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 Diagnosis 2018-12-06T15:11:36+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 Prevention 2018-11-06T00:19:58+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 Treatment 2018-11-06T00:37:20+00:00