Keeping up with physical therapy during the holidays is tough. There are so many other things to do – cooking, parties, shopping, travel, and visiting with family and friends. But if you’re in physical therapy over the holidays, there’s a reason. You’re having pain, or not moving as well as you want to. These issues place limitations on your life, which are going to affect your ability to do things – like cooking, partying, shopping, traveling, or enjoying time with friends and family. So even though keeping up with your PT this time of year is tough, it’s important. That’s why we’re going to give you our best tips to help you through the holidays.

PLAN

Some of what makes the holidays challenging is the crazy schedule. To survive this, you’re going to have to plan ahead. We’re not just talking about appointments on your calendar, either (although those are important). Here are some things to think about planning ahead:

Your PT appointments

Your schedule is busy during the holidays. So is your PT’s. Plan and schedule your appointments in advance. You’ll get the times and days that work best for you, and you’ll already have your PT appointments in your calendar to plan other things around.

Your exercise

Hopefully you have a regular time to exercise. With the holiday mania about to shake up your routine, that time may no longer work. Think about when you’re going to exercise ahead of time and you’ll stay consistent.

Your diet

Healthy eating often gets derailed during the holidays. Putting low quality fuel into your body won’t help you feel better. Think about planning what you’re going to eat ahead of time. We’re not saying to skip every holiday treat offered to you, but maybe think about which ones you really need to have, and which ones you can skip in advance. It makes saying “no thanks” to that third slice of fruitcake easier.

MODIFY

We’re realistic. We understand that life isn’t the same during the holidays as it is during the rest of the year. That’s part of what makes this time of year special! With that in mind, our next set of tips focuses on making modifications to help you get through the holidays successfully.

Your PT Plan

When you planned your PT appointments out well in advance, you might have run into some challenges. Talk to your therapist about how you might be able to modify your plan of care through the holidays to make it all work. Maybe you’re going to PT three times a week and you can only come twice a week for a week or two. Plan this sort of thing in advance with your PT and you can work together to come up with the best plan.

Your exercise

Exercise is so important, it made our list twice. Now that you know when you’ll exercise, you might have to modify your routine to make it fit. Again, we recommend talking with your PT to see what you can do. Maybe your home exercise program can be modified so you can do everything in the kitchen during downtime when you’re cooking up your holiday feast. Maybe you can reduce the number of exercises to focus on maintaining the gains you’ve made until things settle down.

Your schedule

In your planning in advance (see how important it is?) you might have found that your normal routine wasn’t going to work. If your PT appointments or exercise time is usually right after work and you’ve now got commitments during that time, maybe you can move them to the morning before work. If you’ve been exercising outside, the shortened days may move you into the gym. Be flexible and consider temporarily modifying your schedule and your routine to make it work better during the holiday season. You can always go back to your previous routine after.

The holidays are a special time of year. Keeping up with your health and your physical therapy can be challenging during this time. But you don’t have to fall behind. With some planning and flexibility, you can stay healthy, survive the holidays and head into next year with good momentum!

By: Jenifer Walker, PT, DPT, CHT

Since the title of our next blog is in the form of the question. The answer is, if you are currently experiencing any pain, swelling, or functional limitations with one or both of your hands, then the answer is an emphatic YES!

Most people these days know that when their back is bothering them, or they have elected to have surgery on one of the joints in their body, they can follow up with their favorite PT at Carousel.  But did you know that some physical therapists choose to specialize in the treatment of the hand and upper extremities?

CHTs are highly skilled in evaluating edema, pain, range of motion, strength & endurance, sensibility, activities of daily living, work activities, avocational activities, and sports activities.  We commonly manage conditions such as:

• • • • • • • Amputations
            • Arthritis
            • Burns
            • Disease processes
            • Fractures & dislocation,
            • Sprains & strains
            • Infections
            • Joint contractures
            • Nerve compressions
            • Nerve injuries
            • Rotator cuff injuries
            • Impingement syndrome
            • Tendinitis
            • And tendon injuries

One of the major skillsets developed by CHTs is the fabrication of customized orthotic devices for the upper extremity.

These are commonly required for carpal tunnel syndrome, cubital tunnel syndrome, tendinitis, basilar joint arthritis of the thumb, finger dislocations, finger fractures, tendon injuries, lateral epicondylitis, and joint sprain/strains. Orthotic devices are often required following surgery for the fingers/hand/wrist as well.

So, if you are unsure whether you should see a CHT, you can have a FREE consultation with me, and with your doctor as well! See you soon!

Recently we introduced you to Long COVID and all of the challenges it brings. This month we’re going to talk about what physical therapists can do to help people living with Long COVID. Early in the pandemic, therapists started seeing people with what would later be known as Long COVID. They noticed that some of the symptoms people were describing overlapped with conditions they had treated before. Specifically, Myalgic Encephalomyelitis better known as Chronic Fatigue Syndrome (CFS) also caused severe fatigue and delayed symptoms after activity. Because of this overlap, the current treatment for Long COVID is heavily based on what we know works to manage these diseases. Here are a few of those strategies.

PACING

The first strategy that can help manage Long COVID symptoms is pacing. This is simply doing less activity than you have energy for. By keeping bouts of activity short with lots of breaks, pacing can help avoid severe fatigue immediately after activity. It can also avoid the delayed “crash” of  PESE. A useful metaphor is to think of your energy level as a battery. When you do activities, you drain your battery. When you rest, you charge it back up a little bit. Physical therapists can help patients learn how much energy is in their “battery” and work to teach them strategies to conserve it. When used effectively, pacing can help patients with Long COVID accomplish more with less fatigue and less bouts of PESE.

WHAT ABOUT THIS PESE THING?

Post-exertional symptom exacerbation is a disabling and often delayed exhaustion disproportionate to the effort made. Patients are referring to this as a “crash”. PESE is very common in people suffering from Long COVID. 75% of people who have Long COVID have PESE after 6 months. The activity that brings on the crash is something that the person could easily tolerate before their COVID-19 infection. Things like taking a shower, walking, attending a social activity, or even being in a high sensory environment with flashing lights and loud noises may all now trigger a crash.

HEART RATE MONITORING

Another strategy that comes from ME and CFS management is heart rate monitoring. With the huge number of wearable devices that monitor heart rate, this is becoming an easier strategy to use than ever. Heart rate monitoring uses your heart rate as a gauge of how hard your body is working. It’s based on your resting heart rate, which should be taken after you’ve been lying down, relaxed for at least 20 minutes. First thing in the morning before you get out of bed is a great time to measure your resting heart rate. Once you have your baseline, the goal is to keep your heart rate within 15 beats of your RHR while you’re doing activities. This keeps your heart rate below the threshold at which your muscles start to produce lactic acid. Build up of lactic acid is what gives you “the burn” when you’re working out really hard. It also causes your muscles to fatigue more quickly – by keeping activity light enough to avoid lactic acid, we can also reduce fatigue.

EXERCISE

What about exercise? Sure, lots of people think about exercise when they think about PTs. But exercise can make some diseases worse. For people living with Long COVID, CFS, or ME, “toughing it out” or “pushing through it” won’t make them stronger. It will cost them days of their lives – leaving them barely enough energy to get out of bed or complete basic tasks. For long-term, sustainable recovery, the first goal of rehabilitation of these folks is to stabilize and manage their symptoms. Using pacing, heart-rate monitoring, and other strategies like breathing exercises can stop the fatigue cycle and start to get the body responding to activity more normally. Only then can we very gradually and cautiously introduce exercise into the mix, monitoring symptoms during and after activity to make sure we don’t overdo it.

As we learn more about the pathology behind Long COVID’s symptoms, rehabilitation will surely change and improve. But people who are living with Long COVID can’t afford to wait until science figures everything out about their disease. Fortunately, physical therapists have training and strategies that can help improve their lives right now.

Physical Therapy Is For Everyone!

Physical therapists are highly trained health care professionals. They are experts in human movement who are trained to evaluate and treat all kinds of musculoskeletal issues with exercise and other techniques. Everyone moves and everyone can benefit from exercise, so physical therapists can help people through their entire lives!

PHYSICAL THERAPY FOR CHILDREN

Physical therapists start treating some people very shortly after birth. Common reasons a baby might need PT include torticollis and cerebral palsy. Torticollis is a postural issue caused by a tight neck muscle. Babies with torticollis hold their heads tipped to one side. Cerebral palsy is a neurological disorder that causes difficulty with movement and coordination.

As children get older, some have trouble hitting their motor milestones – think of these as the “firsts” – sitting up, rolling over, crawling, standing, and walking. Physical therapists can help here too, using their expertise to help develop motor skills and coordination to get these children back on track.

PHYSICAL THERAPY FOR ADOLESCENTS

In adolescents, sports injuries become more common. Whether it’s an ankle sprain or an ACL surgery, a PT can help. The rapid growth in adolescents can cause issues too. Things like growth plate fractures, growing pains, Osgood-Schlatter’s disease, and Sever’s disease are all common in adolescence and are related to the changes the body is going through.

PHYSICAL THERAPY FOR ADULTS

As adults, a lot of us will have back pain – studies say up to 80% of us. Physical therapy is one of the first treatments recommended for back pain. Physical therapists also see adults for injuries – maybe from weekend warrior-type sports injuries, overuse, or from an accident at work. Some adults also start to show symptoms of diseases like multiple sclerosis, or myositis which also benefit from physical therapy.

PHYSICAL THERAPY FOR OLDER ADULTS

Later in life, people tend to have more health issues that impact their ability to move. Things like arthritis, joint replacements, strokes, and heart attacks are all things a PT can help with. Physical therapists also help people age better – keeping them moving with exercise programs that help reduce falls or helping them make adaptations and modifications to keep them in their homes safely.

Movement is a constant in life. As movement experts, PTs can help people of any age. Some specialize in treating pediatric patients, and some specialize in treating geriatric patients, but all PTs have the expertise to help people move better.

References:

https://www.cdc.gov/ncbddd/cp/facts.html

PT for pediatric ataxia – https://pubmed.ncbi.nlm.nih.gov/31392562/

Adult in workplace – https://pubmed.ncbi.nlm.nih.gov/32270086/

Adult myopathy (an example of something treated for adults, not geriatrics necessarily) – https://pubmed.ncbi.nlm.nih.gov/31115788/

The Role of a Physical Therapist in Healthy Aging – https://www.ncoa.org/article/the-role-of-a-physical-therapist-in-healthy-aging

How Physical Therapists Can View Normal Versus Abnormal Aging – https://www.foxrehab.org/pt-impact-older-adults-optimal-function

Nobody is going to be surprised to hear that Physical Therapists work with muscles. But we bet a lot of people would be surprised to learn that the muscles inside your pelvis are included. While the pelvic muscles don’t get as much attention as the biceps or hamstrings, they can still cause problems that need treatment. Here are a few examples:

URINARY INCONTINENCE

Urinary incontinence is the involuntary leakage of urine. More than 13 million people in the United States have this issue. There are different types of incontinence, but the most common are stress and urge incontinence.

• Stress incontinence is when leakage happens during coughing, sneezing, or laughing.
• Urge incontinence is a result of the bladder being overactive or unstable. People with urge incontinence often have triggers that cause the involuntary loss of urine, such as hearing running water.

PELVIC PAIN

This is defined as any pain that occurs either internally or externally in the pelvic or genital area. Both men and women can be affected, but it’s more common in women.

What’s the Cause?

Most incontinence is caused by issues with the pelvic muscles – either weakness or tightness. There can be other contributing factors like spasms that cause bladder contractions, or conditions like anxiety may increase the urge to empty the bladder.

Pelvic pain is also usually attributed to either tightness or weakness of the muscles of the pelvic floor. The pelvis is made up of three bones, forming three joints where they meet. These joints need to be stabilized by an outside force. The job of the muscles and ligaments in and around the pelvis is to  provide that stabilizing force. If the muscles are too tight, the joints will have an excessive amount of compression on them. Too loose, and the joints of the pelvis can experience shear forces. Both conditions result in pelvic pain.

WHAT CAN PT DO?

Because incontinence and pelvic pain are usually musculoskeletal conditions, physical therapy can offer a lot of effective treatments. Some examples include:

Exercise – Strengthening or stretching of the pelvic muscles or the core can help correct imbalances, improve pelvic stability and reduce pain.

Biofeedback – This involves using sensors placed on the body while doing exercise to help the patient identify which muscle groups are working and bring awareness to areas of tightness or weakness.

Education – For incontinence,  learning how the bladder normally functions can help you to understand changes that can be made to improve symptoms. Learning about posture and how to improve the alignment of the pelvis and the trunk can help to reduce pain and improve tolerance for positions like sitting and standing.

Manual Therapy – Joint mobilizations, trigger point release, soft tissue massage, myofascial release, and other techniques can help improve mobility of the pelvic joints, decrease tone in spastic muscles, and reduce pain.

If you’re experiencing pelvic problems, our specially trained physical therapists can complete a comprehensive evaluation, help determine the cause, and design a customized treatment plan to help.

_______________________________________________________

References:

1. Research (peer-reviewed)
   1. Geriatric incontinence – https://pubmed.ncbi.nlm.nih.gov/34519024/
   2. Assess Pelvic Floor Guide – https://pubmed.ncbi.nlm.nih.gov/34807882/
   3. Pediatric pelvic floor – https://pubmed.ncbi.nlm.nih.gov/10458431/
   4. Using PTs for Pelvic floor – https://pubmed.ncbi.nlm.nih.gov/35353916/
   5. Urinary Incontinence prevalence – https://pubmed.ncbi.nlm.nih.gov/35173077/
   6. Physical Therapy Treatment of Pelvic pain – Physical Therapy Treatment of Pelvic Pain – PubMed (nih.gov)
2. Articles and Content
   1. Pelvic floor muscles and training – https://pubmed.ncbi.nlm.nih.gov/35036386/
   2. Exercise in pregnancy (helping incontinence – one of the symptoms – https://pubmed.ncbi.nlm.nih.gov/34478617/

You might be wondering who would keep an injury secret. The answer is – lots of people!

The first thing that comes to your mind might be an athlete, like a football player, or maybe a baseball pitcher. But athletes aren’t the only ones that keep injury secrets. Performers like dancers keep injury secrets, and so do workers in all types of jobs.

Why would anyone want to keep their injury secret instead of getting it treated and letting it heal? Read on…

STIGMA

Although there have been big improvements in the culture around sports, performing arts, and worker’s comp, some people still have the old “no pain, no gain” attitude. To some people, reporting an injury is an act of weakness, or a way of letting the team down.

There can also be external pressure from coaches, parents, teammates, supervisors, or fans to keep playing or working.

FEAR OF LOSS

With the focus on head injuries in recent years, athletes that get hit in the head know if they report concussion symptoms, they’re coming out of the game. Workers who get hurt on the job fear loss of pay, or loss of their job. Performers who get hurt might fear that their replacement will outshine them on the stage and take their place.

COMPETITIVE ADVANTAGE

While the first two reasons can apply to athletes, performers, workers and most any other group that might be hiding an injury, this one is limited to athletes. If an opposing team knows a player is injured, and what the injury is, they might be able to take advantage of it. For example, if a football team has a running quarterback that has an ankle injury, it will change how the opposing defense plays.

These reasons all make some sense, but they’re also all shortsighted. Finishing a game, dancing tomorrow night, or working one more shift are never worth your long-term health. Hiding a minor injury can turn it into a major one. It’s never weak to report an injury and you’re not letting your teammates, or coworkers down. If you’re not up to your best, you owe it to the people counting on you to let them know. Letting a healthy player, performer, or worker take your place is the right thing to do. If you’re injured, don’t hide it!

Let the right people know, then go to the right person for help – your physical therapist!

Every October we celebrate National Physical Therapy Month to raise awareness with consumers about the many benefits of physical therapy. It’s also a great opportunity to appreciate the outstanding impact Physical Therapists and Physical Therapists Assistants have on society and healthcare.

People everywhere experience the transformative effects physical therapy can have on their daily lives, but some common misconceptions often discourage people from visiting a physical therapist.

This year marks the 30th-anniversary of NPTM emphasizing physical therapists’ value as movement experts as well as the benefits of regular physical activity, and the unique value PTs and PTAs bring to help people get moving.

The core of the physical therapy profession is about care and service. So, this is a great time to get to know about the important work we do. Because all-in-all our care revolves around you!

It seems like common sense—everybody falls, no matter what age. However, for many older adults, an unexpected fall can result in a serious and costly injury. The good news is that most falls can be prevented. And one of the ways you can prevent a fall is by knowing who you can call on for help.

That’s why falls prevention should be a team effort, where each member of the team offers expertise in their area of responsibility or field of work. Some members include health care professionals, like your primary care physician, an occupational therapist, physical therapist, pharmacists, and more.  While health care professionals provide much of the expertise and experience to ensure you live independently and falls free, there are other resources in your community that contribute to falls prevention.

Let’s get to know your falls prevention team

From medication and vision impairment to poor lighting and chronic conditions, the factors to watch for are numerous. That’s why having a team to help spot and address fall risks is so helpful. Below are all of the resources that play a significant role in promoting safety and preventing falls for you.

Your falls prevention team should include:

• family and friends
• an occupational therapist (OT)
• your primary care physician (PCP)
• a pharmacist
• a physical therapist (PT) 
• your local fire department
• your senior center
• your hardware store
• your faith-based organization(s)
• your library
• your local sporting goods store

Each of them brings a unique mix of expertise and familiarity that can provide important protections against falling. Check out this video to learn more.

Your family and friends

You know them, you trust them, and they are happy to help. Family and friends provide some extra hands or another set of eyes to check and rid your home of falls hazards. The next time they come over to visit or help around the house, ask them to take a little extra time helping you find common fall hazards. This checklist shows you what to look for. Family and friends can also join you during doctor visits and help ask questions and gather information about prevention falls.

Your occupational therapist (OT)

Whether you’re already working with an OT or not, they are a vital part of any falls prevention team. They can ensure your assistive devices fit your needs and assess your home to identify hazards to be eliminated and modifications that can prevent falls. During Falls Prevention Awareness Day a few years ago, we toured a real home with Scott Trudeau, PhD, OTR/L from the American Occupational Therapy Association. The video is a wonderful example of how teamwork can prevent falls.

Your primary care physician (PCP)

Primary care physicians are often best positioned to work with patients on falls prevention and get the process started because they see patients regularly. Your PCP knows your medical history and manages chronic illness like diabetes and arthritis that may put you at risk. PCPs can recommend evidence-based programs designed to reduce fall risk, spot hidden injuries resulting from a fall, and evaluate side-effects and other problems with medications that may increase your risk of falling.

Be proactive about addressing falls when you visit your doctor. Even if your appointment was made for something else, sharing information is always important. Tell your doctor if you’ve fallen recently, feel unsteady on your feet or are worried about falling. A good PCP wants to build trust and be accurate so you stay healthy.

Your pharmacist

Most older adults take some kind of medication or supplement each day. The effects of medications on our risk of falling isn’t usually something we think about when we’re trying to get over a cold or manage disease like high blood pressure or arthritis. That’s why pharmacists are an important part of any falls prevention team. When you pick up your medications, use the opportunity to get counseled about any side effects you’re experiencing, and any changes in the medications you’re taking. Check out this video which explore the role of medications in falls and the many ways that pharmacists can help.

Your physical therapist (PT)

Physical therapists are important members of the falls prevention team. They can work with you to improve balance, strength, and mobility to prevent falls and can help address the reasons you may be feeling unsteady. Physical therapists can also help you identify what you can do each day to manage your falls risk and connect you to resources in the community to maintain and improve your strength and balance.

Your fire department 

Your local fire department can play a key role in falls prevention and do more than help you in case you do fall. Fire departments can help prevent falls by offering home safety checks to spot falls hazards*, such as rugs without non-slip backing or too many electrical devices plugged into one outlet. They also can assist in testing and replacing smoke alarms. Firefighters can also connect you to resources in the community to prevent falls. View this infographic to learn more tips on how the fire department can help reduce your risk of falls.

Your senior center

Senior centers are local community-based meeting places where you can gather to enjoy recreational, social, cultural, health and wellness and educational programs to remain physically active, learn new things, and stay engaged with the community. They connect you to a broad array of community services like transportation, nutrition, and benefits access. Senior centers also are a trusted community hub for health and fitness programs to encourage exercise and movement.

Your hardware store

You can find household goods and many other home products and appliances to maintain and improve your home at any local hardware store. Your hardware store is the ideal one-stop shop if you want to make modifications to your home to reduce your risk of falls. They have all the supplies and materials needed to make your home a safe and comfortable place to age in place and remain independent, such as grab bars, a hand-held shower head, nightlights and lightbulbs for brighter light, and nonslip pads for your rugs. They can also help you find what you need to make these recommended home modifications. Installing a walk-in bathtub can also make bathing easier and safer.

Your faith-based organization(s)

You can depend on your faith-based organization to support and encourage you along your falls prevention journey. Faith leaders are trusted sources of important information and can connect you to community resources to address your needs, especially when it comes to your health. You can also count on your faith community for social support, whether it is joining you in a new activity, preparing for a medical visit, or going along with you to a falls screening or other falls prevention event.

Your library

Libraries are a valuable place to learn about falls prevention. They are filled with books and other media for you to use so you can be more informed and educated about your health. Library staff can also help you find specific information on falls risk factors and often know about important community events and other resources. Libraries are also a common place for falls prevention programming, such as A Matter of Balance, Tai Chi, and Bingocize! 

Your local sporting goods store

Your local sporting goods store is a valuable resource for the most appropriate shoes, clothes, and equipment to help you stay active and falls free. These stores can help you pick out the best shoes for walking, hiking, and other exercise activities. Sporting goods stores can also help you pick out the right equipment for health and fitness programs, such as yoga mats, ankle weights, dumbbells, walking sticks, and more. They also carry water bottles and specialized clothing to help you stay cool during the summer and warm during the winter.

Ready to build your falls prevention team?

As you start to pull together those who will help you protect your health and independence, you can always turn to organizations like ours for information. Falls Prevention Awareness Week only happens once a year, but we are constantly creating new resources for older adults, caregivers, and professionals to use whenever you need. Check out NCOA’s Falls Free CheckUp, a quick 12-question screen to help you better understand your risk for falling.

Falls Prevention Awareness Week is made possible in part by grant number 90FPSG0051 from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.  

source:  ncoa.org

*Carousel PT offers home safety checks, such as evaluating proper nighttime lighting and clear paths of travel to restrooms when falls are the highest risk, and much more.

A concussion is a mild traumatic brain injury caused by a direct blow to the head, face, or neck. In the United States, an estimated 300,000 sports-related concussions occur annually.

In high school gender-comparable sports, girls have a higher concussion rate than boys. Female athletes have also been shown to have a greater recovery time in postconcussion symptoms as compared to males.

Signs of a Concussion

Concussion symptoms usually appear within minutes of the injury, but some symptoms may take several hours to occur. Any athlete who has lost consciousness during a sports-related impact should be examined for a concussion or a spine injury.

A headache is the most common complaint of an athlete with a concussion. If you suspect your child has suffered a concussion, they may exhibit the following symptoms, which could worsen with stress or activity:

• Loss of consciousness
• Headache
• Feeling in a “fog”
• Difficulty remembering
• Behavioral changes (irritability, rapid changes in mood, exaggerated emotions, aggressiveness, depression, decreased tolerance to stress, etc)
• Nausea/vomiting
• Difficulty with balance
• Pupils that are enlarged or not equal in size
• Double or blurred vision
• Slurred speech
• Difficulty falling asleep
• Excessive drowsiness

What to Do If you Suspect a Concussion

• Do not allow the athlete to return to any sporting event.
• The athlete should be allowed to rest until there is a resolution of symptoms. This allows the brain to recover. Rest involves allowing time to sleep or take frequent naps. It is important to minimize distractions, such as television, the Internet, reading, or phone use.
• It is not necessary to wake the athlete up every hour. This disturbs sleep patterns, which can interfere with the healing process of the brain.
• The athlete should avoid pain relievers, like aspirin or other anti-inflammatory medicines. These may increase the risk of bleeding in the brain.
• The athlete should not be left alone after the injury. Symptoms should be monitored closely. If they worsen, the athlete may need to be evaluated in the emergency room to determine if a more serious brain injury exists.

Our physical therapists can assess symptoms to determine if a concussion is present, and treat your injury by guiding you through a safe and personalized recovery program.

source:

choosept.com