Movement is Medicine: Physical Therapy & Arthritis

In addition to Women’s Health month, May is also national arthritis month. Arthritis may seem relatively benign – everyone knows someone who has arthritis. But here are some numbers that help put the problem of arthritis into perspective:

  • Arthritis is the leading cause of disability.
  • Arthritis affects 1 in 5 adults and 300,000 children
  • 1/3 of working-age people with arthritis have some kind of limitation in their ability to work
  • Arthritis costs $156 billion each year in medical expenses and lost wages
  • Nearly 1 million hospitalizations happen each year due to arthritis

It’s a serious condition, and a serious problem. The good news is that physical therapy is one of the most effective treatments for arthritis.

The Benefits of Physical Therapy for Managing Arthritis Symptoms

Arthritis comes in 2 forms: osteoarthritis and rheumatoid arthritis. Osteoarthritis occurs because of wear and tear on the joints over time. Rheumatoid arthritis is an inflammatory, autoimmune disease. It occurs because of the immune system attacking the joint lining. Physical therapy can reduce joint pain, improve mobility, and help to prevent further damage to the joints. Using individualized exercises, physical therapists help people manage their condition and reduce discomfort. Physical therapists often combine advice on lifestyle modifications with exercise to maximize improvement. Let’s look at the types of exercise that can help manage arthritis symptoms next.

RANGE OF MOTION EXERCISES

These gently move affected joints through their entire range of motion. This can help reduce stiffness and improve mobility. Examples would include things like gentle stretching, tai chi, or gentle yoga.

AEROBIC EXERCISE

Aerobic exercise creates repeated motion, moving the synovial fluid in the joints. It also increases blood flow and releases endorphins which reduce pain. Aerobic exercise also helps to control weight. Weight loss is proven to reduce the stress on your joints, which can reduce pain. Aerobic exercise for people with arthritis should be low impact. This would include things like walking, cycling, or swimming.

STRENGTH TRAINING

Strength training is an important part of managing arthritis. It decreases pain, improves strength, and function. Stronger muscles around the affected joints provide better support and protection.

AQUATIC EXERCISE

Exercising in a therapeutic pool can be a great way for people with arthritis to get started. The buoyancy of the water helps to relieve some of the body’s pressure on the joints. The water pressure also provides compression on the joints. This offers some stability and pain relief. The movement of your body through the water creates resistance for your muscles. This allows them to get stronger in a protective environment.

EDUCATION

Besides designing a custom exercise program, a physical therapist will educate people with arthritis on lifestyle modifications to help mange their symptomsSome suggestions might include weight loss, getting enough sleep, eating a healthy diet, and managing stress. A PT can also modify daily activities to help protect joints affected by arthritis. This can slow down or prevent progression of symptoms.

Physical therapy is a safe and effective treatment for arthritis. Current clinical guidelines for treating arthritis include strong recommendations for exercise and other physical therapy treatments. If you’re one of the 53 million Americans with arthritis, give us a call. We are a great provider to help you reduce pain, manage your symptoms, and move better.

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References:

 

  1. Research (peer-reviewed)
    1. Knee osteoarthritis: key treatments and implications for physical therapy- https://www.sciencedirect.com/science/article/abs/pii/S1413355520302434
    2. Osteoarthritis Management: Updated Guidelines from the American College of Rheumatology and Arthritis Foundation – https://www.aafp.org/pubs/afp/issues/2021/0115/p120.html
    3. Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice – https://sport-physiotherapie-halle41.ch/wp-content/uploads/2021/03/9-Physical-therapy-for-patients-with-knee-and-hip-osteoarthritis-2019.pdf
  2. Articles and Content
    1. May Is National Arthritis Awareness Month – News
    2. Benefits of Exercise for Osteoarthritis | Arthritis FoundationHow Can Physical Therapy Help to Avoid Surgery? – Tucson Orthopaedic Institute

As Pandemic Emergencies End, People Battling Long Covid Feel ‘Swept Under the Rug’

Lost careers. Broken marriages. Dismissed and disbelieved by family and friends.

These are some of the emotional and financial struggles long covid patients face years after their infection. Physically, they are debilitated and in pain: unable to walk up the stairs, focus on a project, or hold down a job. Facing the end of the federal public health emergency in May, many people experiencing lingering effects of the virus say they feel angry and abandoned by policymakers eager to move on.

“Patients are losing hope,” said Shelby Hedgecock, a self-described long covid survivor from Knoxville, Tennessee, who now advocates for patients like herself. “We feel swept under the rug.”

The Centers for Disease Control and Prevention estimated in March that 6% of U.S. adults, or about 16 million, were experiencing long covid, or ongoing health problems that continue or emerge after a bout of covid-19. Researchers estimate that 1.6% of U.S. adults, or about 4 million, have symptoms that have significantly reduced their ability to carry out day-to-day activities.

While patients are no longer contagious, their health issues can stretch on and affect almost every system in the body. More than 200 symptoms and conditions, including fatigue and depression, are linked to long covid, said Linda Geng, a physician who treats patients at Stanford Medicine’s Post-Acute COVID-19 Syndrome Clinic.

The severity and duration of long covid vary. Some people recover in a few weeks, while a smaller number have debilitating and lingering health issues. There is currently no test, treatment, or cure. There’s not even an accepted medical definition.

“When you don’t have any tests that show that anything’s abnormal, it can be quite invalidating and anxiety-provoking,” Geng said.

The physical and emotional toll has left some feeling hopeless. A 2022 study of adults in Japan and Sweden found that those with post-covid conditions were more than twice as likely to develop mental health issues, including depression, anxiety, and post-traumatic stress, as people without them.

“One of my friends committed suicide in May of 2021,” Hedgecock said. “She had a mild covid infection, and she progressively had medical complications continuously pop up, and it just got so bad that she decided to end her life.”

In Los Angeles County, 46% of adults who contracted covid were fully recovered a month later, but the rest — a majority — reported one or more continuing symptoms, according to a 675-patient study by the University of Southern California’s COVID-19 Pandemic Research Center. The researchers found chronic fatigue topped the list of health issues, followed by brain fog and persistent cough, all of which affect people’s daily lives.

Among the respondents who identified as living with long covid, 77% said their condition limited daily activities such as going to school or work or socializing. One-quarter reported experiencing severe limitations.

Taking antivirals cuts the risk of developing long covid in people who are newly infected. But for people already suffering, medical science is trying to catch up.

Here’s a look at Hedgecock and two other patients who have had long covid for years.

A Debilitating Brain Injury

Before contracting covid during spring 2020, Hedgecock’s life revolved around fitness. She worked as a personal trainer in Los Angeles and competed in endurance competitions on the weekends. At 29, she was about to launch an online wellness business, then she started having trouble breathing.

“One of the scariest things that happened to me was I couldn’t breathe at night,” Hedgecock said. “I did go to the emergency room on three different occasions, and each time I was told, ‘You’re up and you’re moving. You’re young; you’re healthy. It’s going to be fine.’”

Her primary care physician at the time told her she didn’t need supplemental oxygen even though her oxygen saturation dipped below normal at night, leaving her gasping for breath and crying in frustration.

Her condition kept her from one of her favorite hobbies, reading, for 19 months.

“I couldn’t look at a page and tell you what it said. It was like there was a disconnect between the words and my brain,” she said. “It was the strangest, most discouraging thing ever.”

Months later, under the direction of a specialist, Hedgecock underwent a test measuring electrical activity in the brain. It revealed her brain had been starved of oxygen for months, damaging the section controlling memory and language.

Since then, she has moved back to Tennessee to be close to family. She doesn’t leave her apartment without a medical alert button that can instantly call an ambulance. She works with a team of specialists, and she feels lucky; she knows people in online long covid groups who are losing health coverage as Medicaid pandemic protections expire, while others remain unable to work.

“A lot of them have lost their life savings. Some are experiencing homelessness,” she said.

In Bed for a Year

Julia Landis led a fulfilling life as a therapist before she contracted covid in spring 2020.

“I was really able to help people and it was great work and I loved my life, and I’ve lost it,” said the 56-year-old, who lives with her husband and dog in Ukiah, California.

In 2020, Landis was living in an apartment in Phoenix and received treatment via telehealth for her covid-related bronchitis. What started out as a mild case of covid spiraled into severe depression.

“I just stayed in bed for about a year,” she said.

Her depression has continued, along with debilitating pain and anxiety. To make up for her lost income, Landis’ husband works longer hours, which in turn exacerbates her loneliness.

“It would be nice to be living somewhere where there were people around seven days a week so I wouldn’t have to go through days of being just terrified to be alone all day,” Landis said. “If this were cancer, I’d be living with family. I’m sure of it.”

Landis refers to herself as a professional patient, filling her days with physical therapy and medical appointments. She’s gradually improving and can socialize on occasion, though it leaves her exhausted and can take days to recover.

“It’s terrifying because there’s just no way of knowing if this is going to be for the rest of my existence,” she said.

‘I Felt Betrayed’

Linda Rosenthal, a 65-year-old retired high school paraprofessional, has long covid symptoms, including inflammation in her chest that makes breathing difficult. She has found it hard to get medical care.

She called and set up a treatment plan with a local cardiologist near her home in Orange County, California, but received a letter five days later telling her he would no longer be able to provide her medical services. The letter gave no reason for the cancellation.

“I was so surprised,” she said. “And then I felt betrayed because it is terrible to get a letter where a doctor, although within their rights, says that they don’t want you for a patient anymore, because it causes self-doubt.”

Rosenthal found another cardiologist willing to do telehealth visits and who has staff wear masks in the office even though the state rule has expired. The practice, however, is more than an hour’s drive from where she lives.

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This piece originally appeared in St. Louis Post-Dispatch.

https://stltoday.com/lifestyles/health-med-fit/as-pandemic-emergencies-end-people-battling-long-covid-feel-swept-under-the-rug/article_ffacea9d-9b48-54e5-af24-eba65a5777f6.html

Physical Therapies for Parkinson’s Disease-An Exerpt

This piece originally appeared in Parkinsons’s Foundation.org
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When you live with Parkinson’s disease (PD), symptoms can change as the disease progresses. Allied health professionals are medical experts from a variety of fields who can help manage your symptoms at every stage. Having an allied healthcare team is critical to living well with Parkinson’s, as they can help guide exercisenutrition and medications. Rehabilitation is defined as a set of treatments and therapies that can help people with Parkinson’s maintain or improve activities for daily living and independence. Rehabilitation professionals include physical and occupational therapists and speech-language pathologists skilled in PD who can keep you moving well, engaging in activities you love and communicating with the people in your life.

Rehabilitation & Parkinson’s

Research shows that rehabilitation can play a crucial role in prevention of injuries and help enhance quality of life. Most often, people with Parkinson’s are only referred to rehabilitation services when recovering from an injury, such as a fall. However, it is recommended that people with PD should begin rehabilitation at diagnosis and consistently every six to 12 months.

Rehabilitation therapies and exercise can:

  • Slow disease progression
  • Address movement symptoms
  • Improve daily functioning
  • Enhance mood and mental health

Despite mounting evidence, only 14% of people living with PD use speech, occupational or physical therapy as part of a treatment plan. Some medical centers and doctors’ offices incorporate rehabilitation and exercise into care regimens, but many do not.

Building Your Rehabilitation Team

Rehabilitation professionals are medical experts who can help manage your symptoms at every stage and maximize your quality of life. Those skilled in PD can keep you moving well, engaging in activities you love, and communicating with the people in your life. Rehabilitation specialists include:

  • Physical Therapists help people with PD keep moving well, as long as possible, while enhancing the ability to move. Research shows that physical therapy — including gait and balance training, resistance training and regular exercise — may help improve or hold PD symptoms at bay.
  • Occupational Therapists help people with PD continue pursuing the activities that make life meaningful and focuses on remaining independent — whether in work, hobbies, social life or in daily activities.
  • Speech Language Pathologists evaluate speech, voice, communication, swallowing and memory/thinking function. They establish a treatment plan that is consistent with personal goals, such as improving specific communication skills, swallow function and thinking skills.

Physical Therapy

Why Physical Therapy:

A physical therapist is uniquely trained to design an exercise routine that targets specific motor impairments. Physical therapists also have an opportunity to provide frequent, direct feedback to help make you aware of how to exercise most effectively and safely.

A physical therapist can provide:

  • Education and self-management advice.
  • Exercise routines that have been associated with improvements (or slower declines) in mobility, quality of life and disease severity.
  • Answers to questions about the type, intensity, frequency or duration of exercise that is best for you.
  • Ways to maintain safety when exercising.
  • Help with:
    • Normal physical activity routine
    • Walking (slowness, small steps)
    • Freezing of gait (feeling glued to the floor or difficulty getting started)
    • Balance or stability
    • Posture
    • Pain
    • Moving around the house (getting up from a chair, moving around in bed)
    • Getting around (in/out of a car or bus, elevators, stairs and uneven ground)
  • Address fear of falling, fall prevention or worries about your safety.
  • Other health problems that affect mobility, including joint or muscle pain from arthritis, problems with endurance due to a heart or lung condition or a broken bone or surgery.

When To Find a Physical Therapist:

Physical therapists can be helpful at all stages of PD. Movement impairments in the early stages of the disease may not be obvious. By engaging a physical therapist with neurological specialization as part of their medical team, people with Parkinson’s disease can address bothersome symptoms and learn ways to prevent falls before they happen. Talk to your doctor about getting a baseline physical therapy evaluation and then continue with periodic re-evaluations.

According to the Parkinson’s Outcomes Project, the largest clinical study of Parkinson’s disease through our Global Care Networkincreasing physical activity to at least 2.5 hours a week can slow decline in quality of life. The Parkinson’s Foundation has identified specific care approaches associated with better outcomes across people who seek expert care at our designated Centers of Excellence. Among others, best practices include early referral to physical therapy and encouragement of exercise as part of treatment.

Setting Movement Goals with your Therapist:

Each individual works with their physical therapist to set personalized movement goals. Physical therapists can help you optimize your exercise routine based on the latest research, re-learn challenging tasks or stay safe and independent in the home.

Some of the most common movement goals for people with Parkinson’s include:

  • Learning about exercises
  • Improving walking, balance or posture
  • Addressing fall risk
  • Treating pain

Before your first visit, think about your movement goals and write down your problems and questions. This will help you organize your thoughts. You can do this for future visits, too.

Finding Expert PD Physical Therapy

It is important to find a physical therapist who has specialty training and experience working with PD, like LSVTBig. You may find experienced physical therapists working in hospital outpatient departments, home health agencies, nursing homes or within the community close to your home. Ask your neurologist for a referral at your next appointment.

Training Future Physical Therapists in Parkinson’s

Did you know the Parkinson’s Foundation is working to better educate physical therapy students across the country to ensure better PD care for everyone?

The Parkinson’s Foundation Physical Therapy Faculty Program is improving Parkinson’s physical therapy care by training faculty leaders across the U.S. so they can, in turn, educate physical therapy students. The intensive course allows physical therapy educators to immerse themselves in learning the latest evidence-based findings in Parkinson’s research and care. Physical therapy educators can make a great impact on the lives of people with PD by bringing this knowledge back to their students, our future practitioners.

For more information on other therapies for Parkinson’s, please click below.

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this excerpt originally appeared in parkinson.org

Parkinson’s Disease: Activities of Daily Living

Advanced Parkinson’s disease (PD) often complicates the daily activities a person with living with Parkinson’s. Below we highlight how care partners can help their loved ones adjust to these changes.

Standing and Sitting

When at home, make sure your loved one uses a chair with sturdy arm rests and a stable base. Avoid soft, low seating or upholstery such as velour or velvet, which can make it more difficult to move.

Tips for helping your loved one safely sit and stand:

  • Remind them to scoot their hips forward to the edge of the chair when attempting to get up.
  • Check that your loved one’s feet are placed firmly underneath before standing. You may need to help with proper foot placement.
  • Use cues like “nose over toes” to provide a goal for leaning forward and transitioning to a standing position.
  • Avoid pulling arms or legs when helping them stand.
  • Use chairs with arm rests. Ask them to put both hands on the arm rests and lean forward before sitting. The backs of both legs need to be against the seat before attempting to sit. This helps maintain smooth, controlled motion and avoids “crash landings,” which can be dangerous.
  • Use a transfer belt to lift your loved one if your loved one cannot get up independently. This often makes aiding safer (for both of you) and easier. These belts can be purchased at a medical equipment store.
  • Remind your loved one to continue to use their walker when turning to sit down.

Walking

Walking changes are common in Parkinson’s and can become more difficult to manage as PD progresses. Tips for helping your loved one to walk safely:

  • Avoid distractions when walking. Attempts to do more than one thing at the same time make walking and balance more difficult.
  • Remind them to take big steps. People with PD often need reminders, or “cues,” to take long steps as automatic motions become more difficult to perform. Keep cues short and simple, for example, “Big steps.” People with Parkinson’s often take smaller steps, which are more unstable than bigger steps.
  • Watch out for pets in the home. Pets provide physical and mental benefits, but they can also be a tripping hazard. Work with your pets so that they learn not to spend too much time “underfoot.”

Freezing

  • People with Parkinson’s sometimes experience “freezing” episodes (feeling like your feet are glued to floor). Freezing is a significant cause of falls, so it is important that you understand what is happening and what you can do to support your loved one.
  • Avoid tight turns when possible. Instruct your loved one to make wider turns as freezing often happens while turning around in close quarters.
  • Count aloud or clap a rhythmic beat can sometimes help, some care partners will even put on music that is in the style of a “march” when their loved one is frozen.
  • Try a visual cue. Some people respond better with a visual cue, such as asking them to step over your foot.

Helping Your Loved One Up from a Fall

Even with safety precautions in place, sometimes falls occur. It is important to have a back-up plan before a fall happens.

Mealtime and Swallowing

Advanced Parkinson’s frequently causes difficulty with eating and drinking because of movement and swallowing problems. Making some adjustments to mealtime can help your loved one eat and get the nutrition they need.

Dressing

Advancing Parkinson’s can make getting dressed a more challenging activity, where care partners often need to help. Changes to clothing and the dressing routine can improve safety and reduce frustration.

Dressing tips for care partners:

  • Ensure adequate time for dressing. Stress can make PD symptoms worse, so your loved one may not be able to help as much if you are rushing.
  • Dress at the right time. Consider waiting to dress until your loved one’s PD medications are working and they are more mobile.
  • Be prepared. Gather all necessary clothing items before beginning to dress to eliminate multiple trips to the closet or dresser.
  • Choose the right clothes. Opt for clothes that is soft and stretchy with an elastic waistband, front openings and bras that hook in the front. Tube socks may be easier to put on than dress socks. Explore more clothing tips.
  • Offer choices. Giving your loved one a voice in a process that may make them feel discouraged can make a big difference. For example, ask them to choose between a red or blue shirt.
  • Encourage participation in physical movement. Allow your loved one to be involved in the dressing process as much as possible. Find ways to encourage extra arm or leg movement for your loved one during dressing to keep muscles flexible. This also builds range of motion and flexibility exercise into the daily routine.
  • Stay safe while dressing. When possible, ask your loved one stay seated or lying down while putting on pants, socks and shoes. This will help reduce loss of balance and falls, and help you reduce back strain.

Safety in the Bathroom

Bathing, using the toilet, personal hygiene and grooming are basic activities of daily living that advanced Parkinson’s can make more challenging. The following tips will help make these activities easier, and safer, for you and your loved one.

Safety in the Bedroom

Parkinson’s can create many challenges to getting a good night’s rest, both for you and your loved one. If your loved one is not sleeping well, it is highly likely that your sleep will be disrupted as well.

Travel and Transportation

Leaving the home for appointments, family events or other activities can be difficult for a person with advanced Parkinson’s. These outings are often necessary, and can add to quality of life, so it is important to consider methods that promote safety and decrease care partner stress.

Medication Management

Getting medication on time is key to managing Parkinson’s at any stage, but especially in advanced Parkinson’s. PD medications are scheduled at a particular time of day to try to avoid a “wearing-off” effect before the next dose.

Some PD medications, like carbidopa/levodopa (Sinemet), only last for three to five hours (or less), and then symptoms usually return, making it harder to move. Help your loved one stick to medication timing by keeping everything organized.

  • Keep an updated list (name, dose, frequency and purpose of the medication). Download our Medication Form and share it with your doctors.
  • Set up medications in a weekly pill box with a secure lid.
  • If taking medication four times a day or less, you can purchase a weekly pill box with four compartments per day. Try to find one with a removable strip for each day, so the day’s medications can be easily carried with you when you leave home.
  • If dosing is more than four times daily, consider purchasing seven weekly pill boxes, using one box for each day. Tape over the days of the week and write down medication dose times.
  • Place all medications into pill boxes, including over-the-counter medications.
  • Some pharmacies can package medications and will send them to your home on a monthly basis. All medications are organized into individual packets labeled with medication day, date and time to be taken. Check with your pharmacy to see if they provide this service.
  • Store all medication bottles and pill boxes in a secure place where they will not be mistaken for food.
  • Set a reminder for pill times. A smart phone works well and is easily programmable. When the alarm rings, provide the medication right away.
  • When away from home, carry your loved one’s daily pills with you. A long wait at an appointment, heavy traffic or other delay could mean that the next dose is needed before you get home.
  • If you loved one takes an MAO-B inhibitor (rasagiline, selegiline), talk to the PD doctor before adding new prescriptions or over-the-counter medications. Some over-the-counter medications may not be safe. Ask the doctor about cold medications.

Skin Care

An often-overlooked symptom of Parkinson’s is the effect on skin. People with PD have an increased risk of developing melanoma, a type of skin cancer linked to sun exposure. The person with Parkinson’s may also have more difficulty changing position, which can result in skin breakdown.

  • Avoid hot, mid-day sun and seek shade when outside. Be sure to apply sunscreen and a sunhat.
  • Help your loved one change position every two hours. If your loved one is in a wheelchair, get a cushion to lessen the risk of pressure sores. See an occupational or rehab therapist to make sure the right cushions are used.
  • Check skin regularly for redness, blisters and/or open sores. Report any changes promptly to their doctor.
  • Avoid skin contact with plastic coating and tapes from incontinence products; these can irritate the skin.
  • Use lotion to prevent dryness.
  • Consider an eggcrate or alternating pressure mattress pad to reduce pressure points.

Physical Therapy

People living with PD or other neurological conditions often move differently, with gestures and actions that become smaller and slower. They may have trouble with getting around, getting dressed and with other activities of daily living. LSVT BIG effectively trains improved movements for any activity, whether “small motor” tasks like buttoning a shirt or “large motor” tasks like getting up from sofa or chair or maintaining balance while walking. The treatment improves walking, self-care and other tasks by helping people “recalibrate” how they perceive their movements with what others actually see. It also teaches them how and when to apply extra effort to produce bigger motions – more like the movements of everyone around them.

LSVT BIG trains people with Parkinson disease (PD) to use their body more normally. So, conisder this 4 week program because LSVT BIG trains people with Parkinson disease (PD) at any stage to use their body more normally.

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This piece originally appeard in the Parkinson’s.org blogs

Physcial Therapy exerpt included by staff of CPT

 

Physical Therapists Help Active People Live Better

Physical therapy has lots of benefits for active people. Athletes, performers, weekend warriors, and people who work in physically demanding jobs can all benefit from the expertise of a physical therapist. Here are 3 ways physical therapists help active people stay that way.

Injury Treatment

Active people get hurt. Physical therapists have the knowledge and skills to help people recover from injuries faster. In addition to helping people recover, physical therapists will look for the root cause of the injury and address that as well, to help keep the injury from coming back. If the injury is severe and requires surgery, a physical therapist will guide the recovery and make sure the person gets back to their activity. But in some cases, a physical therapist can help an injured person avoid surgery in the first place.

Injury Prevention

Surgery isn’t the only thing physical therapists can help people avoid. A physical therapist can also help with injury prevention too. A thorough assessment of an athlete’s strength, mobility, balance, and coordination helps to identify issues that could lead to injury. A PT can then design a program to improve the problem areas before they lead to injury. A PT can also assess an existing training plan and help to identify areas that may lead to sprains, strains, or overtraining.

Improve Performance

In addition to helping people improve areas where they’re weak, therapists can help people get better in areas of strength. A physical therapist can create a program to improve strength, flexibility, coordination, agility or speed. Physical therapists are movement experts. They can break down the requirements of a specific physical task like lifting or throwing, then design a training program that will help people meet those demands.

Physical Therapy is more than just a way to get back on your feet after an injury – it can also help you stay at the top of your game. Whether you’re an athlete, a dancer, or someone who wants to stay in shape, physical therapy can help you reach your performance goals. With the right exercises and treatments, our physical therapists can help you improve strength, flexibility, and endurance so that you can perform at your best and lower your risk of injury.

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REFERENCES:

  1. Research (peer-reviewed)

    1. What we currently do for sports – https://pubmed.ncbi.nlm.nih.gov/31077961/

    2. Sports injury prevention – https://pubmed.ncbi.nlm.nih.gov/35421834/

    3. https://pubmed.ncbi.nlm.nih.gov/34238639/

  2. Articles and Content

    1. https://www.idsportsmed.com/7-benefits-of-sports-physical-therapy/

    2. https://www.childrens.com/amp/health-wellness/how-physical-therapy-helps-athletes-and-what-to-expect

    3. How Can Physical Therapy Help to Avoid Surgery? – Tucson Orthopaedic Institute

Moving Through Fibromyalgia With Physical Therapy

Nearly 5 million people in the United States have fibromyalgia. This chronic condition causes widespread pain, fatigue, and cognitive issues. It can be difficult to manage and can severely impact quality of life. The best treatment plans combine exercise, modalities and education. Physical therapists are experts in all three, so they’re the perfect practitioner to help!

EXERCISE

Currently, recommendations for the management of fibromyalgia include patient education and non-pharmacological interventions. The right exercise routine can help with pain, fatigue, sleep disturbances, depression, and more. A combination of strengthening, stretching and aerobic exercise is the most effective. You and your PT will work together to find the right type and intensity of exercise to best manage your symptoms.

MODALITIES

Exercise isn’t the only tool the PT has to help people with fibromyalgia though. Gentle manual therapy and massage have been shown to help reduce pain and muscle stiffness caused by fibromyalgia. Physical therapists also use modalities to reduce symptoms.

Examples include:

electrical stimulation

laser

biofeedback

dry needling in states where it is allowed

In addition to land-based exercise, some clinics also have the option of aquatic therapy. This combines the benefits of exercise with the warmth of a therapeutic pool.

EDUCATION

Education is another important component in treating fibromyalgia. A physical therapist spends more time with their patients than most other practitioners. They have the time to help you understand what’s going on, and what you can do about it. Research shows that people with more knowledge about their condition have better outcomes, more confidence, and cope better.

While there is no cure for fibromyalgia, physical therapists can help with pain management, strength, mobility, fatigue and function to help patients find relief from their symptoms.

 

References:

Research (peer-reviewed)

Therex effectiveness – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632473/

PT for fibromyalgia – https://pubmed.ncbi.nlm.nih.gov/31140398/

Exercises for fibro – https://pubmed.ncbi.nlm.nih.gov/29185675/ 

Manual therapy for fibro – ​​https://pubmed.ncbi.nlm.nih.gov/32604939/

Aquatic PT for fibro – https://pubmed.ncbi.nlm.nih.gov/23818412/

Effectiveness of exercise with fatigue, etc for fibro – https://pubmed.ncbi.nlm.nih.gov/32721388/

 

Articles and Content:

https://pubmed.ncbi.nlm.nih.gov/11028838/

https://pubmed.ncbi.nlm.nih.gov/36051912/

https://www.choosept.com/guide/physical-therapy-guide-fibromyalgia

Dry Needling by a Physical Therapist: What You Should Know

Dry needling is a technique physical therapists use (where allowed by state law) to treat pain and movement impairments. As part of their entry-level education, physical therapists are well educated in anatomy and treatment of the body. Physical therapists who perform dry needling supplement also obtain specific postgraduate education and training.

The physical therapist inserts a “dry” needle, one without medication or injection, into areas of the muscle.

Other terms used to describe dry needling include:

  • Trigger point dry needling.
  • Intramuscular manual therapy.

Dry needling is not acupuncture, which is based on traditional Chinese medicine performed by acupuncturists. Dry needling is a part of modern Western medicine and is supported by research.

What Is a Trigger Point?

A trigger point is a taut band of skeletal muscle within a larger muscle group. Trigger points can be tender to the touch. Touching a trigger point may refer pain to other parts of the body.

What Kind of Needles Are Used?

Dry needling involves a thin filiform needle. The needle penetrates the skin and stimulates underlying myofascial trigger points and muscular and connective tissues. The needle allows a physical therapist to target tissues they are not able to reach with their hands.

Physical therapists wear gloves and personal protective equipment when dry needling. The used sterile needles are disposed of in a medical sharps collector.

Why Dry Needling?

When physical therapists use dry needling, it is typically part of a larger treatment plan.

Dry needling can release or inactivate trigger points to relieve pain or improve range of motion. Research suggests that dry needling improves pain control and reduces muscle tension. Study findings also show that dry needling can normalize dysfunctions of the motor end plates, from which nerve impulses get transmitted to muscles.

This hands-on musculoskeletal treatment combined with diagnostic skills are recommended by our physical therapists as a part of your physical therapy plan of care.

 

Cold Weather Makes Warm Ups Even More Important!

Warm-ups are always important. They gradually raise your heart rate and get you breathing a little faster. This sends more oxygen, energy, and nutrients to your heart, lungs, and muscles so they can perform at their best. Warm-ups also get the aerobic energy system started, which takes several minutes. Getting it going before your activity also helps you perform better.

WHAT’S DIFFERENT IN THE COLD?

Our bodies have a few tricks to stay warm in the cold. One of these is to narrow the blood vessels closest to the skin. That means that the more superficial muscles get less blood flow, making them more likely to be injured if you place too much demand on them before they’re ready. The restriction in the blood vessels also makes your heart work harder. This doesn’t mean you can’t be active in the cold, it just means that you should take a little more time to get your body ready.

HOW TO WARM UP

Start with something to raise your heart rate, maybe a brisk walk or light jog. Follow that with a dynamic warm-up like walking or jogging while pulling your knees up high to your chest. Some high-front kicks with straight knees will loosen your hamstrings. Walking lunges with an upper-body twist will get your whole body moving. Your warm-up should match the activity you have planned. If you’re not sure how it should look, ask your physical therapist!

CONSIDER YOUR CLOTHES

Dress in layers so you can adjust your clothing to your activity level. After you warm up, you might want to take off a layer to avoid getting too hot during your main activity. You can always add layers back when your activity level drops or the temperature changes.

EVEN THOUGH IT’S COLD, COOL DOWN

We know it’s tempting to rush inside to a warm blanket and hot drink, but don’t skip the cool down. Keep moving with a walk or another form of active recovery so your heart rate can come down gradually. A cool-down also helps your muscles to transition back to a relaxed state and can reduce soreness following your workout. Since your muscles are still warm, your cool-down is the right place for static stretching.

The shorter days and lower temperatures don’t mean that you’re stuck inside for all of your exercises. Follow these tips and you can safely keep moving outside. If you’d like a customized warm-up or cool-down or have questions about your exercise routine, your physical therapist is a great person to ask!

 

5 Reasons You Need a PT to Coordinate Your Fitness Regimen

Physical therapists aren’t just for people that are injured or have had surgery. Physical therapists can also help healthy people improve their fitness. Here are 5 reasons why you should consider seeing yours.

YOU WANT A BASELINE

When you see a physical therapist to improve your fitness, you’ll get an assessment of your strength, range of motion, posture and movement patterns. This not only helps your physical therapist design a customized program just for you, it gives them a baseline to compare things to in the future should you start having pain or suffer an injury.

YOU WANT EXPERT GUIDANCE

Sure, other professionals could help with your fitness routine, but the fitness industry is not well-regulated. Some certifications just require an online course and paying a fee. There are no licenses or other requirements to use many titles. Becoming a physical therapist requires at least a bachelor’s degree and most PTs practicing today have a doctorate. Every PT has passed a national board exam and maintains a state license. That guarantees you that every physical therapist is a verified expert in human movement.

YOU WANT TO PREVENT INJURY

Physical therapists don’t just work to heal injuries, they are also experts in preventing them. After a thorough assessment, a PT can help you design a program that will not only help you reach your fitness goals, but that can address any issues that increase your risk for injury.

YOU WANT UNBIASED ADVICE

Yoga instructors will want you to do yoga. Personal trainers will want you to come to their gym. Pilates instructors will want you to do Pilates. Strength coaches will want you to strength train. A physical therapist doesn’t have a bias or vested interest as to what type of fitness regimen you choose. They are only interested in helping you reach your goals.

YOU HAVE A HISTORY

If you have some kind of history that affects your ability to exercise, a PT is the best person to help you design a fitness regimen. It doesn’t matter if it’s an old injury from athletics or work, back pain that comes up from time to time, COPD, arthritis or heart disease, a PT can help you safely work around it and meet your fitness goals.

What is Frailty? Are you Frail?

Frailty is a syndrome in which a person becomes unable to deal with everyday stress placed on the body. Their muscles may lack strength and power. Their heart and lungs may lose the capacity to help them take part in daily activities and life events. These changes make it difficult or impossible to do things like bathe, dress, care for a family member, prepare meals, or attend social activities.

People of any age can become frail due to trauma, disease, persistent pain, or a reduction in physical activity. People who have more than one chronic health condition at midlife — such as high blood pressure, diabetes, heart disease, or stroke — are more likely to become frail as they age.

Physical therapists help individuals with frailty restore their overall mobility (movement), so they can return to desired activities. They help them improve their:

  • Strength and flexibility.
  • Aerobic capacity (the ability of the heart and lungs to get oxygen to muscles).
  • Balance control. 

What is Frailty?

Frailty is the inability to perform daily activities due to factors such as muscle weakness and the loss of heart and lung capacity. Inactivity is a major cause of frailty. Inactivity can occur due to the presence of health conditions, an injury, or lifestyle choices. Being inactive, regardless of the reason, can cause weakness in all body systems. It only takes a few days in the hospital to experience a decline in the strength needed to move. Spending eight days or more in the hospital over a one-year period is linked to a loss of leg strength in otherwise healthy aging adults. Up to 30% of critical care patients in hospitals are frail.

When a person is not physically active, specific problems can result, including:

  • Small, weak, and rigid muscles (known as sarcopenia).
  • Stiff joints.
  • Weakened heart and lung function (cardiorespiratory system).
  • Balance problems and an increased risk for falls.

Frail people often are scared to perform activities or don’t want to do them because it makes them tired. This lack of activity increases frailty over time, creating a challenging pattern of physical inactivity and frailty. Some people do not understand how to improve their condition, so they continue to be inactive.

When a person becomes frail from lack of physical activity, they are at a higher risk of falling. Falls often cause injuries that can lead to hospitalization, disability, and death.

Signs and Symptoms

A person with frailty may experience:

  • Severe fatigue, weakness, and/or exhaustion.
  • Low energy.
  • Weight loss.
  • Difficulty standing, sitting, or walking.
  • Trouble getting out of bed or a chair without help.
  • Inability to perform simple household tasks.
  • Poor balance or fear of falling.
  • Feeling unable to work.
  • Inability to socialize with friends and family.

How Is It Diagnosed?

Frailty can be diagnosed by your doctor or by a physical therapist. Your physical therapist will conduct a thorough examination to determine your:

  • Lung (aerobic) capacity.
  • Balance and posture.
  • Fall risk.
  • Flexibility.
  • Strength.
  • Mobility (movement).
  • Muscle power.

Our Physical Therapists will ask you or a caregiver questions about your health, symptoms, and how well you move around. They also will conduct a hands-on examination and will observe your movements.