Best Way To Get Rid Of Back And Neck Pain… Physical Therapy!

Written by: Dennis Kaster, PT-- Stevens Point North

Physical Therapy is one of the most effective and cheapest ways to treat back and neck pain, but few people know that. 

Most back and neck pain is caused by muscle weakness, tightness, poor posture, or poorly set-up workstations that put extra stress on the body. 

A Physical Therapist will assess which of these issues is causing the pain and help you get rid of it by doing specific stretches, strengthening, improving posture, performing treatment to decrease pain or swelling, using better lifting mechanics, or helping you set up your work or home workstations to put less stress on your body. 

The typical process in the past has been that when someone injures their back, they go to a medical doctor.  The doctor would decide what to do next, which many times included rest, medications, or expensive imaging. 

Several years ago a large medical organization, Virginia Mason, broke down the process of medical care for back injuries, looking for the quickest, most effective, and cheapest way to treat low back pain.  In the end, they found that people who saw a physical therapist first for lower back pain recovered much quicker, returned to work sooner, and experienced a much lower overall cost of care.  

This is because Physical Therapists specialize much more in the anatomy and mechanics of how the back works and how to stop and prevent pain.  Physical therapists also do not prescribe opioid pain medications.  Many times medical doctors prescribe opioid prescriptions, advise patients to rest until the pain goes away, or order expensive medical imaging, which many times is not necessary.  Many other research studies have found the same results.

As a result of the findings of multiple research studies, many insurance companies no longer require a physician referral to cover physical therapy, as they realize that people with mechanical low back pain respond much quicker and better if they see a Physical Therapist first.  Most people are not aware of this. 

Several studies have shown that as little as 7% of people with low back pain see a Physical Therapist.  This is crazy…..when Physical Therapy is one of the most effective ways to treat low back pain. 

Also, Physical Therapists have the expertise to recognize more serious medical issues that would require a referral to a medical doctor. 

So, if you see a Physical Therapist first and your pain is due to a medical issue, you can rest assured that the Physical Therapist will recognize it and direct you to the appropriate care. 

PLEASE HELP US TO GET THE WORD OUT!!  IF YOU HAVE BACK OR NECK PAIN, SEE A PHYSICAL THERAPIST FIRST.  IF YOU OR SOMEONE YOU KNOW HAS BACK OR ANY MUSCLE OR JOINT ISSUE, LET THEM KNOW THAT PHYSICAL THERAPY MAY BE THE BEST FORM OF TREATMENT FOR IT. 

If you have questions, please give us a call and we can answer them for you or check with your insurance to make sure our treatment is covered.

References

• Furhmans V. Withdrawal Treatment: a novel plan helps hospital wean itself off of pricey tests.  The Wall Street Journal. January 12, 2007

• Pendergast J, Kliethermes S, et al, A Comparison of Health Care Use for Physician-Referred and Self-Referred Episodes of Outpatient Physical Therapy. Health Research and Educational Trust DOI:10:1111/j.1475-6773.01324.x, Oct. 2011

• Mitchell JM, de Lissovoy G. A comparison of resource use and cost in direct access versus physician referral episodes of physical therapy. Phys Ther. 1997;77: 10-18

• Moore JH, McMillian DJ, et al. Risk determination for patients with direct access to physical therapy in military health care facilities. J Orthop Sports Phys Ther. 2005;35:674-678

• Leemrijse CJ, Swinkles I, Veenoff C. Direct access to physical therapy in the Netherlands: Results from the first year in community based physical Therapy. Phys Ther 88;8:936-946

• Kenney. Transforming Healthcare, Virginial Mason Medical Center’s Pursuit of the Perfect Experience.  CRC Press, 2011

Why do you make physical activity a priority in your life?

Dean J Sondrol, PT

Why do you make physical activity a priority in your life? This question was a recent topic of discussion one day between myself and some of my clients at Advanced Physical Therapy and Sports Medicine, and then later on between some friends and I. It was sparked by a recent article I read on the APTA Website- see article below. 

Here are some of the responses that came up:

-to stay’ healthy (was the most common)

-to keep up or stay with my children (one of my main reasons)

-to enjoy the outdoors; hiking, kayaking, and biking

-to dance at my granddaughter’s wedding

-my wife tells me to, or my kids tell me I need to

-so I look good

-cause of my heart attack or new hip or knee

-So I can play high school sports (from some of the younger people)

-in case I get COVID (a more recent reason)

-so I can fit into that dress or pair of jeans

-my high school reunion is coming up

-so I can drink more beer, or eat more food

-it just feels good

Of course, this also led to a discussion on why we don’t make physical activity a priority in our life, (that is a topic for an article in itself).    The benefits of physical activity are well documented, we all have heard reason on TV, at the Dr office, from social media and from family and friends.  So I won’t lecture you in this article but I would encourage you to find the one or two reasons why you should make physical activity your priority.  Write it down if you want, post it on your phone, or just think about it from time to time.  I will also think of my reasons why I’m doing that activity and it makes that walk or work out all the more meaningful.  So if you see me out running, biking, or walking and ask what I’m thinking about I would probably tell you my children or how many more miles I should run so I can eat that jelly doughnut.    

You may have some of the same or have your own reason.  Please feel to share your reason with me…. Remember to keep making physical activity your priority!

From: Top 10 Benefits of Physical Activity.  From Choose PT August 2020

https://www.choosept.com/resources/detail/top-10-benefits-of-physical-activity

Most Americans do not move enough. The good news is that regular physical activity is one of the easiest ways to reduce your risk for chronic disease and to improve your quality of life.

Make physical activity a priority to:

1.    Improve your memory and brain function (all age groups)

2.    Protect against many chronic diseases.

3.    Aid in weight management.

4.    Lower blood pressure and improve heart health.

5.    Improve your quality of sleep.

6.    Reduce feelings of anxiety and depression.

7.    Combat cancer-related fatigue.

8. Improve joint pain and stiffness.

9. Maintain muscle strength and balance.

10. Increase the life span.

Physical therapists are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement. Physical therapists treat people of all ages and abilities and empower you to take an active part in your care. After an evaluation, your physical therapist will create a treatment plan for your specific needs and goals.

Choose more movement. Choose better health. Choose physical therapy.

Better going into surgery, better coming out.

Briana Wasielewski, PTA, CCCE, BS

Having the best rehab after surgery is one of the top priorities of all surgical candidates. Many spend a lot of time getting the best surgeon in place, getting their place to rest in order, and thinking about who can help them with daily life and getting to and from appointments once the surgery is done. While these are all things one should think about prior to surgery, many do not think about what they can do to ultimately increase their chances of having a better surgical outcome: exercise prior to surgery. 

Exercise comes in many forms and is something everyone can do before surgery. If done appropriately, exercise before surgery will likely improve recovery. Who better to help figure out your unique pre-op exercise plan than a physical therapist? 

First, a physical therapist will discuss and evaluate your reason for surgery. Many times the reason a patient is thinking about having surgery is that they have pain or their movement is affected. Exercise is usually not something surgical candidates think they can or should do before considering surgery. Prehab exercise is specifically designed by physical therapists to improve the outcome of patients’ post-surgical rehab. The idea here is “the better going into the surgery, the better coming out”. Whether that means breathing exercises, simple strengthening, flexibility work, or practicing how to use crutches, seeing a physical therapist before surgery can help the healing process in the long run.  

A physical therapist prehab visit also gives the opportunity for surgical candidates to ask questions specifically about the most dreaded part of having surgery: the recovery. Physical therapists are experts in rehabilitation and can tell you exactly what to expect in recovery, and how to prepare yourself with pain management tools.  

If you are thinking about having surgery or know someone who is, make sure you prepare yourself and your body by seeing one of our physical/occupational therapists.

Head to our location page to find a clinic near you!

Hand Therapy

By ASHT (American Society of Hand Therapists)

What is hand therapy?

Hand therapy is the art and science of evaluating and treating injuries and conditions of the upper extremity (shoulder, arm, elbow, forearm, wrist and hand). Hand therapy uses a number of therapeutic interventions to help return a person to their highest level of function. It evolved from the need for a specialist with the knowledge and experience required to manage the challenging recovery of complex hand and upper extremity injuries

What is a hand therapist?

A hand therapist is an occupational or physical therapist who, through advanced continuing education, clinical experience and integration of knowledge in anatomy, physiology and kinesiology, has become proficient in treatment of pathological upper extremity conditions resulting from trauma, disease, congenital or acquired deformity.

What does a hand therapist provide?

Hand therapists bridge the gap from medical management of upper extremity conditions to successful recovery, allowing individuals to function normally in their daily lives. Hand therapists provide non-operative interventions, preventative care and post-surgical rehabilitation for a wide variety of upper extremity disorders, from simple fingertip injuries to complex replanted extremities. Patients with chronic conditions, such as arthritis, or neurologic conditions, such as a stroke, can benefit from hand therapy through education on joint protection and energy conservation, and with recommendations for adaptive equipment or devices to improve function. A hand therapist employs a variety of techniques and tools, including activity and exercise programs, custom orthotic fabrication, management of pain and swelling and wound and scar care. A hand therapist can also be a consultant in the industrial world, training employees and recommending modifications of workstations and alternative work methods to help ensure healthy work styles of all employees.

Where do hand therapists work?

• Hospitals

• Rehabilitation centers

• Industrial medicine facilities

• Privately owned therapy clinics

• Sports medicine facilities

• Academia

Why APTSM?

At Advanced Physical Therapy & Sports Medicine we have a dedicated team of Occupational Therapists who specialize in hand therapy. Our hand therapists offer a variety of treatments to develop or maintain functional living in those with certain physical conditions or musculoskeletal disorders.  They focus on the client, placing a paramount focus on client goals. If you or a loved one suffers from hand-related aches and pains, call us today and set up a free, 15-minute consultation to receive expert advice from one licensed hand/occupational therapists— 920-991-2561

Start the Year Right, Prevent and Treat Shoulder Pain

Phil Sorensen, PT, CSCS

From Thanksgiving through Christmas & New Years I have had more friends and family members ask me about their painful shoulders than any other body area. Not one had a specific injury. Pain developed with use/reaching, exercise, work and in most cases was interfering with their ability to sleep. The good news for them was their condition is very treatable and responds well with physical therapy. The longer you ignore symptoms and the repetitive pain with daily use, reaching, etc. the more challenging it can become to relieve. Structure of the Shoulder: In most parts of the body, the bones are surrounded by muscles. In the shoulder region, however, the muscle and tendons are surrounded by bone. If you tap the top of your shoulder, you can feel bone immediately under the skin, this is called the acromion of the scapula. Directly under this bone is the rotator cuff, a group of four muscles and tendons. In the image below, the supraspinatus is one of the tendons that are most commonly involved. It along with the bursa (a fluid-filled sack) is positioned right between the humerus (upper arm bone) and the acromion that you tapped. This structure of muscle-tendon between bones is a contributing factor to the development of impingement syndrome (shoulder bursitis, rotator cuff or biceps tendinopathy).

Muscles of the Shoulder: Proper rotator cuff (RC) and scapular muscle strength is critical in both preventing and treating shoulder pain/impingement. The RC role is to keep the ball of the humerus in the correct position with the scapula. The rotator cuff enables the other major muscles of the arm, the deltoid and Latissimus dorsi (“lats”), to properly perform their job during reaching, lifting, pushing, or pulling. Balanced strength around the shoulder blade, in the lower & middle trapezius, rhomboids & serratus anterior (scapulothoracic) muscles, is crucial for shoulder blade movement and shoulder mechanics. Weakness and imbalance in these muscles and/or the RC is another primary factor with impingement syndrome, shoulder bursitis & rotator cuff tendinopathy. Corrective Measures: Learning proper technique to balance the previously mentioned muscles in various positions then progressing to movements can be complex and is where the skills of a PT are of great benefit to optimize your time and efforts. Below is a link to a video demonstrating a great shoulder stability exercise that engages these muscles using a small looped band while doing a small forward reach. CLICK HERE

In addition to developing proper rotator cuff & scapulo-thoracic muscle strength, it’s important to address adequate shoulder, rib cage & thoracic (upper back) mobility. Your physical therapist will assess, treat and instruct you in things you can do to improve your mobility. In most cases, shoulder impingement, bursitis, &/or rotator cuff tendon injuries can be completely rehabilitated and should leave no residual effects once a person has recovered. Shoulder pain can be debilitating by limiting your ability to exercise and perform daily tasks. Start the year out right, be proactive in the care of your shoulder. Call and set up an appointment to see a PT today. The longer a condition is left untreated, the more potential for harm and tissue damage which may lead to a longer recovery process.

Contact us to start your recovery or prevention journey today!

Osteoarthritis of the Thumb CMC Joint

Written by: Tammy Vanevenhoven PT, DPT, CHT

As the season of fall hovers over us and the leaves begin to fall, the temperatures outside continue to fall as well. For those who suffer from arthritic hands stiffness and pain, it can quickly be felt by the changes in the temperature. Osteoarthritis is the most common of all joint diseases. It often affects the larger weight-bearing joints of the hips and knees, but it also commonly affects the smaller joints of the hands; especially the base of the thumb called the CMC joint (carpometacarpal joint). The CMC joint of the thumb is considered a saddle joint that allows the thumb its vast ability to grasp objects of various shapes and sizes, to open doors, jars, and packages, etc. It also allows pinching-- a more precision type movement for writing, buttoning, using scissors, picking up small objects or turning a key. We need our thumbs as they contribute to 60% of our hand function.

Signs and Symptoms of CMC joint arthritis are:

*pain at the base of the thumb after activity

*pain with active movement of the thumb especially with pinch

*morning stiffness

*joint tenderness to palpation

*crepitus (crunching noise in the joint) with thumb movement

*joint deformity with bony nodules felt at base of thumb

*weakness of hand grip (opening a jar, sealed packages, etc.) or with pinch (writing, buttoning, turning a key, etc.)

How is CMC joint arthritis diagnosed?

Usually a standard radiographic x-ray will show joint space narrowing, bony changes such as spur formation, and joint erosion. Based on the x-ray, the arthritic changes are usually classified as mild, moderate, or severe joint destruction.

What can be done non- surgically to help the painful arthritic thumb?

A certified hand therapist (CHT) or an occupational therapist can be of great help in alleviating pain in the arthritic thumb by fabricating a thumb spica splint that stabilizes the base of the thumb while still allowing use of the thumb tip for light pinch and grip activities. Stiffness can be reduced by using a paraffin bath that is composed of paraffin wax and mineral oil which is then melted to a therapeutic warm temperature which molds around the bony prominences of the hand to help soothe pain and improve movement of the joint. Your hand therapist will also educate you on joint protection by recommending built up handles on objects that are difficult to grip such as tools, scissors, writing and eating utensils. Key adapters can also be placed on your keys to allow ease with key pinch. An electric can opener can also be used to avoid stressing the arthritic thumb with a manual can opener. Protecting the hands from the cold weather is very important. Wearing mittens and using warming packs if you like to be outdoors will help keep your hands from getting stiff and painful while you cross country ski, ice fish or while taking a winter hike.

What does the surgery for CMC joint replacement entail?

CMC joint arthroplasty is the most common joint replacement of the arthritic hand. The beak ligament reconstruction, or the LRTI, is the most common surgical procedure performed. The hand has, thankfully, many muscles that perform the same function. They are called “spare parts.” The eroded CMC joint is removed and one of these extra tendons of the hand/wrist is sacrificed and bundled up to fill in the joint space at the base of the thumb. Patients are placed in a cast and often external pins are inserted for extra immobilization.  At four weeks the cast and pins are removed, and the patients are placed in a forearm-based thumb spica splint and sent to therapy to see a certified hand therapist or an occupational therapist that specializes in treatment of the hand. Therapy includes gentle progressive range of motion to restore normal movement of the thumb, fingers and concurrent wrist; which becomes stiff from being in the cast. Swelling control and pain management are treated by working on scar mobility to avoid tendon adherence. Hypersensitivity often occurs from the surgeons having to retract the superficial radial nerve to perform the operation. Therapists can ease this sensitivity by performing desensitization exercises to calm the nerve pain. Restoring functional hand strength while appreciating joint protection and education of patients for life-long care for the arthritic thumb are just some of the various ways your hand therapist can help.

If you would like more information in treating your arthritic hands you can call Advanced Physical Therapy and ask to speak to a certified hand therapist or occupational therapist that can assist you in answering your questions. APTSM New London phone: (920)982-0100.

The 4 P's of Energy Conservation

The 4 P’s of Energy Conservation

Laura Johnson, PT, DPT

Has it been exhausting for you to complete your typical morning routine, or maybe you are having shortness of breath while grocery shopping?  When individuals have a diagnosis of Chronic Obstructive Pulmonary Disease (COPD), Multiple Sclerosis (MS), or Congestive Heart Failure (CHF), or are recovering from a recent illness or surgery, it can be difficult to complete daily chores due to fatigue and decreased activity tolerance.  Your lungs and heart may not be working as efficiently as they should, so it is important to conserve energy throughout the day.

In order to succeed, there are 4 simple steps to consider, and we are going to refer to these as the 4 P’s of Energy Conservation

1.     PRIORITIZE: Decide what needs to be done today, and what can wait for a later date.  Try to scatter your household chores throughout the week.  One day for laundry, next day for vacuuming and another day for grocery shopping.  If you are partaking in a social engagement, plan to skip some daily activities to reserve some energy before the fun begins! A good quality rest period each day is best!

 2.     PLAN: Plan ahead to avoid extra trips.  Gather supplies and equipment needed before starting an activity.  For example, before showering, make sure your towel, clothes and necessary daily items are all located in the bathroom area.  Also have a chair available to provide yourself a seated rest break if needed.  Another technique is to plan to alternate heavy and light tasks.  Find a good balance between work, rest and leisure.

3.     PACE: Slow and steady pace, never rushing!  Some individuals try to complete as many tasks as possible, as quickly as possible.  Unfortunately, this leads to complete exhaustion, and inability to perform tasks later in the day.  This can also lead to a greater chance of falls due to increased fatigue: We all know a fall can be extremely traumatic.  Plan to rest before you feel tired. Provide yourself with enough time to take short, frequent rest breaks. 

4.     POSITION: Think about your body position while completing tasks throughout the day.  Bending and reaching can cause fatigue and shortness of breath.  There is adaptive equipment available to make some daily tasks less stressful on your body.   Examples are: 1) Use a reacher to grasp the cleaning supplies in the low cupboard, 2) Use elastic shoe laces to avoid bending over to tie your shoes, or 3) Use a sock aid to get your socks or compression stockings on.  Eliminating some strain when bending or reaching will allow your lungs to expand more fully, which in turn helps get more oxygen into the body. 

Conserving your energy can allow you to complete the tasks you want to complete throughout the day.  You do not want to run out of energy before the day is through and we definitely do not want you to entirely stop your activity for constant rest.  Get moving, but move smarter!

If you’re interested in developing an energy conservation plan specific to your needs, contact one of our physical or occupational therapists today to discuss it further.

Click here for a complete list of locations.

Image by Pavlofox from Pixabay