Category Archives: Blog

Breast Cancer Awareness Month 2017

October 17, 2017 Teresa Stockton - Blog, Cancer Related Care, Women's Health

October is Breast Cancer Awareness Month. There were 1.7 million new cases of breast cancer diagnosed in 2012 worldwide. In honor of Breast Cancer Awareness Month, we are providing this helpful information, facts and statistics about breast cancer.

What is breast cancer?
Breast cancer occurs when cells in the breast divide and grow without their normal control. Tumors in the breast tend to grow slowly. By the time a lump is large enough to feel, it may have been growing for as long as 10 years. (Some tumors are aggressive and grow much faster.) Between 50-75 percent of breast cancers begin in the milk ducts, about 10-15 percent begin in the lobules and a few begin in other breast tissues [4].

Learn more about breast anatomy.

Non-invasive breast cancer – ductal carcinoma in situ (DCIS)
Ductal carcinoma in situ (DCIS) occurs when abnormal cells grow inside the milk ducts, but have not spread to nearby tissue or beyond. The term “in situ” means “in place.” With DCIS, the abnormal cells are still inside the ducts. DCIS is a non-invasive breast cancer. You may also hear the terms “pre-invasive” or “pre-cancerous” to describe DCIS. Although DCIS is non-invasive, without treatment, it can develop into invasive breast cancer.

Learn more about DCIS and the risk of invasive breast cancer.

Learn about treatment for DCIS.

Did you know?
In 2017, it’s estimated that among U.S. women there will be*:

252,710 new cases of invasive breast cancer
40,610 breast cancer deaths
50,000 cases of ductal carcinoma in situ, a non-invasive breast cancer

There are more than 3.1 million breast cancer survivors in the U.S. today. Thanks in part to Susan G. Komen’s investment in research in early detection and treatment, breast cancer mortality (death) in women in the U.S. declined by 38 percent from 1989-2014 [1].

*American Cancer Society. Cancer Facts and Figures 2017. Atlanta, GA: American Cancer Society, 2017.

Content provided by Susan G. Komen. For more information visit the Susan G. Komen website by clicking here.

Physical Therapy Following a Total Knee Replacement

October 12, 2017 Teresa Stockton - Blog, Knee

There are over 600,000 total knee replacements done each year in the U.S. As the workforce ages and as obesity levels continue to rise, this number is expected to increase.

Candidates for a knee replacement include patients experiencing difficulty doing simple daily activities, including walking or going down steps, and where conventional treatments are no longer helping. Common causes that lead to a replacement include pain with simple ADL’s (activities of daily living), pain at rest, chronic swelling, inflammation not improving with medication, knee deformity, knee stiffness, or trauma to the joint. When you are scheduled for a total knee replacement, ask to see your physical therapist for a pre¬surgical exercise and stretching program. This will help your knee recover its range of motion and strength.

Surgery consists of resurfacing the knee’s damaged and worn joint surfaces with artificial parts made of metal or plastic. Most patients are in the hospital for an average of 3¬5 days. And more than 90 percent of people report significant decrease in pain and improvement in ability to perform ADL’s within one month after surgery. Currently, many knee replacements are lasting 20 years or more with appropriate activity modification. One of the most important factors in success after a total knee replacement is follow up with physical therapy and a lifelong exercise program. Physical therapy typically starts during the hospital stay with the goals being to get the individual up and walking decreasing swelling in the knee and increasing knee ROM (range of motion). Upon hospital discharge, patients either go home and receive home physical therapy for one to two weeks, or to an extended care facility to continue their therapy.

Typically, patients need outpatient physical therapy after therapy at home, which usually begins two to four weeks after surgery. Outpatient physical therapy is recommended for three times a week for up to three months. Therapy goals initially are to reduce swelling and pain, and improve knee range of motion in both directions. To achieve these goals, treatment may consist of soft tissue massage to increase circulation and decrease swelling, stretching to improve flexibility, patellar mobilization, range of motion exercises, and modalities such as ice and electrical stimulation to help decrease pain and swelling. Physical therapy will progress to lower extremity strengthening exercises, balance activities, and fine tuning the gait pattern. Various activities and techniques will be used to improve strength, balance, and gait. As patients reach the end of their course of physical therapy, a personalized home exercise program is developed with the focus on independence with all ADL’s and returning to activities such as walking, swimming, dancing, golf, and biking. It is important for patients to stay active and maintain strength, flexibility, and endurance.

Physical Therapy Month 2017 – Managing Pain Safely

October 10, 2017 Teresa Stockton - Blog, Events

This Physical Therapy Month we want patients to try physical therapy first! Physical therapy is a safe non-invasive form of treatment for patients experiencing musculoskeletal pain or injuries.

PHYSICAL THERAPY is a safe and SMART alternative to opioids.

Great candidates to be referred to physical therapy instead of prescribing pain pills include:

A patient that has had pain for more than 90 days
A patient that complains of pain disturbing their sleep or daily activities
A patient that has a history of substance abuse or has been on pain medication for an extended period of time
A patient that expresses an interest in avoiding opioids

Try physical therapy and see the difference!

Treating Childhood Obesity With Activity

October 5, 2017 Teresa Stockton - Blog, Pediatrics

When talk focuses on childhood obesity in the United States, words like “critical” and “epidemic” are often used. The tried-and-true prescription of more exercise and better nutrition still holds true, but overweight children face unique challenges when it comes to weight loss.

Why Has Childhood Obesity Increased and What Are the Effects?
The statistics are disturbing. Not only are the overall obesity rates increasing, the heaviest kids are heavier than they were 30 years ago. Why is this happening? Experts who have studied childhood obesity attribute it to a change in lifestyle. The active lifestyle of the past—walking to school, playing outside, and engaging in after-school activities—has been replaced by a sedentary lifestyle of watching TV, playing video games, and using electronic devices like phones, computers, and tablets. Eating habits have changed noticeably, with convenience foods that are higher in fat and calories replacing fruits and vegetables.

The consequences of obesity are significant. A child who is obese may develop high blood pressure, high cholesterol, and type 2 diabetes. These conditions can increase the risk of cardiovascular disease such as a heart attack and stroke. In addition, older teens who are obese may have an increased risk of death during adulthood.

Obesity can also affect emotional health. A child who is obese may have emotional problems in school, and struggle with low self-esteem and depression.

What Is One of the Best Solutions?
Exercise is one of the main tools to fight childhood obesity. The US Department of Health and Human Services encourages children of all ages to be physically active. If your child is overweight, obese, or even of normal weight, recommendations to improve your child’s health include:

Encouraging your young child (aged 1-4 years old) to actively play daily in a safe environment
Encouraging your older child (aged 5 years and up) to participate in moderate to vigorous activity every day—Your child should aim for at least one hour per day of moderate to vigorous activity. At least 3 days out of the week should be vigorous activity.

Since children often engage in shorter bursts of activity throughout the day, it is okay to count these times as exercise.

Examples of different types of physical activity include:

Moderate-intensity: Brisk walking, hiking, skateboarding, baseball, rollerblading, and bike riding
Vigorous-intensity: Jumping rope, running, and playing sports like basketball, hockey or tennis

The main difference between moderate- and vigorous-intensity exercises is the demand on the body. Vigorous activities force the body to work harder. The heart beats faster and breathing becomes more rapid, but energy is used up faster.

Rollerblading
Learning karate
Playing organized sports (field hockey, soccer, football)
Swimming
Gymnastics
Strength training with weights
Rock climbing
Cross-country skiing

Before your child jumps into a new fitness routine, it is important that you work with your child’s doctor. Being obese can put a strain on muscles and bones, possibly causing back pain and foot or ankle problems. The doctor can assess your child’s overall health and recommend safe exercises.

What Else Can Be Done to Encourage Activity?
Another important piece to the puzzle is to focus on screen time. Screen time refers to how many hours per day your child spends in front of a screen—whether it be watching TV, playing video games, or using electronic devices. These are sedentary activities that contribute to obesity. The NHLBI recommends that screen time should be limited to less than 2 hours per day, which leaves more time for exercise. You can further encourage your child to be active by planning family outings, like going on a hike, riding bikes, or playing flag football. That way, the whole family can become healthier together.

by Patricia Kellicker, BSN and Rebecca J. Stahl, MA

RESOURCES:
American Council on Exercise
http://www.acefitness.org

Shape Up America
http://www.shapeupus.org

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Healthy Alberta
http://www.healthyalberta.com

REFERENCES:
Aerobic, muscle, and bone-strengthening: What counts? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/basics/children/what_counts.htm. Updated June 5, 2015. Accessed March 2, 2016.

Chapter 3: Active children and adolescents. US Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/chapter3.aspx. Accessed March 2, 2016.

How much physical activity do children need? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/basics/children/index.htm. Updated June 4, 2015. Accessed March 2, 2016.

Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LW, Koes BW. Musculoskeletal problems in overweight and obese children. Ann Fam Med. 2009;7(4):352-356.

NCHBI integrated guidelines for pediatric cardiovascular risk reduction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 12, 2013. Accessed March 2, 2016.

Obesity in children and adolescents. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 10, 2016. Accessed March 2, 2016.

Last reviewed March 2016 by Michael Woods, MD Last Updated: 3/2/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Most Common Hockey Upper Body Injuries

October 3, 2017 Teresa Stockton - Blog, Sports and Fitness

Hockey season is getting ready to start and the sport of hockey can be quite dangerous. It is important for players to know how to prevent and treat injuries that occur during games. Unfortunately, these injuries leave us with some questions with descriptions such as “lower-body” and “upper-body” injuries. These injuries are purposely vague to leave some question as to the exact nature of the injury.

The accompanying infographic gives players an assist by listing off some common “upper body injuries.” It features tips and tricks to remain healthy both on and off the ice. The following should ease the minds of players who want to play the game as safely as they possibly can.

Click arrows in the bottom right corner to expand full screen

Upper Body Injuries by Pro Stock Hockey, an online resource for authentic pro stock hockey equipment (https://www.prostockhockey.com/)

Common Causes of Carpal Tunnel Syndrome

September 28, 2017 Teresa Stockton - Blog, Wrist

Carpal Tunnel happens when the tendons become swollen (tenosynovitis) or if the tunnel size itself decreases because of injury-causing compression to the median nerve. When compression occurs, a person can experience numbness, tingling, or a dull sensation of the thumb, index, middle and ring fingers. Symptoms may include pain during pinching and gripping, or a feeling of clumsiness and the inability to hold things. The best way to avoid carpal wrist pain is to understand the main causes of carpal tunnel and use that information at work and at home.

WHAT IS THE CARPAL TUNNEL?
The carpal tunnel is a small space at the wrist in which the median nerve and nine tendons pass through. The median nerve travels on top of the tendons through the tunnel. The tunnel itself is made up of your wrist bones and along the top of the tunnel is a thick fibrous ligament called the transverse carpal ligament.

COMMON CAUSES OF CARPAL TUNNEL
Carpal Tunnel is typically not related to a specific injury. Some common causes of carpal tunnel syndrome include:

Genetic Predisposition – Many cases can be a result of physical characteristics of carpal tunnel or medical conditions associated with CTS, which also run in the family.

Repetitive Movements – Certain types of work, leisure, and sports activities require use of the hand and wrist repetitively. Occupations such as manufacturing/assembly line workers, grocery checkers, musicians, carpenters, and many others require the same movements. Common hobbies such as golfing, knitting, and gardening also require repeated movements that cause carpal tunnel syndrome.

Injury or Trauma – Sprain or fracture of the wrist can cause swelling and pressure to the median nerve.

Pregnancy & Menopause – Hormonal fluctuation in women plays a role in CTS. Such fluctuation may cause fluid retention and other changes that cause swelling in the body. Fluid retention frequently occurs during the last trimester of pregnancy and is the reason for CTS.

Medical Conditions – Diabetes, hypothyroidism, lupus, obesity, and rheumatoid arthritis.

ACTIVITIES TO AVOID TO MINIMIZE SYMPTOMS

Avoid keeping your wrists bent in either direction. The best position for the wrist is neutral (straight)
Avoid rapid repetitive forceful or prolonged hand or arm use such as seen with factory work or data entry.
Avoid tight gripping and pinching
Avoid pressure to the palm or wrist
Avoid extreme cold or vibration.

PT News

September 26, 2017 Teresa Stockton - Blog, PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

1. Foot Pain in Dress Shoes
Written by the Therapy Team at the Jackson Clinics Physical Therapy – Northern Virginia

Have you ever had a long anticipated night on the town spoiled by sore feet? The source of your discomfort just might be those pretty shoes you have chosen to wear. Read more

2. Knee Pain… Could it be Patellar Tendinitis?
Written by the Therapy Team at Denali Physical Therapy – Anchorage, AK

What is Patellar Tendinitis?
The patellar tendon is a ligament that connects the shin bone to the patella that helps the muscles extend the knee. Read more

3. ARC Physical Therapy+ Expands with a New Clinic in Urbandale, Iowa
Written by the Therapy Team at ARC Physical Therapy – Urbandale, IA

ARC Physical Therapy+ is pleased to announce the opening of a new clinic in Urbandale, Iowa on September 25^th, 2017. This makes the third ARC Physical Therapy+ clinic in Iowa and the 18^th clinic across Iowa, Missouri and Kansas. Read more

Physical Therapy for Balance & Fall Prevention

September 22, 2017 Teresa Stockton - Aging, Balance & Vestibular Rehab, Blog

“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.

Women’s Health: The Sacroilial (SI) Joint and How It Affects You

September 19, 2017 Teresa Stockton - Back, Blog, Women's Health

It has been estimated that about 95% of the population will experience low back pain at some point during a lifetime. Low back pain may be due to many different causes and anatomical structures, one such structure is the SI joint. Here is some pertinent information about the SI joint and how it may affect your general health.

8 FUN FACTS:

What is the SI joint?
It is a joint connecting the sacrum and the ilium, 2 bones included in the pelvis. The pelvis connects the upper body to the lower body, more specifically the spine to the hips.

What does the SI joint do?
It helps to stabilize your core during functional and work activities and helps with shock absorption during weight-bearing activities including walking. Stability is also assisted by the ligaments, fascia, and muscles that attach to the joint. This includes back, gluteal, hip, and pelvic floor musculature.

Who feels SI pain?
People with leg length discrepancies, asymmetrical lower extremity weakness, scoliosis, pregnant women due to increased ligamentous laxity, women > men due to pelvic anatomy, and those who have experienced a traumatic event such as a fall or a motor vehicle accident or that perform repetitive activities with poor body mechanics including lifting and bending.

Where would you feel SI pain?
Directly over the SI joint, in the buttock, lateral or posterior thigh, or sometimes in the groin.

When may you feel SI pain?
Rolling in bed, rotating your trunk, walking, stair ascent or descent, standing from a sitting position, single leg activities

What positions/activities should be adopted?
Sleep with a pillow between your lower extremities, perform slow, controlled movements, maintain equal weight-bearing through lower extremities with transitional movements and standing, log roll during bed mobility to keep lower extremities symmetrical, swing lower extremities out of the car before standing up to prevent trunk rotation.

How can PT help?
Physical therapy has been found to help patients with SI pain get pain relief, reduce inflammation and muscle spasms, improve healing, muscle extensibility, joint mobility and range of motion, strength, muscle control, and gait mechanics.

What does PT treatment for SI pain involve?
Stretching, mobilization techniques, education on proper body mechanics with functional activities, massage, myofascial release, modalities including electrical stimulation for pain modulation and ultrasound to assist with healing and inflammation, muscle energy techniques, and a core stabilization and strengthening exercise program, tailored to the individual patient. If a leg length discrepancy is found, a heel lift may be helpful to restore abnormal forces being placed through the SI joint with weight-bearing activities. An initiation of a home exercise program is also an integral part of physical therapy treatment.

Safe Lifting Practices for Back Injury Prevention

September 14, 2017 Teresa Stockton - Back, Blog, Industrial Rehab

Whether at home or at work safe lifting practices can keep your back healthy and safe. Before lifting heavy objects decide how you will lift carry & place the item before you pick it up. Test the weight of the load by moving or tipping it. Figure out if you can break the load down by placing the contents of large containers into a number of smaller ones before moving them. Is the path clear? What is the weight of the load? How much stress will be placed upon your back? Is there traffic, a tripping hazard, a doorway to go through, or a stairway to go up or down? Avoid carrying an object that requires two hands to hold, either up or especially down a flight of stairs. Use the elevator. Plan a rest stop, if needed. Knowing what you’re doing and where you’re going will prevent you from making awkward movements while holding something heavy. Clear a path, and if lifting something with another person, make sure both of you agree on the plan.

KEY STEPS FOR SAFE LIFTING PRACTICES

Establish a Base of Support: Use a wide, balanced stance with one foot in front of the other. Make sure that you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.

Keep Your Eyes Up: Looking slightly upward will help you maintain a better position of the spine. Keeping your eyes focused upwards helps you keep your back straight.

Get a Good Grip: With your palms and make sure you have an adequate hold on the object. Be certain you will be able to maintain a hold on the object without having to adjust your grip later. You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can desensitize the fingers and make you unable to feel the object.

Lift Gradually with Your Legs: Without using jerky motions. By using your leg strength, your chance of lower back injury is greatly reduced.

Tighten you stomach muscles: As you begin the lift and keep you head and shoulders up.

Pivot – Don’t Twist: Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

Weight: A lighter load normally means a lesser risk of injury. The weight of the object should be within the capacity of the person to handle safely.

Handling: It is easier to pull or push a load than it is to lift, put down or carry.

Keep the Load Close: Holding a 20lb object with your hands 20 inches from the body creates more compressive force on your low back than holding it 10 inches away. This is because the muscles in your back have to work to counterbalance the weight when it is further from the body. As the compressive force on your low back increases, so does the risk of muscle strains, ligament sprains and damage to the disks in the spine.

Frequency: The more times a load is handled, the more tired the muscles become, making it easier for the person to be injured.

Distance: The farther the load has to be moved, the greater the risk of injury.

Duration (TIME): Where the job involves repetitive movements, reducing the time spent on handling will help to ensure the movements are not causing unnecessary strain.

Forces Applied: Forces should be applied smoothly, evenly and close to the body. Forces exerted should be well within the capacity of the person, and the person should maintain proper posture.

Nature of the Load: Loads that are compact, stable, easy to grip, and capable of being held close to the body are much easier to handle.

Terrain: Rough ground, steep slopes, slippery and uneven floors, stairs and cluttered floors make moving a load awkward and increase the chance for injury.

Environment (Climate & Lighting): If it is too hot, too humid, too cold or the lighting is inadequate, the capacity to work safely is reduced.

Condition of the Workplace: Safe and comfortable working conditions, with adequate space to perform the task, and tools and equipment that are well-maintained, make their job safer.

Age/Gender: Young and old workers alike may be at an increased risk of injury from manual materials handling activities. Ensure abilities of employees are in line with functional job requirements.

Training: Proper training for the specific task is vital to reduce injury.

Team Lifting: If one person cannot lift or move a heavy, large or awkward object safely, organize a team lift. Team lifting reduces the risk of injury, reduces fatigue and makes the task much easier.

Raise/Lower Shelves: The best zone for lifting is between your shoulders and your waist. *Put heavier objects on shelves at waist level, lighter objects on lower or higher shelves.

Avoid Lifting from the Floor: Lifting from the floor can greatly increase your risk of injury for two reasons. Firstly, it is difficult to bring objects close to your body when picking them up from the floor, especially large objects where your knees can get in the way. Secondly, your low back must now support the weights of your upper body as you lean forward, in addition to supporting the weight of the item you are lifting. Lifting the same 20lbs from the floor more than doubles the amount of force on your low back when compared with lifting is from waist height. Even a one pound object lifted from the floor increases you risk of injury if you use a bent over posture.

Get Help When You Need It: Don’t try to lift heavy or awkward loads on your own. Even though the muscles in your upper body may be strong enough to handle the load, the muscles, ligaments and disks in your lower back may be injured because of the additional forces they have to withstand. Get help from a co-worker, and whenever possible, use a cart, hand truck or other mechanical device to move the load for you.

This content was written by Fit2WRK who has partnered with PT and Me to give a comprehensive look into the services physical and occupational therapists provide. For more information on Fit2WRK click here.