Tag Archives: Home Exercise Program

chronic back pain

Effective Chronic Back Pain Treatment

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For chronic back pain, exercise, physical therapy, manual therapy and mindfulness-based stress reduction have the best evidence for effectiveness.

Chronic back pain is one of the most frequent reasons people visit the doctor — it’s estimated that 31 million Americans experience low-back pain at any given time. Yet doctors are finding drugs should actually often be the last line of treatment for it. A new guideline out Feb 14th 2017, from the American College of Physicians (ACP) suggests doctors recommend exercise and treatments like heat wraps, yoga, and mindfulness meditation to their patients before turning to medications like opioids or even over-the-counter painkillers. “That marks a big departure from previous guidelines,” Roger Chou, a professor at Oregon Health and Science University, told Vox1. (Chou’s evidence review can be found at: https://goo.gl/MWzWvK)

Why Send Patients to Physical Therapy for Chronic Back Pain?

It is the long term benefits of physical therapy interventions such as multifidus, transversus abdominus and pelvic floor neuromuscular reeducation that benefits your patients.
• Multifidus muscle recovery requires specific, localized, retraining.3
• PT + meds 30% recurrence versus 84% meds only (1 year follow-up).4
• PT + meds 35% recurrence versus 75% meds only (2-3 year follow-up).4
• Less likely to have further healthcare costs.4

Back Pain Conditions Commonly Seen by physical therapists include:
• Low Back Pain (LBP)
• Arthritis Pain
• Strains & Sprains
• Muscle Spasm
• Herniated Discs
• Degenerative Discs
• Radiculopathy/Sciatica
• Piriformis Syndrome
• Sacroiliac Joint Dysfunction
• Scoliosis
• Spondylosis
• Stenosis

In physical therapy our goals are to Improve:
Mobility — Knowledge of Safe Positions — Movement Awareness — Functional Strength — Coordination

“Exercise or alternative therapies, the ACP noted, can work as well as or better than medications, but don’t come with the side effects.1” Physical Therapy is a safe, proven way to treat patients experiencing back pain.

Evidence showed that acetaminophen was not effective at improving pain outcomes versus placebo. Low-quality evidence showed that systemic steroids were not effective in treating acute or subacute low back pain2. (ACP Newsroom)

back pain 3

Treatment
We offer a comprehensive approach incorporating manual therapy, prescriptive therapeutic exercise and modalities. Our programs improve the patient’s physical condition and symptoms. We also provide the patient with movement awareness, knowledge of safe positions, functional strength, and coordination. All of this promotes the management of low back pain (LBP).

Treatments offered include:
• Comprehensive Evaluation with an emphasis on determining the source of the problem.
• Individualized & Specific Exercise Programs
• Manual Therapy (hands-on treatment)
• Modalities as Needed
• Progressive Home Program to help restore independence and self-management

Information provided by North Lake Physical Therapy – Portland, OR
To learn more about North Lake Physical Therapy click here.

References:
1. http://www.vox.com/science-and-health/2017/2/14/14609508/doctors-admit-drugs-cant-fix-back-pain
2. https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain
3. Spine (Phila Pa 1976). 1996 Dec 1;21(23):2763-9. Hides JA, Richardson CA, Jull GA.
4. Spine (Phila Pa 1976). 2001 Jun 1;26(11):E243-8. Hides JA, Jull GA, Richardson CA.

postoperative physical therapy

Postoperative Physical Therapy

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Postoperative physical therapy after a Total Hip Replacement is essential to your recovery. Your physical therapist will follow your physician’s protocol and will focus on range of motion exercises, progressive strengthening exercises, gait training, balance training, and activity specific training to meet your specific needs. Modalities such as ice and e-stim may be used to help reduce discomfort and swelling. It is very important to complete your home exercise program as directed by your physical therapist and physician.

RANGE OF MOTION EXERCISES
Swelling and pain can make you move your knee less. Your physical therapist can teach you safe and effective exercises to restore the range of motion to your knee so that you can perform your daily activities.

STRENGTHENING EXERCISES
Weakness of the muscles of the thigh and lower leg is typical after surgery. Your physical therapist can determine the best strengthening exercises for you with the goal of no longer needing a cane or walker to walk.

post op

BALANCE TRAINING
Specialized training exercises can help your muscles “learn” to adapt to changes in your world such as uneven or rocky ground. When you are able to put your full weight on your knee without pain, your physical therapist may add agility exercises so that you can safely and quickly change directions or make quick stops or starts. They may use a balance board that will challenge your balance and knee control. These exercises will be safe and fun.

GAIT TRAINING
Your physical therapist will work with you in retraining your gait following your surgery using appropriate assistive devices such as a walker or cane. They will make sure that you will be able to safely and confidently go up and down stairs, negotiate curbs, and inclines, etc.

ACTIVITY SPECIFIC TRAINING
Depending on the requirements or your job or the type of recreational activities you enjoy, your physical therapist will tailor your program so that you can meet your specific demands.

This article about postoperative physical therapy was written by STAR Physical Therapy, an outpatient physical therapy group with over sixty locations in Tennessee. Established in 1997 with one clinic and one mission – to serve. Today, they have grown to offer that direct service in more than 60 clinics, and while they’ve grown, one thing that has not changed is their commitment to you, their communities, and their employees. For more information click here.

Medial epicondylitis golfer's elbow

Golfer’s Elbow (Medial Epicondylitis)

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Medial epicondylitis is most commonly referred to as Golfer’s Elbow and is a painful condition where the tendons that attach to the inside of the elbow become inflamed due to repetitive use of the hand, wrist, forearm and elbow. It often occurs with repetitive activities such as, swinging a golf club or tennis racket, work or leisure activities requiring twisting and gripping such as shoveling, gardening and swinging a hammer. It can also appear in other sports-related activities such as throwing and swimming. Medial epicondylitis is most commonly seen in men over the age of 35, but can be seen in any population.

Medial epicondylitis affects the group of muscles that are responsible for bending the wrist, fingers and thumb and that rotate the wrist and forearm. The tendons that connect those muscles to the medial epicondyle (bump on inside of elbow). Tendons are made up of collagen fibers that are lined up next to each other. The repetitive forces pull on those tendons creating pain and tenderness. Without treatment those tendons can eventually pull away from the bone. Acute injuries to your elbow can create an inflammatory response which can cause redness, warmth and stiffness in your elbow.

Medial epicondylitis is most often caused by an abnormal arrangement of collagen fibers. This condition is called tendinosis. During tendinosis the body doesn’t create inflammatory cells as it does during an acute injury. Instead, fibroblasts are created which help make up scar tissue to fill in the spaces between the collagen fibers. This increase in scar tissue can lead to increased pain and weakness in the tissues. Physical therapy is the most common non surgical treatment for medial epicondylitis. Your therapist will perform an evaluation where he/she will ask you several questions about your condition, pain level and other symptoms you may be experiencing. He/she will perform motion and strength testingon your entire upper extremity. Your physical therapist will also palpate your arm to determine which tendon(s) may be inflamed. He/she will use special tests designed to differentially diagnose your condition from others that may have similar presentations, such as Cubital Tunnel Syndrome.

golf ball on tee

After you have been evaluated by your physical therapist, he/she will formulate an individualized treatment plan that can include any of the following:

1. Pain Management: this can include Mechanical Diagnosis & Therapy, ice, ice massage, moist heat, electrical stimulation and ultrasound.
2. Range-of-Motion Exercises: stretches and mobility exercises to help maintain proper movement in your elbow, forearm, wrist and hand.
3. Strengthening Exercises: progressive resistive exercises to help build strength in your arm, elbow, forearm, wrist and hand. These can include weights, medicine balls and/or resistance bands. This will also include your Home Exercise Program.
4. Manual Therapy: used to ensure full, pain-free movement is achieved and can include joint mobilizations, manual muscle stretches and soft tissue massage.
5. Neuromuscular Re-education (Functional Training): used to help you return to your prior level of function for both home and work activities. Will include retraining proper movement patterns with necessary modifications based on current level of function and patient limitations.
6. Patient Education: used to help retrain patient on proper postural control during everyday activities including dressing, self-care, work and sports activities. This can include helping return a patient to their specific sport, such as making adjustments to their golf swing or throwing technique.

Once you’ve completed your care under the direct supervision of a physical therapist you’ll want to do everything you can to prevent this from reoccurring. This can occur by maintaining proper awareness of your risk for injury during your daily movements. Key things to keep in mind:

1. Maintain proper form during all repetitive movements both at work and home.
2. Continue your Home Exercise Program in order to maintain proper strength in your shoulder, elbow, forearm, wrist and hand.
3. Use proper posture and body mechanics with lifting or carrying to avoid any undue stress on your joints and tendons.

This information was written by Plymouth Physical Therapy Specialists, an outpatient physical therapy group with fourteen locations in the surrounding Plymouth, Michigan area. At Plymouth Physical Therapy Specialists, they are committed to using evidence-based treatments in their practice. This means that their therapists utilize the most current and clinically relevant treatments in their approach to rehabilitation. For more information click here.

PT News

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

basketball

1. How Does an NBA Player Overcome Career Limiting Ankle Injury?
Written by Nick Mezyk, DPT, Clinic Director at ProCare Physical Therapy – Johnstown, PA

If you have played sports long enough, you have most likely experienced the following… You’re running down the field, court or track, and you go to make a quick cut. Except you end up crumbling to the ground because you rolled your ankle causing a popping sensation on the outside portion of that ankle. Read more

mountain biking

2. Ride More, Hurt Less on Your Next Bike Ride
Written by Grace Ellison, PT, DPT at Integrated Rehabilitation Group, Silver Lake Physical Therapy – Everett, WA

Whether you are enjoying a weekend trail ride or training for your next triathlon. It is important to ensure that you are taking the correct steps to stay injury free during your next time out. Read more

gym guy

3. Top Equipment Free Exercises You Should Be Doing 
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

The idea of exercising always conjures up visions of personal trainers, expensive gyms, high-end equipment, and lots of grunting, groaning, and personal torture. That’s never the case when we use the term exercise. Read more

Home Exercises are Key to a Successful Rehab Program

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When a patient walks in for physical therapy, one of the things they are sent home with is a home exercise program. These are needed for a number of reasons.

  • Continuation of forward progression in rehabilitation: Physical and occupational therapists tailor each program to the abilities and strengths of each patient. A patient that completes their home exercise program is more likely to excel in the one-on-one sessions at the clinic and experience fewer setbacks in rehabilitation.
  • Increases level of mobility and enduranc: Exercise in the home is designed to continue the progress of the clinic visit by  increasing a patient’s flexibility and stamina. A good home exercise program allows a patient to increase function and improve muscle memory so that progress is gained rather than lost from one visit to another.
  • For some patients, therapy doesn’t end at discharge:  A home exercise program can help a patient remain pain free and functional without having to pay for repeat visits and costly medically bills. For patients experiencing chronic pain – a home exercise program is the ticket to staying out of the doctors office.

Despite the benefits of a home exercise program, patients have trouble following through on their home exercise program goals. We’re going to go over some of the more common excuses:

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