Published November 30, 2016 - Stephanie Shimel, DPT
Physical therapy can help breast cancer survivors in many ways, this includes: improving functional recovery following surgery, reducing chemotherapy fatigue and nausea, reducing swelling, increase strength, regaining range of motion and flexibility, reducing/eliminating pain, and improving perceived quality of life
1. Following Mastectomy: PT provides many techniques including arm mobilization, postural education, shoulder strengthening, prevention and treatment of upper extremity edema, scar tissue techniques, and education regarding arm function
2. Fatigue: Gradual return to exercise may help manage nerve irritation and fatigue, a very common complaint among patients with breast cancer.
3. Lymphedema: Supervised exercise along with massage, education on skin care, range-of-motion, use of compression sleeves, and manual lymphatic drainage can all help control symptoms that may result from removal of lymph nodes
4. Strength: Gradual return to exercise with supervision can re-educating muscles, restore movement, improve posture, and reduce fatigue and nerve irritation
5. Range of Motion: Improving soft tissue function, joint mobility, and decreasing scar tissue to increase mobility.
6. Pain: Exercises and manual techniques can help reduce pain and restore normal function of joints and muscles.
7. Flexibility: Stretching can improve posture, which helps pain management and prevents stiffness.
8. Education: PT offers several ways to prevent infection, swelling, reduce pain, and improve sleeping techniques
9. A study in BMC Medicine found that supervised strength and conditioning during the first 18 weeks following chemotherapy helped patients offset deconditioning side effects.
10. Base of support: At Neil King Physical Therapy, we develop strong communication and relationships with our patients, allowing them to expand their support system.
Physical therapists are crucial in identifying, treating, and preventing impairments that are a result of cancer treatments. Skilled physical therapy can help these patients reach their optimal potential for participation in life’s activities.
Author: Stephanie Shimel, DPT
Published November 15, 2016 - Angela Poole, PTA
I’m frequently asked about the difference between Physical Therapy and Occupational Therapy. Physical Therapists (PTs), Physical Therapist Assistants (PTAs), Occupational Therapists (OTs) and Occupational Therapy Assistants (COTAs) often work in the same settings. There is a lot of cross-over with the therapies, utilizing some of the same approaches and in many cases the therapists work closely together.
Most adults have had PT at some point in their lives and have an idea of what it involves. When most people think of physical therapy, they think about exercise, massage, stretching, and joint mobilizations. PT also includes instruction in proper gait, navigating obstacles such as stairs, getting into and out of the bed or car. PTs instruct and recommend the use of assistive devices such as wheelchairs, walkers, canes, etc. In a nutshell, PT treats a specific injury or condition in order to allow the patient to regain their functional mobility by increasing their range of motion, strength, and balance.
Unlike PT, most people have no idea what Occupational Therapy involves. OTs and COTAs goals are to help individuals participate in what they want and need to do to have a meaningful life. We often don’t think of the activities that we do during the day as occupations, but they are. Balancing the check book, organizing medications, doing laundry, cooking, washing dishes, showering, toileting, and getting in and out of bed are all occupations of a mature independent adult. These are the meaningful activities that promote the quality of life. OTs instruct in the use of adaptive/assistive devices such as a reacher, leg lifter, shower chair, etc., to help people perform the activities of daily living.
To sum it up PTs treat the injury/condition to improve functional mobility and OTs help the individual to engage in meaningful activities of daily living while dealing with the injury/condition. Ultimately, the goal of all therapy is to promote independence.
Published October 12, 2016 - Maria Roszczenki, MPT
Manual Physical Therapy is a hands-on approach that is used in the rehabilitation of musculoskeletal problems.
In manual therapy clinicians use their hands to manipulate muscle tissue, fascia, and joints in order to decrease discomfort and pain created by muscle spasms, tension, and joint dysfunction.
Manual therapy techniques are less familiar to physicians as historically physical therapy was based on the use of modalities such as hot or ice packs, ultrasound, and therapeutic exercise.
Manual therapy is used for the treatment of joints that have decreased mobility after surgical procedures, applications of casts, or just due to postural misalignment. With the hands-on approach the soft tissue can be restored to optimal flexibility which may reduce or completely end pain and restore the area to normal function.
Manual therapy often is very effective in reducing the pain from severe headaches and migraines. Soft tissue work not only helps to reduce muscle tension, but will improve circulation of blood and lymph. The same is true of the manipulation of post-surgical scar tissue. This will reduce the possibility of adhesion's and one may expect a restoration of good movement patterns without pain.
Physical therapists commonly use the following manual therapy techniques: soft tissue mobilization, strain-counter strain, joint mobilization, muscle energy, high velocity/low amplitude thrusting, and myofascial release. These techniques aid in the healing process and help prevent the recurrence of pain.
Author: Maria Roszczenko, MPT
Published September 7, 2016 | Shannon Stermer, DPT
Since 1999, Americans have increasingly been prescribed opioids - painkillers like Vicodin, OxyContin, and Methadone, with a combination of drugs like Percocet. While appropriate in certain cases, when properly dosed, there are a lot of risk factors to consider. These risks include depression, overdose, and addiction, plus withdrawal symptoms when stopping.
Here are some statistics about America’s opioid use:
- In 2012, health care providers wrote 259 million prescriptions for opioid pain medication, enough for every American adult to have their own bottle.
- As many as 1 in 4 people who receive prescription opioids long term for non-cancer pain in primary care settings struggles with addiction.
- Sales of prescription opioids have nearly quadrupled since 1999.
- Deaths related to prescription opioids have quadrupled.
- Heroin-related overdose deaths have more than quadrupled between 2002 and 2014, and people addicted to prescription opioids are 40 times more likely to be addicted to heroin.
- More than 165,000 persons in the United States have died from opioid pain medication related overdoses since 1999.
- Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids.
Patients should choose physical therapy when the risks of opioid use outweigh the rewards.
The CDC is urging health care providers to reduce the use of opioids, in favor of safe alternatives like physical therapy. Experts agree that the potential side effects of opioids should not be considered first line or routine therapy for chronic pain. Even when opioids are prescribed, they recommend that patients receive the lowest effective dosage and should be combined with non-opioid therapies, such as physical therapy. Patients want to do more than mask the pain, they want to overcome it.
“Opioids reduce the sensation of pain by interrupting pain signals to the brain whereas Physical therapists treat the pain through movement while partnering with patients to improve or maintain their mobility and quality of life.”
Opioids are prescribed to an estimated 116 million Americans each year for chronic pain while the risks for continued opioid use increases. The CDC has sited high quality evidence supporting exercise as part of a physical therapy treatment plan for chronic pain conditions and note that non-opioid therapies are “preferred” for chronic pain. Clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient.
Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for non-opioid treatment.
Author: Shannon Stermer, DPT
Published August 26, 2016 | Sheila Polcyn, PT
What is Fibromyalgia?
It is defined as a condition lasting more than 3 months of unknown cause which isn’t clearly defined. But what is it really? The word is derived from the Greek and New Latin language that translates into “muscle and connective tissue pain”. While there may be a genetic and environmental predisposition to fibromyalgia, it is more prevalent in middle-aged women but men and children can be susceptible as well.
What are Some of the Symptoms?
Many may experience non-specific pain sensations all over their body with extreme tenderness to light pressure. Along with the pain, there could be complaints of fatigue, sleep problems, memory issues, and mood disorders as well. In some cases, there could be other symptoms of tension headaches, TMJ, IBS, anxiety, and depression. But there are outside contributing factors that may contribute to these fibromyalgia symptoms like physical trauma, infection, surgery, and psychological stress. All of these indicators can accumulate gradually overtime without any triggering cause.
Physical Therapy Treatment for Fibromyalgia
While there is no cure, Physical therapy is an effective option that offers help for people suffering from fibromyalgia due to the nature of muscle and connective tissue involvement. Physical Therapy focuses on the treatment, healing, and prevention of injuries or disabilities associated with fibromyalgia and can treat the side effects such as pain, fatigue, deconditioning, muscle weakness, and sleep disturbances, as well as other disease consequences.
The following tools allow a Physical Therapist to provide a one-on-one experience to help their patient’s manage their symptoms:
Soft tissue mobilizations and relaxation exercises to reduce muscle tension
Teach proper posture to allow the muscles to work more efficiently, this will help in avoiding extreme fatigue and pain
Exercise that improves fitness levels, aids in sleep, and reduces pain and fatigue.
Stretching exercises to improve muscle flexibility and joint mobility
Patient education of more sensible decision-making about lifestyle changes to prevent painful flare-ups rather than focus on the chronic problems of pain, stiffness, and fatigue associated with fibromyalgia.
The ultimate goal of Physical Therapy in treatment of fibromyalgia is for patients to become independent in a home exercise program and to learn any specific treatments that will help manage their symptoms and improve their quality of life.
Published August 16, 2016 | Daniel Ormsby, DPT
“Going under the knife” is a well-known expression and often becomes reality for many people at one (or more) points in their lives. There is a wide range of surgical interventions to fix common orthopedic conditions but the path that leads someone to the operating room varies from person to person, but the end game is the same. People often seek surgical intervention for pain relief to allow them to return to normal functioning with every daily life.
Unless the path to surgery was related to a sudden trauma or a congenital disorder, the mechanism of the injury is due to faulty movement patterns that slowly overload the body’s joints and soft tissues. Eventually, failure of these overloaded tissues will occur. Most orthopedic injuries fall into this category of faulty movement and overload.
For a person to fully return to optimal functioning and to prevent future injury, movement patterns need to be assessed and corrected. Examples of movement patterns include the techniques used while sitting, standing, walking, lifting, or getting on and off the toilet. Not using the body correctly will always lead to eventual breakdown and injury. Once a person is taught to move correctly, we can be confident that we have reduced the probability of re-injury and failure of surgery.
The patient will undoubtedly have impairments related to surgery. Swelling, post-surgical pain, limited range of motion (ROM), joint stiffness, and muscle dysfunction are often present once surgery is complete. Physical therapists will manage swelling, pain, ROM and joint issues with manual techniques and therapeutic exercise. It is important to teach the correct bio-mechanics and movement techniques that can ensure surgery is a one-time occurrence. Remember, surgery is often done for pain relief, but it does not necessarily correct the underlying problems that lead to “going under the knife”.
Published August 11, 2016 | Neil King, MPT
During a women’s pregnancy her body and the baby are changing and growing on a daily basis. If prior to the pregnancy the mother’s body has pelvic misalignments or her fascial structure was tight, it may affect space and movement patterns of the baby during development. As the pregnancy continues, an unaligned body predisposes a woman to a variety of common discomforts such as back pain, hip pain, sciatica, leg cramps, difficulty with breathing and swelling in the legs.
Rolfing® can be done preconception to improve structural integrity and balance of the body. A balanced pelvis has a consistent tone at the pelvic floor allowing for a more centralized space for a baby to grow and an easier pathway for the baby to drop through the birth canal. An unbalanced pelvis has a consistent tone at the pelvic floor allowing for a more centralized space for a baby to grow and an easier pathway for the baby to drop through the birth canal. An unbalanced pelvis has a distorted pelvic floor and as the ligaments soften during pregnancy pain and stress can occur to the sacroiliac and pubic symphysis joints. Pelvic asymmetries can also affect the position and movement of the baby as it grows. Proper pelvic alignment expands the birth canal which can ease labor for the mother and baby.
Rolfing® can also be done during pregnancy to lengthen the superficial layers of fascia to help restore spinal height and decrease compression forces to the lumbar spine and diaphragm. By maintaining fascial length as the mother’s body grows during pregnancy, she maintains a strong structural foundation to support her body as the baby’s growth changes her center of gravity and pulls the pelvis forward. Maintaining fascial length keeps the baby in a neutral position throughout the pregnancy decreasing stress to the pelvis and improving access of the birth canal. In the case of twins, symmetry of the pelvis and body is crucial to allow equal space for each baby to grow decreasing stress to the mother’s body and the babies’ developmental process. Post Natal Rolfing® can help reorganize a mother’s body back to the strong resilient structure it was prior to the physical and possibly traumatic changes that occurred during the pregnancy.
Published August 2, 2016 | Tina Schaffner PT, DPT, OMPT
One of the most common goals of patients coming into physical therapy for spine related pain, whether it be low back pain or neck pain, is core strength. But what does core strength really mean? Many believe sit-ups and crunches are the primary way to achieve core stability but there is more to it and that six pack of abs are simply just the “icing on the cake,” as they look good on the beach but have little to do with supporting your trunk.
Core strength and stability rely on the coordination of the small and large muscles of the spine in a neutral position. Neutral allows for balanced length and strength of the musculature and joints in the front and the back of the spine. In this position the muscles are able to control the spine and engage the hip musculature to do the heavy lifting they were designed for.
But why is it important to have a solid foundation?
Decrease pain. A strong core stabilizes the individual vertebra in the spine resulting in less movement when performing daily functions like bending and lifting.
Support of the extremities and the head. Strong trunk allows for a stable base from which the arms and legs can function. The glutes and the shoulder blade muscles are able to maintain the support for the hips and shoulders if they have a firm anchor from which to act.
Optimize organ function. Strength in the trunk allows for improved posture allowing for proper rib cage expansion, improved oxygenation, improved gut function and pelvic health.
Improve posture. Optimizing the length in the front and the back of the trunk gives the ability to maintain the neutral position that will lead to improved posture and a leaner, stronger appearance.
Injury prevention. The core is the foundation for the whole body. Weakness can be the reason for recurrent ankle sprains, hamstring pain, piriformis overuse and low back strain among other issues.
With a neutral spine, proper posture, and a good core foundation, you can prevent further or future injury to the entire body.
Published July 18, 2016 | Nicole Mayer
Wearable technology has definitely seen a surge in popularity among the smart phone savvy public. But what about everyday people who are looking to keep up with an exercise routine that they just started or the others looking to motivate themselves to get moving again? Almost anyone would benefit from these devices and should definitely do some research.
Everyday smart watch users enjoy seeing how many miles they have walked in a day and exploring why they feel cloudier than usual for the day because they didn’t sleep well. Some of the new smart watches even have built-in workout guides that will track how many miles you have cycled on that trail and record how many sit-ups you have just done. Who wouldn’t have fun exercising with this gadget?
A big question to ask yourself is out of the many functions available, which functions of a smart watch will you actually use?
Here are some questions that may help you decide:
Am I athletic and/or do I hope to become athletic? Why do I still feel groggy in the morning even after sleeping all night? How many steps did I walk yesterday because my legs sure are sore? Is there a way to queue myself from my phone for interval treadmill training?
If at least two of these questions intrigue you than you may want to research which smart watch is for you.
Which smart watch is right for me?
Once you have decided which features of a smart watch are a necessity for you then you can start comparing what you actually see yourself using.
Most consumers are familiar with brands FitBit and Apple. Here is a good example of how you could compare the ones which you are most interested in:
|FitBitBlaze||Apple Watch Sport|
|Offer workout guides||yes||yes|
|Sync with smartphone||yes||yes, but only with iPhone|
|Set daily goals with notifications||no||yes|
|Answer phone from watch||no||yes|
|Music control from playlist||yes||yes|
|Customization of bands||yes||yes|
|Battery life||5 days||18 hours|
Will I know how to use it?
The answer is yes. If you own and operate a remote, you will be able to use a smart watch. Most manufacturers such as Apple, Jawbone, Garmin, and FitBit offer instructional videos that show how to use multiple features with ease. Here are a couple of examples:
But will I use it?
The answer should be yes.
Think about it from a psychological point of view. If you are spending a decent amount of money on a single item that will help your physical well-being, why wouldn’t you use it? Don’t let it turn into a paperweight on your desk and a trinket on your shelf. Make it motivate you to get moving and help you feel better about yourself. Anytime is a great time to invest in your health.
“The only bad workout is the one that doesn’t happen.”
Author: Nicole Mayer, Neil King Physical Therapy