Tag Archives: treatment techniques

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.

Exercise for Chronic Disease Relief

May 25, 2017 Teresa Stockton - Blog, General Information

For people in need of chronic disease relief, exercise can decrease discomfort, improve daily functioning, and enhance overall quality of life. There are many activity choices. Overall, find something that you enjoy doing and a place that is comfortable for you to do it in. Although being physically active is good for anyone, some exercises provide specific benefits. Here is how different types of exercise can help people with specific chronic diseases.

CHRONIC DISEASE RELIEF : TYPES OF EXERCISE
There are 3 basic categories of exercise:

Aerobic Exercise
These are exercises that raise your heart rate through repetitive movement of large muscles groups. The 2 types of aerobic exercise are:

Weightbearing exercise —Your muscles work against the force of gravity. Examples include jogging, walking, and dancing.
Non-weightbearing exercise —The force of gravity does not play a major role. Examples include biking, swimming, and rowing.

Strength Training Exercise
These are exercises that increase the power, tone, and efficiency of individual muscles by contracting isolated muscles against resistance. An example is lifting weights. The increase in heart rate is short-lived compared to aerobic exercise.

Stretching
These are exercises that improve or maintain the flexibility of your muscles. Good flexibility is important to keeping a full range of motion and decreasing your chances of injury. Ideally, you should stretch after each exercise session.

DISEASE IMPACT
Overall, all 3 types of exercises are important in a chronic disease relief program. However, the list below demonstrates how a certain types of exercise can directly impact your specific health condition.

Heart Disease
Researchers and healthcare professionals have found that regular exercise reduces the risk of having a heart attack, particularly for people with coronary artery disease (CAD).

Specific benefits of exercise for people with heart disease include:

Stronger heart muscle
Reduced cholesterol
Reduced plaque build-up inside the arteries
Better weight and blood pressure control

Type of exercise that can reduce risk of heart disease and heart attack: Aerobic

High Cholesterol
Cholesterol is found in cells throughout your body. Although it tends to get a bad rap, cholesterol is actually essential for life. It only contributes to heart disease when you have too much of certain types of cholesterol or too little of other types.

Exercise can help reduce cholesterol, and even better, it can help raise your HDL (good) cholesterol. Aim for at least 30 minutes of exercise most days of the week. Even short, 10-minute spurts of exercise can help. Exercise also has the added benefit of weight loss, which can also help to lower cholesterol levels.

Type of exercise that has been shown to improve cholesterol levels: Aerobic

Diabetes
Diabetes is a disorder of the body’s insulin production and usage, and it is a major risk factor for coronary artery disease. If there is not enough insulin, glucose (fuel for all cells) cannot get from the blood to the cells. As a result, the body is essentially starved and the glucose builds up in the blood. Exercise can make the cells more sensitive to insulin, and more glucose can move from the blood into cells.

Since exercise changes the way your body reacts to insulin, you may need to check your blood sugar before and after exercising. Talk to your doctor before you begin an exercise program to learn about what your levels should be.

Types of exercise that influence insulin sensitivity and cardiovascular risk factors: Aerobic and strength training

High Blood Pressure
The risk of high blood pressure increases as we age. Exercise can help to lower your risk and even control your blood pressure if it’s already high. Exercise helps with blood pressure by making your heart work more efficiently. This means your heart does not have to work as hard to pump blood, so there is less pressure on your arteries.

A good target for blood pressure is 120/80 mm Hg. Adding moderate physical activities to your normal routines can help you get there. You should aim for at least 30 minutes of aerobic activity on most days of the week. Even several 10-minute spurts throughout the day can help.

Types of exercise that have been shown to lower blood pressure: Aerobic and strength training

Stroke
A stroke occurs when not enough blood is reaching part of the brain. This causes the cells in that area to die. People who have already had a stroke are at increased risk for recurrent stroke or other cardiovascular problems.

A stroke can create some physical impairments. Exercise may improve strength and coordination of the affected muscles. Exercise recommendations may vary depending on the severity of the stroke and the person’s limitations.

Type of exercise for stroke recovery: Aerobic, strength training, and stretching

Cancer
Studies suggest that people with cancer who do not have depression have a better chance of survival than those who do. Exercise is a great way to avoid depression and improve your overall mood. It’s not clear exactly how exercise impacts mood, but it probably works by causing the brain to release chemicals, like endorphins, and increase body temperature, which can have a calming effect.

Types of exercise found to boost energy and mood: Aerobic and strength training

Lung Disease
Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis, is the most common form of lung disease in adults. Exercise improves activity levels and decreases symptoms.

Types of exercise shown to improve respiratory ability: Aerobic

Arthritis
Continuous motion is essential for the health of your joints, especially arthritic ones. Regular exercise promotes strength and flexibility, and helps preserve the resiliency of joint surfaces.

Types of exercise shown to improve joint health: Nonweightbearing aerobic, strength training, and stretching (water exercises are ideal)

Osteoporosis
Osteoporosis is a bone-thinning disease that can lead to fractures. Weightbearing exercises maintain bone density and strength by tipping the balance in favor of bone formation. Weightbearing activities include walking, jogging, hiking, dancing, stair climbing, tennis, and other activities that you do while on your feet.

Type of exercise shown to improve bone density: Weightbearing aerobic and strength training

In any condition, a well-rounded exercise program will have all 3 types of exercise involved. Aerobic exercise will increase your endurance and ability to get through longer workouts. Strength training will build muscle strength and allow you to tolerate higher intensities as well improve balance and agility. Stretching can decrease stiffness and increase mobility.

Talk to your doctor before beginning any exercise program. You can also consult with an exercise specialist to help you develop a routine.

by Carrie Myers Smith, BS

RESOURCES:
National Institutes of Health
http://www.nih.gov

The American Orthopaedic Society for Sports Medicine
http://www.aossm.org

CANADIAN RESOURCES:
Canadian Society of Exercise Physiology
http://www.csep.ca

Healthy Canadians
http://www.healthycanadians.gc.ca

REFERENCES:
Depression. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 11, 2016. Accessed March 23, 2016.

Exercises for arthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/living-with-arthritis/exercise/. Accessed March 23, 2016.

Fagard RH. Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc 33. S484-S492; 2001.

Gordon NF, Gulanick M, Costa F, Fletcher G, Franklin BA, Roth EJ, Shephard T. AHA scientific statement: Physical activity and exercise recommendations for stroke survivors. Circulation. 2004;109: 2031-2041. Circulation website. Available at: http://circ.ahajournals.org/content/109/16/2031.full. Accessed March 23, 2016.

Junnila JL, Runkle GP. Coronary artery disease screening, treatment, and follow-up. Primary Care: Clinics in Office Practice. 2006 Dec; 33(4).

Onitilo AA, Nietert PJ, Egede LE. Effect of depression on all-cause mortality in adults with cancer and differential effects by cancer site. Gen Hosp Psychiatry. 2006 Sep; 28(5): 396-402.

Physical activity for cardiovascular disease prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed March 23, 2016.

Physical activity guidelines for Americans. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 9, 2013. Accessed March 23, 2016.

Weightbearing exercise for women and girls. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00263. Updated October 2007. Accessed March 23, 2016.

Last reviewed March 2016 by Michael Woods, MD Last Updated: 5/8/2014

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.

PT News

May 23, 2017 Teresa Stockton - Blog, PT News

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

1. Decreasing Cartilage Loss in Osteoarthritis
Written by the Therapy Team at The Jackson Clinics Physical Therapy – Northern Virginia

Although some over-the-counter nutritional supplements have been advertised as capable of rebuilding cartilage in arthritic joints, the claims most often do not stand up under scientific scrutiny. Read more

2. Treating Degenerative Meniscus Tears
Written by the Therapy Team at The Jackson Clinics Physical Therapy – Northern Virginia

During the aging process, the fibrous cartilage between the thighbone (femur) and the shinbone (tibia) within the knee can degenerate and become prone to tearing. Read more

3. Five Stretching Tips Before You Workout
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

As temperatures start to warm up, many of you will start to hit the streets, trails, and parks to exercise outdoors. Read more

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.

Total Knee Replacement Prehab: Move to Improve Your Outcomes

April 20, 2017 Teresa Stockton - Aging, Blog, Knee

Many people with arthritis favor their joints over time in an effort to relieve pain and thus become weaker in their leg muscles or lose range of motion. However, the better shape you are in before surgery the better your results will be after surgery so it is important to strengthen your leg muscles and work on your range of motion. Before surgery your physical therapist will teach you appropriate exercises to help improve strength, range of motion, and balance. They will also teach you how to walk with an appropriate assistive device such as a walker or cane in the immediate post operative recovery period. Finally, they will discuss precautions and advise you in a few short term home adaptations such as removing loose rugs to help make your recovery easier and safer.

Prehab Goals
• Develop an exercise program with your PT to help you
• Improve strength
• Improve range of motion
• Improve balance
• Gait training — Review walking with an appropriate assistive device such as a walker or cane in the immediate post operative recovery period
• Discuss precautions and review a few short term home adaptations that can help make your recovery easier and safer

Pre Surgery Exercise Plan
Make every effort to begin these exercises as early as possible before your surgery. Only do what you are able to do without increasing your pain. It is important for you not to exacerbate your pain prior to surgery. Ice packs for 15 minutes following your exercises may be helpful to reduce any soreness in your knee.

This information was written by STAR Physical Therapy, an outpatient physical therapy group with 60 locations in Tennessee, offering more than 15 comprehensive specialty services. STAR Physical Therapy was established in 1997 with one clinic and one mission – to serve. Today, they’ve grown to offer that direct service in more than 60 clinics. 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.

More about knee replacements and physical therapy can be found here:

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.

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.

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.

April is Occupational Therapy Month!

April 4, 2017 Teresa Stockton - Blog, Events

Occupational Therapy Month is when we celebrate and recognize all of the work our OT’s do. Occupational therapists (OT) help people of all ages participate in the things they want and need to do in their homes, at work, in school and throughout the community. From a patients initial evaluation to the development and follow through of their rehabilitation plans, an OT works hard to make sure that their patient is able to return to the activities they enjoy and need to live a full and healthy life.

In an outpatient setting, some of the responsibilities of our occupational therapists may include:

Hand and upper extremity movement and rehabilitation
Teaching patients to use assistive devices to complete activities of daily living (ADL’s)
Rehabilitating patients recovering from stroke to regain strength, movement, and learn to accomplish ADL’s in modified ways.
Working with employers to create programs designed to reduce risk and injury in the workplace.
Helping children struggling to achieve developmental goals progress to their highest possible levels
Working with patients suffering from neurological conditions such as Parkinson’s to remain active.

This Occupational Therapy Month the AOTA is celebrating 100 years of helping people live their lives to the fullest.
For more info go to: www.aota.org

PT News

March 28, 2017 Teresa Stockton - Blog, PT News

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

1. Exercise after Knee Replacement Surgery
Written by the Therapy Team at Cornerstone Physical Therapy – Gahanna, OH

If you’ve been undergoing treatment for knee arthritis and haven’t gotten any pain relief yet, your doctor may recommend a total knee replacement surgery. Read more

2. Low Back Pain and Sciatica Workshop
Written by the Therapy Team at Oregon Spine & Physical Therapy – Eugene, OR

If you are suffering with chronic back pain or sciatica and you’re looking for some help… why don’t you start by attending one of our Educational Workshops so you can make a better, more educated and more informed decision about your options to ease it. Read more

3. Inflammation and Your Diet
Written by Cheryl Schwieters, Physical Therapist Assistant at the Center for Physical Rehabilitation – Grand Rapids, MI

Throughout the day the body is constantly being bombarded with substances that can trigger inflammation. Read more