inter-rater reliability and excellent sensitivity. (You can read more at the US National Library of Medicine).

Once you have taken your test – ask your physical therapist to go over the results and what options are available to decrease the risk of falls. Find your PT HERE!

Tinetti-Balance-Tool

For more information about balance and fall prevention click the links below:


    
PT News PTandMe

PT News November 2018

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

PT News PTandMe

This time in PT News we recap what our clinics have been posting throughout November, 2018. Featuring published articles from PTandMe partnering clinics!

Seeing a physical therapist first with Direct Access

1. Seeing A Physical Therapist First, Through Direct Access, Improves Outcomes and Saves Money
Written by Mishock Physical Therapy & Associates with six physical therapy locations throughout Montgomery, Berks and Chester, PA Counties.

With direct access, getting the help you need has never been easier. Direct access is a law that allows you to seek care from your physical therapist without a physician referral. This means that as a patient, you can call us directly if you have an injury, pain, stiffness, or weakness that you want evaluated.  Read more

 

things you should know about vertigo

2. Things You Should Know About Vertigo
Written by the Therapy Team at Momentum Physical Therapy with 12  physical therapy locations throughout Greater San Antonio.

While anti-nausea medication and rest can help, there are ways to treat vertigo without medication. Vertigo can be helped with physical therapy. BPPV (Benign Paroxysmal Positional Vertigo), commonly described as having “loose crystals in the inner ear,” is the most common type of treated with physical therapy.  Read more

Questions to ask before surgery

3. Questions To Ask Before Choosing Surgery
Written by the Therapy Team at The Center for Physical Rehabilitation with 6, but soon to be 7, physical therapy locations throughout the Greater Grand Rapids Area.

Having surgery can be an intimidating process. Know what your surgical goals are. Are you looking to return to normal daily life functions or do you have plans to return to or start into high-level fitness/athletics? Read more

how do falls happen

How Do Falls Happen?

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

Statistics show that the majority (60 percent) of falls happen on the same level resulting from slips and trips. The remaining (40 percent) are falls from a height. This document will summarize information on “falls on the same level” (slips and trips). Falls from an elevation, such as falls from ladders, roofs, down stairs or from jumping to a lower level, etc., will discussed in another document since each type of fall requires different features in a fall prevention program.

Slips
Slips happen where there is too little friction or traction between the footwear and the walking surface.
Common causes of slips are:
• Wet or oily surfaces
• Occasional spills
• Weather hazards
• Loose, unanchored rugs or mats, and flooring or other walking surfaces that do not have same degree of traction in all areas

tripping

Trips
Trips happen when your foot collides (strikes, hits) an object causing you to lose the balance and, eventually fall.
Common causes of tripping are:
• Obstructed view
• Poor lighting
• Clutter in your way
• Wrinkled carpeting
• Uncovered cables
• Bottom drawers not being closed, and uneven (steps, thresholds) walking surfaces

Find a physical therapist near me

Click here to see the Fit2Wrk presentation: Slips and Falls in the Workplace

For more information about balance and fall prevention click the links below:


    
Fall Prevention Physical Therapy

Physical Therapy for Balance & Fall Prevention

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

“Falls are the leading cause of injury death for Americans 65 years or older. Each year, about 35–40% of adults 65 and older fall at least once.”
— Center for Disease Control

Physical Therapy for Fall Prevention
Physical therapy fall prevention programs are tailored around each individual’s needs. The length of the program is dependent on the severity of the symptoms and the goals of each individual. Most patients will follow a gradual path of three distinct phases. After an initial evaluation to determine needs and goals of patient and we will set up treatment plan with patient input. The first phase typically includes therapeutic interventions designated to decrease symptoms and the establishment of a Home Exercise Program (HEP). We will then Continue the use of therapeutic interventions with the addition of ADL modifications, and energy conservation techniques. Finally we will continue the program until the patient’s goals are met.

The main objectives in a fall prevention program are to:

  • Increase independence with Activities of Daily Living (ADLs)
  • Increase independence with functional mobility
  • Decrease fall risk
  • Prevent future fall
  • Increase safety

Pain Relief
Our PTandMe licensed physical therapists are skilled in helping patients significantly reduce the risk of falls so that seniors can continue to age independently. If you or someone you know may benefit from a fall prevention program – call a clinic near you today and see what options are available for you! To find a PTandMe partnering location in your area click here.

postural hypotension PTandMe

Postural Hypotension: What It Is and How to Manage It

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

Postural hypotension (or orthostatic hypotension) is when your blood pressure drops when you go from lying down to sitting up or from sitting to standing. When your blood pressure drops, less blood can go to your organs and muscles. This can make you likely to fall.

What are the symptoms?
Although many people with postural hypotension have no symptoms, others do. These symptoms can differ from person to person and may include:

  • Dizziness or lightheadedness
  • Feeling about to faint, passing out or falling
  • Headaches, blurry or tunnel vision
  • Feeling vague or muddled
  • Feeling pressure across the back of your shoulders or neck
  • Feeling nauseous or hot and clammy
  • Weakness or fatigue

When do symptoms tend to happen?
When standing or sitting up suddenly

  •  In the morning when blood pressure is naturally lower
  • After a large meal or alcohol
  • During exercise
  • When straining on the toilet
  • When you are ill
  • If you become anxious or panicky

What causes postural hypotension?
Postural hypotension may be caused by or linked to:

  • High blood pressure
  • Diabetes, heart failure, atherosclerosis or hardening of the arteries
  • Taking some diuretics, antidepressants or medicines to lower blood pressure
  • Neurological conditions like Parkinson’s disease and some types of dementia
  • Dehydration
  • Vitamin B12 deficiency or anemia
  • Alcoholism
  • Prolonged bed rest

What can I do to manage my postural hypotension?

  • Tell your healthcare provider about any symptoms
  • Ask if any of your medicines should be reduced or stopped
  • Get out of bed slowly. First sit up, then sit on the side of the bed, then stand up
  • Take your time when changing position, such as when getting up from a chair
  • Try to sit down when washing, showering, dressing or working in the kitchen
  • Exercise gently before getting up (move your feet up and down and clench and unclench your hands) or after standing (march in place)
  • Make sure you have something to hold onto when you stand up
  • Do not walk if you feel dizzy
  • Drink 6-8 glasses of water or low-calorie drinks each day, unless you have been told to limit your fluid intake
  • Avoid taking very hot baths or showers
  • Try sleeping with extra pillows to raise your head

This information was written by Proactive Physical Therapy, an outpatient physical therapy clinic in Sioux Falls, South Dakota. At ProActive Physical Therapy, their number one priority is the patient. They strive to provide individualized treatment with hands-on, compassionate care. They do not rush their patients or their clinicians. Rather, they perform comprehensive evaluations and encourage patient input for treatment planning and goal setting. For more information click here.

Vestibular Rehabilitation Programs

Vestibular Rehabilitation Programs

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

Vestibular_Rehab_FBsize

Patients with vestibular dysfunction often complain primarily of dizziness and “spinning” sensation as well as headaches, deconditioning, and muscle tension. Decrease feelings of vertigo and dizziness improve balance, posture control and gaze stability increase overall endurance and conditioning.

Vestibular rehabilitation programs can help patients with acute or chronic vestibular and/or balance dysfunction secondary to complications associated with:
• Benign Paroxysmal Positional Vertigo (BPPV)
• Labyrinthitis
• Vestibular Neuritis
• Meniere’s Syndrome
• Perilymph Fistula
• Bilateral Vistibular Loss
• Cervicogenic Dizziness (Cervical Vertigo)
• Migraine Related Dizziness

vertigo diagram

All patients will go through a physical therapy evaluation consisting of:
• Extensive Interview
• Neuromusculoskeletal Exam
• Oculomotor Exam

Each patient receives an individualized treatment program that includes:
• Education
• Home Exercise Program
• Repositioning Maneuvers
• Habituation Exercises
• Eye Exercises
• Balance Exercises
• Conditioning Exercises
• Functional Activities