• man with osteoarthritis in his knee

    Posted on 10/25/2021

    Did you know that knee osteoarthritis affects nearly 14 million adults in the United States1 per year? Or that meniscus tears are present in 60-90%1 of those with knee osteoarthritis? With symptoms ranging from knee pain, swelling, stiffness and limited range of motion, medication, injections, surgery and physical therapy are all commonly prescribed to manage knee pain. Medication and injections, however, may simply serve to mask your pain. Surgery can be costly and taxing on your body. Physical therapy, on the other hand, emphasizes a more holistic approach to the body with emphasis on education, pain management and strength and conditioning.

    At first glance, it can be frustrating when you are referred to physical therapy for management of knee pain related to structural issues like osteoarthritis or a knee joint tear. Is the physical therapist going to magically reverse your arthritis or heal your meniscus? Shouldn’t you address the structural problem head-on instead of just “strengthening around it?”

    Not necessarily.

    Surgery or osteoarthritis physical therapy?

    If we dig deeper, a better question to consider might be, “Do I need to change the structure of my knee in order to resume the activities I enjoy?” There are several studies to suggest that abnormal findings on X-rays and MRIs can be common, even in persons without knee pain. In fact, a 2020 study2 of a population with a median age of 44 and no knee pain found that an astounding 97% of knees had abnormalities on MRI. In addition, when comparing physical therapy management to surgical intervention, there are many cases with similar outcomes.

    Now, this is not to say that everyone with knee pain should get physical therapy instead of surgery. Sometimes, surgery is exactly what’s needed to improve your overall quality of life. However, including a physical therapist on your health care team – before and after surgery – is beneficial, even without changing the structural abnormalities that are often presumed to be the problem.

    If physical therapy isn’t changing the “structural problem,” what exactly is the benefit?

    People are more than pictures, and pain is far more complicated than what that picture shows. X-ray and MRI findings can absolutely be helpful in developing a plan of care; however, they are only one piece of the puzzle. While physical therapy is unlikely to result in a change in the X-ray or MRI findings, it can identify and help modify factors contributing to your knee pain and functional limitations.

    Focusing on your unique condition, a physical therapist can work with you to determine the following:

    • Health and lifestyle factors contributing to your knee pain
    • Activity modification so you can safely perform activities of daily living
    • Stretches and strategies to improve motion and strength
    • Swelling and pain control
    • How and when to appropriately get back to activities that cause you pain/discomfort

    This combination can help patients to better understand their condition and develop a plan that assists in recovery. Doing all of this may greatly enhance your quality of life and ease the pain and symptoms you are currently experiencing.

    Now, if you and your doctor determine that knee surgery is necessary, remember, physical therapy is a vital part of preparing for your procedure and recovering after it. Before surgery, we will work together to get you as healthy and strong as possible, which will enable your post-surgical recovery to be that much more successful and faster. Following surgery, we will focus on helping you to restore your strength, balance and flexibility.

    No matter what, physical therapists are committed to helping you be as mobile, independent and pain-free as possible. Our goal is to build a relationship in which you feel comfortable asking us questions, are an active partner in your care and we’re able to work together to ensure the best outcomes possible.

    If you have knee pain, contact us today and experience the power of physical therapy.

    References:

    1. Bhushan R. Deshpande, BS, Jeffrey N. Katz, MD, MSc, Daniel H. Solomon, MD, MPH, Edward H. Yelin, PhD, David J. Hunter, MBBS, PhD, Stephen P. Messier, PhD, Lisa G. Suter, MD, and Elena Losina, PhD. The number of persons with symptomatic knee osteoarthritis in the United States: Impact of race/ethnicity, age, sex, and obesity (2017)
    2. Horga, L.M., Hirschmann, A.C., Henckel, J. et al. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol (2020)

    By: Patrick Smith, P.T., DPT. Patrick is board-certified clinical specialist in sports physical and orthopedic physical therapy, a fellow of the American Academy of Orthopedic Manual Physical Therapists and a treating physical therapist with NovaCare Rehabilitation in Philadelphia, PA.

    HealthWorks and NovaCare are part of the Select Medical Outpatient Division family of brands.

     

  • Posted on 10/18/2021

    Technology has brought many wonderful things to our fingertips. However, an undue side effect of all this technology and connectivity is a condition known as tech neck.

    If you have a stiff neck, experience headaches or feel frequent muscle tension around your neck and shoulders, your technology-using habits are likely a contributing factor. Physical therapy exercises can help to alleviate your pain.

    Many suffer unnecessary pain due to poor posture when using a computer, tablet or smartphone. Poor posture greatly increases the amount of pressure placed on your muscles. Sitting straight up, the weight of your head is 10-12 pounds. Slouching forward with head dropped down, the weight of your head is more like 50-60 pounds to your neck. It’s easy to understand why your muscles are hurting when you imagine them supporting five times more weight for several hours each day.

    If you’re suffering from tech neck, the good news is that it’s often reversible and treatable. Here are five strengthening and stretching exercises to combat it:

    Chin retraction

    You may often find yourself sitting slouched forward with your head well in front of your shoulders. This is the starting position for retracting your head.

    Pull your chin backward while looking directly forward. You should feel a “double-chin” forming under your jaw. Repeat this forward/backward exercise 10 times once every hour or two while working.

    Perform this daily while sitting at your work space.

    Trap stretch

    What about neck exercises for computer or laptop users? Tension in the upper trapezius muscles, which span the back of the neck and shoulders and are responsible for moving the head and shoulder blade, is common. The trap stretch can be performed any time, and you only need 20-30 seconds to help release tension on one side of your neck.

    To stretch the right side, place your right hand on your waist or lower back, tilt your head to the left while looking back to the right. Place your left hand on top of your head and gently pull toward the left until you feel a comfortable stretch. Hold this stretch for as long as 60 seconds and repeat on the other side.

    Perform this daily while sitting at your work space.

    Thoracic extension

    Lean forward in your chair as if you’re smashing a pillow between your belly and thighs. Place your hands with fingers crossed behind your head.

    Reach your elbows toward the ceiling while keeping your belly close to your thighs, causing only your upper back to straighten. The thoracic extension reverses the forward bend and slouchy posture so many assume throughout the workday.

    Perform this daily while sitting at your work space.

    Prone retraction

    Lie face down on the floor with your arms at your side, hands near the hips.

    Keep your neck straight (do not look upward) and simultaneously lift your chin, arms and knees off the ground. Hold the position for 2-3 seconds and release to the floor. Repeat 10 times for three sets.

    Perform this exercise  2-3 days each week to promote strengthening of the muscles across the back of your neck, shoulders and torso.

    Prone scaption

    Lie face down on the floor with your arms reaching upward and slightly outward from your head.

    Keep your neck straight and simultaneously lift your chin, arms and knees off the ground. Hold the position for 2-3 seconds and release to the floor. Repeat 10 times for three sets.

    This exercise emphasizes the lower trapezius muscle between your shoulder blades due to the overhead arm position. The prone scaption should be performed 2-3 days each week to promote strengthening of the muscles across the back of your neck, shoulders and torso.

    Finally, sit up straight. It’s not a complicated tip, but it is easy to forget that we need to maintain good posture when working with technology. Elevate your computer screen so that it is at eye level. If you’re working on a laptop, generally you’ll have to direct your gaze downward while keeping your posture upright, but do your best to comfortably elevate the computer. If you’re on a phone/tablet, simply make an effort to hold the device higher in front of your face.

    If you have pain that persists and is impacting your daily activities, contact us today to request an appointment with a licensed physical therapist. A physical therapy plan of care can efficiently and effectively strengthen your body, reduce pain and prevent injury.

    By: Joe Zucco, P.T., DPT, FAAOMPT, center manager for Select Physical Therapy in Sarasota, FL.

    Select Physical Therapy and HealthWorks Rehab & Fitness are part of the Select Medical Outpatient Division family of brands.

     

  • Posted on 10/1/2021

    At Healthworks Rehab and Fitness, we believe movement is medicine. So, what moves you? Physical activity is key to good health, vitality, energy, strength and might even make you laugh more.

    If pain or a medical condition is holding you back, we’re here to help. Physical therapy is a moving experience.

    Physical therapy gets you back to life and the things that are most important to you. Whether it’s running a marathon, playing with the grandkids or simply cooking dinner pain-free, the benefits of physical therapy can change lives for the better.

    That’s why we’re excited it is October, one of our favorite months of the year. Why, you may ask? October is National Physical Therapy Month. For 31 days, we get to celebrate all things physical therapy and the many ways our dedicated physical therapists and physical therapist assistants help improve the quality of life.

    There is so much to share about the benefits of physical therapy, including the highly-trained clinicians who provide it. Did you know that physical therapy helps people manage pain and chronic conditions? How about the power of physical therapy to help heal from recent injury and reduce the risk of future injury? Or prepare the body for surgery and successful recovery or avoid the need for surgery altogether? Well, physical therapy does all this and more.

    Physical therapy is also a safe alternative to taking prescription medication. It treats common aches and strains, sprains and fractures, and helps with many other issues and conditions, including:

    • Back sprain/strain
    • COVID-19 fatigue and other debilitating illnesses
    • Headaches and concussions
    • Vertigo, dizziness and balance
    • Disc injury and pinched nerves
    • Rotator cuff tear, bursitis and frozen shoulder…and more

    So, what moves you? That marathon? Those grandkids? That culinary masterpiece? Whatever it is, physical therapy, and our compassionate team of licensed therapists, can help get you moving.

    Request an appointment today and see how physical therapy can physically, emotionally and mentally enrich your life.

    #ThePowerOfPhysicalTherapy #WhatMovesYou #ChoosePT

     

  • Close up of female hand while playing the piano

    Posted on 6/9/2021

    The first week of June has been annually designated by the American Society of Hand Therapists as Hand Therapy Week. It’s a time for raising awareness of hand, wrist, arm, elbow and shoulder injuries and conditions and the therapists who have specialized training to treat them. This week is also a great time to spotlight the individuals who most benefit from hand therapy, individuals like musicians.

    Playing a musical instrument is emotionally, mentally and physically demanding. Musicians, like athletes, are at risk for career-ending injuries in the neck, shoulder, wrist and hand. In a musicians’ lifetime, 63-93% will experience musculoskeletal symptoms related to their instrument play. Even the most conscientious musician can begin with symptoms or injury at various times through their play and performance season.

    The challenges musicians face are practice and rehearsal patterns established by others (an orchestra conductor, for example) in large segments of time, without rest or stretch breaks. There is also fierce competition for work, and musicians may be reluctant to complain of injury or new symptoms for fear of losing out on an opportunity. Additional injury risk factors include inadequate physical conditioning, poor posture, abrupt increase in play time and patterns, poor techniques or a change in the instrument.

    Symptoms, whether intermittent or persistent, are seen most often when learning to play over the age of 50. In professional musicians, symptoms can present when increasing the complexity or time spent playing.

    Common symptoms include:

    • Pain
    • Muscle cramping
    • Tremors/spasms
    • Inability to control motion
    • Headaches
    • Numbness/tingling
    • Stuck, catching or locking joints
    • Inability to straighten fingers

    Hand therapists have the important skills needed to evaluate musicians and identify abnormal sensation, poor posture and other causes of symptoms.

    A therapist identifies risk factors and develops a rehabilitation program specific to the musician’s instrument, goals and play demand. The plan may start with an active rest period, avoiding activities that cause symptoms while mentally rehearsing and initiating new normal movement patterns. During this stage, the therapist modifies the play/practice schedule and explores pain control techniques and strategies including diet, exercise, sleep and posture.

    When the active symptoms quiet down, the hand therapist begins the advanced rehabilitation phase with a goal to return to play. The therapist monitors play and rest cycle and a home program is developed to provide visual feedback using imagery and mirrors. The advanced rehabilitation phase also involves aerobics and fitness, strengthening, postural exercises and increased duration and complexity of play.

    The hand therapist works with the musician to develop a return to normal play schedule that is timed incrementally. The schedule starts with a slow and easy repertoire and passages, increasing to fast and more challenging passages for up to 10 minutes. Activities that help with return to play include warm-up with brisk walking, cycling and stretching.

    The musician will warm-up with their instrument using easy scales, long movements, slow and quiet play. As rehabilitation progresses, 50 minutes is generally the maximum play time before rest is suggested. The therapist also instructs the musician on symptom management techniques during rest and after play. These management techniques include ice, hydration and stretching.

    Hand therapists identify the root cause of injury, provide a whole-body approach to care and work in collaboration with music instructors to ensure continuity with proper technique and posture. Education and early intervention is key, as early treatment leads to better outcomes.

    If you or a loved one are a musician and suffering from pain or discomfort while playing, request an appointment today and experience the power of hand therapy. Our certified hand therapists will help you get back to doing what you love – creating beautiful music!

    By: Rob McClellan, OTR/L, CHT. Rob serves as the hand program coordinator for Physio.

    Physio and RUSH are part of the Select Medical Outpatient Division family of brands.