Tag Archives: Workout

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:

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.

Exercise and Bone Health

September 1, 2016 Teresa Stockton - Aging, Blog, Sports and Fitness

Bone is living tissue that is constantly undergoing a process called remodeling. In remodeling, cells called osteoclasts are breaking down old bone, as cells called osteoblasts are replacing it with new tissue. Many factors can affect the remodeling process and leave you with bones that are less dense and more fragile.

Some factors that interfere with bone health and remodeling are:
• Increased age
• Low vitamin D—The body makes vitamin D in response to sunlight. You can also get vitamin D by eating certain kinds of food or by taking a supplement.
• A diet low in calcium
• Smoking
• Lack of exercise—especially weight bearing and resistance exercise

Why Exercise Is Good for Bone Health
Regular weight-bearing and resistance exercise helps build muscle, as well as maintain and increase bone strength. Exercise causes the muscle to contract against the bone. This action stresses or stimulates the bone, and the bone becomes stronger and denser. The 3 main types of exercise are (some activities can be more than 1 type):

Aerobic (Cardiovascular) Exercises to Improve Bone Health
In aerobic exercise, you continually move large muscles in the legs, shoulders, and buttocks. This action causes you to breathe more deeply, and your heart to work harder pumping blood, thereby strengthening your heart and lungs. Examples include:
• Walking
• Jogging
• Running
• Aerobic dance
• Bicycling
• Swimming

Weight-Bearing Exercises to Improve Bone Health
In weight-bearing exercises, your bones and muscles work against gravity, and your feet and legs bear the weight. Your bones adapt to the weight and pull of the muscle during weight-bearing exercise. Examples of weight-bearing exercises include:
• Jogging
• Walking
• Stair climbing
• Dancing
• Soccer

Resistance Exercises to Improve Bone Health (Strength Training)
Resistance exercises use muscle strength to improve muscle mass and strengthen bone. Examples include:
• Weight lifting, using:
• Free weights
• Weight machines
• Elastic tubing

• Calisthenics such as push-ups and chin-ups

Tips for Beginning:
Aerobic or Weight-bearing Exercises to Improve Bone Health
• Warm up for 5 minutes before activity. This can consist of dynamic stretches that involve movement and a light walk.
• Start the activity slowly for the first 5 minutes.
• Slowly increase your intensity so that your heart rate increases. A person doing moderate-intensity aerobic activity can talk. A person doing vigorous-intensity activity cannot say more than a few words without stopping to take a breath.
• Gradually increase your workout until you are working out at least 150 minutes a week at moderate–intensity or 75 minutes a week at vigorous intensity.

Resistance Exercises to Improve Bone Health
• Begin each exercise with light weights and minimal repetitions.
• Slowly (over weeks) increase weight, never adding more than 10% in a given workout.
• Do these exercises 2-3 times a week. Allow for 1 day between each workout for your bones and muscles to rest and repair themselves.
• Gradually increase the number of repetitions to 2-3 sets of 8-10 repetitions with a rest period of 30-60 seconds between sets.
• Although stiffness the day after exercise is normal, if you are in pain, you did too much. Decrease the intensity or the duration of your exercise.

Before starting any type of exercise program, check with your doctor about any possible medical problems you may have that could limit your ability to exercise.

by Mary Calvagna, MS

RESOURCES:
National Osteoporosis Foundation
http://www.nof.org

The President’s Council on Physical Fitness, Sports, and Nutrition
http://www.fitness.gov

CANADIAN RESOURCES:
Canadian Orthopaedic Foundation
http://www.canorth.org

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

REFERENCES:
2008 Physical Activity Guidelines for Americans. US Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/default.aspx#toc. Published October 2008. Accessed January 21, 2016.

Bone remodeling. University of Washington website. Available at: http://courses.washington.edu/bonephys/physremod.html. Updated March 30, 2007. Accessed January 21, 2016.

How much physical activity do adults need? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html. Updated June 4, 2015. Accessed January 21, 2016.

Osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 13, 2015. Accessed January 21, 2016.

Skeleton keys. Smithsonian Museum of Natural History website. Available at: http://anthropology.si.edu/writteninbone/young_old.html. Accessed January 21, 2016.

Last reviewed January 2016 by Michael Woods, 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.

PT News

August 23, 2016 Teresa Stockton - Blog, PT News

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

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

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

Juvenile Rheumatoid Arthritis

July 19, 2016 Teresa Stockton - Blog, Pediatrics

Definition

Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis, is a disease of the joints in children. It can affect a child over a long period of time. JRA often starts before the child is 16 years old.

In Juvenile rheumatoid arthritis, the joint becomes swollen. It will make the joint painful and difficult to move. JRA can also lead to long term damage to the joint. For some, JRA can interfere with the child’s growth and development.

There are 5 major types of juvenile rheumatoid arthritis:
• Pauciarticular JRA—4 or less joints are affected in the first 6 months of illness
• Polyarticular JRA—5 or more joints are affected in the first 6 months of illness
• Enthesitis associated arthritis—swelling of the tendon at the bone
• Psoriatic arthritis—associated with a skin disease called psoriasis
• Systemic onset JRA (also called Stills disease)—affects the entire body, least common type of JRA

Causes

Juvenile rheumatoid arthritis is caused by a problem of the immune system. The normal job of the immune system is to find and destroy items that should not be in the body, like viruses. With JRA, the immune system attacks the healthy tissue in the joint. It is not clear why this happens. The immune system problems may be caused by genetics and/or factors in the environment.

People of Hispanic American, Asian American, Pacific Islander, Native American, or African American descent are at higher risk.
Having prediabetes means that you are at high risk for developing diabetes and may already be experiencing adverse effects of elevated blood sugar levels.

Risk Factors

Girls are more likely to get JRA than boys.

There are no clear risk factors for JRA. Factors that may be associated with some types of JRA include:
• Family history of:
• Anterior uveitis with eye pain
• Inflammatory back arthritis (ankylosing spondylitis)
• Inflammatory bowel disease

Symptoms

• Symptoms may include:
• Joint stiffness, especially in the morning or after periods of rest
• Pain, swelling, tenderness, or weakness in the joints
• Fever
• Weight loss
• Fatigue or irritability
• Swelling in the eye—especially associated with eye pain, redness, or sensitivity to light
• Swollen lymph nodes
• Growth problems, such as:
• Growth that is too fast or too slow in one joint (may cause one leg or arm to be longer than the other)
• Joints grow unevenly, off to one side
• Overall growth may be slowed

Some symptoms are specific to each type of juvenile rheumatoid arthritis . For example:
• Symptoms common with pauciarticular JRA include:
• Problems most often found in large joints. These joints include knees, ankles, wrists, and elbows.
• If the left-side joint is affected, then the right-side similar joint will not be affected. For example, if the right knee is affected, then the left knee will be healthy.
• May also have swelling and pain at on the tendons and ligaments attached to the bone

• Symptoms common with polyarticular JRA include:
• Problems found most often in small joints of the fingers and hands. May also affect weight-bearing joints like the knees, hips, ankles, and feet.
• Joints on both sides of the body are affected. For example, if the left hand is affected, then the right hand will also be affected.
• May also have a blood disorder called anemia. This is an abnormally low number of red blood cells.
• One type of polyarticular JRA may occur with:
• A low-grade fever
• Nodules—bumps on parts of body that receive a lot of pressure such as elbows

• Symptoms common with systemic onset JRA include:
• Some of the first signs may be a high fever, chills, and a rash on the thighs and chest. May appear on and off for weeks or months
• May have swelling in the heart, lungs, and surrounding tissues
• The lymph nodes, liver and/or spleen may become enlarged
• Children with enthesitis arthritis often have tenderness over the joint where the pelvis and spine meet.
• Children with psoriatic arthritis often have finger or toe swelling. There may also be damage on fingernails.

Often, there are remissions and flare-ups. Remission is a time when the symptoms improve or disappear. Flare-ups are times when symptoms become worse.

Diagnosis

You will be asked about your child’s symptoms. You will also be asked about your family medical history. A physical exam will be done. An eye examination may also be done to check for swelling in the eye. Your child may be referred to a specialist if JRA is suspected. The specialist is a doctor that focuses on diseases of the joints.

Images may be taken of your child’s bodily structures. This can be done with x-rays.

Your child’s bodily fluids may be tested. This can be done with:
• Blood tests
• Urine tests
• Tests of joint fluid

Treatment

Talk with your doctor about the best plan for your child. The plan will work to control swelling, relieve pain, and control joint damage. The goal is to keep a high level of physical and social function. This will help keep a good quality of life. Treatment options include the following:

Medication

There are several types of medication that may be used:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)—to help swelling and pain
• Disease-modifying antirheumatic drugs (DMARDs)—to slow the progression of the disease
• Tumor necrosis factor (TNF) blockers—to decrease swelling, pain, and joint stiffness
• Interleukin inhibitors—to reduces disease activity
• Corticosteroids through IV or by mouth—for swelling
• Steroid injections into the joint—may help relieve swelling and pain in some children

Polyarticular JRA may become inactive in children who begin medications within 2 years of onset.

Physical Therapy

Exercise is done to strengthen muscles and to help manage pain. Strong nearby muscles will support the joint. It also helps to recover the range of motion of the joints. Normal daily activities are encouraged. Non-contact sports and recreational activities may be good options. Physical activities can also help boost a child’s confidence in their physical abilities.

Physical therapy may be needed. This will help to make the muscles strong and keep the joints moving well.

Maintenance Devices

Splints and other devices may be recommended. They may be worn to keep bone and joint growth normal. Some joints may get stuck in a bent position. These devices can help prevent this.

Prevention

There is no known way to prevent JRA.

by Jacquelyn Rudis

RESOURCES:
American College of Rheumatology
http://www.rheumatology.org

Arthritis Foundation
http://www.arthritis.org

CANADIAN RESOURCES:
The Arthritis Society
http://www.arthritis.ca

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

REFERENCES:

Hofer MF, Mouy R, et al. Juvenile idiopathic arthritides evaluated prospectively in a single center according to the Durban criteria. J Rheumatol. 2001. 28:1083.

Juvenile idiopathic arthritis (JIA) enthesitis related. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2015. Accessed December 21, 2015.

Juvenile idiopathic arthritis (JIA) oligoarticular. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2015. Accessed December 21, 2015.

Juvenile idiopathic arthritis (JIA) polyarticular. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2015. Accessed December 21, 2015.

Juvenile idiopathic arthritis (JIA) systemic-onset. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2015. Accessed December 21, 2015.

JAMA Patient Page. Juvenile idiopathic arthritis. JAMA. 2005;294:1722.

Petty RE, Southwood TR, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol.1998; 25:1991.

2/5/2013 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: De Benedetti F, Brunner HI, Ruperto N, et al. Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis. N Eng J Med. 2012;367(25):2385-95.

2/24/2014 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Limenis E, Grosbein HA, et al. The relationship between physical activity levels and pain in children with juvenile idiopathic arthritis. J Rheumatol. 2014 Feb;41(2):345-351.

9/2/2014 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Guzman J, Oen K, et al. The outcomes of juvenile idiopathic arthritis in children managed with contemporary treatments: results from the ReACCh-Out cohort. Ann Rheum Dis. 2014 May 19.

Last reviewed December 2015 by Kari Kassir, MD Last Updated: 12/20/2014

July 2016 Events

June 23, 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 July 2016!

INDIANA PHYSICAL THERAPY EVENTS

JEFFERSONVILLE, IN
DATE: July 15th, 2016 7:00AM – NOON
Steel Dynamics Health & Safety Fair
CLINIC: New Horizons Physical Therapy – Jeffersonville
New Horizons Physical Therapy will be participating in Steel Dynamics – Jeffersonville location’s Health and Safety Fair. The fair is open to Steel Dynamics employees and their families and they look forward to seeing you there! For more information about New Horizons Physical Therapy, visit them online at www.newhorizonsphysicaltherapy.com.

MICHIGAN PHYSICAL THERAPY EVENTS

MONROE, MI
DATE: July 5th, 2016
Clinic Relocation
CLINIC: Advanced Physical Therapy – Monroe
Advanced Physical Therapy is the leading provider of physical therapy, spine care and sports medicine in Southeast, MI. They are proud to be part of the Monroe community, and are committed to helping you, their friends and neighbors, get through your pain and on with life. Visit them at their new location: Hampton Plaza 1291 N. Telegraph Rd., Monroe, MI 48162 www.advphysicaltherapy.com.

SOUTHGATE, MI
DATE: July 18th, 2016 7:30PM
Building Better Runners Series (FREE)
CLINIC: Advanced Physical Therapy – Southgate
Join Advanced Physical Therapy at their Southgate location for a FREE talk focused on the Runner’s Core Routine. Come and learn a step-wise approach to strengthening the lower extremity, specific for runners. This “learn by doing” presentation will build on our Glute Activation talk. Come dressed and ready to participate. Coaches are always welcome, as are your athletes. To sign up please call 734-284-6582 to reserve your spot. More info on Advanced PT at www.advphysicaltherapy.com.

TENNESSEE PHYSICAL THERAPY EVENTS

PULASKI, TN
DATE: July 23rd, 2016
Registration Due for 2nd Annual Golf Scramble
CLINIC: STAR Physical Therapy – Pulaski
STAR Physical Therapy – Pulaski is raising money for The American Heart Association through a fun Golf Tournament. The event will be held August 6th but registration for teams is due on July 23rd. For more information or to register call STAR Physical Therapy at 931-292-6311. For more info about STAR Physical Therapy you can visit them online at www.starpt.com.

MT. JULIET, TN
DATE: July 21st 2016, 2:00PM – 3:00PM
Back Pain Talk
CLINIC: STAR Physical Therapy – Mt. Juliet
STAR Physical Therapy – Mt. Juliet South is hosting a FREE talk about back pain and how physical therapy can help at the Del Webb Country Club. Anyone in the Del Webb community is welcome to attend. A question and answer section will be held at the end. For more info about STAR Physical Therapy you can visit them online at www.starpt.com.

VIRGINIA PHYSICAL THERAPY EVENTS

BLACKSBURG, VA
DATE: July 29th, 2016, 2:00PM
Dizziness/ Vestibular Rehabilitation Talk
CLINIC: University Physical Therapy – Blacksburg
Kelly Wilson, PT, DPT from University Physical Therapy – West Blacksburg is hosting a FREE talk at the Blacksburg Public Library to discuss dizziness, vertigo and vestibular issues and how physical therapy can help. For more information about University Physical Therapy visit them online at www.universityptonline.com.

BRAMBLETON, VA
DATE: July 2016
New Clinic Opening
CLINIC: The Jackson Clinics – Brambleton
The Jackson Clinics are happy the announce the opening of their newest location in Brambleton, VA – located at 42365 Soave Dr. Bramleton, VA 20148. For more information about the Jackson Clinics visit them online at www.thejacksonclinics.com.

WISCONSIN PHYSICAL THERAPY EVENTS

PLOVER, WI
DATE: July 18th, 2016
New Clinic Opening
CLINIC: Sport and Spine Physical Therapy – Plover
Sport and Spine Physical Therapy is proud the announce the opening of it’s newest location in Plover! Located at 1767 Park Avenue, Suite 200, Plover, Wisconsin. Caitlyn Barr, DPT, will be the physical therapist on site. For more information about Sport and Spine physical therapy visit them online at www.sportspinewi.com.

WAUSAU, WI
DATE: July 19th, 2016, 6:00PM – 8:00PM
WVAM Sports Physical Event
CLINIC: Sport and Spine Physical Therapy – Wausau
Sport and Spine Physical Therapy along with other members of the WVAM are providing physicals for athletic students at the Bone and Joint Clinic at 5200 Hummingbird Road. The Cost for a physical is $25. $20 from each physical will be donated back to the athlete’s athletic department. For more information about Sport and Spine physical therapy visit them online at www.sportspinewi.com.

Click here to print a downloadable events flyer.

What Does It Really Mean to Have Prediabetes?

June 9, 2016 Teresa Stockton - Blog, General Information

Type 2 diabetes usually occurs as a result of genetics and lifestyle. It is marked by abnormally high levels of blood sugar, known as glucose. Glucose is the primary source of energy for our cells that the body makes from food we ingest. The onset of type 2 diabetes is triggered when the body is no longer able to properly use insulin, the hormone that helps cells take in glucose from the blood. When glucose stays in the blood stream instead of moving into the cells, nerves and blood vessels can be damaged. This increases the risk of cardiovascular disease, stroke, blindness, kidney disease, and circulation problems.

What Is Prediabetes?
Prediabetes is a condition that precedes the onset of type 2 diabetes. It is characterized by blood glucose levels that are elevated, though not high enough to be classified as diabetes. Doctors usually refer to prediabetes as impaired glucose tolerance or impaired fasting glucose. The American Diabetes Association (ADA) recommends screening for all adults 45 years old and older. Also, if you are younger than 45 and are overweight or obese and have risk factors for diabetes, you should be screened. Risk factors include:
• Family history of diabetes
• Having hypertension, high cholesterol, or high triglycerides
• Sedentary lifestyle
• History of gestational diabetes or giving birth to a baby weighing more than 9 pounds (4 kilograms)
• History of cardiovascular disease
• Having a condition associated with insulin resistance, such as polycystic ovary syndrome or metabolic syndrome

How Do You Know If You Have Prediabetes?
During a routine office visit, your doctor can order tests, such as:
• Fasting plasma glucose test—For this test, you fast overnight and have your blood glucose measured in the morning before eating. Results in the range of 100-125 mg/dL (5.6-6.9 mmol/L) may indicate prediabetes.
• Oral glucose tolerance test (OGTT)—Again, you fast overnight and have your blood glucose measured after the fast. Then, you consume a sugary drink and have your blood glucose measured two hours later. Results in the range of 140-199 mg/dL (7.8-11 mmol/L) indicate prediabetes.
• Hemoglobin A1c (HbA1c)—This is an indicator of your average blood sugar levels over the previous three months. Results in the range of 5.7%-6.4% indicate prediabetes.

What Can You Do If You Have Prediabetes?
If you are diagnosed with prediabetes, it is important to take action to manage your condition. If you are overweight, your doctor may recommend that you lose weight. Reducing your body weight, even by 5%-10% can help improve your health. In general, changing your diet and being physically active and exercising at least 30 minutes a day will help you stay on track. Participating in a behavioral modification program may further help you achieve your weight loss goals.

Because many of the lifestyle-related risk factors associated with diabetes are also risk factors for other health issues, making lifestyle changes to reduce your risk of diabetes may have a positive effect on your overall health.

Some people can take medication to manage their blood glucose levels, though lifestyle modification should be the first approach to manage prediabetes. Medications that may be used include metformin, pioglitazone, and acarbose.

How Can You Prevent Prediabetes?
The same strategies that are used to lower your risk of type 2 diabetes can be applied to prediabetes, as well. The American Diabetes Association (ADA) recommends these strategies:
• Lose excess weight.
• Exercise for at least 150 minutes per week.
• Reduce your intake of calories and fat.
• Try to eat more fiber and whole grains.

If you do have prediabetes, you can take steps that may slow or avoid the progression to type 2 diabetes. It will take a lot of effort on your part, but the potential benefits—being healthy and living longer—are worth it.

by Julie J. Martin, MS

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

National Diabetes Education Program
http://www.ndep.nih.gov

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

The College of Family Physicians of Canada
http://www.cfpc.ca

REFERENCES:
Am I at risk for type 2 diabetes? Taking steps to lower the risk of getting diabetes. National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/risk.pdf. Published June 2012. Accessed April 26, 2016.

American Diabetes Association and National Institute of Diabetes, Digestive and Kidney Diseases. The prevention or delay of type 2 diabetes. Diabetes Care 2002;25:1-8.

Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. NEJM. 2002;346:393-403.

Diabetes mellitus type 2 prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 22, 2016. Accessed April 26, 2016.

Diagnosing diabetes and learning about prediabetes. American Diabetes Association website. Available at: http://www.diabetes.org/are-you-at-risk/prediabetes. Updated December 9, 2014. Accessed April 26, 2016.

Kanaya AM, Narayan KM. Prevention of type 2 diabetes: Data from recent trials. Primary Care. 2003;30:511-526.

Narayan K, Imperatore G. Targeting people with prediabetes. British Medical Journal. 2002;325:403-404.

Nathan DM. Diabetes Care. 2007;30:753.

Prediabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2016. Accessed April 26, 2016.

Tuomilehto J, Lindstorm J. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2004;344:1343-1350.

10/21/2008 DynaMed’s Systematic Literature Surveillance: http://www.ebscohost.com/dynamed: Greaves CJ, Middlebrooke A, O’Loughlin L, et al. Motivational interviewing for modifying diabetes risk: a randomised controlled trial. Br J Gen Pract. 2008;58:535-540.

10/12/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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.

2/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-S61).

2/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-S69).

Last reviewed April 2016 by Michael Woods, MD Last Updated: 6/3/014

Exercise May Reduce Risk of Low Back Pain

May 12, 2016 Teresa Stockton - Back, Blog

Low back pain is a common complaint that can last a few days or weeks or become a chronic condition with significant impact on well being. Treatments can vary depending on the cause.Chronic back pain can be difficult to successfully treat and it may take some time to find what treatment works best for each person. Since treatment is not guaranteed to work, prevention is the best option. Back pain is often the result of long term stress on the back such as poor posture, sedentary behavior, or regular strain on the back. Prevention will likely involve a number of different steps to reduce these stresses. However, existing studies have not found clear recommendations for the best methods to go about it.

Researchers wanted to investigate the effectiveness of a number of interventions for the prevention of low back pain. The study, published in JAMA Internal Medicine, found that exercise alone or in combination with education was most effective for preventing low back pain.

About the Study
The systematic review of 21 randomized controlled trials included 30,850 men and women without low back pain. The participants were randomized to 6 different prevention strategies, including exercise, education, exercise plus education, back belt, and shoe insoles. The control groups received no intervention, minimal interventions, or placebo.

When compared to the control group exercise was associated with:
• Fewer low back pain episodes in the first 12 months (in 4 trials with 898 people)
• Fewer sick days due to back pain in follow up 12 months or longer (in 2 trials with 128 people)
• Reduction in short-term (4 trials with 422 people) and long-term low-back pain episodes (2 trials with 138 people) when combined with education

Education alone, back belts, and shoe insoles did not appear to have any benefit during the trials.

How Does This Affect You?
A systematic review combines the results of several smaller studies to arrive at one result. The benefit of this type of review is that it increases the number of participants which increase reliability of results. However the review is only as reliable as the studies that are included and the method used to combine the results. There were some flaws in every trial that were included in this analysis. For example, many of the included trials had a high dropout rate during the trial which decreases the reliability of their results.

Low back pain is often associated with an imbalance or weakness of certain back muscles. An exercise program will improve your physical fitness, strengthen your back muscles, and help you maintain a healthy weight. Regular physical activity may also help maintain a healthy weight which can also put strain on your back. Choose exercises or activities that you enjoy and will make a regular part of your day. For most people, this could include 30 minutes of moderate aerobic exercise per day.

Check with your doctor before starting any exercise program.

by Cynthia M. Johnson, MA

RESOURCES:
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

Ortho Info—American Academy of Orthopaedics
http://orthoinfo.aaos.org

SOURCES:
Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 2, 2016. Accessed March 22, 2016.

Steffens D, Maher CG, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016 Feb 1;176(2):199-208.

Last reviewed April 2016 by Michael Woods, MD

PT News

May 10, 2016 Teresa Stockton - Blog, PT News

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

1. What does RICE and MEAT have to do with Physical Therapy?
Written by the Therapy Team at Cornerstone Physical Therapy. located in Canal Winchester, OH

When you hear the words rice and meat, we won’t blame you for thinking about food! In the physical therapy world, the RICE method (rest, ice, compression, and elevation) has long been the recommended treatment for sports injuries. Read more

2. Slow and Steady Still Wins the Race
Written by the Therapy Team at the Jackson Clinics Physical Therapy – Middleburg, VA

As the days get longer and warmer, we’re more apt to engage in outdoor activities like walking and running. Spring also begins the season for charity 5k races and half marathons―great inspirations for starting a new exercise program. Read more

3. Staying Active During Pregnancy
Written by Jennifer Ryskamp, PTA at the Center for Physical Rehabilitation – Grand Rapids, MI

I wanted to take this opportunity to connect with my fellow women who are currently pregnant, and let you know that you are not alone. I am speaking specifically to those who have historically always been very active and are now finding themselves forced to slow down due to the immensely wonderful and yet altogether difficult task of growing another human being. Read more

Starting a Workout Program

May 5, 2016 Teresa Stockton - Blog, Sports and Fitness

Yes, we get it, exercise is important, but that alone isn’t enough to make all of us get off of the couch. If you are having trouble starting a workout program that works for you and your schedule, get creative and start small. For most of us, we need someone or something to give us a small push in the right direction – and that’s exactly what we’re going to do. You don’t have to go to a gym with a lot of intimidating machinery, and weights – you can go to a physical therapy clinic. A physical therapist can work with you to develop a functional exercise routine that works for you and your goals… and if you need an exercise or wellness coach – they may just be able to make a recommendation. Okay, you’ve heard the sales pitch, but here are the basics you need to know. Whether you go to a gym, PT, or are starting a program on your own there are a few things you should take into consideration.

Benefits of Exercise

Improved circulation and cholesterol
Weight control
Assists with smoking cessation and addiction
Prevents/manages high blood pressure
Prevents bone loss
Boosts energy level and happy brain chemicals
Improves sleep, strength, and self confidence
Reduces risk of CHD/CVD, stroke
Delays/prevents chronic diseases
Reduces stress and anxiety while increasing relaxation
Prevents cognitive decline
Sharpens memory and boosts brainpower

Is Exercise Safe for Me?

If you have major health issues, consult your doctor before doing any exercise
Medical conditions can benefit from exercise even if you have a health issue or injury

Setting Yourself Up for Success

Set short term and long term goals THAT ARE OBTAINABLE!
Daily Reminders: schedule workouts on your calendar or set the alarm on your phone
Reward yourself for obtaining your goals (with something other than food)
Invest in a good pair of workout shoes
Workout with others
Start slowly
Do things you like and don’t focus on activities that you don’t like

How Often Should I Exercise?

Start small and build for success
American Heart Association recommends 30 min per day, most days of the week
SOMETHING IS ALWAYS BETTER THAN NOTHING!

How Hard Should I Work Out?

During cardio take the talk test: Can you speak in sentences while exercising?
Resistance training: You should be able to perform 10-15 reps with proper form

Stay Safe When You Exercise

Drink plenty of water before, during, and after a workout
Warm up, stretch, and cool down to help prevent injury
Wear good shoes that are appropriate for your foot type

This information about starting a workout program was written by Advance Rehabilitation, a physical therapy group with 15 locations throughout North and South GA, and 2 locations in North FL. Advance Rehabilitation is an outpatient physical therapy group that focuses on providing the highest quality rehabilitation services. They specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. For more information click here.