Tag Archives: fitness

Exercising Do’s and Dont’s

November 15, 2016 Teresa Stockton - Blog, Sports and Fitness

In the third installment of our gym series we examine the proper ways to exercise at the gym from start to finish. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your therapist at your next therapy session.

SCAPULAR RETRACTION / ROW

START POSITION
• Standing or seated with back in neutral with feet shoulder width apart.
• Squeeze shoulder blades together.
• Elbows slightly bent and forearms parallel to the floor.

ENDING POSITION
• Elbows at 90⁰ flexion.
• Shoulders pulled back.
• Hands at your sides at shoulder width and forearms parallel to the floor.

DON’T
• Swing body back and forth.
• Let the weight pull you forward between repetitions (keep the shoulders back).
• Shrug.

ANTERIOR DELTOID – FRONTAL RAISE

START POSITION
• Standing with spine in neutral position with feet shoulder width apart.
• Palms facing down.

ENDING POSITION
• Arm raised to 90⁰ directly in front of you.
• Elbow in full extension.

DON’T
• Raise arm past 90 degrees.
• Swing body back and forth.
• Rotate wrist.
• Shrug shoulders.

LATERAL DELTOID – LATERAL RAISES

START POSITION
• Standing with spine in neutral position with feet shoulder width apart.
• Elbows bent at 90 degrees.

ENDING POSITION
• Arms raised to 90 degrees at your side.
• Palms facing down.

DON’T
• Raise arms past 90 degrees.
• Swing body back and forth.
• Shrug shoulders.

BENCH PRESS

START POSITION
• Lay flat on bench with both feet flat on the ground.
• Place a rolled towed in the center of the chest.
• Arms extended with wide grip to facilitate 90 degree bend at the elbow at the bottom of repetition.

ENDING POSITION
• Lower slowly until the bar touches the towel
• Elbows should not pass the height of the bench bending to about 90 degrees.

DON’T
• Lift feet off the ground.
• Arch your back.
• Bounce bar off your chest (barbell should only touch the towel lightly).

This information about exercise at the gym was written by STAR Therapy Services, an outpatient physical therapy group with six locations in Houston, Texas. At Star Houston Therapy Services, their number one priority is the patient. They strive to provide individualized treatment with hands-on, compassionate care. They perform comprehensive evaluations and encourage patient input for treatment planning and goal setting. For more information click here.

View the complete Exercising Do’s and Don’ts series below:

Type 2 Diabetes (Diabetes Mellitus Type 2; Insulin-Resistant Diabetes; Diabetes, Type 2)

November 10, 2016 Teresa Stockton - Blog, General Information

Definition
Glucose is a type of sugar. It comes from food, and is also created in the liver. Glucose travels through the body in the blood. It moves from the blood to cells with the help of a hormone called insulin. Once glucose is in those cells, it can be used for energy.

Diabetes is a condition that makes it difficult for the body to use glucose. This causes a buildup of glucose in the blood. It also means the body is not getting enough energy. Type 2 diabetes is one type of diabetes, and it is the most common.

Medication, lifestyle changes, and monitoring can help control blood glucose levels.

Causes
Type 2 diabetes is often caused by a combination of factors. One factor is that your body begins to make less insulin. A second factor is that your body becomes resistant to insulin. This means there is insulin in your body, but your body cannot use it effectively. Insulin resistance is often related to excess body fat.

Risk Factors
Type 2 diabetes is more common in people who are aged 45 years and older. It is also common in younger people who are obese and belong to at-risk ethnic groups. Other factors that increase your chance for type 2 diabetes include:
• Prediabetes — impaired glucose tolerance and impaired fasting glucose
• Metabolic syndrome — a condition marked by elevated cholesterol, blood glucose, blood pressure, and central obesity
• Excess weight or obesity, especially central obesity
• Lack of exercise
• Poor diet — high intake of processed meats, fats, sugar-sweetened foods and beverages, and calories
• Family history of type 2 diabetes
• High blood pressure
• History of cardiovascular disease
• Depression
• History of gestational diabetes, or having a baby that weighs over 9 pounds at birth
• Endocrine disorders, such as Cushing’s syndrome, hyperthyroidism, acromegaly, polycystic ovary syndrome, pheochromocytoma, or glucagonoma
• Conditions associated with insulin resistance, such as acanthosis nigricans
• Certain medications, such as glucocorticoids or thiazides
• Certain ethnic groups, such as African American, Hispanic, Native American, Hispanic American, Asian American, or Pacific Islander

Symptoms
You may have diabetes for years before you have symptoms. Symptoms caused by high blood sugar or include:
• Increased urination
• Extreme thirst
• Hunger
• Fatigue
• Blurry vision
• Irritability
• Frequent or recurring infections
• Poor wound healing
• Numbness or tingling in the hands or feet
• Problems with gums
• Itching
• Problems having an erection

Diagnosis
The doctor will ask about your symptoms and medical history. You will also be asked about your family history. A physical exam will be done.

Diagnosis is based on the results of blood testing. American Diabetes Association (ADA) recommends diagnosis be made if you have one of the following:
• Symptoms of diabetes and a random blood test with a blood sugar level greater than or equal to 200 mg/dL (11.1 mmol/L)
• Fasting blood sugar test is done after you have not eaten for 8 or more hours—showing blood sugar levels greater than or equal to 126 mg/dL (7 mmol/L) on two different days
• Glucose tolerance test measures blood sugar 2 hours after you eat glucose—showing glucose levels greater than or equal to 200 mg/dL (11.1 mmol/L)
• HbA1c level of 6.5% or higher—indicates poor blood sugar control over the past 2-4 months

* mg/dL = milligrams per deciliter of blood; mmol/L = millimole per liter of blood

Treatment
Treatment aims to:
• Maintain blood sugar at levels as close to normal as possible
• Prevent or delay complications
• Control other conditions that you may have, like high blood pressure and high cholesterol

Diet
Food and drinks have a direct effect on your blood glucose level. Eating healthy meals can help you control your blood glucose. It will also help your overall health. Some basic tips include:
• Follow a balanced meal plan. It should include carbohydrates, proteins, and fats.
• Be aware of appropriate serving size. Measure your food to help understand ideal serving size.
• Do not skip meals. Plan your meals and snacks through the day. Having meals throughout the day can help avoid major changes in glucose levels.
• Eat plenty of vegetables and fiber.
• Limit the amount of fat (especially saturated and trans fats) in your foods.
• Eat moderate amounts of protein and low-fat dairy products.
• Carefully limit foods containing high concentrated sugar.
• Keep a record of your food intake. Share the record with your dietitian or doctor. This will help to create an effective meal plan.

Weight Loss
If you are overweight, weight loss will help your body use insulin better. Talk to your doctor about a healthy weight goal. You and your doctor or dietitian can make a safe meal plan for you.

These options may help you lose weight:
• Use a portion control plate
• Use a prepared meal plan
• Eat a Mediterranean-style diet

Exercise
Physical activity can:
• Make the body more sensitive to insulin
• Help you reach and maintain a healthy weight
• Lower the levels of fat in your blood

Aerobic exercise is any activity that increases your heart rate. Resistance training helps build muscle strength. Both types of exercise help to improve long-term glucose control. Regular exercise can also help reduce your risk of heart disease.

Talk to your doctor about an activity plan. Ask about any precautions you may need to take.

Medication
Certain medications will help to manage blood glucose levels.

Medication taken by mouth may include:
• Biguanides reduce the amount of glucose made by the body
• Sulfonylureas encourage the pancreas to make more insulin
• Insulin sensitizers to help the body use insulin better
• Starch blockers to decrease the amount of glucose absorbed into the blood
• Sodium-glucose co-transporter 2 (SGLT-2) inhibitors to increase glucose excretion in urine
• Bile acid binders

Some medications needs to be given by injection, such as:
• Incretin-mimetics stimulate the pancreas to produce insulin and decrease appetite, which can assist with weight loss
• Amylin analogs replace a protein of the pancreas that is low in people with type 2 diabetes

Insulin
Insulin may be needed if:
• The body does not make enough of its own insulin
• Blood glucose levels cannot be controlled with lifestyle changes and medications

Insulin is given through injections. There is one short-acting inhaled insulin which may be available for select persons.

Blood Glucose Testing
You can check the level of glucose in your blood with a blood glucose meter. Checking your blood glucose levels during the day can help you stay on track. It will also help your doctor determine if your treatment is working. Keeping track of blood sugar levels is especially important if you take insulin.

Regular testing may not be needed if your diabetes is under control and you don’t take insulin. Talk with your doctor before stopping blood sugar monitoring.

An HbA1c test may also be done at your doctor’s office. This is a measure of blood glucose control over a long period of time. Doctors advise that most people keep their HbA1c levels below 7%. Your exact goal may be different. Keeping HbA1c in your goal range can help lower the chance of complications.

Counseling
Depression can undermine your recovery and put you at risk for other complications. Feelings of sadness, hopelessness, and loss of interest in your favorite activities that stay with you for at least 2 weeks should prompt you to call your doctor. Depression is treatable. Your doctor may refer you to counseling to help you better manage your depression and diabetes.

Decreasing Risk of Complications
Over a long period of time, high blood glucose levels can damage vital organs. The kidneys, eyes, and nerves are most affected. Diabetes can also increase your risk of heart disease.

Maintaining goal blood glucose levels is the first step to lowering your risk of these complications. Other steps:
• Take good care of your feet. Be on the lookout for any sores or irritated areas. Keep your feet dry and clean.
• Have your eyes checked once a year.
• Don’t smoke. If you do, look for programs or products that can help you quit.
• Keep track of your moods and be alert for persistent depressive symptoms.
• Plan medical visits as recommended.

Prevention
To help reduce your chance of type 2 diabetes:
• Participate in regular physical activity
• Maintain a healthy weight
• Drink alcohol only in moderation (2 drinks per day for a man, and 1 drink per day for a woman)
• Eat a well-balanced diet:
– Get enough fiber
– Avoid fatty foods
– Limit sugar intake
– Eat more green, leafy vegetables
– Eat whole fruits, especially apples, grapes, and blueberries

by Debra Wood, RN

RESOURCES:
American Diabetes Association
http://www.diabetes.org

National Diabetes Information Clearinghouse
http://diabetes.niddk.nih.gov

CANADIAN RESOURCES:
Canadian Diabetes Association
http://www.diabetes.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

American Association of Clinical Endocrinologists, American College of Endocrinology. Medical guidelines for the management of diabetes mellitus. The AACe system of intensive diabetes self-management. 2002 update. Endocrine Practice. 2002;8(suppl 1):S40-S82.

American Diabetes Association Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2010;33:S62-S69.

Boren SA, Gunlock TL, Schaefer J, Albright A. Reducing risks in diabetes self-management: a systematic review of the literature. Diabetes Educ. 2007;33:1053-1077.

Causes of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/Diabetes/causes-diabetes/Pages/index.aspx. Updated June 2014. Accessed September 3, 2015.

Diabetes. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/diabetes/home/index.html. Updated August 18, 2015. Accessed September 3, 2015.

Diabetes mellitus type 2 in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults. Updated August 29, 2016. Accessed September 29, 2016.

Diabetes mellitus type 2 in children and adolescents. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T901364/Diabetes-mellitus-type-2-in-children-and-adolescents. Updated June 9, 2016. Accessed September 29, 2016.

Diagnosis and classification of diabetes mellitus. Diabetes Care. 2005;28(suppl 1):S37-42.

Dietary considerations for patients with type 2 diabetes. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T270045/Dietary-considerations-for-patients-with-type-2-diabetes. Updated January 19, 2016. Accessed September 29, 2016.

Gaede P, Vedel P, Larsen N, et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;248:383-393.

Harsch IA. Inhaled insulins: their potential in the treatment of diabetes mellitus. Treat Endocrinol. 2005;4:131-138.

Lee DC, Sui X, Church TS, Lee IM, Blair SN. Associations of cardiorespiratory fitness and obesity with risks of impaired fasting glucose and type 2 diabetes in men. Diabetes Care. 2009;32:257-262.

Marre M. Reducing cardiovascular risk in diabetes. J Hypertens. 2007;(supp 11)S19-22.

Physical activity/exercise and diabetes. Diabetes Care. 2004;27(suppl 1):S58-62.

Rosenbloom AL, Silverstein JH, Amemiya S, et al. ISPAD Clinical Practice Consensus Guideline 2006-2007. Type 2 diabetes mellitus in the child and adolescent. Pediatr Diabetes. 2008;9:512-526.

Rosenzweig JL, Ferrannini E, Grundy SM, et al. Primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008;93:3671-3689.

Skyler JS, Bergenstal R, Bonow RO, et al. Intensive glycemic control and the prevention of cardiovascular events: Implications of the ACCORD, ADVANCE and VA diabetes trials: a position statement of the American Diabetes association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. Circulation. 2009;119:351-7.

Standards of medical care in diabetes—2009. Diabetes Care. 2009;32:S13-61.

Statement by an AACE/ACE Consensus Panel on Type 2 Diabetes Mellitus: An Algorithm for Glycemic Control. Endocr Pract. 2009;15:540-559.

Traina AN, Kane MP. Primer on pramlintide, an amylin analog. Diabetes Educ. 2011;37(3):426-431.

Type 2. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/type-2/?loc=HomePage-type2-tdt. Accessed September 3, 2015.

UK Prospective Diabetes Study Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes. Lancet. 1998;352:954-965.

US Preventive Services Task Force: Screening for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148:846-854.

11/29/2006 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Lindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006;368:1673-1679.

9/19/2006 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database of Syst Rev. 2006;CD002968.

6/1/2007 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007;356(24):2457-2471.

7/13/2007 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Farmer A, Wade A, Goyder E, et al. Impact of self-monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial. BMJ. 2007;335(7611):132.

12/13/2007 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Milman U, Blum S, Shapira C, et al. Vitamin E supplementation reduces cardiovascular events in a subgroup of middle-aged individuals with both type 2 diabetes mellitus and the haptoglobin 2-2 genotype. A prospective double-blinded clinical trial. Arterioscler Thromb Vasc Biol. 2008;28(2):341-347.

2/28/2008 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Davies MJ, Heller S, Skinner TC, et al. Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ. 2008;336(7642):491-495.

2/28/2008 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Christian JG, Bessesen DH, Byers TE, Christian KK, Goldstein MG, Bock BC. Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight. Arch Intern Med. 2008;168:141-146.

6/18/2008 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560-2572.

2/24/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Liese AD, Weis KE, Schulz M, Tooze JA. Food intake patterns associated with incident type 2 diabetes: the Insulin Resistance Atherosclerosis Study. Diabetes Care. 2009;32:263-268.

5/11/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Loimaala A, Groundstroem K, Rinne M, et al. Effect of long-term endurance and strength training on metabolic control and arterial elasticity in patients with type 2 diabetes mellitus. Am J Cardiol. 2009;103:972-977.

8/19/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Li TY, Brennan AM, Wedick NM, Mantzoros C, Rifai N, Hu FB. Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes. J Nutr. 2009;139:1333-1338.

10/12/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Crandall JP, Polsky S, Howard AA, et al. Alcohol consumption and diabetes risk in the Diabetes Prevention Program. Am J Clin Nutr. 2009;90:595-601.

11/20/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Lund SS, Tarnow L, Frandsen M, et al. Combining insulin with metformin or an insulin secretagogue in non-obese patients with type 2 diabetes: 12 month, randomised, double blind trial. BMJ. 2009;339:b4324.

12/21/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2010;33(2):414-420.

2/15/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-61).

2/15/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-69).

7/2/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010;121(21):2271-2283.

10/5/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;341:c4229.

1/4/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Pan A, Lucas M, Sun Q, et al. Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med. 2010;170(21):1884-1891.

5/6/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Muraki I, Imamura F, Manson J, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 2013;347:f5001.

4/14/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Xi B, Li S, et al. Intake of fruit juice and incidence of type 2 diabetes: a systematic review and meta-analysis. PLoS One. 2014;9(3):e93471.

7/21/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Afshin A, Micha R, et al. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2014;100(1):278-288.

9/11/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Tovote KA, Fleer J, Snippe E, et al. Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial. Diabetes Care. 2014;37(9):2427-2434.

9/16/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Zhou D, Yu H, He F, et al. Nut consumption in relation to cardiovascular disease risk and type 2 diabetes: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2014;100(1):270-277.

Last reviewed January 2016 by Kim Carmichael, MD

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.

McKenzie Method: Diagnosis & Treatment

November 1, 2016 Teresa Stockton - Back, Blog, Manual Therapy

MECHANICAL DIAGNOSIS PHASE:
This system is based on the symptomatic and mechanical responses of patients to various repeated movements or static loading forces(that is a mechanical evaluation). It allows the classification of patients into broad, rather than tissue-specific, categories and thus leads to the formulation of treatment. Rather than seeking to make a diagnosis, which is the identification of a disease by the means of its signs and symptoms, The McKenzie system concentrates on syndrome identification. A syndrome is a characteristic group of symptoms and pattern responses characteristic of a particular problem. The system is now widely used to classify and treat patients with mechanical disorders.

PHYSICAL EXAMINATION PHASE:
• Explanation of problem to patient and reason for required exercise program
• Time scale
• The appropriate loading strategy, or strategies needed to manage the condition demonstrated to and practiced by the patient.
• The repetitions and regularity of exercise program explained to patient
• The expected pain response explained to patient

ASSESMENT PHASE:
• Symptomatic diagnosis
• Mechanical Diagnosis

PATIENT MANAGEMENT PHASE:
• Patient education component of management
• Information about the problem itself
• What patients can do to help themselves
• Information about tests, diagnosis and interventions
• Active Mechanical Therapy component:
• The specific exercises should be demonstrated to the patients, they should practice these, the expected pain response should be explained, as well as any warnings against lasting aggravation of their condition and as necessary progressions and alterations should be given.

This information was written by Hamilton Physical Therapy Services, L.P., an outpatient physical therapy group with five locations in Mercer County, New Jersey since 1978. Their modern state-of-the-art facilities are equipped to offer patients an excellent opportunity to reach their optimal functional abilities. Managed and operated by physical therapists mandates that patient care is our number one priority. For more information click here.

PT News

October 25, 2016 Teresa Stockton - Blog, PT News

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

2. Coping with a Mysterious Pain Syndrome
Written by the Therapy Team at the Jackson Clinics – Middleburg, VA

As its name suggests, complex regional pain syndrome (CRPS) is a complicated and painful condition. Approximately 80,000 Americans are diagnosed with CRPS each year, usually in the arm, hand, leg or foot. Read more

3. Is Something Better than Nothing?
Written by Erin Clason at the Center for Physical Rehabilitation – Grand Rapids, MI

When it comes to strength training, the answer is a resounding “Yes!” Most of us are aware of the benefits of strength training in areas like everyday physical function, bone rebuilding, self-confidence, fat reduction, and elevated metabolism. Read more

At the Gym: Exercising Do’s and Dont’s

October 13, 2016 Teresa Stockton - Blog, Sports and Fitness

In the second installment of our “At The Gym” exercise series we examine the proper ways to exercise at the gym from start to finish. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your therapist at your next therapy session.

PLUS PUSH-UP

START POSITION
• Get on elbows and knees.
• Knees bent
• Straight or neutral back done by drawing the stomach in and the buttocks down.

ENDING POSITION
Push elbows into mat while trying to increase the space between the shoulder blades (round out your back between the shoulders).DON’T

DON’T
• Drop the head.
• Raise the buttocks or let the low back excessively curve inward.

PLUS PUSH-UP: STAGE 2

START POSITION
Push-up position

ENDING POSITION
• Push hands into mat while trying to increase the space between shoulder blades.
• Rounded upper back appearance.

DON’T
• Drop the head.
• Raise the buttocks or let the low back excessively curve inward.

SCAPULAR DEPRESSION

START POSITION
• Seated with shoulder blades drawn downward (don’t shrug shoulders).
• Hands hold just outside of the curvature of the bar to comfort.
• Knees bent underneath knee pad and feet on the floor.
• Keep your back straight with a slight posterior lean from the hips.

ENDING POSITION
Bring bar to chest with elbows bent.

DON’T
• Lift feet off the ground.
• Rock at the waist.
• Elevate or let shoulders pull forward.
• Hyperextend the low back as you pull in.

EMPTY CAN

START POSITION
Standing with hands at your side and thumbs pointing downward with feet shoulder width apart.

ENDING POSITION
Arms raised to about 60⁰ with thumbs facing down and slightly to your side.

DON’T
• Swing body back and forth.
• Shrug shoulders.
• Lift above 60⁰.

FULL CAN

START POSITION
Standing with hands in front of you with thumbs pointing upward and feet shoulder width apart.

ENDING POSITION
Arms raised to 90 – 120⁰ with thumbs facing up.

DON’T
• Swing body back and forth.
• Shrug shoulders.
• Lift above 120⁰.

This information was written by STAR Therapy Services, an outpatient physical therapy group with six locations in Houston, Texas. At Star Houston Therapy Services, their number one priority is the patient. They strive to provide individualized treatment with hands-on, compassionate care. They perform comprehensive evaluations and encourage patient input for treatment planning and goal setting. For more information click here.

View the complete Exercising Do’s and Don’ts series below:

PT News

September 27, 2016 Teresa Stockton - Blog, PT News

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

2. Going in Reverse: When Your Back Impedes Driving
Written by the Therapy Team at the Jackson Clinics – Middleburg, VA

When backing up your car, do you find it difficult to turn around to see what’s behind? Loss of rotational ability in the back is one of the problems we develop as we age. Read more

3. 4 Ways To Improve Your Quality of Life Today
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

How often do you get home tired from a long day, frustrated with work, traffic, or co-workers? Our blood pressure has increased, stress levels have caused emotional, behavioral, and physical changes in us that otherwise would not be part of our normal calm day. Read more

October 2016 Events

September 22, 2016 Teresa Stockton - Blog, Events

Check out our Physical Therapy Monthly Events Calendar! Focusing on events from PTandMe.com participating physical and occupational therapy clinics. Read more to find out what’s happening in your community in October 2016!

GEORGIA PHYSICAL THERAPY EVENTS

FOLKSTON, GA
DATE: October 21st 2016, 5:00PM – 7:00PM
20 Year Anniversary Cookout
CLINIC: Advance Rehabilitation Physical Therapy – Folkston
Advance Rehab is celebrating its 20 year anniversary in Folkston, Georgia with a cookout and live music by local artist Justen Harden
For more information about Advance Rehabilitation Physical Therapy, visit them online at http://www.advancerehab.com.

IDAHO PHYSICAL THERAPY EVENTS

BOISE, ID
DATE: October 18th – 15th 2016
2016 NPI Annual Fall Conference
CLINIC: Intermountain Physical Therapy & Hand Rehabilitation – Boise
Intermountain will have a booth at this year’s event. Stop on by and see how physical therapy brings patients back to their full potential! For more information about Intermountain Physical Therapy & Hand Rehabilitation, visit them online at http://www.intermountainpt.com.

MICHIGAN PHYSICAL THERAPY EVENTS

MONROE, MI
DATE: October 4th 2016, 3:00PM – 6:00PM
Monroe Open House
CLINIC: Advanced Physical Therapy – Monroe
Advanced Physical Therapy’s Monroe clinic is celebrating their relocation with an open house! Join us for snacks, drinks and check out the new digs. We’d love to have you as we get to know our new neighbors and friends! First 100 guests will receive a free gift. For more information about Advanced Physical Therapy, visit them online at http://advphysicaltherapy.com.

NEW JERSEY PHYSICAL THERAPY EVENTS

BORDENTOWN, NJ
DATE: October 17th 2016, 4:30PM – 8:00PM
Work Comp Seminar at Villa Mannino Restaurant
CLINIC: Hamilton Physical Therapy Services, L.P.
Attention all work comp case managers and adjusters! Join Hamilton Physical Therapy and Princeton Brain & Spine Care as they talk about the Evaluation and Rehabilitation of Concussions in the injured workers.

AGENDA:
4:30 pm – 5:30 pm — Registration & Vendor Exhibit
5:30 pm – 5:45 pm — Opening Remarks
5:45 pm – 7:30 pm — Clinical Presentation
7:30 pm – 8:00 pm — Q&A Session

For more information contact Jaime Caceres at Hamilton Physical Therapy Services in Hamilton, New Jersey at (609) 585-2333. Also, visit Hamilton Physical Therapy Services online at http://www.hamiltonphysicaltherapy.org.

TENNESSEE PHYSICAL THERAPY EVENTS

NASHVILLE, TN
DATE: October 15th 2016, 8:00AM – 11:00PM
2016 – 2017 Heart Walk at Vanderbilt University Sport Field
CLINIC: STAR Physical Therapy
Help STAR Physical Therapy reach their goal to raise $5,000 for the American Heart Association. You can help us by donating to our team ($20 donations receive a custom t-shirt) or join the STAR Physical Therapy Heart Walk Team and join us at the event! For more information about STAR Physical Therapy, visit them online at http://www.starpt.com.

TEXAS PHYSICAL THERAPY EVENTS

CLEVELAND, TX
DATE: October 15th 2016, 9:00AM
Walk with a Doc for Hardhats & Little Heads
CLINIC: Cleveland Physical & Occupational Therapy
Cleveland Physical & Occupational Therapy is participating in this year’s Walk With A Doc at the Cleveland High School Track! Bring your friends and family to enjoy a day of fun! Participants will walk on the track with national award winning doctor Dr. Sulaiman, explore vendor booths, receive health and community information as well as meet local fireman and police officers all while getting healthy! Special appearances by Reggie Airman Dixon, Maurice Termite Watkins, and Reggie Johnson. Children will be provided with free bikes, helmets, t-shirts, water bottles, goodie bags and more as part of the Hard Helmets for Little Heads initiative while supplies last. All materials will be distributed on a first come, first served basis. For more information, please contact Kimberly Hughes at (281) 592.2224 – ext. 206 or at khughes@hcset.com. You can also visit the official event website here: http://walkwithadoc.org/our-locations/cleveland-texas/. For more information about Cleveland Physical & Occupational Therapy, visit them online at http://www.clevelandpt.com.

WISCONSIN PHYSICAL THERAPY EVENTS

JEFFERSON, WI
DATE: October 10th 2016, 5:30PM – 6:30PM
JUMP: Great Apple Crunch Fun Run
CLINIC: Sport & Spine Physical Therapy – Jefferson
Sport & Spine Physical Therapy in Jefferson, Wisconsin invites Jefferson community members of all ages to join us in our 4th annual one mile FUN RUN/WALK! Participation ribbons for all children
There will also be refreshments. In the event of inclement weather, it will be canceled with no make-up date. For more information contact Jo Christianson at christiansonj@tds.net. Also, please visit Sport & Spine Physical Therapy online at http://sportandspineclinic.com.

MERRILL, WI
DATE: October 8th 2016, 8:00AM – 1:00PM
2016 Leaf Pile Run 6th Annual 5k Run/Walk & 1k Kids Run
CLINICS: Sport & Spine Physical Therapy & Merrill Physical Therapy
Please join Sport & Spine Physical Therapy, Merrill Physical Therapy and other WVAM members for a fun and festive fall run, to help support Wisconsin Valley Athletic Medicine by participating in the 2016 Leaf Pile Annual Event. All 5k and 1k participants receive a complimentary wristband for same day entry to Helene’s Hilltop Orchard to enjoy a hayride, corn maze, cow train, and the play area. Complimentary beverages from Red Eye Brewing Co. and root beer from Central Beer Distributors. Need more info? Contact Andy at Sport & Spine Clinic at adavis@usphclinic.com or call (715) 693-7727. For more information about Merrill Physical Therapy, visit them online at http://www.merrillpt.com.

At the Gym: Exercising Do’s and Don’ts

September 15, 2016 Teresa Stockton - Blog, Sports and Fitness

In this new monthly series we examine the proper ways to exercise at the gym from start to finish. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your therapist at your next therapy session.

SCAPULAR STRENGTHENING

START POSITION
• Lay face down on the edge of the bench with arm hanging downward
• Rolled towel under forehead for support

ENDING POSITION
Arm raised straight to your side no higher than the torso with palms facing down

DON’T
• Arch your back when lifting dumbbell
• Lay with face turned sideways
• Raise the dumbbell too high

EXTERNAL ROTATION – SIDE LYING

START POSITION
• Side lying with elbow at 90⁰ bend
• Support the head and rolled towel under arm holding dumbbell

ENDING POSITION
Side lying with external rotation at the shoulder until you feel an anatomical stop at the shoulder (about 45⁰); keep elbow bent

DON’T
• Create rotation at the torso
• Don’t raise the arm from the towel

EXTERNAL ROTATION – PRONE

START POSITION
• Lay face down with head facing to the side
• Forearm hanging off table with elbow bent to 90⁰
• Bicep is on the bench and supported by a towel

ENDING POSITION
About 45⁰ of external rotation

DON’T
• Externally rotate past 45⁰
• Raise arm from the towel

D2 FLEXION

START POSITION
• Standing with feet shoulder width apart
• Hold handle with arm crossing body to opposite side
• Palm facing body.

ENDING POSITION
• Arm raised slightly above the shoulder (about 120⁰ which is slightly higher than shown) with thumb facing upward
• Creating a “disco” motion

DON’T
• Let thumb face sideways or downward at end of exercise
• Lean backwards or sideways to assist in exercise
• Shrug shoulders

This information about how to exercise at the gym was written by STAR Therapy Services, an outpatient physical therapy group with six locations in Houston, Texas. At Star Houston Therapy Services, their number one priority is the patient. They strive to provide individualized treatment with hands-on, compassionate care. They perform comprehensive evaluations and encourage patient input for treatment planning and goal setting. For more information click here.

View the complete Exercising Do’s and Don’ts series below:

Protect, Stretch & Rest: General Tips

September 13, 2016 Teresa Stockton - Blog, Industrial Rehab

These are some general healthy tips to remember during your day-to-day activities.

• If you are doing strenuous, household or outdoor work protect your hands with gloves in order to prevent injury and/or loss of moisture.
• Take frequent breaks or switch to a new activity. Overuse of repetitive motions, such as pressing buttons, can cause tendonitis of the elbow or lead to Carpal Tunnel Syndrome.
• If you find yourself sitting at your computer for hours each day, stop each hour and stretch your fingers, arms and the rest of your body to help prevent injury to your bones, joints and muscles.
• If you have pain during your activity, stop. Pain is one of the ways your body is letting you know that you are overextending a particular muscle group.

World Physical Therapy Day

September 8, 2016 Teresa Stockton - Blog, Events

World Physical Therapy Day is on September 8th. The day is an opportunity for physical therapists from all over the world to raise awareness about the crucial contribution the profession makes to keeping people well, mobile and independent. This year the focus is on adding years to your life by being physically active! See how a little bit of movement can go a long way!

To learn more about World Physical Therapy Day click here.