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Do You Know Your Movement Vital Signs?

movement vital signs

Do You Know Your Movement Vital Signs?

Most people think of heart rate or blood pressure when they think of vital signs. It is common to use numbers to quantify health and risk of disease. The American Heart Association encourages people to "know their numbers" referring to blood pressure, blood cholesterol, blood glucose, and weight. However, research is now showing the importance of moving properly for health. Let's take a look at some of the numbers you can use to quantify your movement health: Walking Speed Walking speed has been called the "sixth vital sign" in medical literature recently. It is easy to measure, and takes into account strength, balance, coordination, confidence, cardiovascular fitness, tolerance to activity, and a whole host of other factors. It has also been shown to be predictive of future hospitalizations, functional decline, and overall mortality. Normal walking speed is considered to be 2.6-3.1 mph.

Push Ups - Push ups are popular to build strength, but a recent study found that they can show us a lot about your heart too. Researchers found that men who could do 40 or more consecutive push ups were at a 96% lower risk for cardiovascular disease than were men who could do less than 10. The push up test was also more useful in predicting future cardiovascular disease than aerobic capacity measured on a treadmill.

Grip Strength -Hand grip strength has been shown to be strongly correlated with health. The stronger your hand grip is, the less likely you are to suffer from cardiovascular disease, respiratory disease, COPD, and all types of cancer. In the study, muscle weakness was defined as grip strength <26 kg (57 pounds) for men and <16 kg (35 pounds) for women. Grip strength below these numbers was highly correlated with an increase in disease.

Standing From the Floor - If you can't easily get down on the floor and back up your health might be in trouble, according to a study that looked at more than 2,000 people. The study asked people to go from standing to sitting on the floor and back up with as little support as needed. They found that if you need to use more than one hand to get up and down from the floor that you were 2 to 5 times more likely to die in the next 7 years than someone who can do it with just one hand, or even better, no hands at all.

Moving well is obviously important to overall health and longer life. These tests can give a snapshot of how you're doing. If you're having trouble with any of them, considering seeing a movement specialist - your physical therapist.

Content Credit : APTA PPS TOOLKIT

Photo Credit : RUN 4 FFWPU @ Pexels.com

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I Laughed So Hard that Tears Ran Down My Leg.



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Kim Johnson, MPT

If you find the title of this rings even slightly true for yourself or someone you know, then physical therapy with a pelvic specialist would be beneficial. A therapist that specializes in the pelvic floor can work with a variety of diagnoses and conditions including: pelvic pain, post-surgical care (post-prostatectomy, post-hysterectomy to name a few), pregnancy and post-partum, and by far the most widespread condition we treat is urinary incontinence.

Incontinence can present itself in a variety of ways, for example, “I only leak when I cough, laugh, or sneeze” or “I just can’t seem to get in the house fast enough when I get home.” The most common types of incontinence are stress, urge or a mix of both.

Stress Incontinence relates to physical stressors which can cause leakage. Stressors include but are not limited to: coughing, laughing, sneezing, lifting, running, changing position, and squatting down. Often times with stress incontinence there is a small volume loss of urine. Stress incontinence is typically a product of pelvic floor muscle weakness or motor dysfunction, and can be treated very successfully with conservative physical therapy.

Urge incontinence occurs when you have a very strong and immediate urge to urinate. Essentially the bladder contracts at the wrong time. Typically with urge incontinence there is a large volume of urine lost, compared to stress incontinence. Treating urge incontinence sometimes requires a combination of strengthening, soft tissue work, habit retraining, and possibly medication intervention..

Many people actually suffer from a mix of both stress and urge incontinence. Your physical therapist will work to provide a thorough physical therapy diagnosis of each individual’s situation, and together with the patient will develop a customized treatment plan based on that patient’s case. The treatment can include strengthening, bladder retraining, manual therapy, breathing work, relaxation, dietary recommendations, and biofeedback. What a person is eating and drinking can play a huge role in continence. For example, caffeine is a bladder irritant. Sometimes just removing most caffeine from a diet can calm the bladder and allow a person to sleep through the night instead of being woken multiple times to urinate. Often time people don’t consume enough water through the day and that also can cause issues. Water will dilute urine, making it less irritating to the bladder wall. This can reduce frequency, urgency and urine leakage.

Time and time again I have had people say that their leakage is “normal.” I would disagree; incontinence is common but definitely not “normal.” Just because you have had a baby or are over the age of 65 does not mean that you should have to deal with incontinence. So many men and women live their lives around their incontinence, and it does not have to be so. Therapy is a non-surgical option, which can be very helpful and liberating. Please seek out one of our Pelvic Floor therapists if you, or someone that you know, is suffering with incontinence.

For more information visit our site at https://www.advancedptsm.com/pelvic-health

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Let me give you a helping hand!

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By Jen Taber, OT, CHT

Summer is here and we are anxious to participate in our favorite activities! We often don’t think about how big a part our hands play in helping us to do those things we love. Sometimes pain can prevent us from enjoying activities to their fullest, but there are helpful tips that can be incorporated to minimize the symptoms. They are called joint protection techniques.

“Joint protection techniques are ways of doing activities so that the risk of overuse/pain is decreased. These techniques can be included into all activities and will help to reduce the stress on your joints. Joints that have already been weakened by arthritis are at risk of being damaged by stress and strain. Improper use of diseased joints may lead to impaired function and deformity.” (Spectrum Health Joint Protection Techniques handout)

For example, if you enjoy gardening, make sure you are breaking up the tasks or switching activities so that you are not constantly grasping the handles of the shovel or pinching to pull up weeds. This ensures that a variety of muscles are being used and joint surfaces do not become overly compressed and irritated. Adaptations to tools such as enlarged/padded handles or spring loaded options, can decrease stresses on the joints for those who have arthritis to accomplish tasks much easier.

Some people enjoy mowing the lawn but it can also be taxing to the small joints of the hand. Holding onto the handles for long periods of time or the vibration can cause numbness/tingling in the hands. Periodic breaks during an activity like this is important. Also, using anti-vibration gloves may be helpful in reducing the impact to the carpal tunnel area and can be found at a local hardware store or online.

Finally, you should prioritize activities you want to accomplish during the day. Consider how long the activity takes and plan those that are more difficult to do during times that allow you to take breaks. Regardless of the activity, respecting pain is of utmost importance.

Hopefully the tips mentioned above, assist you in completing the activities you have been waiting months to do! SO GET OUT THERE AND ENJOY!

Photo by Zhivko - Pixabay

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No Referral Need for PT

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By Andy Taber, PT, DPT

It still surprises me how many patients are not aware of the choices they have when seeking medical care, and in particular, physical therapy! As an advocate for my profession, I always try to be proactive in educating and informing patients of their rights when seeking medical treatment.

Under current Wisconsin law, Direct Access allows physical therapists to evaluate and treat patients without a referral from a doctor.

Historically, one of the main barriers between injured patients and proper PT services was the necessity of a doctor’s referral prior to any appointments. This extra step often prevents patients from seeking treatment from a qualified physical therapist. Indeed, each year, over 100 million Americans suffer from wellness and mobility impairments, and yet only 10% actually make their way to a physical therapy clinic. With the implementation of Direct Access, however, the process is streamlining. By placing the power directly into the hands of consumers and clinicians, direct access provides a new avenue through which a patient can receive evaluation and treatment for a host of injuries or conditions.

Put simply, Direct Access grants the patient the ability to “refer themselves” to their desired physical therapist, who may then provide evaluation and treatment without the sign-off of a physician. This may seem like a small deviation from the standard medical referral model, but in actuality, it could potentially have a profound effect on eliminating much of the bureaucratic red tape that the previous referral system was built upon. Some key benefits of this reform are as follows:

1. Direct Access eliminates the burden of extraneous visits to physicians. The referral requirement can cause delays and denials of services provided by physical therapists. These delays in care result in higher costs, decreased functional outcomes, and frustration to patients!

2. It promotes more efficient treatment by eliminating sometimes unnecessary and frequently expensive diagnostic testing, like MRI’s and X-Ray’s.

3. Direct Access can lead to both a better treatment experience and outcome for the client. Patients who visited a physical therapist directly for outpatient care had fewer visits (27%) and lower overall costs on average than those who were referred by a physician while maintaining continuity of care within the overall medical system and showing no difference in health care use in the 60 days after the physical therapy episode.

Direct Access also allows for patients to be treated sooner rather than later. Sometimes, injuries are not addressed until weeks, or even months, after originating. This may be due to patients having a difficult time getting in to see a specialist or reluctance in seeking treatment due to uncertainty on which doctor to see. Have you ever tried to “ride out” pain because you didn’t want to spend the time or money on doctor’s visits, specialists, procedures and medications? There is a better way to manage and treat your pain! In Wisconsin, the Direct Access law allows most people with most insurances to see a physical therapist without a prescription or referral from a doctor.

Physical Therapists are experts on the musculoskeletal system, including:

• Pain from muscle injuries

• Joint pain like arthritis

• Nagging back or neck pain

• Sports injuries

• Recovery from broken bones or fractures

• Post-operative rehabilitation

• Vertigo and other balance issues

• A host of other pain resulting muscle, bone and joint problems.

Physical therapists are also trained to ask the right questions, explore all possible causes, offer a clinical diagnosis and let you know if a customized PT plan is right for you - or if you should seek additional insight from a doctor or specialist. Now, most patients can see a physical therapist the same day of an injury, if desired! Treating injuries sooner will not only help speed up the healing process, but it may also decrease the financial burden of medical diagnoses that linger for longer periods of time. Research has shown that early physical therapy treatment decreases overall medical expenses in the long run, for a particular diagnosis!

If you are currently suffering from a recent injury or a nagging issue that’s been around for several weeks or months, feel free to stop by and speak with one of our therapists at Advanced Physical Therapy and Sports Medicine to determine how we can help you on your road to recovery!

Click here for a complete list of locations and therapists.

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Why flip flops may not be the best option for your feet

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If you wear flip flops into my clinic you get my ceremonial response!

I take them and throw them out onto the lawn in front of our clinic space ….  Seriously I do eventually go out and retrieve them and we have a little laugh.  There are however, some sound reasons I dislike the favorite summer footwear of the ladies and gentleman who come to see us.

   Many of the patients we see are seeking help for foot and ankle related pain or difficulty wearing certain types of shoes. The flip flop, while being easy to slide on and off and comfortable for our poor foot who has been trapped in a hot restrictive boot all winter, does not offer what a good sandal or supportive shoe offers.

   Ask yourself, why do we wear shoes? Our friends who are a part of the barefoot running trend question this all the time. But especially here in the mid-west there are reasons to wear shoes:

1)     Protection of the bottom of the foot: the shoe offers an interface between our soft tissues on the bottom of the foot (some have softer than others …. hence the term “tenderfoot “from the westerns of my childhood) and the surface we are walking on.  We walk and or run on hot, sharp, uneven or even toxic surfaces. So for this function the flip flop does provide a very thin layer of protection.

2)     Protection of the toes and top of the foot:  There is a reason folks wear steel toed work boots in industrial settings and why there is the sign in the restaurants: no shoes no shirt no service. Wearing flip flops while mowing the lawn or doing gardening for example, where your foot encounters all kinds of nasty sharp, hot or chemically irritating things is, as my father would say …. “Not real smart. “

3)     Sun protection: A recent in-service to our staff by a local dermatologist pointed out that we as therapists should screen for Melanoma (skin cancer) on the toes as well as more common areas such as the ears neck and face. This reminds us to protect the exposed tops of the toes to the dangers of sun exposure, which honestly, I never thought about.

 

4)     Shock absorption:  Depending on who you read, 2-5 times your body weight is transferred from the ground through your heel and foot. A cushioned shoe along with a healthy foot and leg absorb much of this shock and dampen it. The flip flop, especially a well-worn one offers very little shock absorbing qualities.

 

5)     Support: Our feet are a complex system of bones, muscles, tendons and the nervous system that senses as well as activates the motors that drive us through life. A proper fitting shoe helps to stabilize the foot and control excess motion by the shape of the shoe, and by controlling the heel bone which is the key that locks and unlocks the foot. The flip flop just sits under the heel; it doesn’t wrap around the heel nor does it control the heel.

 

6)     Lastly in order to hold the flip flop on your foot so it is under the foot when your heel contacts the ground you need to pull down with your toe flexors (this is the flip sound) In a regular shoe or a sandal with heel strap, the sole remains in contact with the bottom of the foot through the swing phase due to the foot being enclosed in the shoe /sandal.  This is the only time the toe flexors are on constantly instead of on and off through the gait cycle. This can create a muscle imbalance that can lead to the foot being held in a positon leading to hammer, claw or mallet toes. Also in order to be sure the sole is under the heel at heel contact (the flop sound) a person alters their stride which can impact the entire leg and lower body alignment.

   So am I going to tell my patients “You are not allowed to wear flip flops ever?” If I did, I may get run right out of the clinic.   Instead I suggest that much like cheesecake and my diet, limit flip flop wear in your shoe wear “diet. “  

So if you must wear flip flops here are my suggestions:

1)      Choose a hybrid flip flop, one that has a heel strap

2)     Use flip flops only for short bouts of walking (across the beach versus hiking down the Grand Canyon)

3)     Replace flip flops regularly to maximize shock absorption.

4)     Never wear flip flops to do lawn mowing, household cleaning or other more dangerous tasks.

5)     Sunscreen tops of toes (don’t grease the bottom of the foot however)

6)     Pack a “back up “pair of shoes to switch to at the first signs of heel, arch or toe pain.

7)     Limit wear time to short trips. If you are shopping, hiking, or touring; wear a sandal.

 

References: 

 

Zhang, Xiuli, Max R. Paquette, and Songning Zhang. "A comparison of gait biomechanics of flip-flops, sandals, barefoot and shoes." Journal of foot and ankle research 6, no. 1 (2013): 45.

Salathé Jr, Eric P., George A. Arangio, and Eric P. Salathé. "The foot as a shock absorber." Journal of biomechanics 23, no. 7 (1990): 655-659.

Photo Credit: Composita on Pixabay

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#1 Thing You Can do to improve your PT Experience

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Dealing with the pain and limited mobility associated with an injury or illness can be stressful for so many reasons. You might have questions like, “How long will I be sidelined?” and “What do I need to do to get better?” Or maybe you’re worried about how you’ll pick your children up from school, walk to the train for your commute or prepare meals for your family.

These are all perfectly normal concerns. Luckily, there are some ways that you can gain control over the situation and ensure that you return to the activities you care most about—especially if physical therapy is part of your plan.

What you can do before your very first appointment—and during physical therapy—to take control of that injury-related stress? First and foremost, it’s important to come prepared for physical therapy. And no, I’m not talking about dressing appropriately and arriving on time (or even better, 15 minutes ahead of your scheduled appointment). That stuff is important, of course, but there’s one thing you can do in the days leading up to your appointment that will set you up for success.

Any guesses? I’m talking about starting a list. What kind of list? Well, every time that you feel pain in the affected area or notice an activity that is harder than it was pre-injury, add it to the list! And the more specific you are, the better. Here’s an example to help drive this point home: Let’s say that you’re recovering from a moderate meniscus tear and you have an appointment with your physical therapist in three days. Take notes on how your knee feels first thing in the morning after you’ve been off your feet. How does your knee react when you stand up from a chair—does it feel unstable? Or do you find that you need to clutch the back of the couch on your way to the bathroom? Sharing each of these details helps your physical therapist understand your limitations beyond the injury printed on your intake form.

Now let’s take that list a step farther and add some details about the activities that you typically participate in on a regular basis. Let’s say that you normally play a weekly round of golf, spend your mornings weeding your garden or meet up with friends for a four-mile walk two evenings a week. These activities have become an important part of your life so let’s make sure that they’re factored into your list, perhaps in the “what you hope to get out of physical therapy” category. Painting a clear picture of how active you are—and what types of activities and sports you participate in—can help your physical therapist design an individualized treatment plan and to better help you on your road to recovery. Have you been to physical therapy lately for an injury? Did you find anything else that helped maximize your time in rehab or that improved communication with your physical therapist?

Borrowed from APTA PPS Toolkit March 2019.


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Spring Into Running

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Kaitlyn Smith, PT, DPT, LAT

Yes, spring is here!! Yes, we survived another Wisconsin winter! Winter is over...right? We’re all itching to get outside and soak in some Vitamin D, well I know I am at least. What better way to enjoy the outdoors than to go for a jog or run?  Yes, I said it, you can enjoy the sun, birds, trees, and flowers while running. BUT before you begin, it is very important to understand the basics of running, in order to prevent injury and set you up for success.

To simplify the mechanics of running, think of a bouncing ball. As the body lands on your foot it enables us to store elastic energy and utilize it in the following step, this is a means of conserving energy rather than utilizing a great amount of muscular force to advance the next step. With that said, there are times such as jumping, accelerating, and running uphill which require significant muscular force generation beyond what our body can store from the previous step. Our job is to put the body in the most optimal position to utilize the maximum potential of our spring-like energy (no pun intended).

When we are walking or jogging on flat ground, the body transmits forces and momentum to the tendons, which return most of that energy to the body in a cycle and repetitive motion. Win/Win if you ask me! The trick is maintaining optimal positioning even when we get tired. Proper running form is fundamental and will aid in preventing injury.

From a number of biomechanical studies, ideal running form requires: 

1.     Relaxed yet compact arms

2.     Balanced forward and upright posture

3.     Feet landing directly under your center of mass

4.     Stride symmetry

5.     Good cadence and low ground contact time

You may be wondering why or how the aforementioned requirements correlate to proper form, increased efficiency, and preventing injury. Let’s delve into more insight on how to understand the meaning behind these.

Relaxed Yet Compact Arms: Sound counter-intuitive? It is possible to relax your shoulders and upper arm musculature while maintaining your elbows in a bent position. Your relaxed shoulders will contribute to rotational flow at the shoulders which also transcends to the hips as well, leading to the “spring-like” energy to propel you forward and make running more efficient.  The arms should be compact, meaning a nice bend at the elbow. This bend should position your elbow at an approximate 45 degree angle. If you were to put a penny on the inside of your elbow, it should not fall out as you move your arm back and forth. The more movement of your forearm up and down throughout running, the more your bicep and tricep muscles have to work and use precious energy.

Balanced Forward and Upright Posture: This is what keeps your momentum going forward. I like to begin incorporating this by standing and slightly leaning your entire body forward as if you are on a ski jump (ok maybe not as far forward as the Olympians). You will feel your body want to propel forward and this is how you should feel while running. Additionally, leaning forward will help to facilitate foot-strike directly under your center of mass.

Foot Landing Directly Under Center of Mass: For all you physics fans, I like to use the analogy of a force vector to explain the meaning behind this recommendation. If the foot lands in front of the body, the force travels up through the leg and to the body. The body must then overcome this force, acting against the body, to move forward. Overcoming the force against the body takes extra energy and muscle power to propel. Instead, if the foot lands directly under the body, the force through the leg is transmitted straight up and forward to the body rather than at an angle acting against the body.

Stride Symmetry: Symmetry is incredibly important to decrease risk of injury. Inadequate load distribution between the right and left leg often leads to tendinitis along with other overuse injuries such as IT band syndrome. Despite, often-times runners have asymmetries and are unaware since symmetry is difficult to measure yourself. A trusted professional can measure and analyze your stride length, hip rotation, foot landing, specific muscular strength, and range of motion. Physical Therapists are qualified professionals who can analyze and design a treatment plan to address individual asymmetries. This may include video or visual analyzation, positional and functional muscular strength testing, and specific movement assessments.

Good Cadence and Low Ground Reaction Force: Cadence is the amount of times your feet contact the ground within 1 minute. Each person should find their individual cadence recommendation, which is based on a variety of factors. As a general rule of thumb, efficient running coincides with a high cadence. In order to have a high cadence, the time spent on each foot must be low, thus leading to a low ground reaction force and utilizing our “spring-like” energy. Additionally, ALL of the above recommendations help to achieve a high cadence. Therefore, if you begin implementing one of these recommendations, the others may fall into place as well.

Mind you, establishing and maintaining proper running form does not happen overnight, it will take persistence to develop and maintain good running habits. Quantifying your effectiveness of the above recommendations will bring enormous improvement to your running performance. Whether your goal is running for 15 minutes every day or qualifying for the Boston Marathon, having a reliable support system is strongly recommended.

References

Roberts TJ, Azizi E. Flexible mechanisms: the diverse roles of biological springs in vertebrate movement.  J Exp Biol. 2011 Feb 1;214(Pt 3):353-61.

Lyght M, Nockerts M, Kernozek TW, Ragan R. Effects of foot strike and step frequency on Achilles tendon stress during running.  J Appl Biomech. 2016; 32:365-72.

Cavagna GA, Saibene FP, Margaria RJ. Mechanical work in running. Appl. Physiol. 1964; 19:249-56.

Cover Photo by Composita of Pixabay

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Athletic Trainers - An Extension of Your Health Care Team.

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You have probably seen us. Yes, the one wearing khakis, a polo, and a fanny pack, while running across the field with scissors to assist an injured player. Or, perhaps donning our teams colors, proudly; while weathering the storm to monitor the sky with our trusty lightning detectors. The Athletic Trainer.

Often times, Athletic Trainers are mistaken for personal trainers. However, Athletic Trainers are actually an extension of your health care team! Athletic Trainers are allied health professionals who have endured diverse education and extensive hands on training that must meet the requirements of the Board of Certification Inc., while working within the guidelines put forth by state licensing board. It is these educational requirements, certification and licensure, work setting, and standards of practice that set athletic trainers apart.

While athletic trainers work collaboratively with other health care professionals, namely physicians and physical therapists, they often work independently to educate athletes on injury prevention, provide immediate and emergent care, evaluate and clinically diagnose injuries, and assist with therapeutic intervention and rehabilitation.

Recognition of the skill set of athletic trainers is the most notable reason for the rapid growth within the profession. Traditionally, athletic trainers have worked with secondary school, collegiate, and professional athletics. As valued members of the health care team, athletic trainers are extending their care to those in occupational and industrial work settings, performing arts and dance, law enforcement, military personnel, physician offices and sports medicine clinics.

Possessing the knowledge and tools to help you recover quickly, and safely, athletic trainers are health care. So – When in doubt, seek an AT out!

Cassy Timmers, ATC, LAT

Licensed Athletic Trainer

Appleton North High School

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Sharing Your Goals!

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When you kick off a new project at work, chances are you spend a fair amount of time setting and reviewing goals. These goals help you—and those you’ll be working with—get a clear sense of what you’re looking to achieve and begin to map out a plan of attack. Along with specific goals, you also probably find it helpful to set some key milestones to ensure that you stay on task and to prevent your motivation from waning.

These same principles apply when going to physical therapy for an injury. Communicating what you hope to get out your therapy sessions can help your physical therapist to individualize the treatment plan and design an exercise program that aligns with your goals. The idea is to move from “I’m here because my knee hurts” to “I’d like my knee to feel better so I can get back to doing X, Y and Z.”

Let’s talk about a concrete example to illustrate goal-setting in action: A father of three ruptures his Achilles tendon while moving something heavy at work. When he lands in rehab, he explains to his PT that he’s due to walk his oldest daughter down the aisle at her wedding in a few months. This gives the PT a specific goal—and a timeline—to aim for. Of course, not every patient has a goal tied to such a momentous occasion. It can be as simple as carrying your groceries to your car unassisted or lifting your grandchild into a high chair. Either way, it’s important to have goals—and to communicate them clearly to your physical therapist.

Your PT wants you to get better but without the right guidance from you, he might default to following a checklist and design a program that may miss your goals. Only you know precisely what you want out of PT: If you have a wrist injury and getting back to your racquetball hobby is important to you, then be specific! Another patient could come in with the same injury but have completely different goals, so guide your PT to help you achieve what’s most important.

Proper communication ensures success, and that means you can’t passively participate in your care and simply listen to what the PT recommends. Instead, communication needs to be a two- way street. So next time you’re at physical therapy, speak up: Make sure that your PT knows precisely why you’ve made the appointment, what you hope to get out of it and why it’s important to you. This information not only helps your PT make important decisions about your care but also to think of new ways to keep you motivated during therapy.

If you find yourself making an appointment to see a physical therapist for a new injury or a nagging pain, make sure that you prepare in advance. Being prepared to answer this one simple question can help to ensure that rehab is a success: What brings you to physical therapy today? After all, you wouldn’t walk into a kickoff meeting at work without first giving some thought to the goals that you planned to share with your team, would you?

Content borrowed from PPS of APTA.

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Come to PT First!

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By Bill Rein, PT, MSPT, OCA, COMT, FAAOMPT

Come to PT first!!!!

It's human nature,   when we injure ourselves we immediately want to know what we damaged.  If  we roll our ankle (Is it broken?), twist our knee (Did I tear a ligament?),  strain our low back (Did my disc just explode?).   

Two summers ago I was playing beer league softball.   In the midst of reliving my glory days I fully extended for a fly ball landing awkwardly on my right side and twisting my knee.    Not only did I badly miss the ball, I could barely walk following this incident (although a teammate told me I looked really good doing it).    Over the next few days multiple scenarios ran through my head ranging from how I would work on crutches after they repair my ACL, to how likely it was that I would end up with a knee replacement at 50.    I scheduled an appointment with an Orthopedic doctor I work with frequently and contemplated scheduling an MRI on my own.   

The next day,  after I took a deep breath,  stopped catastrophizing and thought about the situation rationally, I decided to perform some light exercise and see if I could improve my mobility and decrease my pain.     Now, mind you,  I’ve been a PT for 10 years at this point.    This is a conversation I have had with people daily for that length of time,  yet, my critter brain was in such a state of fight or flight I couldn’t see anything but the worst possible scenarios playing out.    Literally 2 days later following  a very rudimentary ROM and light closed chain strengthening regimen my knee felt like nothing had happened and I was back to embarrassing myself on the softball field.   

So, the moral of the story should be apparent , but if you are anything like the guy in this story who hurt his knee on the softball field, it doesn’t occur to you right away.   COME TO PT FIRST!       It will save you time, money and likely, pieces of yourself that you can’t get back.   

Now I know what you’re thinking and let me answer for you before you ask:  

  • No you don’t need a referral      

  • Yes,  we can order Xrays if we need to   

  • Yes, we are less expensive than getting an MRI,  Injections or surgery

  • Yes,  we are qualified and capable of recognizing when your condition would warrant you seeing your physician.

  • For Low Back and Neck issues we are qualified and capable of manipulating the spine

The fact is that there is mounting evidence that if you come to PT 1st it will:

1  Lower utilization of high-cost, often unnecessary medical services such as advanced imaging (MRI) and ER visits

2 Greatly reduce the amount of opiods prescribed to you. ( 1)

So the next time you strain a muscle,  tweak your back, or come up lame after laying out for an unreachable fly ball in a meaningless softball game,  come to PT first.    We will  get you back to embarrassing yourself as soon as possible.  

1 Frogner BK1, Harwood K2, Andrilla CHA1, Schwartz M3, Pines JM4.    Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs.    Health Serv Res. 2018 Dec;53(6):4629-4646. doi: 10.1111/1475-6773.12984. Epu

Photosource: pixabay

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