April 2019: The Female Athlete Triad

2019-04-04T20:48:49+00:00

Since April is “All About Adolescents,” we thought we would dive into an important topic that affects injury recovery in our young female population. Have you or an adolescent female you know had a difficult time recovering from an overuse injury? This young woman may be suffering from a phenomenon know as “Female Athlete Triad.”   This condition is the culmination of 3 main factors including:

Energy Deficiency

  • Disordered Eating
  • Decreased Caloric Intake
  • Insufficient protein intake
  • Disruption of hormone levels
  • Decreased micronutrient levels (iron/zinc) = anemia

Disruption in Menstrual Cycle

  • Irregular menstrual periods
  • Amenorrhea: Complete cessation of menstrual periods

Decreased Bone Mineral Density

  • Osteopenia
  • Osteoporosis

 

HOW DO THESE TIE TOGETHER?

Low energy availability for a prolonged period of time will ultimately lead to a decrease in a person’s basal metabolic rate (BMR). This BMR reduction will result in higher levels of blood cortisol (stress hormone) and decreased levels of estrogen. This decrease in estrogen will lead to irregularity or complete absence of the menstrual period. The lack of estrogen and increased cortisol will finally result in decreased bone mineral density and ultimately osteopenia (osteoporosis in severe cases).

When this energy deficit becomes a chronic issue and leads to the other precipitating factors, the young woman may experience symptoms including increased fatigue, difficulty recovering from training, delayed healing, cardiac arrhythmia, difficulty gaining muscle mass, stress fractures, as well as difficulty concentrating and cognitive issues.

As physical therapists, we are trained to recognize the signs and symptoms of the female athlete triad and treat accordingly. As part of our integrative treatment approach, we may counsel the young woman on proper nutrition, incorporating adequate rest into the training schedule, and injury prevention methods. If your daughter, sister, friend, etc., may be suffering from the female athlete triad, have them schedule an appointment at IP to begin their road to a successful recovery!

April 2019: The Female Athlete Triad2019-04-04T20:48:49+00:00

March 2019: Buff Your Cuff & Stay Out of Surgery

2019-03-08T15:16:28+00:00

 

 

 

 

 

 

 

What body part is treated most in our clinic behind the low back and neck? If you guessed the shoulder you are correct! Recent studies show that shoulder injuries and disorders make up roughly 15-25 percent of all outpatient physical therapy visits. Of these patients, we are typically diagnosing and treating conditions that include:

  • Impingement Syndrome (subacromial, subcoracoid, internal)
  • Labral Tears (SLAP, bankart)
  • Adhesive Capsulitis
  • Degenerative Arthritis
  • AC Joint Disorders
  • Scapular Dyskinesia
  • Bursitis
  • Rotator Cuff Tendonopathy
  • Rotator Cuff Tear (Partial and Full Thickness!)

When people hear or see the word TEAR, the first knee-jerk reaction is, am I going to need surgery? While surgery is an option for some severe cases, our goal at IP is to get our patients out of pain and back to their functional and recreational activities without going under the knife! With the right PT protocol, conservative treatment can be just as successful, if not more successful than surgery.

If you have been to IP for a rotator cuff tear, we most likely have provided you with an article that discusses the non-surgical approach to treatment. In this study, done by Kuhn et al. in 2013, they found that of the 452 subjects with full-thickness rotator cuff tears, 75% recovered successfully with physical therapy. With customized, appropriate therapeutic exercises, manual treatment, and compliance with our home exercise program, these outcomes are very realistic!

Another non-operative approach and adjunct to physical therapy treatment is PRP (Platelet-Rich Plasma) stem cell injections. Dr. Abrahamson of Integrative Sports Medicine can diagnose a rotator cuff tear using diagnostic ultrasound and perform either of these techniques on-site at 2020 if he deems the procedure is appropriate. This, along with the appropriate rehab protocol can significantly reduce recovery time! Read more on these procedures here:

If you’ve been told surgery is your only option for a shoulder injury (or any musculoskeletal injury), consider trying a conservative approach first! We will design a customized, evidence based plan of care to get you back to optimum performance faster!

https://www.ncbi.nlm.nih.gov/pubmed/23540577

 

March 2019: Buff Your Cuff & Stay Out of Surgery2019-03-08T15:16:28+00:00

February 2019: Bringing Function Back

2019-02-05T18:05:24+00:00

We’re Bringing Function Back.

Back pain. Most of us have experienced or at least know someone who has been affected by the dreaded sciatica, SI, disc herniation, or general low back pain. In fact, did you know that up to 84% of adults will experience an episode of low back pain at some point in their life? With that in mind, it is important for you to know that most back pain, whether acute or chronic, can be treated conservatively with PT. In this post, we’re going to debunk some of the most common misconceptions about low back pain.

MYTH: I should rest after a low back flare up or acute injury.

FACT: Light movement, walking, and restorative PT exercise will help to “pump” out the inflammation your body has produced in response to the initial injury. Laying in bed all day will lead to inhibition of lumbar and core stabilizers and overall exacerbation of symptoms.

MYTH: If I have a disc herniation (PSA: discs don’t “slip”), I am going to need an injection or surgery.

FACT: Through our use of active traction, exercise, and manual treatment, disc herniations can become asymptomatic

MYTH: I’ve been dealing with this pain for years, I doubt it’s going to improve.

FACT: At IP, we treat many patients who have dealt with chronic, severe low back pain and made huge improvements to their overall function and quality of life!

IP Exercises to Address Back Pain:

Supine Windmill: Great exercise for back pain, increased mobility and shoulder stability! Pro-tip – keep both shoulders on the ground and look in the opposite direction.

 

 

 

 

 

 

 

Prone Rudder: Another great home exercise to address low back pain and improve posterior chain activation! Pro-tip: Keep both elbows on the ground and knees and feet squeeze tight together throughout the motion

February 2019: Bringing Function Back2019-02-05T18:05:24+00:00

Invert Your Perspective in 2019!

2019-01-17T20:46:43+00:00

In our last post, we discussed the importance of SMART goal setting and ways you can prevent yourself from ditching your New Year’s resolution before Valentine’s Day. If you have been wondering what goals we have set for ourselves at IP, we are going to flip the clinic upside down! John, Alex, and Jen all want to practice their variations of headstands and handstands!

Why you ask? Here are some of the benefits of practicing a form of inversions:
1) Increased core and cervical stability
2) Trains your vestibular system
3) Increased blood flow to the brain to improve concentration
4) Decreased lymphatic pooling in lower extremities
5) Builds humility through regular mistakes and practice
6) It’s FUN!

Not convinced you want to try yet? It doesn’t have to be a scary as it sounds. At IP, we have dozens of ways to modify and add assistance to various inverted poses for you to receive the therapeutic benefits of “inverting your perspective.”

                         

Invert Your Perspective in 2019!2019-01-17T20:46:43+00:00

January 2018: Setting SMART Goals in the New Year

2019-01-10T23:33:32+00:00

Welcome to 2019!

Time for your newsfeeds, timelines, conversations, etc. to be filled with hopeful New Year’s resolutions and the clichéd “New Year, New Me” mantra. Did you know that 80% of these resolutions fail by February? You don’t have to be part of this statistic! At IP, we want to help you reach your health related goals this year. Whether you want to lose those 20 lbs you’ve been struggling with, perform your favorite activities pain free, or simply start a daily walking program, we have some helpful tools to help get you started!

First things first: Set a SMART goal

S-Specific
M-Measurable
A-Attainable
R-Realistic
T-Timely

Bad Example: I want to start working out so I can lose weight.

Good Example: Starting today, I want to walk a minimum of 10,000 steps a day and lose 10 lbs by our vacation in April.

In the “bad” example, the goal does not have a definitive timeline. How many times have you said to yourself or heard someone say, “I need to start working out.” If you do not give yourself a start day, it may never come! The first goal also does not have any measurable, specific details of what “working out” may mean. If a person has been leading a sedentary lifestyle, starting a strict exercise regimen can be daunting and lead to failure before the person even starts! By setting an achievable goal of 10,000 steps (which can be tracked with their phone, fitness band, or pedometer), the person is increasing their activity level which can eventually lead to an overall healthier, more active lifestyle and losing the 10 lbs and not just “weight” in general. Finally, make your goals realistic by keeping them smaller and setting milestones towards a bigger goal.

Setting successful goals takes practice and recognition that these goals will continue to evolve with you! Exercise and leading a healthy life is not something that is achieved and then checked of the list. Figure out what methods work for you and most importantly, find something that you will maintain! Ask your team at IP how we can help you reach your 2019 SMART goals!

IP Exercise:  Invert Your Perspective
This exercise is great for neck stability, balance and is a progressive step towards handstands! You get all the benefits of inverting while being accessible to most people. Stay tuned for handstand modifications for any level!

 

 

 

January 2018: Setting SMART Goals in the New Year2019-01-10T23:33:32+00:00

December 2018: Deck the Halls with Differential Diagnosis

2018-12-06T15:11:36+00:00

What is Differential Diagnosis?:

In the physical therapy setting, differential diagnosis involves comprehensive screening for systemic disease that may mimic musculoskeletal or neuromuscular conditions.

Why PT Should Be Your Go-To For Primary Care:

At Integrative Physiotherapy, we ensure that each patient is given a clear diagnosis and plan of care following their initial evaluation. Our therapists take a thorough, comprehensive history and perform evidence-based special tests to determine this diagnosis. If clinical red flags are suspected and your symptoms are not appropriate for physical therapy services, our team will help direct you to the appropriate healthcare practitioner and coordinate your plan of care. For confirmation of an injury or to rule out a systemic cause of musculoskeletal pain, John and Alex may also order imaging.

Some diagnoses that have been referred out for medical care include:

  • Cardiac distress
  • Kidney Stones/Kidney Infection
  • Multiple Myeloma
  • Lyme Disease
  • Gallstones
  • GERD/Stomach Ulcers

Medical management, along with our holistic treatment approach can get you back to feeling your best FASTER!

Case Example of Differential Dx at IP:

Santa sits a LOT in his sleigh. In this year’s sleigh preparation, he’s occasionally experienced a dull ache in his right shoulder.  Sometimes it wakes him during the night and he notices it when prepping presents or following a big snack of cookies and milk.

After treating it with ibuprofen and seeing his primary care physician, who ordered imaging that came back negative for a shoulder injury, Santa’s symptoms got worse…the pain intensified, he’s started having headaches a couple times a week and he felt pain more often with daily activities.

Santa then called to see Dr. John.

Dr. John got a comprehensive history; asked about Santa’s symptoms (the how, when, where and what), collects range of motion/strength measurements and does evidence-based ‘special tests’. Santa left with a clear diagnosis of cervical stenosis contributing to shoulder pain and headaches as well as gallstones… Santa was sent back to his PCP for medical management of the gallstones.

This story has a happy ending, thanks to the comprehensive differential dx process and after a few weeks of PT, Santa recovered successfully with IP’s patient-specific plan of care to strengthen and provide neuromuscular reeducation for improved posture in both sitting and standing. He was discharged pain free with a plan for how to keep the problem from returning and with appropriate medical management of his gallstones.

Although his symptoms may have indicated a possible shoulder injury, Santa was rehabilitated correctly thanks to differential dx and the IP experience, just in time for the holidays!

IP Exercise: Show Your ‘Presence’

This exercise tests your balance and give your inner ear fluid a workout (as well as your shoulders!). Stand on 2 bosu balls, holding medicine balls in each hand. Arms should be in a goal post position. Close your eyes and shake your head side to side for as long as possible while keeping your balance. Stop in the clinic to “Show Your Presence” this month for a chance to win a month free gym membership!

December 2018: Deck the Halls with Differential Diagnosis2018-12-06T15:11:36+00:00

November 2018: Fallin’ Into Fall Prevention

2018-11-06T00:19:58+00:00

Fall Into the Root of the Problem:
Falls are one of the leading causes of injuries across the ages in the U.S. However, as you likely expect…the prevalence of fall-related injuries is higher in older adults and is more common in women compared to men. Factors such as balance (vestibular), vision, and deficits in gait patterns all contribute to fall risk.

In people ages 65+ falls are a major cause of injury related to hospitalization. In this age group specifically, fall-related injuries are frequently associated with disability, loss of independence, fear-avoidance behavior, restriction in daily activities, and functional decline.

Preventing Falls (And Picking Yourself Back Up)
Maintaining an active lifestyle is one of the most effective ways to avoid fall-related injuries and to help you pick yourself back up so you don’t find yourself saying “I’ve fallen and I can’t get up!”. Consuming enough calcium (milk, yogurt, fish, broccoli…) to prevent osteoporosis and weight training for strong bones will help reduce any damage if you take a tumble. Use good gait patterns (avoid shuffling, pidgeon-toe patterns…) and don’t forget to swing your arms! The counterbalance between arms and legs when moving is imperative to promote positive gait patterns.

Fall Facts:
As we’re heading into snow season, falls become more prevalent in ALL age groups. Whether you’re snowboarding, navigating icy parking lots, winter hiking, or hanging decorations outside in slick conditions, some key approaches will help keep you strong and stable!
 Strengthen your knees
 Stabilize and strengthen low back
 Keep posterior chain active
 Maintain glute activation in ambulation (“Strong Foundations” as Dr. John likes to say!)

IP Exercise: Plow
For this exercise you need a friend, partner or friendly neighbor! (As well as slippery socks, sliders, or paper plates). Stand on the sliders and wrap the band around your friend, hold the ends of the band and bend the knees have your partner pull you – side to side and make it fun. Have more questions? Schedule today to learn more about how to move to your best self!

November 2018: Fallin’ Into Fall Prevention2018-11-06T00:19:58+00:00

October 2018: Talkin’ About TMJ – What is TMJ? Symptoms, Exercises and Treatment

2018-11-06T00:37:20+00:00

What is TMJ?

TMJ is the temporomandibular joint that hinges your jaw. Disorders of the jaw joint, muscles and nerves can be caused by inflammation, injury, and various disease processes of the joint. It presents by way of clicking, popping, difficulty chewing, migraines, mobility impairments and even ear pain, blurry vision, or shoulder pain. TMJ symptoms occur in 5-12% of the general population and are twice as prevalent in women.

How can TMJ symptoms be treated?

If you are wondering which type of doctor treats TMJ, it is important to note that you have options. Physical therapists, massage therapists, dentists, orthodontists and maxillofacial surgeons are all trained to treat TMJ disorders. TMJ pain can refer to the neck, traps, and even your shoulders!

Some Common Treatments – Can TMJ be cured without surgery?

Often times, individuals suffering from TMJ are looking for alternative options for treatment prior to committing to surgery. Thankfully, there are nonsurgical treatment options for TMJ that may help you manage your symptoms.

For some, nightguards can be used to manage symptoms. For others, sensory motor control exercises for your jaw and neck can be helpful, as well as postural re-education (have you ever done postural re-education for other body parts with Dr. John??) Your PT or massage therapists can use soft tissue techniques like dry needling (which we offer at IP!), joint mobilization, and craniosacral therapy. PRP (Platelet Rich Plasma) injections are an emerging treatment as a regenerative technique for TMJ disorders. Did you know PRP is a service offered in our space? Dr. Abrahamson offers this treatment!

Fun Fact:

Platysma – Your platysma is a broad sheet of muscle that supports your jaw. It originates from your chest and shoulders and connects directly to your skin. This muscle helps you make funny faces and when sags, can lead to what is commonly known as “turkey neck”.

 

 

 

TMJ Jaw Exercise

IP Exercise: Say “E”!

 

Dr. John’s “E!” Exercise is great for TMJ treatment – it works to activate the platysma. This jaw exercise is also beneficial for patients with cervical dysfunctions. Schedule today to learn more about how to move to your best self!

 

October 2018: Talkin’ About TMJ – What is TMJ? Symptoms, Exercises and Treatment2018-11-06T00:37:20+00:00