Tag Archives: injury

ASHT: Hand Therapy Awareness Week

June 6, 2017 Teresa Stockton - Blog, Events, Hand

Prevent hand and wrist injuries while cooking. Professional hand therapists promote wrist and hand health in the kitchen.

USE THE RIGHT TOOL FOR THE JOB
Use easy-to-grip versions of tools like spoons, knives and bottle/can openers to decrease the stress on your hands and use scissors to open bags (or packages) instead of your thumbs.

SIT OR STAND UP STRAIGHT
Correct posture is important because the nerves that operate your fingers start in neck. During activities which require you to be looking down at what you are doing, like chopping vegetables, take a moment to stand up straight, turn your head side to side/up and down, and stretch your arms over your head.

SLIDE, DO NOT LIFT
When working in the oven, always slide the shelf out so you can get a good, safe grasp of the panhandles.

KEEP YOUR SHOULDERS DOWN
Your arms should be at your sides and the counters you work on should be waist high. Many kitchen counters are too high for the average person. As a result, you may be forced to raise the shoulder you are using to cut the food and lean to the opposite side of your body when preparing food. This causes increased stress on the neck, shoulder and arm muscles and nerves.

Physical Therapy Helps With TMJ Pain

June 1, 2017 Teresa Stockton - Blog, Head

Physical Therapy can help those suffering with pain associated with the facial region, head, and/or neck, including those struggling with Temporomandibular (TMJ) disorders.

The temporomandibular joint or TMJ, is a complex joint located in front of each ear. It is responsible for allowing mouth opening and closing. When the TMJ is not working correctly, you may experience jaw pain, clicking, popping, or locking of the joint. You may also experience headaches, neck pain, sinus pain, dizziness, and ear ringing or pain. TMJ pain or Temporomandibular Dysfunction (TMD) is not strictly limited to the jaw, jaw, it can also be influenced by activities, positioning, or alignment of the head and neck.

COMMON CAUSES

Excessive grinding or clenching of teeth
Joint stiffness
TMJ Disorders
Poor Posture or Ergonomics
Other neck conditions including pain and headache
Stress and muscle tension

PHYSICAL THERAPY TREATMENT FOR TMJ
Physical therapy treatment includes an in depth evaluation of the structures of the cervical spine, jaw joints and head. Treatment could include manual therapy techniques for the spine, jaw and soft tissues, exercise for the jaw and neck, and modalities. Evaluation focuses on the relationship of the muscles, joints and nerves of the jaw, head, neck and face and how they relate to each other. Manual therapy may be used to improve range of motion and mobility of the jaw and neck. Exercise is designed to restore the proper balance of the spine and head to take unnecessary stress off of sensitive tissues and to support the body so it can perform the activities of daily living efficiently and comfortably. Modalities will decrease the short-term discomfort and joint irritation. We will look at how you interact with your environment to see if there are activates you preform that put increase stress on your body which could cause increased pain. Most importantly, in addition to these techniques, the patient is provided with a home exercise program to aid in symptom reduction. Each treatment plan is based on a patient’s individual needs and the therapist, patient, and referring practitioner work as a team to reach the patients goals.

This information was written by Rehab Associates of Central Virginia, an outpatient physical therapy group with 13 locations in Central Virginia. Their physical therapists have advanced degrees in specialty orthopedic care from head to toe. From musculoskeletal headaches to lower back pain to heel pain syndrome, they can help take away your pain and help you return to normal activity. For more information click here.

Guidelines to Prevent Throwing Injuries

May 18, 2017 Teresa Stockton - Arm, Blog, Elbow, Shoulder, Sports and Fitness

In this third intallment of our series to prevent throwing injuries, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.

INTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high up on a doorway and face away from door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the ceiling. Rotate from your shoulder bringing your hand forward while keeping your arm parallel to the floor and your elbow bent to 90 degrees.

EXTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high on a doorway and face toward the door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the door. Rotate from your shoulder bringing your hand away from the door while keeping your arm parallel to the floor and your elbow bent to 90 degrees.

SHOULDER INTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising closest to the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand toward your stomach while keeping the elbow bent to 90 degrees.

SHOULDER EXTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising furthest from the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand away from your stomach while keeping the elbow bent to 90 degrees.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

Repetitive Strain Injury (RSI)

May 4, 2017 Teresa Stockton - Blog, Industrial Rehab, Wrist

The Following are Seen as Causes of Repetitive Strain Injury:

The overuse of muscles in our hands, wrists, arms, shoulders, neck and back
The area is affected by repeated actions, which are usually performed on a daily basis over a long period
The repetitive actions are done in a cold place
Forceful movements are involved
Workstations are poorly organized
Equipment is badly designed
The individual commonly adopts an awkward posture
There are not enough rest breaks

Prevention 101: Nine Easy Ways to Reduce Your Risk of Developing Repetitive Strain Injury:

TAKE BREAKS when using your computer. Every hour or so, get up and walk around, get a drink of water, stretch whatever muscles are tight, and look out the window at a far off object (to rest your eyes).
Use good posture. If you can’t hold good posture, it probably means it’s time for you to take a break from typing. If you are perpetually struggling to maintain good posture, you probably need to adjust your workstation or chair, or develop some of the support muscles necessary for good posture.
Use an ergonomically-optimized workstation to reduce strain on your body.
Exercise regularly. Include strengthening, stretching, and aerobic exercises. Yoga and pilates may also be helpful.
Only use the computer as much as you have to. Don’t email people when you could walk down the hall or pick up the phone and talk to them. It’s not only better for your hands – it’s friendlier. Think before you type to avoid unnecessary editing.
Don’t stretch for the hard-to-reach keys, e.g. BACKSPACE, ENTER, SHIFT, and CONTROL… basically everything but the letters. Instead, move your entire hand so that you may press the desired key with ease. This is crucial when you are programming or typing something where non-letter keys are used extensively.
Let your hands float above the keyboard when you type, and move your entire arm when moving your mouse or typing hard-to-reach keys, keeping the wrist joint straight at all times. This lets the big muscles in your arm, shoulder, and back do most of the work, instead of the smaller, weaker, and more vulnerable muscles in your hand and wrist. If you find it difficult to do this, then your shoulder and back muscles are probably too weak. It is OK, and in fact a good idea, to rest your elbows/wrists when you are not typing.
Use two hands to type combination key strokes, such as those involving the SHIFT and CONTROL keys.
When writing, avoid gripping the writing utensil tightly. Someone should be able to easily pull the writing utensil out of your hand when you are writing. If your pen or pencil requires you to press too hard, get a new one (my favorite is Dr. Grip Gel Ink).

Article provided by Fit2WRK. The information noted above is a summary of one of the components of Fit2WRK.

True or False: Cracking Your Knuckles Can Lead to Arthritis

May 2, 2017 Teresa Stockton - Blog, Hand

Crack. Pop. Click. These sounds jump from the joints of the many children and adults who are in the habit of cracking their knuckles.

If you cracked your knuckles as a child, you may have been warned that it could cause you to develop arthritis later in life. Is this true? Probably not, according to a handful of studies on the subject. While cracking your knuckles may not cause arthritis, some researchers believe that habitual cracking could create some problems later on. Not to mention that the incessant pops and clicks are likely to be a major annoyance to those around you.

Evidence for the Health Claim
Your knuckles are the joints in your fingers and toes. They are located where two bones meet, and they are bathed in a liquid called synovial fluid, which lubricates the joints. Sometimes a bubble of gas develops in the synovial fluid, and when the joint is manipulated in certain ways (eg, when a person is bending or compressing his or her hand), the bubble can burst, making an audible popping or cracking sound.

Arthritis is an extremely common problem for older adults, with the majority of people over age 65 have signs of the condition. There are two major forms of arthritis. Rheumatoid arthritis results from inflammation of the joints and can cause pain, redness, swelling, and eventually deformity and loss of function. Osteoarthritis, the most common form, results from wear and tear on the joints over time, which is why it tends to affect older adults.

While there is no reason to believe that knuckle cracking would lead to rheumatoid arthritis, it makes sense that habitual trauma to a joint might eventually cause tissues to break down and wear away leading to osteoarthritis. In fact, some researchers have reported cases of people who habitually cracked their knuckles and went on to develop osteoarthritis or other joint problems. For example, in a case report published in the British Medical Journal, researchers report that a man who habitually cracked and popped many of his joints had damage in his right hand indicative of arthritis.

Another study published in the Proceedings of the Institution of Mechanical Engineers simulated the act of cracking knuckles and found that the energy used to crack your knuckles is enough to damage the cartilage in your joints.

Do these reports mean knuckle cracking can lead to arthritis? Or are they just chance findings, since so many people develop osteoarthritis whether they crack their knuckles or not?

Evidence Against the Health Claim
While individual reports may cite cases in which voracious knuckle crackers develop arthritis, other studies tell a different story.

In 1975, Dr. Robert L. Swezey and Stuart E. Swezey conducted a study of 28 nursing home residents who could recall whether or not they had cracked their knuckles earlier in life. After performing x-rays on the participants’ hands, the researchers concluded that there was no link between habitual knuckle cracking and arthritis.

Another study, published in the Annals of Rheumatic Disease, looked at a group of 300 habitual knuckle crackers. The researchers found that the participants who cracked their knuckles regularly did not experience more cases of osteoarthritis. Knuckle crackers, however, were more likely to have hand swelling and reduced grip strength in their hands. Whether the knuckle-cracking caused the swelling and loss of hand function or those with hand problems were just more likely to crack their knuckles, the researchers could not say.

Researchers also compared a group of people with osteoarthritis in the hand with those who did not have the condition. The two groups were asked whether they cracked their knuckles and, if so, the duration and the frequency of this behavior. When the researchers analyzed the findings, they found no correlation between knuckle cracking and the development of osteoarthritis.

Conclusion
Some people who crack their knuckles do it out of habit or boredom. Many others say it helps relieve joint pain and tension and allows for a greater range of motion in their joints. If you are in the habit of cracking your knuckles, the evidence available today suggests that it will not cause you to develop arthritis. While some insatiable knuckle crackers may go on to develop problems down the road, the occasional painless cracking is probably harmless.

Keep in mind, though, that while cracking your knuckles seems like nothing more than an innocent, mindless habit, for the person sitting next to you, it may be just as irritating as the sound of fingernails on a chalkboard.

by Krisha McCoy, MS

More PTandMe articles about arthritis can be found here:

REFERENCES:

Brodeus R. The audible release associated with joint manipulation.J Manipulative Physiol Ther. 1995;18:155-164.

Castellanos J, Axelrod D. Effect of habitual knuckle cracking on hand function.Ann Rheum Dis. 1990;49:308-309.

Protapapas MG, Cymet TC. Joint cracking and popping: understanding noises that accompany articular release.J Am Osteopath Assoc. 2002;102:306.

Swezey RL, Swezey SE. The consequences of habitual knuckle cracking.West J Med. 1975;122:377-379. Available at: http://www.pubmedcentral.gov/picrender.fcgi?artid=1129752&blobtype=pdf. Accessed July 11, 2006

Watson P, Hamilton A, Mollan R. Habitual joint cracking and radiological damage.Br Med J. 1989;299:1566.

Watson P Kernohan WG, Mollan RA. A study of the cracking sounds from the metacarpophalangeal joint.Proc Inst Mech Eng. 1989;203:109-118.

3/17/2011 DynaMed’s Systematic Literature Surveillance DynaMed’s Systematic Literature Surveillance: Deweber K, Olszewski M, Ortolano R. Knuckle cracking and hand osteoarthritis.J Am Board Fam Med.2011;24(2):169-174.

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.

Returning from a Soccer Injury

April 27, 2017 Teresa Stockton - Blog, Sports and Fitness

Soccer is the most played sport in the world and is the number one sport in many countries. It is a great cardiovascular workout that combines aerobic and anaerobic movements. However, due to the sudden changes in pace and the speed at which the game is played there is a high chance of a soccer injury.

Sports injury expert Dr. David Geier reveals that that the six most common soccer injuries are ankle sprains, joint fractures, anterior cruciate ligament (ACL) tear, meniscus tear, adductor strain, and hamstring strains. These injuries are due to the amount of stress a soccer player will put on their leg joints. The good news is that through physical therapy these injuries can be recovered from.

Ankle Sprains
The ankle sprain is the most common and least serious soccer injury. The most common recovery method is to put ice on the ankle to stop the swelling, strap it, and lightly exercise it through physical therapy. One effective motion exercise is to sit on a chair with the foot flat on the floor and gently move the knee from side-to-side to stop it becoming stiff. A player should be out for a maximum of six weeks.

ACL
An ACL soccer injury can leave a player out of the game for much longer. For example, an ACL tear may require surgery (making a new ligament) in order to return to the pitch. While surgery may be required, physical therapy is definitely needed to help rebuild knee strength. The exercises will include mobility and strength exercises such as knee flexion and extension, heel slides, and isometric quadriceps exercises. As the knee joint gets stronger, plyometric drills will be introduced to the therapy to see whether the knee is strong enough to play competitive sport. These exercises may include resistance band jumps, hopping exercises and box jumps.

Hamstring Strains
After knee and ankle injuries the next most common injury are hamstring strains. These are often caused through a combination of sudden explosive moments and overuse. We have all seen a soccer, football, or basketball player burst forward only to suddenly stop and crumple to the ground. That is nearly always a hamstring injury. Depending on which grade of hamstring injury the player has will change the therapy needed. If it is a grade one injury then as the muscle slowly heals the player will use ice alongside resting. Function training will also be required to regain strength and flexibility. A grade two or three injury may require surgery.

Career Threatening Injuries
A career threatening injury is the biggest risk of playing soccer. However, there is hope for injured and senior soccer players. Walking Soccer, which was developed in 2011 in England, according to British newspaper The Telegraph, allows those with mobility injuries to keep playing. As the name suggests running is outlawed, which in turns takes much of the risk and pressure off of the leg joints that can be easily injured.

The new game has been endorsed by English soccer legends such as Alan Shearer, who according to journalist Dan Fitch who works for news site Betfair Soccer who preview the Champions League fixtures in Europe, is the third fastest player to score 50 goals in the English Premier League. Shearer himself is retired and told The Telegraph that after retiring he couldn’t play the sport he made his name in due to persistent injuries. Walking Soccer has allowed Shearer and other ex-pros to play without the worry of injuries or heavy contact from other players. For amateurs and professionals alike walking soccer is a godsend.

Soccer injuries can be serious and more often that not require physical therapy to recover from. Even if you have suffered a serious injury there is still hope through new sports such as Walking Soccer.

PT News

April 25, 2017 Teresa Stockton - Blog, PT News

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

2. What You Eat Affects Inflammation and Healing
Written by Meghan Russo, PTA at the Center for Physical Rehabilitation – Grand Rapids, MI

Did you know that many foods can decrease or increase inflammation and help to decrease pain? Read more

3. Tips for Beginner Runners
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

If you think running is not for you – think again. Read more

The Benefits of Physical Therapy for Women’s Health

April 18, 2017 Teresa Stockton - Blog, Women's Health

Women’s health can cover a multitude of subjects, from pregnancy to aging – the female body undergoes many changes. Physical therapists’ most common women’s health clients come in experiencing incontinence, osteoporosis, and pregnancy-related back pain.

URINARY INCONTINENCE
Urinary incontinence is a loss of bladder control that results in leakage when the muscles of the pelvic floor are weak or overactive. Causes include childbirth, hormonal changes, surgical trauma, pelvic fractures, chronic cough, obesity, muscle weakness, or even repetitive lifting. Physical therapy can help decrease or resolve urinary leakage, identify bladder irritants and strengthen pelvic floor muscles through an individualized exercise program.

OSTEOPOROSIS
Keeping the bones strong as you age, especially after menopause, is a challenge many women face. An excessive decline in bone mass is called osteoporosis, and it is a leading healthcare concern for women. A physical therapy program can help improve your posture and strength, prevent falls, and decrease your risk for fractures.

A physical therapist that specializes in women’s health and treating pelvic floor dysfunction can help as well.

PELVIC FLOOR DYSFUNCTION
Exhibits Several Symptoms:

Urinary Incontinence
Fecal Incontinence
Constipation
Diarrhea
Pelvic Floor Pain

PREGNANCY-RELATED BACK PAIN
Many women experience low back pain during pregnancy. This is due to several factors such as:

Hormonal Changes – this causes increased looseness of the pelvic ligaments to prepare your body for birthing your baby.
Increased Weight Gain – This places increased stress on all the joints of the body. Increased breast weight can overload
the neck and upper back.
Postural Changes – Body weight shifts forward as the baby grows and this increases the arch in the lower back. Stomach
muscles and the lower pelvic muscles become weaker which decreases support for the lower back.
Altered Movement Patterns – Due to your changing body, women often begin to move in different patterns that can increase stress to the low back or pelvic joints.

Guidelines to Prevent Throwing Injuries

April 13, 2017 Teresa Stockton - Arm, Blog, Shoulder, Sports and Fitness

In our second installment of “Guidelines to Prevent Throwing Injuries” we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.

SHOULDER ABDUCTION
Begin with your arms at your side with your palms facing forward. Raise your arm straight out to the side until they are straight overhead.

SHOULDER SCAPTION
Begin with your arms at your side. Raise your arms at a 45 degree angle creating a V shape with your arms until they are overhead.

D2 EXTENSION
Secure band to wall or top of the doorway. Pull diagonally down across your body toward your opposite hip. Make sure to keep the elbow straight. Return to the starting position with a straight elbow and repeat.

D2 FLEXION
Secure band to bottom of the doorway. Pull diagonally up across your body away from your body. Make sure to keep the elbow straight. Return to the starting position with a straight elbow and repeat.

See the entire Guidelines to Prevent Throwing Injuries series here:

Effective Chronic Back Pain Treatment

April 11, 2017 Teresa Stockton - Back, Blog

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)

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.

For more information about back pain physical therapy click the links below.