Hand and Orthopedic Physical Therapy Specialists

Your Physical Therapy Experts… serving our community since 1978

Orthopedic / Sport Injuries

Benefits of Walking

Benefits of Walking

Finding an exercise program that fits your endurance, time commitments, and style is so often elusive. That gym membership, a shiny new treadmill, P90X, a road bike, a Pilates reformer, and set free weights aren’t paying the dividends anticipated. Instead of shelling out money for your next exercise program consider integrating good old fashion walks into your routine.

Walking 30 minutes a day 5 days a week not only improves your overall health but also prevents disease. Walking has been shown to decrease symptoms of diabetes and depression, increase bone density therefore preventing cancer, and the list goes on. Plus walking is FREE, it does not collect dust, and can be easily incorporated into your lifestyle permanently.

Here are some ideas to incorporate walking into your daily life forever:

  • Go for a walk while you talk on the phone
  • Park further away and walk to your destination
  • Walk on your lunch break
  • Take a break from sitting and walk around
  • Schedule walking meetings when possible
  • Walk your kids to school/ sporting events/ lessons when possible
  • Go on a walk with friends and chat instead of sitting
  • Go for a family walk after dinner and enjoy the scenery and time together
  • Plan activities like hiking and exploring new areas on foot
  • Take the stairs

It is amazing what small, sustainable changes like walking can do.

Everybody Walk, is a national initiative and has a great website of all the tools and information to get going.

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Understanding Pain

Understanding Pain: Describing your Symptoms

9I6ZOHTDUPIt is effortless to know you are in pain, but when pressured to describe your pain or talk about when it occurs and how it feels, it becomes much harder.  It is much easier to simply ignore the hurt and try to carry on the best you can.  While this is one coping mechanism, a more powerful approach is to take some time to learn the behavior of your pain and how to briefly, accurately describe it.  Here are some questions paired with an example to get your mind churning about how you feel.

Answer the question “What brings you here” as briefly as possible: I am having dull pain in my low back.

Describe the onset and timing of your symptoms:  I have had back pain off and on for the past 2 years, but in the past 4 months it has grown particularly painful, especially when I sit for long periods of time and as the day progresses.

What makes the pain better or worse: Standing up and stretching decreases my pain.

Describe your symptoms with adjectives such as (sharp, dull, on the surface, deep, etc): The pain I feel is like a dull ache.

Point to the location of your symptoms:  My back pain originates from this circle around my spine.

Rate the severity of your symptoms: (I know this is extremely difficult to quantify, refer to this post for more about the pain scale)  I would rate my back pain as 3 of 10.  It is more annoying than anything because it keeps me from sitting when I am trying to get something done.

List other things happening at the time of your symptoms:  I recently moved to an apartment with a flight of stairs- so I am often carrying my son up the stairs which may contribute to my back pain.

Describe when the symptoms occurred (if acute the setting and your condition): Three months ago my low back pain became significantly worse.

Although difficult, understanding the nature of your symptoms can be incredibly advantageous and lead to better care.  Reflecting before your next appointment about these questions will allow you to present your symptoms in the most accurate and efficient method possible- enabling your therapist to gather accurate information quickly, get you going on a treatment plan and give you in return the best results.

Questions Source: How to Describe Medical Symptoms to Your Doctor

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Time for a Tune-Up

maintain carRecently I took my car in for a tune-up. At the bottom of the receipt was a phrase that resonated with me because of its application to health and wellness. It said, “ABC Auto wants to remind you; it’s better, and cheaper, to maintain than to repair.” Another well-known phrase attributed to Benjamin Franklin says, “an ounce of prevention is worth a pound of cure”.

Often as we live life, we have those little aches and pains that rear their heads and often those aches and pains tend to go away on their own. Our bodies do a pretty good job of healing themselves. Sometimes, however, those aches and pains start to become a little more nagging and persistent, and maybe they don’t stay so little. It’s tempting to continue to “wait it out” and think that it’ll just eventually go away. While it’s true that sometimes time is all that’s needed, the fact is the body sometimes needs help with healing, and those nagging pains can turn into bigger problems if left alone for too long. I’ve treated many patients after having shoulder surgery who didn’t have any big injury, but something that started as a nagging pain and over time became worse until they needed surgery. A little attention given early on could have prevented, or at least significantly prolonged, the need for surgery.

Physical therapists are musculoskeletal experts; we have been trained to diagnose and treat those little nagging aches and pains in a way that doesn’t just put a bandaid on the symptoms, but treats the root cause. More and more research is showing that early physical therapy can be as effective if not more so than knee surgery, back surgery, or shoulder surgery. The Center for Disease Control has recently recommended nonopiod treatment for chronic pain whenever possible, and physical therapy has been shown to be an effective treatment.

So next time you feel that ache in your shoulder, neck, or knee; or, if you’ve been dealing with pain for a while and have been trying to “wait it out”, come see us and let us help you get back to doing life!

Justin Carrier, PT, DPT, OCS

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Thoracic Spine Anatomy and Pain

It’s likely that those reading this have some form of pain in their mid-back. As I mentioned in my last entry, these symptoms are often dismissed or minimally treated. In order to understand how to take care of your thoracic spine, it’s helpful to understand a bit about the anatomy in the area. I will outline the very basics here.

t spineThe thoracic spine starts below the neck and consists of all the levels of the spine that have ribs attached to them. There are 12 bones, or vertebrae (numbered T1-T12), and 24 ribs (one on each side of the vertebrae). The whole design is meant to protect our heart, lungs, and other vital organs. It’s very stable and not meant to move much. But, it is meant to move some. If you doubt this, place your hands on your ribs and take a deep breath. You will feel your ribs moving as you breathe.

In between each vertebra is a fluid-filled disc to assist with mobility and shock absorption. The discs in the thoracic spine are smaller and better protected than in the low back and neck. Disc symptoms can be difficult to discern and can be missed by healthcare practitioners. If you have pain with bending backwards and rotating your trunk, there’s a chance that you have thoracic disc pain. Thoracic disc problems can bring about some weird symptoms too, including fatigue, anxiety, nausea, and others. It is important to check with your doctor if you experience these symptoms. However, in the absence of another illness, they could be coming from issues in your back. This is because the nerves that control our intestines and other important organs for daily function come from this area and can become blocked.

Each rib has 6 connections and each vertebrae is attached to up to 4 ribs and 2 other vertebrae. Any of these joints can become “stuck” leading to decreased motion and increased pain. We often feel that our back is “out” when this happens. It is important to realize that the goal of treatment is to restore normal movement. If one leaves a visit with the mindset that the spine is now “aligned” he or she feels like they can’t move for fear of knocking something back “out”. The opposite is true – enjoy that new mobility, you need to move!

If you are experiencing pain in your thoracic spine, you may have a joint, disc, or muscle imbalance or spasm contributing to your symptoms. Because the thoracic spine protects so many important things it is always good to check with your doctor before PT. If you’re clear for major issues then a consultation with a PT may be in order! I’ll tell you what we can do about it in my next entry!

Todd Schwartz PT, DPT, OCS

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Workplace Stretches

Desk jobs are known to take a toll on your body, but it doesn’t have to be this way.  Combat your aches and pains with 7 simple stretches to relieve tension, encourage proper posture, and increase flexibility while at your workplace.

chin tuckChin Tuck | Loosens stiffness in the neck and shoulders

  • Look straight ahead
  • Lower chin to your chest and hold 15-30 seconds
  • Return to starting position
  • Draw chin and head back toward shoulders, hold 15-30 seconds

 

 

 

head turnHead Turn | Releases tension in your neck

  • Look straight ahead, keeping shoulders straight
  • Turn your head to one side and hold for 15 to 30 seconds
  • Return to starting position and repeat on the other side

 

 

 

Shoushoulder blade pinchlder blade pinch | Encourages proper shoulder posture

  • With shoulders down, squeeze shoulder blades together pretending to hold a pencil by your spine
  • Hold for 10 seconds

 

 

 

trap stretchTrap stretch | Improves range of motion in your neck and loosens shoulders

  • Place hand on top of your head while looking straight forward
  • Gently pull your head until you feel a good stretch, 20-30 seconds
  • While head is tipped look down at armpit- switch sides

 

 

 

mid back stretchMid back stretch| Stretches the upper back

  • With thumbs down, cross arms and interlock fingers at chest level
  • Slowly stretch your arms forward, drop head down, keep reaching and breath, hold 20+ seconds

 

 

 

baseball stretchBaseball stretches | Stretches backside of shoulder

  • Extend and cross arms
  • Place lower hand on opposite shoulder and gently pull while keeping other arm straight
  • Switch arms and repeat

 

 

 

Tlumbar extensionhoracic/ lumbar extension | Relieves tightness and pain in your upper back

  • Place both hands on lower back with fingers facing down
  • Roll shoulders back and bend at the hips backward to feel a stretch

 

 

 

Check out more ideas to help prevent injuries.

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Desk Ergonomics

Ergo chair

The desk jockey, the computer czar, the digital overlord.  However you choose to define your time at a desk, chances are your body is taking a beating from all the time spent slouched in a chair. Few jobs escape time in front of a computer and the accompanying low back pain, carpal tunnel, and stiffness.  However, knowing proper posture while at a desk will set yourself up for a much more positive experience at work or home.

Chair:

  • Your feet should rest comfortably on the floor with your knees in line with your hips or slightly below.
  • Modify your chair by adding a foot rest if your feet don’t rest on the floor
  • If additional lumbar support is needed, place a cushion in the curve of your lower back

Posture:

  • Keep shoulders and arms in a relaxed position. Elbows should be ≥ 90⁰
  • Center your body in front of the keyboard and monitor.
  • Sit up straight
  • Keep documents in front of your work space, don’t lean. If you are right handed, keep the right side of desk clear for writing.

Wrists:

  • When typing keep your wrists in a natural, straight position
  • Use a wrist rest to minimize stress, when typing keep your wrists above the rest and during a break rest your palms (no wrists) on the rest
  • Keep your mouse within easy reach on the side of your keyboard

Monitor Height:

  • Position your monitor an arm’s length away, directly in front of you. The top of the screen should be just below eye level

Headset:

  • Invest in a headset if you frequently talk and type to prevent cradling the phone between your head and neck

For more work tips and injury prevention check out other posts.

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Heart Health

heart health

February is synonymous with roses, chocolates, plush bears, love, valentines, red, and…. heart health.  That’s right, each year the president proclaims February as heart health month, a tradition that dates back to 1964.  Cardiovascular disease is the single leading cause of death for men and women in the United States each year, a statistic concerning enough to warrant a month of awareness.  President Obama said that nearly half of all Americans have at least one major risk factor, many who don’t even know it.  While age, gender, and family history are unchangeable factors; high blood cholesterol, high blood pressure, physical inactivity, obesity, smoking, diabetes, and poor diet are all modifiable.  Changes in these areas can make a big difference.

Here are 7 keys to prevention

-Get Moving

-Control Cholesterol

-Manage Blood Pressure

-Reduce Blood Sugar

-Stop Smoking

-Eat Right

-Lose Weight

One of our main goals in physical therapy is to help you get moving and to instill confidence in your ability to take control so you can live an active, heart-healthy life. Sometimes this can be difficult in the presence of pain, weakness, or other physical ailments. The path to success can seem very difficult or even impossible if every step along the way causes pain. A physical therapist is the ideal practitioner to assess both general health and physical limitations. Your therapist is trained to calculate ideal activity levels related to heart health as well as treating muscle weakness or tightness, arthritis, or other structural issues that need to be addressed. The net effect is less pain and a healthier body. The first step is to recognize that you desire a change.

What will you do this month to show your heart some love?

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Why Breathing is associated with Neck Pain

picjumbo.com_HNCK5911Often I see patients with neck pain and/or nerve symptoms in the arm. These type of patients have complaints of neck tension and reports that a neck massage helps improve symptoms for a short period of time.

There is a strong correlation between how this patient is breathing and their neck pain.

Breathing is accomplished by expanding and contracting the space in the lungs. When the lungs expand the pressure inside the lung is less than the pressure in the surrounding air so the air rushes down the throat into the lungs. Exhaling or breathing out is when the pressure in the lungs is greater than the pressure exerted on the outside of your body causing air to leave the lungs.

Simple physics is used to get air into the lungs. You increase the volume in the chest cavity, pressure will drop in the lungs and air will rush in to fill the space. This requires that we somehow increase the volume or space in our chest cavity. The natural designed way to do this is with the diaphragm. The diaphragm, a giant sheet like muscle that your heart and lungs sit on, will contract and push down into the stomach, this increases the volume of your chest cavity and thus you breathe in.  When you don’t use the diaphragm or suppress the contraction you are required to use the muscles in your neck to lift the rib cage, against gravity, to increase the volume in your chest.

Imagine using the muscles in your neck all day every day for breathing. This will cause muscle tone, tension and begin to pinch the delicate nerves that leave the neck and travel down the arm.

Stomach breathing is not just for Yoga and singers. Use of your diaphragm will give your neck muscles the much needed break they deserve. So remember “breathe in to your tummy” let your diaphragm contract and push your stomach out.

Shonn Tanner, DPT

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Harnessing the Power of Ice and Heat: When to use ice and heat

DSC_0665To ice or not to ice, to heat or not to heat- that is the question.  Especially when plagued with a recent injury or struggle with a chronic ache or pain.  Ice and heat can both provide inexpensive and powerful pain relief; so what is the difference, does it matter, what will help the most?  To answer these questions here is a brief physiology lesson on what ice and heat do.

ICE
· Constricts or slows down blood flow to the injury
· Decreases the amount of blood in the muscle
· Slows circulation
· Reduces swelling, muscle spasms, and pain

HEAT
· Warms and opens blood vessels
· Increases blood flow
· Supplies oxygen and nutrients to reduce pain in joints and relaxes soreness
· Stimulates the healing process
· Decreases muscle spasms
· Can increase range of motion

Understanding what ice and heat do to alleviate pain makes it easier to understand when you use each. Most often, if you have swelling you have pain. Generally, it is best to ice a new or acute injury and heat a recurring or chronic injury.  Icing an injury for the first 24-48 hours helps decrease swelling and inflammation allowing your body to start the healing process quicker.  Chronic injuries on the other hand will benefit from the increased blood flow and healing that heat brings.

Application
· Don’t apply ice or heat directly to the skin, wrap in a thin towel first
· Apply ice or heat for no longer than 20 minutes at a time

There are instances when ice and heat may be used alternately, the physiological response of which is to decrease inflammation. If you are ever questioning if you should use heat or ice, your physical therapist is a great resource to help you maximize the healing benefits of heat and ice.

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3 Tips for Injury Free New Year Goals

3 Tips for Injury Free New Year GoalsYour New Year’s Resolutions are carefully crafted outlining your fitness and health goals for the new year. That triathlon/ CrossFit/ walking/ yoga/ P90X/ cycling/ lifting/ running goal is about to be dominated. The gym is packed with eager fitness enthusiasts pounding the treadmill. Wait, that is until an overtraining or overuse injury derails your efforts. It is estimated that 460,000 injuries are caused by exercise and exercise equipment alone each year in the U.S. (US Consumer Product Safety Commission) Overtraining injuries are an all too common scenario when changing type of activities, increasing intensity or submitting your body to more activity than it is used to.

Pushing yourself is a healthy part of seeing results; however, doing too much too soon prevents your body from adapting and recovering from activity. Instead avoid the shin splints, sprains, strains, back pain, tennis elbow, and plantar fasciitis altogether:

Ease into it: If you have been inactive for a few weeks, months or years. Don’t expect the endurance you once had. Aim for long term consistency. Establish stepping stones to your ultimate goal. Walk before you run, develop correct form/ mechanics before adding weight, speed, or intensity.

Listen to your body: Your body has a great feedback system designed to keep you healthy. If you begin to feel overly fatigued or start to have nagging pain, decrease your training, cross train, or rest.

Increase intensity gradually: Aim for steady, gradual progression. Incrementally increase the difficulty, duration, speed, repetitions, and intensity of your workouts.

If you are starting to feel the effects of an overuse injury or want to start out a new fitness program right, we are here to help. Let your New Year’s Goals become a reality.

 

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Tips for Traveling without Pain

traveling pain free

After months of stewing over the perfect presents for your family members, you braved the mall, tied the last bow, and sealed the last card.  It is time to hit the road/ sky to enjoy a wonderful holiday season surrounded by those you love most.  However, the thought of your reoccurring (hip, back, neck, leg…) pain are crowding your thoughts and making you anxious.  After all your hard work and preparation, the last thing you want is for pain to diminish the magic and joy of the holidays.  That being said, here are a few tips to ease your mind and put you on a trajectory of health while traveling.

Suitcases: While 50 lbs is the weight limit for most airlines, your back may have an entirely different rule book.  Pack in multiple suitcases if possible. When lifting, hold the suitcase close to your body, engage your core, and lift from your legs.

Posture: Posture matters, especially when sitting for long periods of time.  Be aware of how you are sitting, adjust the seat of the car so you aren’t reaching for the wheel, rest both feet on the floor, don’t hunch.   What is your neck, your low back, your legs, etc doing?  If you plan on sleeping in the car/ plane a neck pillow can be a life saver.

Keep Moving: Every few hours take the time to walk around and stretch, get your blood flow pumping, and stretch out your tight spots.  It is amazing what a few minutes of movement can do.

Back Support: Chances are the seat of your car or the plane was not custom designed for your size/ weight.  Many people find that the back support is a trouble spot.  Roll up a jacket and put it behind your low back to give the back support needed for a more comfortable and ergonomic experience.

Enjoy your holiday season and if things do go south, give us a call and we will help you back to health… back to life…

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The Bridge

bridgeImagine a busy rustic village in a narrow green valley with a wide river running straight down the center. The town is split in half by the river and a long shining suspension bridge with huge stone pillars expands the river. The narrow valley is frequented by violent wind storms that funnel down the valley. These wind storms are so violent they will tear violently on the bridge causing strain in the cables that support the bridge. The huge stone pillars will creak with the strain and anyone found on the bridge will be thrown to the ground as it heaves and shakes. After each storm, workers from the village will pour out from each side making minor repairs to the bridge preventing any real damage that the storm could cause. This is performed with each storm and the bridge, an engineering wonder, has lasted for years without showing signs of any change in its flawless structure.

When the storms became more frequent with little time between storms, the workers could no longer keep up. Little to no work could be accomplished during a storm and storms became so frequent that there seemed no way of determining when one stopped and a new one started. The bridge quickly started to show cracks in the heavy stone buttresses supporting the cables and the cables started to fray. Eventually the storms subsided in number and the bridge could be assessed for damage. The once beautiful stone pillars supporting the large expanse of the bridge were cracked from top to bottom. In some areas, stones were missing completely. Where the stone had once nobly born the weight of the cables, the stones had slipped and the cables sagged. Along the expanse of the bridge, cables supporting the shining suspension bridge were snapped in places. The many intertwined wires that formed the cables had begun to snap along the expanse of the cable and entire portions had started to unravel.

The bridge is your muscle or tendon and the storm represents the stresses we put upon our tissues with use. You can see with repetitive tasks why the damage can be cumulative and harmful. This is where injuries like lateral epicondylosis (tennis elbow), plantar fasciosis, and rotator cuff tears come from.

Repetitive use injuries occur when a tissue is not given proper time to heal. This can be caused by lack of strength from surrounding supportive structures. So, each new stress is not mitigated by the surrounding muscles but repeatedly placed on the already injured tissue. Drugs can inhibit the healing process. Anti-inflammatory medications can inhibit the bodies’ natural response to send workers to fix the damaged tissue. Frequent use of NSAIDS with tissue injury decrease the pain but prevent the mechanism of renewal that naturally occurs in the body. Lastly a person’s natural inclination to “Go! Go! Go!” without rest can increase the propensity to damage from repetitive stress.

If you have suffered any repetitive storms in your life and your bridges are feeling painful, weakened and not up to full operation, see a physical therapist. Therapists are experts in appropriate tissue healing. We can help get you back to full function.

Shonn Tanner, DPT

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The Fountain of Youth

The fountain of youth has been discovered and everyone has access to it! Want to feel 10 years younger with a minimal time commitment and cost? I am referring to cardiovascular exercise. Research has repeatedly shown those who perform regular cardio:

  • iStock_000003324046XSmallthink and sleep better,
  • have lower blood pressure,
  • avoid chronic musculoskeletal conditions,
  • decrease their risk for cancer and cardiovascular disease, and
  • have more energy and improved sense of well being.

People with chronic low back pain who are cardiovascularly fit are 4-7 times less likely to flair up, with consistently lower average pain ratings. Cardio is also shown to decrease the risk for dementia even more than brain teasers. 30-45 minutes, 3 times a week is all it takes.  Look at the return on your investment of time! Dog fat and enjoy walking? At least do it for them!  For the most part, cardio is convenient and cheap; walk out your front door and get to know the neighbors.

For those with chronic conditions, it maybe not be as convenient.  Water exercise and aquatic therapy are magic in these situations. Many pool facilities offer water aerobics classes for all abilities. You don’t even have to be a swimmer. Just walk continuously forward, backward and sideways for that 30 to 45 minutes at your own pace. Take some time for yourself and find a form of cardio you can tolerate. If you won’t do it for yourself, do it for your loved ones who want to see you happy, healthy and vigorous!

Dave Moss, PT, OCS

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Chest Pain, Mid-Back Pain, Neck Pain, Low Back Pain…What is Going On??

Man with chest or rib painScenario #1

You’re at the ER, waiting for the news.

Phew! It’s not a heart attack! You are so relieved!…

You go home, kiss your family, sit down, and thank the universe for your health. Then you try to go to sleep. You toss and turn, maybe mumble some choice words, and remember why you went to the ER in the first place – that stabbing, annoying pain in your left shoulder blade! You’ve ruled out the worst, but are still left with a pain that you don’t know what to do with!

Scenario #2

You had a beautiful day skiing except the part when you smashed your face into a mogul. You pretty much hurt everything – your low back, your mid-back, and your neck. You’ve talked to the doctor, went to the chiropractor, went to the physical therapist, and saw your favorite massage therapist. Your neck now feels good and your low back feels good. You’ve told everyone about the pain in between your shoulders and no one’s really looked at it. Worst yet, some of the providers you talked to shrugged, said, “Hmm, I don’t know what that is,” and proceeded to look at your neck or prescribe a medication. One person even recommended you wear a sling to “rest” your arm. You really want to get back on the skis (and perhaps take a mogul lesson with a good instructor – I do know one, by the way) but you still can’t take a full breath.

What is Going On?

Some of you reading this will relate directly to some aspect of the above scenarios. I hear some variation of the above scenarios on a regular basis. While there are many significant health concerns with pain in the mid-spine, most likely you have a very treatable rib or thoracic dysfunction. Click here to read success stories from some of our patients who have overcome rib and mid-back pain.

Rib pain manifests itself as pain anywhere from the top of the shoulder through the ribcage. Generally patients report localized pain, usually on one side, that may radiate around the side or to the front of the chest. Pain may be sharp or stabbing with particular movements, especially deep breathing, coughing, or sneezing. It can contribute to neck pain, shoulder pain, and even radiating symptoms down the arm.

Treatment is actually fairly straightforward. The affected area needs to be loosened up and moved. Unfortunately, in the world of medicine, there is minimal research on how to treat the ribs and the spine. Therefore, many practitioners have very little idea what to do about it. Rest assured, you don’t have to live with this pain if you seek out a knowledgeable physical therapist or healthcare provider. You can get back to skiing, ping pong, or square dancing if you’d like to!

In the next few months I will outline basic exercises and treatment options available for the ribs and mid-back. In the meantime, if you can relate to the stories above or think you may have a rib dysfunction, the therapists at Hand and Orthopedic are available to answer your questions and get you on the right track!

Todd Schwartz, PT, DPT, OCS

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Who Needs Physical Therapy?

The body is an amazing healer and force for change. The body will often heal itself, but maybe not in the right way. Like a beautifully shaped tree, it grows and adapts. How it forms in the end has a strong correlation to how it is pruned and nurtured over time. We have all seen similar results from our own bodies. All injuries, from a small finger sprain, to a general abdominal surgery, to the simple broken bone, will heal with time. The difference in outcome and resulting function has to do with how the body is adequately stressed as it is healing. As ligaments heal, will they be over-stretched and cause hyper mobility (too much flexibility). Will a scar form that will limit general range of motion through adhesions? Will the bone de-mineralize or adapt to appropriate stress? How we use our bodies will in large part shape our bodies.

tree growing sidewaysWhen left on its own the body will heal but just like a tree that grows sideways in a windy canyon, tissues only adapt to the forces they encounter. Developing compensations by avoiding painful activities will inhibit optimal outcomes. So when I’m asked what kind of injuries need physical therapy my response is, “If your body is healing, you need physical therapy.” You need someone who knows how to tend, nurture and adequately stress tissue to get optimal outcomes.

Some would say the longer you do something the harder it is to change. I propose that the longer you do something (whether correctly or incorrectly), the longer you are changing in that direction. For example, the body, like all living organisms, takes the road of least resistance when given the chance. We have all experienced this; when something is hard or hurts, our first inclination is to avoid it. The longer we persist in using our strongest muscles and avoid working the weak ones, the more over worked the strong ones become and the weaker the weak ones become. This is the case in most of my back pain patients. Our bodies are always changing and they have the potential to change the other way, but the stress has to be correct. You don’t get stronger and get rid of back pain by lifting heavy objects with your back; that is almost intuitive.

If you have an incision in your foot, the doctor will put in stitches. Who will massage the scar? Prevent adhesion of healing tissue? Maintain range of motion while the foot heals? And prevent back and hip compensation from an altered walking pattern? Your physical therapist can do this for you. That is why I love physical therapy! I can help people heal and when they are done with therapy, they are closer to optimal function than they were even prior to injury.

Our bodies have immense power for change and a physical therapist can facilitate that change for the better.

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Save Your Back and Skip the Gift Wrapping

A while ago, I worked with a very memorable patient. I can’t, of course, tell you his name (HIPAA). I will say that he had a full white beard, twinkling eyes, cheeks were like roses, and a nose like a cherry. He had a broad face and a little round belly that shook when he laughed – he was a jolly old fellow. He had a bit of a nervous habit of gnawing on a pencil as I guess he had stopped smoking a pipe sometime in the early ‘80’s.

Father Christmas with wrapped presentsAnyway, he managed a very, very large seasonal manufacturing business. His employees were tasked with gift wrapping items before they were shipped. For years they had simply placed the items on the ground and wrapped them up. His employees were quite short in nature and that’s the way they always did it. However, as his labor force got older they started to complain of back pain from hours on the ground wrapping gifts. Eventually, they resolved to fix the issues and simply placed the items to be wrapped on a table.

Every year I have 2-3 patients that get injured or have an exacerbation of symptoms from wrapping gifts on the ground, similar to these unfortunate employees! What’s the fun in gift giving if you hurt yourself by sitting in an awkward position to wrap the presents?!

A forward-bent position places a lot of strain on the muscles, discs, and ligaments in your back. The longer we maintain this position the more stress is added to those structures and they begin to stretch out more and more. Over time certain structures may give a little bit and cause injury – or at least significant soreness. Those already dealing with injuries are especially vulnerable, particularly those with acute or chronic lumbar disc injuries. I have seen patients return to therapy with radiating pain all the way down their leg simply from wrapping gifts on the ground.

So, as you heat up your hot chocolate, turn on your Barry Manilow Christmas album, and prepare to wrap those gifts please take one more step and put them on a table. You’ll save yourself a lot of grief and probably do a better job wrapping the gifts anyway. Of course, when you consider that all of your work will be undone instantly as folks unwrap your gifts you may just want to skip the wrapping all together…

In case you were wondering, it sounded like the tables worked wonders for my patient and his employees. He is happy to report production is on schedule this winter and he will be ready to deliver when the time comes.

Happy holidays from Hand and Ortho!

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9 Facts That Will Help You Better Understand Your Pain

Pain is a regular part of life, and is meant to help us in protecting our bodies from further injury or harm. It’s actually a good thing to have pain – when it is serving the right purpose. Unfortunately, at times we can experience pain in a way that can range from annoying to debilitating. Chances are you or someone you know has had this experience with pain, and you know how much it can interfere with your life. In fact, 80% of the population will experience low back pain at some point in their lives.

Physical therapy is an effective, efficient, and affordable way to help treat both acute and chronic pain. The following 9 facts were provided by the APTA* to educate patients about pain and offer ideas to help in the recovery process.

1. Pain is output from the brain. While we used to believe that pain originated within the tissues of our body, we now understand that pain does not exist until the brain determines it does. The brain uses a virtual “road map” to direct an output of pain to tissues that it suspects may be in danger. This process acts as a means of communication between the brain and the tissues of the body, to serve as a defense against possible injury or disease.

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