Oh a Resident...so...does that mean you’re a student?

As residents in the University of Wisconsin-Madison Orthopedic Physical Therapy Residency Program this is a statement that we hear quite often. The answer to this question is no as each year the resident has their degree and is choosing to do additional training. This year Advanced PTSM has two residents that are part of the UW Health partnership. Trenton Rehman is a graduate of Marquette University for his Doctor of Physical Therapy and Bachelor of Science in Exercise Physiology and Christopher Chism is a graduate of the University of Wisconsin-Madison for his Doctor of Physical Therapy degree and Concordia University Wisconsin for his Bachelor of Science in Athletic Training. We both practice at the Appleton North location of Advanced PT. In addition to seeing patients at this location we also participate in advanced training in Madison where we cover topics related to orthopedic practice with residents practicing at UW Health or a private practice in Antigo. During this time we also assist the entry level Doctor of Physical Therapy Program at UW Madison as we serve as teaching assistants in orthopedic classes.

What is a residency?

A residency is a post-professional program that one can participate in after graduation, once they obtain their Physical Therapy licensure. This program allows specialization in a field of practice and allows the resident specific skills and training beyond what is taught in the entry level Physical Therapy degree. Currently the American Physical Therapy Association only recognizes residency programs certified under the American Board of Physical Therapy Residency and Fellowship Education. There are currently residency programs in the practice areas of Orthopedics, Sports, Acute Care, Cardiovascular & Pulmonary, Clinical Electrophysiology, Geriatrics, Neurology, Oncology, Pediatrics, Women’s Health, or Wound Management. These programs offer training through a combination of clinical practice, advanced didactic training, research participation and/or teaching experiences. Residency programs can be clinical or nonclinical based, with a focus on advancing knowledge or skills within a specific specialty area of practice. Residency programs cover all the description of specialty practice areas and prepare individuals for the specialty certification exam.  These residency programs allow an in-depth immersion into an area similar to what is provided through the residency/fellowship programs which physicians complete.

Why do a residency?

Each resident has their own reason and motivation for completing a residency program. Typically, it involves the ability to gain mentorship and training from specialists with significant training in the field. This allows the resident to advance in practice over a short period of time. Essentially this allows the resident to fast track their career. It is a way to gain from the knowledge and expertise of others to reach a higher level of experience over a 1-year span than our peers (and even over those with years more experience). This program also allows a greater in-depth training and practice into a specific area, as the DPT degree at the entry level is generalist degree. A residency program allows the participant to be prepared for and sit for the Board Certification in a specific area, such as Orthopedic Certified Specialist exam we will be able to sit for next year. At times, specific future positions or aspirations require advanced specialization through a residency before a person can be qualified to apply.  

Why Advanced Physical Therapy and Sports Medicine?

There are various residency programs across the country with different formats, so selection of the perfect residency program is important. The program at Advanced PT partners with the UW Health system and the University of Wisconsin-Madison Doctor of Physical Therapy program. This program allows a unique partnership of a private practice and academic medicine. We get the opportunity to practice with autonomy at ADPTSM and have all the opportunities that a tier 1 medical system provides. Furthermore, the program offers the opportunity to teach in the PT program and complete research with assistance from some of the top researchers in the field. The position at ADPTSM is also highlighted by mentors which have significant experience in practice with specialization in many body areas and also in clinic management. The residency program has a large national reach with residents from Kansas, South Carolina, Missouri and Wisconsin in just the last 3 years. Similarly, participants of this program are now practicing across the country as their position has help provide them access to practice and leadership positions in top practices across America.

Who is the next resident and when does she/he start?

The next resident is named Johnathan (J.D.)  Freeman will be joining Advanced PT as the next UW Orthopedic Resident for the 2019-2020 year.  J.D. graduated with his Bachelor’s degree in Exercise Science from the University of Omaha, Nebraska and his Doctorate in Physical Therapy from the University of Nebraska Medical Center before applying for Orthopedic Residency. He will be starting at the Appleton North location at the end of June.

Have more questions?

Contact Trenton at TRehman@advancedptsm.com or Chris at cchism@advancedptsm.com.

Thank you Trent!

Thank you Chris!

#1 Thing You Can do to improve your PT Experience

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.

Spring Into Running

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

Let's Talk About Swelling....Glycocalyx?

Let's Talk About Swelling....Glycocalyx?

By: Teresa Iattoni MSPT, CLT, CES

March is lymphedema month, you might ask how does that impact me? Most people will experience swelling during their life, whether it is a result of an injury like an ankle sprain or a result of a chronic condition like lymphedema.  Swelling in the medical world is commonly referred to as edema.  It may be caused from a specific event or have multiple causes.  If you have swelling, you should discuss that with your medical provider.  Swelling can develop due to the following: 1) as a side effect of your medication, 2) as a symptom of a cardiac/lung/kidney condition, 3) because of diabetes mellitus, 4) secondary to a protein deficiency, 5) in the presence of venous insufficiency/varicose veins, or 6) from an infection (Stout et al., 2012). Physical and occupational therapists commonly see swelling related to inflammation from an injury or surgery, which leads to increased pain, decreased muscle activation, abnormal movement, and impaired healing.  In many cases, physical and occupational therapists can help by providing education for appropriate exercises and special treatments for swelling.

What is Glycocalyx?  First, you should understand the basics of the circulatory system.  The heart pumps the blood out into the arteries.  The arteries are linked via small blood vessels (capillaries) to the veins.  The veins take the blood back up to the heart. If our circulation was that simple it would be easy, but our bodies are extremely complex.  The third part of the circulatory system is the lymphatic system.  The lymphatic system follows the path of the veins and eventually brings fluid back to the large vein (superior vena cava).  The lymphatic system’s job is to fight infection by filtering fluid at each lymph node, to maintain the balance of fluid throughout the body, and helps process dietary fat (Lee, Rockson, & Bergan, 2018).  The glycocalyx is a protein tunnel in the capillaries that allows fluid and protein from the blood to go into the tissue spaces in our body (Hansen et al., 2015).  The glycocalyx tunnel functions as a one-way road, so what goes out cannot normally come back in.  The lymphatic system has the job of clearing the extra fluid and waste materials from the tissue space (Levick & Michel, 2010).

How does that relate to my swelling?  Your swelling is best managed by addressing the cause of the swelling and encouraging fluid return thru the lymphatic system.  In cases where the lymphatic system is not working appropriately, lymphedema can occur.  Lymphedema is a high protein swelling.  It commonly appears in arms or legs but can develop in any body part.  Lymphedema left untreated can lead to chronic large body parts, pain, limited motion, repeated infections, and to permanent thickening of tissue (Lymphedema Framework, 2006).  Advanced Physical Therapy & Sports Medicine has specialty trained physical and occupational therapists, who can provide treatment for your swelling and lymphedema, through the application of manual lymphatic drainage, compression garments, exercises, skin care, kinesiotape and pumps.   

References

Hansen, K.C., D’Alessandro, A., Clement, C.C., & Santambrogio, L. (2015). Lymph formation, composition and circulation: a proteomics perspective. International Immunology, 27(5), 219-227.

 Lee, B-B, Rockson, S.G., & Bergan, J. (Eds.). (2018).  Lymphedema: a concise compendium of theory and practice (2nd ed.). Switzerland: Springer

Levick, J.R., & Michel, C.C. (2010). Microvascular fluid exchange and the revised Starling principle. British Journal of Anaesthesia, 108(2), 198-210.

Lymphedema Framework. (2006). Best practice for the management of lymphoedema.  International Consensus. London: MEP Ltd.

Stout, N, Partsch, H, Szolnoky, G, …et al. (2012). Chronic edema of the lower extremities: International consensus recommendations for compression therapy clinical research trials.  International Angiology, 31(4), 316-329.

Athletic Trainers - An Extension of Your Health Care Team.

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

Sharing Your Goals!

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.

Come to PT First!

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

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

Photosource: pixabay

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

Finding the Balance

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