What is Modern Cupping Therapy?

Modern Cupping Therapy is a form of alternative therapy that has gained popularity in recent years. It involves the use of cups made of glass, silicone, or plastic that are placed on the skin to create suction. This suction is believed to increase blood flow to the area and promote healing.

Cupping therapy has been used for centuries in traditional Chinese medicine, and its modern iteration has evolved to become a non-invasive and safe therapy.

Here's what you need to know about this popular alternative therapy:

How does Modern Cupping Therapy work?

During a cupping session, a therapist places cups on the skin and creates suction. The suction is created using a handheld pump. Once the cups are in place, they are left on the skin for several minutes before being removed. Sometimes, they are moved in a very specific pattern or sequence depending on the desired effect.

The suction created by the cups is believed to stimulate blood flow to the area and promote healing. It can also help to relax the muscles, reduce pain, and improve overall circulation.

What conditions can Modern Cupping Therapy help with?

It can be used to help many different conditions including, but not limited to, those listed below:

• Back pain

• Neck pain

• Shoulder pain

• Knee pain

• Migraines

• Arthritis

• Fibromyalgia

• Lymphedema

Is Modern Cupping Therapy safe?

Yes! It is generally safe when performed by a qualified healthcare professional. Minor side effects may include mild discomfort, bruising, or skin irritation. It is important to seek the advice of a qualified healthcare professional before using cupping therapy.

Conclusion

Modern Cupping Therapy is a popular alternative therapy that has gained popularity in recent years. It involves the use of cups placed on the skin to create suction, which is believed to stimulate blood flow and promote healing. The therapy is generally safe when performed by a qualified healthcare professional and can help with a variety of conditions. However, it should not be used as a replacement for conventional medical treatment. If you are interested in trying Modern Cupping Therapy, call today and we can chat further to determine if cupping is right for you and how to work it into your treatment program.

References:

1. Wang, Sz., Lu, Yh., Wu, M. et al. Cupping Therapy for Diseases: An Overview of Scientific Evidence from 2009 to 2019. Chin. J. Integr. Med. 27, 394–400 (2021). https://doi.org/10.1007/s11655-020-3060-y

2. Mohamed, Ayman A., Zhang, Xueyan, and Jan, Yih-Kuen. ‘Evidence-based and Adverse-effects Analyses of Cupping Therapy in Musculoskeletal and Sports Rehabilitation: A Systematic and Evidence-based Review’. 1 Jan. 2023 : 3 – 19.

Trail Blazer to Trailblazer

Ray Mack is inducted into the St. Francis High School Hall of Fame by Dr. Deborah Kerr, Superintendent of Schools, on December 9, 2022

Many physical therapists have an injury story that contributes to a career path.

But most don’t include a connection to a legendary Wisconsin team whose mad dash to a national championship helped make March Madness what it is today.

Ray Mack of Advanced Physical Therapy & Sports Medicine vividly recalled a high school football injury from six decades ago that led him from athlete to athletic trainer.

“As defensive end, it was my job to get crushed first on a student body left,” Mack said. “Hurt my back and that was it. To continue participating in sports, I decided to become a student athletic trainer.”

And the rest, they say, is history. A history that includes the improbable journey with the Marquette Warriors basketball team from 1973 through 1977.

Understand that at the time of Mack’s injury, circa 1970, athletic training was in its infancy: it was the coaches who primarily handled injuries to their athletes. Outside of football hotbeds like Texas, the presence of athletic trainers was few and far between.

The year after Mack’s injury, he became the student trainer at St. Francis High School and would continue for the remainder of his high school career.

“I wanted to continue participating in sports and I had the aptitude for the health and medical stuff,” said Mack.

As a result of his performance, the St. Francis football coach obtained a scholarship for Mack to Marquette University as a student athletic trainer, which also allowed him to attend physical therapy school there. He covered multiple sports at the university including soccer, wrestling and cross country/track. Ray was also one of the first student athletic trainers for the new Marquette University's Title IX women’s sports program.

It was Division 1 college basketball, however, that powered the engine that was Marquette sports.

“I was blessed to be part of the national championship at Marquette in 1977 under legends Al McGuire, Hank Raymonds, Rick Majerus, and Bob Weingart,” said Mack. “All Hall of Fame members.”

While many know the names of the coaching legends, Mack highlighted Weingart’s impressive resume, which included 38 years as Marquette’s head athletic trainer as well as trainer for the USA track team in the 1972 Olympics.

“He was the man at Marquette,” said Mack. “Working with Bob was both an honor and an opportunity.”

It was during Mack’s senior year stint as the Warriors student athletic trainer when he was told he couldn’t continue with the basketball program during his second semester, as he was being sent to New York for his physical therapy residence—exactly when Marquette would make their run to college basketball’s ultimate prize.

Though Mack didn’t exactly appreciate the timing of the move, he later came to appreciate the wisdom of the choice his advisors made, sending him to areas that took him well beyond his identified niche in sports medicine.

“As a function of that experience, I became through my VA tenure an amputee specialist and a medical surgical clinic specialist,” said Mack. “It broadened my horizons dramatically.”

After 45+ years as a physical therapist, Mack continues to treat patients, specializing in the non-operative treatment of orthopedic-related injuries of the spine/pelvis and extremities. His personal interests are as vast as his medical pursuits and include photography, website development, history, learning theory and aquatics.

Oh, throw in mustaches and Hawaiian shirts too.

Mack described his work as an athletic trainer and physical therapist not as an occupation but a vocation, something he was meant to do in life. And while there is plenty to look back upon, there’s much more ahead.

“I'll do this for as long as I feel like I can contribute and make a difference.”

Dry Needling

Autumn Paul, PT, DPT

You may have heard about dry needling from one of your friends or family members and now you are thinking, “What is dry needling? Could I benefit from it?”

Dry needling is where the practitioner uses a solid filiform needle or hollow-core hypodermic needle (similar to an acupuncture needle) and places it through the skin and enters the muscle. The practitioner’s goal is to place the needle specifically into a myofascial trigger point (hyperactive muscle fibers).

These trigger points can be located in a tense band of muscle. For example, many people have tightness/soreness located in their shoulders/neck from the tension that they carry throughout the day.

These hyperactive muscle fibers (tense bands of muscle) can send signals to other parts of your body which are considered “referred pain”.

The goal of dry needling is to pierce these trigger points in order to allow these muscle fibers to relax, which can help reduce your pain levels.

“So what conditions may dry needling help with?”

● Headaches

● Shoulder/neck pain/tightness

● Lower back pain

● Tennis and golfer’s elbow

● Shin splints

● TMJ/jaw pain

● Plantar fasciitis

● Hip Pain

“Can any physical therapist perform dry needling?”

In order to be able to perform dry needling, the physical therapist is required to go through extensive training. This training includes studying human anatomy and hands-on practice. These training sessions are often a weekend course or even several weekend courses.

“Awesome, I want to see a physical therapist who can assess and see if I could potentially benefit from dry needling. How do I make an appointment?”

First, look online to see what location is closest to you. Then, you can request to schedule an appointment with a physical therapist who is certified to perform dry needling.

—-

References:

Firth C, Meon J, Price M, Taylor J, Grace S. Dry Needling: A literature Review. Journal of the Australian Traditional-Medicine Society . 2020;26(1):22-28. Accessed January 14, 2021.

http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143040461&site=eds-live

http://www.kinfolkwellness.com.au/dry-needling-adelaide

Baseline Concussion Testing

Ben Benesh, PT, SCS

What is a concussion?  The Center for Disease Control and Prevention (CDC) definition:

“A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.”

According to a Pediatrics study from 2016, it was estimated that between 1.6 and 3.8 million sports concussions occur annually in the United States. Concussions can happen in sport during a violent head to head collision in football or taking a charge and hitting the back of your head in basketball. They can be sustained during a whiplash-type injury in a flyer during a competitive cheer stunt or when a young athlete takes a volleyball spike to the head or face. Besides the obvious appropriate post-concussion management for these athletes, a proper baseline concussion test is key in the successful return to school and sport.

High school-age athletes are baseline concussion tested as a Freshman and again as a Junior. They are usually tested in school by their athletic training team. The group that needs the most attention are the elementary and middle school-aged children, that do not have access to athletic training staff, and do not have school-based concussion baseline testing. These kids are still playing sports, including collision type sports that put them at risk for a concussion. Over the last 7 years of treating patients following a concussion, I have seen plenty of soccer and football athletes, but have also treated basketball players, volleyball players, wrestlers, competitive cheer athletes, and even swimmers! In order to treat these patients as effectively as possible following a concussion, baseline testing is crucial.

In healthy athletes, baseline concussion testing includes concussion education, past head injury medical history, baseline ImPACT neurocognitive computer testing, baseline vestibular/oculomotor screening and assessment, and baseline balance assessment. These objective measurements will be saved and used following a concussion to determine if your athlete is back to “normal” following injury and can safely return to their sport they love to do.

In this crazy time dealing with the COVID-19 pandemic, sporting events are delayed or canceled and then rescheduled without notice. The training schedule may not be as consistent or as intense as previous years as kids are quarantined or had exposure to COVID-19 or coaches are unable to secure facilities to practice. Parents are often not even able to watch their children play sports because of spectator restrictions in gyms. All of these reasons make this year unique. But the truth is, concussions still happen during a pandemic and we need to be best prepared to give our young athletes the best care possible if they sustain a concussion.

Please contact us for more information or to schedule your Baseline Concussion Test at our Appleton North or Community First Champion Center clinics!

References

https://www.cdc.gov/headsup/basics/return_to_sports.html

McCrory et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. BJSM April, 2017

Elbin et al. Removal From Play After Concussion and Recovery Time. Pediatrics August, 2016

Building Strength

Mitchell Fromm (UW-SP) and Bryan Stuettgen, MPT

Strength is a necessary component of daily living.  Our bodies are designed to respond to stresses placed on them.  The higher the activity level, provided adequate recovery, the more they will adapt to overcome those stressors.  As we age it becomes increasingly important to maintain the recoverable level of stress that will promote growth and maintain strength to reduce injury and prevent muscle loss.

Need for Strength

Within the next 10-15 years, an estimated 30% of the US population will be elderly, putting them at greater risk of health problems and loss of function.  The US National Center for Health Statistics reports the average person spends about 15% of their life in an unhealthy state due to disability, injury or disease occurring in old age (Hunter, 2004).

Age is a major contributing factor to the loss of musculature.  At age 30 muscle breakdown begins to exceed muscle growth.  At age 50 1% of total muscle strength can diminish annually and by age 65 the rate has been found to be around 3% per year (Kennis, 2013).  This age-related loss of muscle contributes greatly to the risk of falling and injury as well as muscle strains and other injuries.  Age-related strength loss is generally characterized by reduced muscle mass and strength and is manifested by preferential type II myofiber atrophy (Hunter, 2004, Van Roie 2013).  It has been considered type II fibers are not able to be activated as well in older populations due to this atrophy and denervation.  Type II muscle fiber type responds better to weight training for strength and power for growth and maintenance over type I which is characterized by its endurance properties.

There are multiple approaches to building strength.  The muscle can advance by recruiting more of the available muscle through training.  Weight lifting or similar activity teaches the muscle to recruit more of the available fibers that exist.  To recruit and utilize muscle a nerve pathway must be available.  Weight training also builds and improves this neuro-muscular connection allowing for more muscle fiber recruitment and better precision of movement.  Another training goal could be hypertrophy or the enlargement of muscle.  Creating more muscle allows for a larger pool of recruitment, which can lead to increased strength through training.  Training cycles targeting both strength and hypertrophy should be included to maximally stimulate muscle fibers and best improve overall growth potential.

Power is lost at an even faster rate than strength.  This loss is directly related to functional ability in daily living.  A study by Pereira (2012) led to findings suggesting that training cessation up to 6 weeks is sufficient to induce significant losses in dynamic strength in 1RM (1 rep maximum weight).  To some extent, functional capacity, and especially explosive force, may be preserved after high-speed power training.  As the older population is more susceptible to detraining from missed activity due to injury or illness, power training should be considered when building an exercise program.

Loss of power generation may also be attributed to the lowered ability to create creatine-kinase during aging, a fuel the body creates and uses to generate power. Calcium release also decreases with age limiting the contraction-relaxation cycle of muscle, and inadequate protein has proven to limit growth potential as it is a staple of building and maintaining muscle.  As they say, the temple cannot be created without the bricks.  Detailing appropriate nutritional adaptations is outside of the scope of this paper, however, proper nutrition must be considered to achieve training adaptations and individual recommendations should be sought by a qualified trainer or nutritionist.

 

Strength in everyday life

Strength is a necessary component in the completion of daily tasks. Walking, maintaining an upright posture, and balance all have strength components where failure in any of the mechanisms may lead to compounding injuries.  Motions beyond them such as bending, lifting, squatting, and transporting items have requisite strength requirements for completion without injury.  The need for strength is apparent and crucial for those seeking to maintain their independence.  Being able to complete tasks unaided reduces or eliminates the need for assisted living while reducing or eliminating those associated costs.  Strength training extends the length of time a person is able to maintain independent motion barring other complicating factors.

Implementing strength training programs can have long-lasting effects.  A long term strength study by Kennis (2013) found that increases in muscle strength and muscle power after a 1-year strength-training intervention theoretically can compensate for age-related losses over 3 to 5 years. Moreover, 7 years after their enrollment in the study, participants of the {strength training intervention} group experienced a significantly lower loss in basic strength compared with the {control} group. 

 

Protocol

Muscle reductions from age are found to be due to multiple factors.  Training both the nervous system as well as targeting the muscle fibers are necessary for a successful strength program.  It is commonly accepted that strength training should be conducted by lifting above 80% of the 1 rep maximum with sets of 6 or fewer repetitions, and hypertrophic training with weights between 67-80% for sets of 6-12 repetitions.  Though these current standards are accurate for those goals, they are not entirely definite and certainly are not exclusive.  Studies conducted and compiled by Van Roie (2013) have examined the growth ability utilizing low weight high rep protocols and found hypertrophy was achievable when the training sessions achieved momentary muscular failure.  Henneman's size principle of motor unit recruitment indicates that, when a submaximal contraction is sustained, initially recruited motor units will fatigue, creating the need to additionally activate larger motor units. When the exercise is repeated to the point of muscle failure, (near) maximal motor unit recruitment will occur, regardless of the external resistance used (Van Roie, 2013).  Expanding on this, one study was conducted in which a highly fatiguing protocol of 60 repetitions at 20–25% of 1RM was immediately followed (no rest) by a set of 10 repetitions at 40% of 1RM. This mixed low-resistance exercise protocol showed interesting benefits on the dynamic strength and speed of movement of the knee extensors (Van Roie, 2013).  Those studies further showed promising results on speed of movement at different resistances, even though training was performed at a moderate speed. 

Studies conducted by Schoenfeld et al (2016, 2017) led to findings indicating that maximal strength benefits are obtained from the use of heavy loads while muscle hypertrophy can be equally achieved across a spectrum of loading ranges.  This is backed by Dr. Mike Israetel when explaining the time under tension can be equal across a range of weights, so long as the muscle fibers are brought close to or achieve fatigue.  As long as all three components (concentric, isometric, eccentric) of the working muscle are achieved through the majority of the range of motion, muscular gains have been found utilizing as little as 30% of the 1RM.  Schoenfeld’s studies contrasted volume with the analysis using binary frequency as a predictor variable revealed a significant impact of training frequency on hypertrophy effect size (P = 0.002), with the higher frequency being associated with a greater effect size than lower frequency (0.49 ± 0.08 vs. 0.30 ± 0.07, respectively).

 Methods such as these or bodyweight protocols are effective for those who are adverse to weight training or unable to due to contraindications, however, volume was the decisive factor in how much could be achieved wherein multiple sessions per week were superior to a single intense session.  Factors that must be considered when using any program or weight is the proper form and control.  Utilizing improper body mechanics can put extreme stress on the joints and swinging weights around with momentum often relates to injury.  It is paramount to only use weights that can be used in a controlled fashion.  This will not only lessen or eliminate an injury risk but subsequently result in better muscular growth as each phase of the muscle contraction and lengthening phases are used appropriately through the entire lift.  Especially in newer lifters, this means that using a lighter weight for more repetitions is the most appropriate choice.  For experienced lifters, incorporating light-weight can allow for an increase in total volume, leading to additional strength gains and improving muscular endurance.  This approach also trains the nervous system to achieve precise motion to achieve a better neuro-muscular improvement.

It can be overwhelming to begin a strength program with a vast amount of information that seems to be ever-changing.  Experts exist in these areas to assist in setting and reaching goals.  Personal trainers specialize in strength and conditioning while ensuring proper form to prevent injury.  When choosing a personal trainer be alert to their credentialing as the field is largely unregulated and there are “internet experts” who claim experience they may or may not have.  Physical therapists are experts in the non-surgical treatment of injuries or conditions.  As such they are great assets in program creation while considering prevention and treatment of injuries, especially for those with a prior history of injury.  Both the physical therapist and personal trainer should have a great working knowledge of anatomy and physiology which is critical for accurate and individualized program creation.  They often work together for the best possible patient outcome.

 

Overall

The need to maintain strength training is clear.  It is highly transferable to everyday life, the amount of which will be directly affected by the effort put into training and the program design.  Multiple programs can be implemented to retain strength, but the secondary and tertiary effects of training must be considered for the best individual approach.  The coach-client relationship should not be overlooked as it is often the largest contributing factor determining compliance and exertion in training, as any properly implemented program will have benefits over the stagnation of not completing any program at all.

Csapo R, Alegre LM. Effects of resistance training with moderate vs heavy loads on muscle mass and strength in the elderly: A meta-analysis. Scandinavian Journal of Medicine & Science in Sports. 2015;26(9):995-1006. doi:10.1111/sms.12536.

Hunter GR, Mccarthy JP, Bamman MM. Effects of Resistance Training on Older Adults. Sports Medicine. 2004;34(5):329-348. doi:10.2165/00007256-200434050-00005.

Kennis E, Verschueren SM, Bogaerts A, Roie EV, Boonen S, Delecluse C. Long-Term Impact of Strength Training on Muscle Strength Characteristics in Older Adults. Archives of Physical Medicine and Rehabilitation. 2013;94(11):2054-2060. doi:10.1016/j.apmr.2013.06.018.

Schoenfeld BJ, Ogborn D, Krieger JW. Effects of Resistance Training Frequency on Measures of Muscle Hypertrophy: A Systematic Review and Meta-Analysis. Sports Medicine. 2016;46(11):1689-1697. doi:10.1007/s40279-016-0543-8.

Schoenfeld BJ, Grgic J, Ogborn D, Krieger JW. Strength and Hypertrophy Adaptations Between Low- vs. High-Load Resistance Training. Journal of Strength and Conditioning Research. 2017;31(12):3508-3523. doi:10.1519/jsc.0000000000002200.

Roie EV, Delecluse C, Coudyzer W, Boonen S, Bautmans I. Strength training at high versus low external resistance in older adults: Effects on muscle volume, muscle strength, and force–velocity characteristics. Experimental Gerontology. 2013;48(11):1351-1361. doi:10.1016/j.exger.2013.08.010.

October is National Physical Therapy Month!

By Adam Wirtz, PT, DPT

In celebration of Physical Therapy month, I thought it would beneficial to share some facts about our profession:

Physical therapists (PTs) are movement experts who optimize the quality of life through prescribed exercise, hands-on care, and patient education.  PTs and the licensed physical therapist assistants (PTAs) may team up to provide care across the lifespan to anyone of any ability.

There are many benefits to physical therapy. Some of these include the following:

Ø It can maximize your movement. PTs can identify, diagnose, and treat movement problems.  Pain-free movement is essential for good quality of life, your ability to earn a living, and your ability to remain independent.

Ø Personalized care that meets your specific needs.  PTs design individualized treatment plans to address each patient’s needs, challenges, and goals.  PTs and PTAs improve patient mobility, manage/decrease pain and other chronic conditions, recovery from injury/surgery, and aim to prevent future injury and chronic disease.

Ø Accessibility.  PTs and PTAs provide care in a variety of settings, including hospitals, private practices, outpatient clinics, homes, schools, sports and fitness facilities, work settings, and nursing homes.  During these uncertain times during the pandemic, choosing to see a PT first can help to reduce patient traffic in physician offices.  This can allow physicians to focus more on caring for patients that are more critically ill or are at risk of becoming critically ill from COVID-19 or other illnesses such as influenza.  It also means that you do not have to risk being around patients at a hospital or clinic that may possibly be ill with a contagious pathogen.

Ø Active participation in care.  PTs and PTAs empower and motivate people to be active participants in their care.  They also work in collaboration with other medical professionals to make sure patients receive high-quality care.

Ø Reduces the use of opioids.  In certain situations, when dosed appropriately, prescription opioid medications can be an appropriate part of medical care.  However, current CDC guidelines are urging medical providers to consider safer alternatives to opioids like physical therapy for most long-term pain.  Opioids have several risks including depression, overdose, and addiction, plus withdrawal symptoms when stopping use.

Ø Avoid surgery.  Before undergoing expensive or invasive surgery, consider physical therapy first.  There is mounting evidence that physical therapy can be as effective or in some cases even better than surgery for conditions such as meniscal tears and knee osteoarthritis, rotator cuff tears, spinal stenosis, and degenerative disk disease.

Now that you are aware of some of the benefits of PT, let’s address the topic of direct access.

Did you know that you have the freedom to choose your own physical therapist?

Ø  Currently, you may be evaluated by a PT without a physician’s referral in all 50 states and the District of Columbia.  In addition, all 50 states and the District of Columbia allow some level of treatment by a PT without a physician’s referral.  This is referred to as “direct access” to physical therapy services.

Ø  Some insurance policies may require you to see a primary care provider or physician prior to seeing a physical therapist.  Also, some insurers may limit your access to preferred providers only.  Contact your insurance company to make sure you are aware of any of these policies.

Ø  If you have Medicare as your primary insurance, you are able to see a PT for an evaluation without a physician’s referral.  The PT would then send the plan of care to the patient’s physician for signature.  Once this is signed treatment can be continued.

Ø  Your physician may refer you for physical therapy that is provided in the physician’s office, or to a facility in which the physician has a financial interest.  However, you are not obligated to attend PT in any specific facility or location.  You can choose where you would prefer to attend physical therapy and which licensed physical therapist you would like to see if you have a preference.

Now that you know all about the benefits of PT and your ability to choose your physical therapist, the next time you have an aching knee, a bum shoulder, a sore heel, or an injured lower back, consider finding a physical therapist first to help you get back to moving well!

Our clinics are low traffic, safe environments that allow for continuity of care for those individuals that may not be able to get into their doctor’s office, especially during the COVID-19 pandemic.  We have implemented deep cleaning protocols and patient screening procedures to minimize the risk of infected individuals entering our clinics.

You can find a physical therapist by checking out our website at www.advancedptsm.com

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

Dennis Kaster, PT

Unfortunately, one of the best-kept secrets around, is that Physical Therapy is one of the most effective and cheapest ways to get rid of back and neck pain.  Most back and neck pain is due to muscle weakness, tightness, poor posture, or work stations that are set up poorly and put extra stress on your body.  A Physical Therapist will assess which of these issues is causing the pain and help you to get rid of it by doing things such as specific stretches, strengthening, improving posture, performing treatment to decrease pain or swelling, using better lifting mechanics, or helping you to 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 low back pain recovered much quicker, returned to work sooner and the overall cost of care was much less.   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
  
  

Pediatric Physical Therapy

By Dr. Beth Leffel, PT, DPT

If you’ve recently had a new bundle of joy you can certainly testify to the massive changes that happen in the first years of life.  But have you ever wondered if your child is where they are supposed to be with their motor skills? Or perhaps you are just curious about what you can expect them to be doing next? Most of us know the basics: roll -> sit -> crawl -> walk, but there is so much more! Here's a list of milestones you should be seeing from birth - 4 years.

0-3 Months

•     Turns head to each side when on back

•     Holds head up 45 degrees when on tummy

•     Head bobs upright in supported sitting

•     Random body movements

3-6 Months

•     Lifts chest from surface when on tummy

•     Pushes up on straights elbows on tummy

•     Rolls belly to back

•     Sits with slight support or independently for brief moments

•     Pivots around on belly

•     Actively moves head when supported in sitting

•     Head control in all positions

 

6-9 Months

•     Sits independently

•     Rolls back to belly

•     Stands, holding (may bounce on legs)

•     Pulls to stand at furniture

•     Belly crawls

•     Gets into hands and knees position

9-12 Months

•     Transitions from sitting to belly

•     Creeps on hands and knees

•     Stands momentarily

•     Cruises along furniture

•     Walks with hands held

 

12-18 Months

•     Stands alone well

•     Kneels

•     Walks without support

•     Creeps upstairs

•     Balance improves

•     Runs/hurried walk

•     Walks backward

•     Walks upstairs with hand hold

 

18-24 Months

•     Kicks a ball forward

•     Runs fairly well

•     Moves on ride-on toys without pedals

•     Walks downstairs with one hand hold

•     Climbs into an adult chair

•     Walks upstairs alone, both feet on the step

•     Walks downstairs holding the rail, both feel on step

2-3 Years

•     Jumps 8-14 inches

•     Jumps from the bottom step

•     Catches large ball, using the body to secure

•     Walks downstairs alone, both feet on the step

•     Walks upstairs with support, alternating feet

•     Able to stop and avoid obstacles while running

•     Pedals tricycle

•     Imitates one-foot standing

•     Jumps sideways, backward, and over a 2-8 inch hurdle

3-4 Years

•     Catches 8” ball with hands only

•     Gallops

•     Walks on a line

•     Stands on one foot

•     Hops on one foot

•     Jumps down from 12 inches

•     Walks up and down stairs alternating feet, without rail

When children are not reaching their milestones pediatric physical therapists are the health care providers to correct the problem. Pediatric physical therapists (PTs) work with children and their families to assist each child in reaching their maximum potential. The goals of treatment include the promotion of active participation in home, school, and community environments. Physical therapists have expertise in movement, motor development, and body function (eg, strength and endurance), this makes PTs the health provider of choice to correct delayed motor development in children.

Pediatric physical therapy is a specialized division of PTs. They apply clinical reasoning during a unique examination, evaluation, and diagnosis process. Pediatric physical therapists also have a universal ability to make exercise fun for the children in order to keep them engaged. As primary health care providers, PTs also promote health and wellness as they implement a wide variety of supports in collaboration with families and other specialists.

If you have questions about Pediatric Therapy contact Dr. Beth Leffel at Marinette or Shawano locations.

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.

Speed and Agility Training

David Reybrock, MPT

Speed and agility are primarily associated with athletes training for sport; but it also occurs in our everyday activities. We are all athletes in one form or another. Whether you are in a sport, involved in recreation, participate in regular exercise, walk a dog, or play with your children; speed and agility training can help enhance your movement skill acquisition and functional mobility.

As movement specialists, Physical Therapists can use speed and agility training to provide stability by varying speeds of motion and body position.  Everyone can benefit from improved balance, quicker feet, and faster reaction time.  Speed and agility in youth can be used for injury prevention, promote exercise participation, and improve physical fitness.  Speed and agility in elderly can be used to improve coordination, prevent falls, and maintain independent living.  Adding speed and agility to an exercise routine or treatment program can help you move more efficiently and effectively.  

What is Speed, what is Agility?

Speed is defined as the ability to move the body in one direction as fast as possible. Training for speed requires strength in the arms and legs to propel your body forward. The muscles in the back of the thigh and leg create triple extension- forceful extension of the hip, knee, and ankle joints. The gluteus maximus muscle of the hip; hamstring muscles of the knee; and gastroc-soleus muscles of the ankle are the muscles used to run faster.

Agility on the other hand, is the ability to accelerate, decelerate, stabilize, and quickly change directions with proper posture. Agility training focuses on performing a variety of movements in a quick manner. It is not simply going as fast as you can, but rather adjusting movements while going as fast and as steady as possible. Training for agility requires good balance and a strong core to support the body as it moves through all three planes of motion.

The combination of speed and agility training should be used to develop movement skills that include acceleration, deceleration, dynamic balance, and change of direction. In developing these skills, appropriate stability, mobility, and sequencing of movement patterns is important for training athletes and treating patients in physical therapy.

Here are some examples of speed and agility drills that can be used to train athletes and treat patients to be able to speed up, slow down, and change direction more efficiently:

Sprints or walking. Run or walk as fast as possible from a standing still position. The distance will vary based on ability and sport specificity. Add change of speed, stop and pivot turns, head movement, inclines or declines to incorporate agility.

High knees wall drill. With arms extended forward and hands on a wall for stability, alternate knees to hip level up and down as fast as possible. For agility, remove hands from the wall and perform with opposite arm swing and change of speed.

Static balance. Sit on a stability ball, stand with a wide or narrow BOS, or single limb stand.

Dynamic balance. Seated balance with arm and leg movement. Tandem forward walking, side-stepping, and carrying objects while walking.

Cone drill example:

Pro-Agility: 20-yard line sprint, 5-10-5
Purpose: Improve the ability to change direction by enhancing footwork and reaction time.
Procedure: Place each cone 5 yards apart. Start in a two-point stance at the starting line, the center cone. Sprint to the end line and touch with your hand. Turn back and sprint to the far cone (10 yards) and touch the line. Turn back and sprint 5 yards through the start line to the finish.

Image- https://mishockpt.com/speed-and-agility-training/

Agility Ladder drill example:

2 feet out, 1 foot in.

Image- https://i.pinimg.com/564x/97/db/15/97db15d22b150e4585a1caa89056b39a.jpg

Plyometrics: Jump, leap, and hop.

References:

Clark, M.A., Sutton, B.G., Lucett, S.C. (2014). NASM Essentials of Personal Fitness Training, 4th Edition, Revised. Burlington, MA: Jones and Bartlett Learning.