New Year Newbie, Master, or Flunkee

Are You a New Year’s Resolution Newbie, Master or Flunkee?

Turning the page on the new year is a chance to wipe the slate clean—and to be better versions of ourselves. And when it comes to what we want to improve, goals that fall in the health and wellness arena top all other New Year’s resolutions. In fact, three of the top four resolutions in a 2018 YouGov poll were health-related: eat healthier (1), get more exercise (2) and focus on selfcare, e.g., get more sleep (4). There are three types of people who choose a goal from the health and wellness category as a New Year’s resolution: the resolution newbie, the resolution master and the resolution flunkee. Let’s see which category you most identify with—and how focusing on the right strategy can help you get healthier in the new year.

Resolution Newbie. Maybe this is your first time making a commitment to your health and wellness. Good for you! Did a recent event like a health scare or loss of a loved one make you see the light? Or perhaps you want to be more active to enjoy activities with your grandchildren or to carry your own bag on the golf course. Whatever your goals are, taking that first step is a big one so you’ll want to be sure that you’re prepared for the challenge. Particularly when exercising for the first time or returning to an active lifestyle after a long hiatus, it’s important to have the proper information and tools to be successful.  And that means tapping the healthcare resources available to you: Clinicians like nutritionists and physical therapists can make sure that your body is prepared to take on new challenges and work with you to a design a program that will help you achieve your goals.

Resolution Master. Perhaps you fall into a different camp: You vowed to get healthy in 2018 and you achieved it! For 2019, your resolution is to continue the work you’ve begun. After all, living a healthy lifestyle is a lifelong commitment; it’s not something you do for a while and then revert back to your former habits. As you prepare to embrace the new year, are there any small tweaks you can make to advance your goals? Maybe you’re thinking about training for and running a half marathon, but don’t know where to begin. A physical therapy evaluation is a great place to start—PTs are trained to assess your movement patterns and identify any limitations or weaknesses. Based on that information, the PT can design a personalized exercise program to help you safely and effectively prepare for the grueling half marathon course.

Resolution Flunkee. Let’s say your plan for 2019 is to get in better shape and improve your overall health (we support that resolution!), but this isn’t your first rodeo. Your 2018 resolution was pretty similar but it’s one year later, and you’re in the same place you were on New Year’s Eve 2017. What stood in your way—was it time? Affordable options? Access to healthy choices and activities? If any of these barriers sound familiar, then along with your resolution, you need an action plan. Without planning ahead, you’ll find yourself staring down the year 2020 with the same goal in mind. But let’s not focus only on the negative—what went right last year? Maybe you made sleep a priority, which in turn helped you to make better food choices at breakfast but by afternoon, you found yourself choosing to energize with a soda and candy bar when all you probably needed was an apple and a 15-minute walk. Take some time to think about the previous year—good and bad—and take with you what you need, and leave the rest behind. After all, you can’t plan where you’re going without understanding where you’ve been. Which resolution type are you?

Ron Lawrence PT

Certified Strength and Conditioning Specialist

Certified Functional Movement Specialist and Level 2 Dry Needling Therapy

Photo Credit:

Photo by Simon Migaj from Pexels

Start of a New Year – Start of a New Deductible

Kelsey Hinkley, PT, DPT

With the start of the New Year, many people’s deductibles start over.  Suddenly, that bothersome knee pain (or insert your own body part/ailment) doesn’t seem to be worth the cost of the ever increasing medical bill. Does this sound familiar?

While we completely respect your dollar, we highly encourage you to seek professional help before that small injury causes more of an issue down the road. With more people having higher deductibles, they may avoid seeking medical care until they can’t tolerate the pain anymore. However, injuries are easier to resolve in the earlier acute or sub-acute stages rather than the chronic, later stages.

We all tend to think it will get better in a few days but then weeks come and go. We continue with our busy schedules and make excuses for why we don’t seek treatment. Time and time again I see people that didn’t realize physical therapy was an option for them. If they would have started their medical treatment sooner, it would ultimately have saved them time, money, and relieved their pain.  

There have been many studies on the effectiveness of early physical therapy intervention with musculoskeletal injuries. One article explored assigning people with low back pain into groups:  early therapy intervention and delayed therapy groups. The outcomes showed that among the 3 groups, the patients in the early intervention had more favorable outcomes including fewer physician visits, less restricted work days, days off from work, and a shorter healing time.  (Zigenfus, et al., 2000)

---

When to Start Physical Therapy Treatment? 

For the majority of cases, “the sooner the better.”  If you aren’t sure, start with a COMPLIMENTARTY FREE 15 MINUTE SCREEN.  Call any office to schedule.   Prompt treatment benefits include but are not limited to:

§  Decrease need for opioids or surgeries

§  Relieving your pain quicker via joint mobility techniques, soft tissue massage, or modalities

§  Improving your scar tissue quality and mobility using techniques to guide the direction it forms

§  Getting you back to a sport or work sooner

§  Strengthen or stretch the injured area with individually prescribed home exercise programs

§  Correct any biomechanical faults that may be affecting your movement pattern

---

What if I do Nothing?

Injuries that are left untreated can take longer to heal and have lingering pain. In addition, they are more likely to reoccur or have flare ups. This can leave you with:

·        Muscle weakness

·        Altered movement patterns or avoidance of a movement

·        Joint stiffness and loss of range of motion

·        Abnormal scar tissue formation

Remember that symptoms lasting longer than three month can become habitual and are much harder to resolve.  The sooner you get on top of your symptoms the better your outcome.

While it may cost you a little more now, it will save you money in the long run. Let the New Year equal a new you! Don’t let that deductible dictate your health and functional mobility!  

References:

Zigenfus G, Yin, J, Giang G, Fogarty W (2000)  Effectiveness of Early Physical Therapy in the Treatment of Acute Low Back Musculoskeletal Disorders. J. Occup. Environ. Med. 42(1) 35.

Photo Credits

NordWood Themes  Sharon McCutcheon

How to prevent falls in the winter

Photo Credit: Pixabay/Derdento

-You hear about it every winter in Wisconsin: someone you know – a family member, a friend, a neighbor - has fallen and become severely injured. It's unfortunate, but true.

Often times a broken bone is the result of these tragedies. We already know that physical therapy (PT) can help prevent falls; let’s say you weren’t convinced PT could help prevent your fall.

What if I told you that physical therapy (PT) could be the difference between your fall resulting in a broken bone or simply a superficial flesh wound?

Physical therapists are movement experts, and research has shown that exercise, the foundation of PT, increases bone mineral content & density across the lifespan – from childhood to older adults (Behringer, et al., 2014 & McMillian, et al., 2017).

More bone mineral density means stronger bones, and stronger bones could be the difference between a bruise and a fractured hip. According to McMillian and company, “a seemingly small 1–3% improvement in bone mineral density may be sufficient to avoid a fracture” (2017). 

Although many various types of exercise are beneficial for bone health, it is hypothesized that higher impact activities (running, jumping, lifting heavier weights, etc.) result in higher bone densities (Behringer, et al., 2014).

A famous Wolff once created a law stating “bones will remodel based on the stresses placed upon them”. In summary, sitting on the couch = weak bones; physical activity = strong bones.

Another large variable playing a role in bone health is nutrition. Making sure you have enough calcium and Vitamin D in your diet also ensures stronger bones; calcium makes our bones strong, and vitamin D assists in our bodies’ absorption of calcium (Behringer, et al., 2014). 

Combine physical activity with these nutrition tips and your long bones will be grinning from end to end. Keep in mind that, which we see less of during the winter months, helps us to obtain more of this crucial vitamin.

Last, but not least, it is very important that when you are planning to increase your physical activity level you consult a medical profession who can create and individualize program that fits all your needs.

As mentioned before, physical therapists are movement experts, and this is where we at Advanced Physical Therapy & Sports Medicine come in.

Happy Bone Building,

Dr. PJ

References:

Behringer M, Gruetzner S, McCourt M, Mester J (2014) Effects of weight-bearing activities on bone mineral content and density in children and adolescents: A meta-analysis. J Bone Miner Res 29: 467–478. 

McMillian L., Zengin A., Ebeling P., Scott D. (2017) Prescribing Physical Activity for the Prevention and Treatment of Osteoporosis in Older Adults. Healthcare 5(4): 85.

Photo Credit: Pixabay/Derdento

Revisiting the Opioid Topic

Prescription medication abuse, specifically relating to “opioids” (the medical word for pain medication), has been well documented. It seems this issue is gaining increased mainstream attention in the media, however, one problem remains: what is the solution?

Although many solutions have been proposed, one has consistently remained atop the lists of many of these solution-seekers: physical therapy. In fact, the U.S. Surgeon General recently penned a letter, which was sent to physicians across the country, addressing this fast-growing issue. In addition to educating people about negative side effects of opioid abuse, related resources specifically listed physical therapy as primary alternative to treatment of chronic pain (APTA, 2016).

At Advanced Physical Therapy & Sports Medicine, we acknowledge the growing opioid epidemic and utilize many treatment interventions specifically aimed at reducing your pain. If reducing pain is your goal, APTSM is your solution!

For more constructive information on the overuse of opioids, please visit http://turnthetiderx.org. or http://www.apta.org/OpioidEpidemic.

All the Best

PJ

Reference:

APTA. (November, 2016).  Surgeon General Letter Urges Action on Opioids Recommends Treatment Guideline That Includes Physical Therapy.PT in Motion, 8(10), 46.

Staying Active During Pregnancy

Staying Active during Pregnancy

With National Women’s Health & Fitness Day coming up on September 26, it is a great opportunity to highlight the importance of staying active and discuss basic guidelines for exercise during pregnancy.

Is exercise during pregnancy safe?

In general, if you are healthy and have a low-risk pregnancy, most exercise is safe to continue or begin. Modification, especially as your baby grows, may be necessary in later stages of pregnancy.  It is important to discuss your exercise routine with your midwife or obstetrician in your early prenatal visits.

Exercises to avoid during pregnancy include: contact sports (soccer, basketball, hockey), activities with a risk of fall, scuba diving, hot yoga  

What are the benefits of exercise during pregnancy?

Benefits may include:

Increased energy

Improved mood

Decreased constipation

Decreased risk of gestational diabetes, preeclampsia, caesarean delivery

Improved muscle strength and tone

Decreased back pain

Promotion of healthy weight gain during pregnancy

 What can the role of a physical therapist be in staying active during pregnancy and the postpartum period?

The anatomical and physiological changes that occur during pregnancy can increase the risk of musculoskeletal pain for pregnant women, especially low back pain or pelvic pain. As musculoskeletal experts, physical therapist have an important role in decreasing pain and improving function during pregnancy. Physical therapists can also assist patients in exercise prescription and modification during pregnancy and the postpartum periods. Physical therapists with specialized training in “women’s health” or “pelvic health” work with patients that may experience pelvic pain or urinary frequency or incontinence.

For postpartum patients, physical therapists also have a role in the assessment and treatment of disastasis recti (abdominal separation). Patients may have pain or dysfunction related to pregnancy and childbirth many years after it started, but physical therapy can still be beneficial.

If you feel that you would benefit from physical therapy during pregnancy or after giving birth, please contact Advanced Physical Therapy & Sports Medicine at (920) 991-2561.

References:

“Exercise during Pregnancy” https://www.acog.org/Patients/FAQs/Exercise-During-Pregnancy

“Exercise during Pregnancy” http://americanpregnancy.org/pregnancy-health/exercise-during-pregnancy/

“ACOG Committee Opinion” https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Postpartum-Care

“Pregnancy and Low Back Pain: Physical Therapy Can Reduce Back and Pelvic Pain During and After Pregnancy”J Orthop Sports Phys Ther 2014;44(7):474. doi:10.2519/jospt.2014.0505

Let's Play Catch, Grandma!

“Grandma/Grandpa, can you play catch with me” says little Billy. “I wish I could, but I’m too stiff and sore” says Grandpa. “Okayyyy” says little Billy.

 Have you encountered a situation where you felt physically limited? If so, it’s never too late to work toward a new goal! But how you might ask? The answer is simple, find something you like to do (that involves movement) and do it! Yes, that simple. As we know, aging takes a toll, but did you know that activity/exercise even increases in importance as we age, especially if you want to keep up to those fast grandkids. You’re never too old to begin. Even if you have not been previously active, it is important to get started! Growing evidence supports the notion that physical activity can preserve independence and offset functional decline, especially after retirement.

Strength is estimated to decrease by 40%-50% between 25 and 80 years of age. A supervised or safe independent exercise program can assist you to lessen this decrease in strength over the years. Simons et al. explains that a walking program or resistance training program both improve function in individuals 66 years or older. Not only will activity & exercise help you to move around better, but it will also help improve your mood, boost your immune system, manage or lessen the impact of diabetes, heart disease, osteoporosis, depression, and many other conditions. Despite all of the great benefits, the amount of individuals who do participate in leisure physical activity is relatively low (15%).

As a healthcare provider, my goal is to allow you to reach your full potential. Whether this is by designing a specific program to achieve your goals, listening to concerns, giving recommendations, or anything else that contributes to your well-being I am here for YOU! As stated before, but I will say it again “You are never too old to set a new goal or dream a new dream.” Let’s work together to increase the amount of individuals living an active lifestyle. So there ya have it folks… it’s time to get moving and grooving.

Kaitlyn J

Sources

Simons R. Andel R. 2006. The effects of resistance training and walking on functional fitness in advanced old age. J Aging Health. 18 (91).

Newsinhealth.nih.gov/special-issues

The Name is Arthur, Arthuritis.

Arthritis has become a very common word in society today, but what is it? Arthritis can be broken down to its word roots to find the definition. “Arthr” is a medical prefix meaning joint, while “itis” is a medical suffix relating to inflammation. For today’s blog, we are going to take things a step further to investigate osteoarthritis (you guessed it, “osteo” means bone). Joints are a meeting place for two bones in the body, with cartilage cushioning in between; the knee is a prime example.  Osteoarthritis (OA) occurs when the cushion between these two bones – the femur and tibia - breaks down, resulting in the infamous situation referred to as “bone on bone”. What many individuals do not realize is that this “bone on bone” situation does not always have to end in a knee replacement. A recent research article showed that participating in physical therapy is beneficial for individuals with knee OA, when compared with other medical treatment not involving physical therapy (Abbott et al., 2013). Even more great, this research study followed-up with patients one year after their physical therapy, and they were still reporting relief!  Obviously the quality of physical therapy is an important factor in this magical logarithm, and that’s where we come in at Advanced Physical Therapy & Sports Medicine. Our great teams of physical therapists at APTSM are excited and willing to take on your “bone-on-bone” nightmare and get you back to dancing the night away.

Polka away Wisconsinites,

Dr. PJ

Reference:

Abbott JH, Chapple C, Pinto D, et al. (2013). Exercise therapy, manual therapy, or both, for management of osteoarthritis of the hip or knee: a randomized clinical trial. Osteoarthritis and cartilage, 21.

What's So Special about Specialization?

Some parents can live vicariously through their own children, often encouraging specialization in ONE sport at very young ages. As a pop culture reference, check out the Netflix Documentary "The Short Game" to see parents coaching their kids in this incredibly competitive tournament and tour, all hoping for them to become the next Tiger Woods. Specialization, defined as the "Hyper-focus of involvement within one-specific SPORT on a year round basis, is a complex process that should not occur until more information regarding advantages and disadvantages are known". We often find parents playing such an important role in promoting specialization, more so than other pressures affecting young athletes.  According to Wilk et al., (2015) in a study researching rehabilitation of the throwing athlete, The shoulder has also been reported as the most common injury region in high school baseball players, and tremendous forces are placed on the glenohumeral joint as anterior shear forces approach 50% of the body weight during the throwing motion".  This throwing motion, if improper or done excessively, can exacerbate such conditions and increase the likelihood of early long-term shoulder pathologies, particularly in baseball players. 

Although there are some advantages to specialization, such as playing at a highly competitive level, motor skill acquisition, as well as enhancement of scholarship opportunities, we can all agree though that some of these advantages are more the exception than the rule. Dr Charles Popkin, pediatric Orthopedic Surgeon at Columbia University reported, "Sadly, what parents want and what parents hope to gain from their children's participation in youth sports is often at as significant extreme to what the kids actually want.... Children who specialize in one sport early in life were found to be the first to quit their sport and ended up having higher inactivity rates as an adult."  As it relates to baseball, Yang et al (2014) stated that "high pitching volume and limited recovery will lead to arm fatigue, placing younger pitchers at a greater risk for elbow and shoulder problems and, subsequently, an increased risk for arm injuries"  Other more serious concerns of intensive training include growth retardation and puberty delay in females, specifically gymnasts (Hecimovich et al., 2004).

Although there are clear benefits to children for being physically active and participating in sports (much more than at home playing video games), there is an appropriate line to be drawn in the sand, or on the court, or on the field. And we must all be cognizant that the age for specialization of sport, if absolutely necessary, doesn't arrive until much later than we may previously have thought.  According to the American Academy of Pediatrics Committee on Sports Medicine and Fitness, specialization is not recommended before the age of 12 or 13 years old.  There are are also methods to avoid the burnout in sport, so that motor skill acquisition can be maintained at a high level, while preserving the long term orthopedic health of the young athlete. Dr. Popkin goes on, "Expose your children to as many activities as possible and support what they like.  But if they're performing more hours of a sport a week than their age in years, they're probably overdoing it. "  Another avenue is to become the coach or volunteer, and then help develop the schedule as to not overdo it for these young athletes.

And for those with an interest in Wisconsin sports and their heroes, we can learn from the phenomenal athletes that have demonstrated an active interest within their communities, such as JJ Watt. We can even read about how JJ Watt doesn't want us to play just one sport. And look where he ended up?

#ChoosePT #ChoosePT1st 

References:

1. Hecimovich, Mark (2004).  Sport Specialization in Youth: A Literature Review.  JACA, 41 (4). 

2. Wilk, Kevin.  Hooks, Todd. (2015) Rehabilitation of the Throwing Athlete.  Where we are in 2014.  Clinical Sports Med 34 (247-261.

3. Rosenbaum, Daryl. Callender, Shelley. (2010) The Early Specialization of Youth in Sports.  Athletic Training & Sports Health Care, 2 (6). 

3. Epstein, David.  Sports Should Be Childs Play.  New York Times. 

4. Brody, Jane.  How to Avoid Burnout in Youth Sports. New York Times.  Popkin, Charles.  Columbia University Medical Center. 

Bike Because Queen Said So!

“I want to ride my bicycle, I want to ride my bike “ - Queen

With World Bicycle Day being June 3rd, it only seems right.

The weather is getting warm, the smell of burgers and brats fill the air, and you’re ready to bust out your bicycle.  New or old, tandem or unicycle, red or green, Trek or Schwinn, you’re ready to hit road for another summer – determined to finally complete that triathlon you’ve put off for the last 3 years. Hold on cowboy - before you mount your horse let’s get a few things straight regarding proper bike fitting. Bike fit varies a lot based on your primary goal: recreational riding vs leisure riding. See below for a great graphic illustrating this from article recently published by the Wisconsin State Journal (2018). In general, seat height should be set with the goal of achieving a 25-30 degree knee bend; specifically avoid your knee going past your toes. This reduces risk of knee pain and makes for optimally efficient riding (Bini et al., 2011). On the contrary, setting your seat too low will result in greater overall fatigue and higher risk for anterior thigh/knee pain. While research has shown upright trunk positions are most comfortable for riders, it obviously results in less advantageous aerodynamics (Priego Quesada et al., 2017); again, your goals should drive your bike fit – no pun intended. If you have further questions, please stop in your local APSTM for a FREE 15-minute screen and pick our providers’ brains in order to optimize your summer biking experience.

Also, please be sure to look into our Tour de Ripon bike even going all summer in the Ripon area; sign up, bike to a restaurant, and get incentivized with free food & drinks!  The event runs from June 1, 2018 – August 31st, 2018 – sign up anytime! More info available on our website and Facebook page.

With World Bicycle Day being June 3rd, it only seems right.

Safe riding,

PJ

References:

Bini, R.,Hume, P., Croft, J. (2011). Effects of bicycle saddle height on knee injury risk and cycling performance. Sports Medicine: 41(6), 463-476.

Kittner, G. (2018). Time to Tune Up. Wisconsin State Journal.

Priego Quesada, J., Perez-Soriano P., Lucas-Cuevas A., Salvador Palmar R., Cibrian Ortiz de Anda, R. (2017). Effect of bike-fit in the perception of comfort, fatigue and pain. Journal of Sports Sciences: 35(14).

A Green thumb’s guide to injury prevention

Most of us don’t think of overuse injuries when starting a new hobby.  Especially those hobbies that involve what we perceive as less strenuous activities.  But, did you know that planting and tending to your garden can predispose you to some of the same injuries of as athletes such as golfers and rowers?  We always advise you to start a new activity at a gradual pace, increasing duration and intensity slowly. The same is true for gardeners anxious to get digging into the fresh spring soil. Don’t attempt to clear all the winter debris in a single day, or plant the flats of annuals brought home from the nursery all at one time.  This is why they have the yard pickup team arrive at your curb over a 6-week timeframe instead of 1x/season.  Instead, undertake these new hobbies at moderate intervals and take a few minutes to stretch prior.

Typically, the pain of sprains, tendinitis and even arthritis is mild at first and often ignored. However, these ailments can develop into serious conditions if left untreated. Here are a few common gardening-related problems that would require medical attention:

TRIGGER THUMBS OR FINGERS

The repetitive motion of opening and closing shears or other hand tools can lead to a painful triggering or locking of the fingers or thumb. The condition is caused when the “eyelet” that holds the flexor tendons in place along the finger or thumb interferes with the smooth gliding of the tendons through it. Patients may feel a pain in the palm or the finger and, in severe cases, the finger is stuck downward and requires “unlocking” with the help of the other hand.  In addition, using vibrating tools and blowers excessively can cause significant vibration concerns. This adds pressure on the median nerve, which could potentially lead to pre-carpal tunnel like symptoms.

WRIST TENDINITIS

Persistent pain in the wrist could develop from repeated motion of the wrist. In De Quervain’s tendinitis, the tendons that attach at the base of the thumb become irritated or constricted, causing painful swelling along the wrist. Heavy raking can cause pain in the forearm about three inches above the wrist, a condition called Intersection Syndrome. It results from the overuse of the wrist extensor tendons, which rub against one another as the wrist repeatedly bends backward. The friction caused by the rubbing tendons leads to irritation, inflammation and painful swelling.

ELBOW EPICONDYLITIS

Tennis and golfer’s elbow (medial and lateral epicondylitis) are painful conditions involving the tendons that attach to the humerus bone at the elbow. With tennis elbow, repeated bending of the wrist while gripping something like a rake weakens tendons attached to the outer, or lateral, side of the elbow. Similarly, weakened tendons attached to the inner, or medial, side of the elbow and can lead one to suffer from Golfer’s Elbow.

In most cases the overuse-related conditions described above can be resolved with activity modification, ice and over-the-counter anti-inflammatory medication. If the pain persists more than five days or so, however, it would be wise to consult with a physician who can assess whether bracing, physical therapy or other treatments are needed.

HAND INFECTIONS

One other gardening-related risk to mention is Sporotrichosis. Also known as Rose Thorn Disease, Sporotrichosis is caused by fungus found in soil, rose thorns, hay, moss and twigs and usually enters the body through a thorn prick. The fungus is more closely related to mold found in stale bread or yeast used to brew beer than to bacteria. Once the mold spores enter the skin, the disease can take days or months to develop. The first symptom is usually a painless bump or lesion that is pink or purple in color. In most cases, the mold spreads to the lymph nodes. Over time, new nodules can develop from your fingers all the way up the arm, becoming open sores or ulcers that are susceptible to infection. The disease is rarely life threatening, but it is important to seek medical attention. Left untreated, the ulcerative lesions can develop into a chronic condition that can persist for several years. All the more reason to wear garden gloves.

(Some content borrowed from WAG, May 2, 2o17)