3 Ways Physical Therapy Can Improve Sports Performance

Sponsored and written by Des Moines University Physical Therapy Clinic

Whether you’re an athlete or a weekend warrior, physical therapy can improve performance and prevent injury. Learn more about the different types of therapy and how it can benefit you.

May Help You Avoid Future Injuries

While physical therapists help you heal and get over injuries, their expertise can also help you avoid future injuries. Your therapist does this by considering:

  • Your sport or activity’s physical demands
  • Any past injuries
  • Your weaknesses

Then, your therapist can create a custom plan for you, which includes exercises that can help you build strength and correct bad habits.

Therapists at clinics that specialize in sports injuries, use wearable technology and motion analysis to assess your unique biomechanics. These clinics often offer a running gait analysis or cycling analysis to pinpoint and correct your problematic areas.

“Every athlete wants to excel,” said Lauren Mach, Head Athletic Trainer and Physical Therapist for Des Moines University Physical Therapy Clinic.

“When we look at professional athletes,” Mach said, “they have several things in common: they work on the fundamental mechanics of their sport, participate in a strength and conditioning program, and activity engage in a recovery program to keep their bodies feeling great!”

By improving your mechanics, you’ll enjoy decreased strain and increased performance.

Relieves Pain

Athletes often have joint or muscle pain that a normal doctor can’t treat. Physical therapists are trained in a variety of techniques, which may include:

  • Manual therapy, like joint mobilization and trigger point therapy
  • Dry needling
  • Applying kinesiology tape

These techniques are used in conjunction with customized exercises to relieve pain, restore function and help you avoid injuries later.

“However, it’s important to know that these techniques alone do not restore function or prevent injury,” Mach said. “Combining these techniques with a good strength and conditioning program, as well has addressing biomechanics deficits can be extremely powerful.”

May Help You Avoid Surgery

Working with a physical therapist may help you avoid painful and expensive surgery that takes a long time to recover from.

Types of Physical Therapy

Now that you know about how physical therapy can improve sports performance, learn more about the different treatment types. These treatments are used in conjunction with special exercises and education to change your movement patterns and achieve your goals.

Manual Therapy

As the name suggests, manual therapy is a hands-on approach for healing. It’s used by a variety of practitioners, including chiropractors, osteopaths and massage therapists.

Manual therapy includes:

  • Joint mobilization and manipulation
  • Strain-counterstrain
  • Soft tissue mobilization
  • Instrument-assisted soft tissue mobilization
  • Myofascial release
  • Visceral mobilization
  • Trigger point release
  • Dry needling

Your physical therapist will select the techniques that are best for you after a comprehensive evaluation.

Dry Needling

Dry needling uses tiny needles to enter the skin and underlying tissues to treat pain and muscle impairments.

It’s often used for:

  • Neck, shoulder, hip or leg pain
  • Lower back pain and sciatica
  • Headaches
  • Overuse injuries, muscle strains, tendonitis and bursitis

Dry needling is often used along with manual therapy, stretching and strengthening, as well as movement and balance exercises.

It has been shown to:

  • Reduce pain
  • Decrease muscle tension
  • Increase range of motion
  • Improve muscle therapy

Although needles are involved in this treatment, side effects are minimal. The muscle that’s being treated will involuntarily contract, which might feel like a dull ache or uncomfortable cramp. However, the feeling is temporary and only lasts a few seconds. Your muscles might feel sore after treatment, but ice, heat, gentle stretching or massaging the area can help relieve any lingering pain.

Kinesiology Tape

If you’re recovering from an injury or have a problematic area, kinesiology tape may help. During this treatment, your physical therapist will apply strips of special tape in specific directions. This may improve mobility because it provides extra support for joints, muscles and tendons.

Kinesiology tape is different from athletic tape, which is used for maximum support and limited motion. This tape is flexible so it can improve motion, decrease pain and improve circulation.

There are some different ways that kinesiology tape is used. Here are some of the most common:

  • Improving athletic performance. Kinesiology tape can improve how your muscles flex and contract, which can boost your performance.
  • Decreasing pain. If you’re dealing with an injury, this type of tape may reduce pain and keep your muscles from spasming.
  • Providing extra stability. Dealing with plantar fasciitis, runner’s knee or a sore IT band? Kinesiology tape can provide extra support while still allowing the joint to move.
  • Managing swelling and scar tissue. Taping can decrease swelling and provide greater range of motion.

Improve Your Performance by Working with a Physical Therapist

Whether you’re dealing with a nagging injury that’s affecting being active or want to set a personal record at your next 5K, working with a physical therapist can help. They have the expertise to create a customized treatment plan that addresses problems now and in the future.

About Des Moines University Physical Therapy Clinic:

Des Moines University Clinic Physical Therapy is the exclusive provider of physical therapy and athletic training services for the MidAmerican Energy Company RecPlex. Read more about physical therapy here and for their location.

The #1 Thing NOT to do if You have Scoliosis

By Rita Miller, PT, MPT, BSPTS C2 Certified in Scoliosis Specific Exercises 

Everyone’s spine has natural curves. These curves round our shoulders and make our lower back curve slightly inward. When viewed from the side, the upper back has a normal round back or kyphosis, while in the lower spine there is “swayback”, or lordosis. When viewed from behind, a spine normally appears straight but some people have spines that also curve from side to side and rotate. This condition of side-to-side spinal curvature is called scoliosis.

Unlike poor posture, these curves can’t be corrected simply by learning to stand up straight. On an x-ray, the spine of a person with scoliosis looks more like an “S” or a “C” than a straight line. A slight curvature may be normal. Scoliosis is present when the spine has one or more abnormal curves of greater than 10°, as measured on the x-ray.

In childhood, idiopathic scoliosis occurs in both girls and boys. However, as children enter adolescence, girls are five to eight times more likely to have their curves increase in size and require treatment.

WHAT CAUSES AIS?

Adolescent Idiopathic Scoliosis (AIS) is a genetic condition, meaning it is inherited and a family may have more than one member with the diagnosis. The exact reason why the spine curves remains unknown (idiopathic). A difference in the rate of growth between the front and back of the spine is the leading theory.

SIGNS AND SYMPTOMS

Adolescent Idiopathic Scoliosis does not usually cause pain, neurological dysfunction such as weakness or numbness in the legs, or respiratory problems (shortness of breath). Most patients are highly functional and without any symptoms. 

Most patients or parents note one or more of the following changes in the patient’s appearance:

  • Chest shifted to one side
  • Head not centered over bottom
  • One shoulder blade more noticeable than the other
  • Unevenness of the waist
  • Clothes hang unevenly
  • One shoulder higher than the other
  • One hip higher than the other
  • Unevenness of the front of the chest

CURVE PROGRESSION

Although we do not know the cause of idiopathic scoliosis, we do know that curves tend to progress based on two major factors: growth remaining in the spine and the curve size. Idiopathic scoliosis curves can get larger during growth of the spine especially during the rapid adolescent growth spurt. Age, the timing of the onset of menstrual periods in girls, the status of the growth plates of the pelvis and hand are all good predictors of how much spine growth is left.

We can review these parameters to estimate the risk of curve progression in your child. Even after your child stops growing, a large curve can get worse. Generally, curves in the thoracic spine greater than 45 or 50 degrees and lumbar curves greater than 35 or 40 degrees will progress even into adulthood. When significant growth remains AND the curve is larger than these thresholds, curve progression is 100 percent.

What Kind of Non-Surgical Treatments Are Available?

Depending on age, skeletal maturity, and curve size, scoliosis has traditionally been managed non-surgically with either a “wait and see” approach if curves are under 25 degrees, or bracing if curves are over 25 and the child has yet to reach full skeletal maturity. More recently, PSSE (Physiotherapy Scoliosis Specific Exercises) have started to be recognized by the Scoliosis Research Society as an effective way to manage the effects of scoliosis during the “wait and see” period, and also during bracing. These exercises are customized for each patient to return the curved spine to a more natural position.

So what is the #1 thing NOT to do if you have a diagnosis of AIS?

Do nothing! “Wait and see” is a fine approach when it comes to certain more invasive approaches, but it is a terrible idea if you plan on a conservative treatment approach. Physical therapy and specifically, Schroth scoliosis specific exercises are proven to be a safe and effective treatment approach with little to no risk of injury. An ever increasing body of evidence demonstrates its effectiveness.

ScoliSpine (located in Boise, Idaho) is the first to be certified in a Scoliosis Specific Exercise Program in the state of Idaho based on the principles of Katherina Schroth known as the “Schroth Method.”

Katharina Schroth (1894-1985) developed the Schroth Method, based on her personal experience with scoliosis as a teen. She dedicated countless hours attempting different corrections of her curve and discovered certain positions, movements and breathing techniques which made her own torso deformity less obvious. Trained as a teacher, Ms. Schroth started sharing her techniques with patients in the 1920’s and eventually established her own clinic in Germany. Her daughter, Christa Lehnert-Schroth P.T. (www.schroth-skoliosebehandlung.de and schrothmethod.com) helped her further develop the theory underlying the Schroth Method. Over one thousand patients are treated annually at Asklepios Katharina-Schroth Klinic in Germany and there is frequently a several month long waiting list.

Courtesy of ScoliSpine

What results can be expected after completing a Schroth program?

  • Improved posture
  • Improved core stability and strength
  • Easier breathing
  • Improved overall movement pattern and function
  • Improved self-management and understanding of the spine
  • Better pelvis alignment *Depending on your age, bone maturity and the degree of curvature, bracing may also be a part of the treatment.

Schroth-specific breathing complements bracing as children are able to achieve a more balanced breathing pattern with bracing and exercise, and Schroth-specific exercises improve postural strength which may improve brace compliance and overall comfort. Adults with scoliosis can also benefit from the Schroth Method.

About Rita Miller, PT

Rita Miller, PT, MPT, CSCS, C2 Certified in Scoliosis Specific Exercises is the owner of ScoliSpine located in Boise, Idaho. Read more

Alana’s Health Journey:

The Darkness I See is Your Shadow Protecting Me

Preface: This blog post is much different than anything we have shared before. It’s a deeply personal experience from my dear wife, Alana. It touches on her near death experience and her interaction with our local health delivery system. It also exposes the problems with the response that has been taken to deal with COVID-19 pandemic. I feel that some of the response our healthcare system has decided on is definitely not in the best interest of the patient.

I often write about resilience and how it’s not just a physical characteristic. It’s comprised of emotional (psychological), mental (cognitive), social (relationships), and spiritual characteristics that are all important to one’s health and recovery. Our healthcare system is great at saving lives, but may have forgotten that these other characteristics of resiliency are just as important as the physical component to recovery.

In her recount, Alana gives strong praise to the surgeon and the team. The nursing staff did their best, but was overburdened. (It placed extra stress on them since a family member couldn’t be in the hospital room to support the patient during the COVID-19 restrictions.)

My plea for any healthcare worker out there that may read this: don’t forget the patient! You’re in healthcare to help people. We cannot neglect the mental state of our patients if we hope to have positive long term results. Let’s find a better way to keep everyone safe and to really help those in need. Our patients are likely in their darkest hour.

Humans, people, and your loved ones are complicated and so is their health. It’s not just the physical aspect of things. It’s also the emotional, mental, social, and spiritual aspects that make up a person that dictate how he/she will physically heal. It’s not just what we do for a person; it’s how we make them feel that will stick with them for a life time. There is never too much compassion for those in need. Thank you for your continued service in tireless work that you’re often not acknowledged and thanked for!

By Alana Shatto

Thurs., 5/14/20

On Thursday morning, I enjoyed a mushroom coffee blend for the first time at breakfast. Not thinking too much about it, I started getting a stomachache by lunch time to the point that I couldn’t eat. After sitting, I had trouble walking around the house. I lied down in my bed with a racing heart and chills (which was unusual for me since I can typically just push through). Ben brought home dinner, and I was able to eat. Although tired, I went to be at 9 p.m. thinking I would be just fine.

Fri., 5/15/20

I tossed and turned most of night. My heart felt like it was racing, and I had the same right calf pain that had been bothering me most nights (I struggle with tight calves and achiness in them at night). Ben got up at 5:15 a.m. to get ready for CrossFit. At about 5:35 a.m., I called out for him several times. I had severe shaking and chills, and I was having trouble breathing. Long gasps for breathe. He took my temperature, 99.1 degrees. He then got out his pulse oximeter, and my heart rate read at 150-160 beats per minute. Very alarmed, he told me that we needed to go to the emergency room (ER) and that he’d go wake up our ten year old daughter, Alexis, to get ready to leave.

He had to help me get dressed to leave. I could hardly think clearly. I could barely walk and make it out to the car. I tried to drink bottled water, but threw it up into a bag as we drove to St. Luke’s Meridian ER in the cold darkness of the morning.

Because of the COVID-19 pandemic, we had to wear masks. Ben told me that I would have to do this alone. He told me that they would be running an EKG and all of these tests to figure out what was wrong. He was sorry that he couldn’t be with me because of the visitor restrictions due to COVID-19.

I don’t really remember saying goodbye to Ben and Alexis nor did I grab my phone thinking maybe he put in my fleece jacket pocket. They wheeled me away in the wheelchair, and things got really crazy (fast)!

The fully masked staff asked me a lot of questions as they began to put in an IV in my wrist and my left inner elbow. They started hooking my body up for an EKG to check my heart. I told them about the mushroom coffee that I had drunk the day before and the symptoms from the day before. It was difficult to breathe in addition to wearing a mask and fogging up my glasses as I tried to calm down.

I was sure I had COVID-19 and would be one of the random younger adults that suffered from cardiac arrest due to it. I thought to myself, “This is the end. I’m going to die alone.”

I could hear the whispers in the hall of the staff going over my symptoms. A man’s voice asked, “Did you hear her cough?”

I thought back earlier in the year…

Alexis, always healthy and strong, had gotten sick on Valentine’s Day, 2/14/20. Over the following six weeks she was diagnosed with adenovirus, pink eye, mono, and an ear infection! A crazy series of illness that kept us home long before the quarantine / stay at home order. I had wondered if we had already had COVID-19, just before all of the fear and testing. I thought this was it; we were through all the illnesses. I had thought we were on the up and up…just in time for summer.

Over the course of the next few hours I was tested for the following:

  • COVID-19 – Rapid 30 minute testing in which a nurse shoved a 14 inch long looking swab up into my left nostril until it hit the sinus cavity.
  • Cat Scan – Chest view as they suspected a blood clot in my lungs or possible pneumonia.
  • Virus Swab – Another test in which a nurse shoved a 14 inch long looking swab up into my right nostril until it hit the sinus cavity. She later came back to tell me that there was a problem with the swab, so I bared it again in my right nostril for a total of three times.
  • Cat Scan – Abdominal view as they hadn’t quite figured out the source of the infection.
  • EKG – Second test to confirm that my heart was functioning and not enlarged.

Of course, all of these tests take time as I’m wheeled on the hospital bed back and forth to get the CAT scans. It’s one heart pounding moment after the next…

“You might have a blood clot in your lungs or you may have pneumonia.”…BUT YOU DON’T.

“You might have COVID-19.”…BUT YOU DON’T.

“Your heart is fine—normal and not enlarged.”

Probably between 9 and 10 a.m., the radiology report came back that they had found the source of the infection:

APPENDICITIS

“Whoa, what?!” Where did that come from?

The ER doctor continues on to say that I have an inflamed appendix and that it needs to come out. There is no other treatment—just surgery.

I think we were all a bit dumbfounded as I didn’t arrive in the ER with right lower quadrant pain, so I wasn’t fitting the medical diagnosis for appendicitis.

After all of the ups and downs, I wasn’t sure about how I felt about going into surgery alone. I knew I didn’t have a choice. I had only been under anesthesia once before for my wisdom teeth to be pulled. I had only been to the hospital to deliver Alexis (natural childbirth). Why at 41 years old am I sitting in the ER with appendicitis?!

“This is the end,” I thought to myself. I’m going to die alone and not even have a phone to call on.

Luckily, at that point the nurse gave me the hospital room phone to call Ben once we discovered that I didn’t have my iPhone in my fleece jacket pocket after all.

The ER doctor had called Ben previously, so he somewhat knew what was going on. I was able to tell him myself about the appendicitis and the surgery. We spoke a few times before I was moved to Pre-Op. At that point, we knew that they were admitting me into the hospital.

Although the staff at Pre-Op was caring, things got worse after giving a urine sample (to make sure that I wasn’t pregnant). I started getting chills no matter how many warm blankets I was given. Between talking to the anesthetist and the surgeon, I was nauseous and dry heaving.

Finally by 12:30 p.m., I was wheeled into the operating room and transferred to the table.

I don’t remember anything after that besides music playing the background.

When I came to, I was struggling to breathe. The breathing tube was still in my throat—I couldn’t move my left hand or speak…An orange plastic cover was over my face. Then things went black again.

I woke up in the recovery room after that. It was likely after 3 p.m. At some point, the surgeon came in to speak with me. He told me that they had removed my appendix, but that there was vein that ran along side of the appendix that had pus which had been sending bacteria through my bloodstream and the appendix was leaking into my abdominal cavity, sepsis! They had cleaned out my innards with saline and an antibiotic solution and had given me 6 liters of fluid since coming to the ER to keep me alive. I would stay at the hospital with intravenous antibiotics.

I don’t remember too much about Fri. night other than I cried on and off. Overnight, I experienced chills, shakiness, and changes in my breathing. Although the night shift nurse consoled me by telling me that this was common with sepsis and after surgery, I felt utterly alone. Again, with the COVID-19 pandemic the hospitals are not allowing any visitors at all.

God was silent though I continued to pray. The darkness of the night overwhelmed me. I was experiencing nighttime terrors. I saw black flashes and movements throughout my empty hospital room. When I closed my eyes, I saw the cloaked Grim Reaper face. I jolted in and out of rest. Darkness like a black ink spilled surrounded me…

Sat., 5/16/20

The morning went poorly. I cried with the surgeon when he came by making his rounds. He had warmth about him and a caring spirit. He told me to expect a three to five day hospital stay.

My best friend Mandy called me on the hospital room line before noon, and I wept with her. I also spoke to my mother-in-law, Debbie, who encouraged me and prayed over me. I spoke briefly to my parents, but the hospital telephone line was low and muffled, making it difficult for people to hear me and for me to hear them.

Once Ben knew that I was staying, he arranged a drop off of my phone and a change of clothes to wear home at some point. He had to package everything up in a plastic bag and drop it off with the guard station at the hospital. Although he was physically there, he could not come to room to see me, encourage me, and pray with me because of the visitor restrictions due to COVID-19. My mental health upon arrival up until now remained poor as I felt so alone.

It was an instant boost in moral to have my phone again and to be able to text. Now I didn’t feel as alone.

In the afternoon, I walked the hospital hallway slowing pushing my IV machine. I started to feel better, but how strange it was to walk the halls of the 6th floor wing and see all these other patients alone in their rooms and in their beds…no friends, no family, no support.

I had previously heard Code Gray announced over the hospital’s public address system, possibly indicating the need for an emergency management response to a combative person with no obvious weapon. I had also heard Code Blue indicating a medical emergency, possibly involving cardiac or respiratory arrest. My heart broke for these patients as they were miserably alone as well.

I dreaded the darkness of the approaching evening…

Early morning on Sun., 5/17/20

Although exhausted and not feeling well, I drifted off to sleep in-between the nurses waking me up to check my vitals or to replace my IV bags with medication. The night terrors returned after 2 a.m.

I laid silently in the hospital bed with tears streaming down my cheeks. I sang, “Come, Holy Spirit.”

The lines of the song, “Way Maker”, filled my head:

You are
Way maker, miracle worker, promise keeper
Light in the darkness
My God, that is who You are

I called out upon the name of JESUS to reprimand the evil spirits. Quiet tears streamed down my face.

Jesus’ voice told me to call out for prayer…breaking the silence I had endured.

I put on my glasses and grabbed my phone. I fumbled to Vineyard Boise’s Facebook page and started my prayer request:

“Prayer request: I had emergency surgery to remove my appendix on Friday. I was already sick beforehand, but I had no idea that I had a serious infection. I have sepsis, bacteria in my bloodstream. Because of COVID-19, no hospital visitors, so Ben and Alexis can’t be here with me. Please pray for healing and a complete recovery so that I am strong and can go home to be with my family. Thanks”

Within in moments of publishing, I was surprised to see that a couple of ladies had already responded and starting praying for me! Wow—people really are awake and on Facebook at all times of the day! Hopeful, I shared the same call for prayer on my personal page.

Setting my phone aside, I laid there thinking, “OK, at least two people are praying for me, and I’m not alone.”

I felt a presence of an invisible scan come over me. It started above my head and traveled across my body to my toes. It was like a sheet pulled off of me from top to bottom. He knit me back together. And I felt peace and drifted off to sleep.

6 a.m.

The hospital room lights glared on! The blood lab technician stormed in (like the previous morning without warning or easiness) with his equipment to draw my blood. I was startled awake.

After he left, I popped up out of the hospital bed and start my bathroom routine. I ordered my breakfast (vanilla pudding and hot tea) at 7 a.m. and was sitting down to eat when the nurse came in.

She was surprised to me eating at the shift change. She said she’d never seen anyone up like that before.

I was up and around until about 10 a.m. I walked the hallway pushing my IV machine. I felt like I had turned the corner. I felt like myself again.

By 11 a.m., the surgeon and his physician assistant (PA) came by during their rounds. The surgeon reported that my 6 a.m. blood test results had come back completely normal! The white blood count was normal. I was only minor low on potassium.

He had expected me to stay in the hospital at least through Mon. and possibly until Wed.

He told me that he had been practicing since 2006 (14 years) and never seen a case like mine before. I was in serious sepsis shock prior to surgery to remove my appendix. They had to pump me full of 6 liters of fluid to keep me alive.

If I hadn’t have come to the ER when I did, I would have died. Ben could have left for CrossFit. I could have died alone in bed while Alexis was asleep in her room.

The surgeon and his PA were warm, caring, and encouraging. He discharged me from the hospital on Sun. afternoon. We addressed my swelling: my stomach, thighs, and ankles were very puffy. He told me that I’d pee out all of the fluid within a couple of days.

I was able to independently shower, dress (though my normal clothes felt tight), and pack my own belongings. I made sure to request my medical records for the hospital stay.

Ben and Alexis got all of my prescription medication (including an 8 day course of two antibiotics) and met me at the hospital parking lot sometime after 3 p.m. It wasn’t all smooth sailing after that. I had nausea from being pushed (way too quickly) in the wheelchair, being in the elevator, and during the car ride home to the point that I had to take the anti-nausea medicine in the driveway.

It wasn’t until I saw my picture that Ben took of me at the hospital, that I realized how swollen, fat, and ugly I felt, but I was alive. It hadn’t dawned on me that I was having trouble moving around due to the water weight gain. Turns out I put on 15 lbs. of swelling while hospitalized. I was worried about how Alexis would “see” me after such a traumatic event for her to witness.

It was later that day that I found out that Ben awoke at that same time (Sunday morning at 3 a.m.) to what sounded like dropping marbles, so he laid awake in bed praying for me. My brother-in-law and sister in-law were awake with their almost 2 ½ year old praying for me at the same time. It turns out that hundreds of people (I didn’t even personally know) began to pray on my behalf throughout Sun.

I won’t lie and say that everything was fine after that because it wasn’t. I had jittery chills and a terrible night of sleep. I was worried about my breathing and my heart rate and that I’d have to go back to the ER. I second thought my decision to come home—knowing the stress and pressure it placed on Ben and Alexis.

Mon., 5/18/20

That Mon. morning, God met me in my devotions that I get automatically emailed every day. It was exactly what I needed to hear, and it encouraged me to keep going.

But he knows the way that I take; when he has tried me, I shall come out as gold. My foot has held fast to his steps; I have kept his way and have not turned aside. (Job 23:10-11)

Later in the day when Ben heard me sneeze or cough, he couldn’t believe that I didn’t have pain my abdominal area. He said that he figured I would be doubled over in pain, but I wasn’t. I told him that I couldn’t believe it either. I truly believed that God had knit me back together.

Thurs., 5/21/20

Unfortunately, I hadn’t lost any of the swelling within the predicted time frame. After speaking with the surgeon’s nurse, I was given a three day course of Lasix, a prescription diuretic that causes you to pee more in order to help your body get rid of extra water.

During that phone conversation, I was given the pathology results: no cancer and no tumor were found in my appendix. The bacteria culture showed that I had an E. Coli (a type of bacteria that normally lives in your intestines) infection. I was on the correct antibiotics to treat the infection.

Luckily, the Lasix worked and by Sun., I had lost 19 lbs. and had minimally swelling in my feet!

LEFT: Sun., 5/17/20 Hospital Discharge with 15 lbs. of water weight gain. RIGHT: Sun., 5/24/20 One week later and 19 lbs. lighter!

In summary, my recovery has been slow and steady. The three laparoscopic incisions on my lower abdomen are slowly healing. The bruises are fading. The nurse said that it could be another one to two weeks before I have my energy and appetite back. I know I’m on the right track though the CAT scan showed that I have a nodule on my thyroid that needs to be further looked at by ultrasound. My thyroid lab tests result fell within the normal range, but it needs to be further followed up with my general practitioner.

It was the worst time amid the COVID-19 pandemic to have an emergency surgery and lonely hospital stay without Ben or Alexis, but I made it and truly appreciate all of the prayers and support we have received…Family and friends brought delicious meals, beautiful flowers, and get well cards. I appreciated the encouragement amidst the struggle.

My story did not end on 5/15. I was lucky to have been given another chance as I know that many others in the hospitals, nursing home, and assisted livings have faced death alone with family outside the window or building because of COVID-19 restrictions. I’m truly sorry for those who have endured such horrendous circumstances.

Although I am still grappling and processing through all that has happened, I have gained a fresh clarity of what is important and what I need to let go of. I hold my relationships with family and friends dearly to my heart. I let go and released my hand of anger, control, and perfectionism. It no longer served me. I feel as though I have been given the opportunity to push a giant “RE-SET” button. I’m more mindful of my thoughts, behaviors, and even the food I’m willing to reintroduce. I have given up my coffee for now as the caffeine seems to directly affect my heart rate at rest, causing it to push near 100 beats per minute, where 60 is typically normal for someone my age.

Should you find yourself or a loved one in a similar situation one day, I hope my honest and candid sharing of my health journey might help you or your loved one through the process.  Mental and spiritual health is so important to recovery and resilience. Forced solitude is very difficult to bear even in short situations and especially, when battling an illness. Any kind of interaction is precious and helpful.

Hold fast. Stay strong.

Take the time to focus on your health and recovery. Often, small changes in your diet, activity level, and relationships can make a big difference. You can take control of your health and your life!

Reach out to others for support. No matter how you feel or where you find yourself, YOU ARE NOT ALONE. God Bless You!

Remember what you’ve learned about the Lord through your experience with Him. (Deuteronomy 11:2)

If you do that, our messes will become our messages.

Osteoarthritis vs. Rheumatoid Arthritis

What’s the Difference?

By Dr. Matthew Crooks

Arthritis is a condition involving tenderness and swelling in your joints, and it’s often coupled with inflammation as well. With over 100 different types of arthritis, the two most common forms are Osteoarthritis (OA) and Rheumatoid Arthritis (RA). Both of these involve inflammation in the joints; however, learn how these conditions differ.

Breaking Down the Differences

The main differentiator between Osteoarthritis and Rheumatoid Arthritis is that RA is an autoimmune disorder while OA is a degenerative disease. Another major difference between the two is that RA is a type of polyarticular arthritis meaning that it affects multiple joints as well as different sides of the body. Osteoarthritis affects only a few joints and just one side of the body.

Autoimmune

An autoimmune disease is one that causes your body to think there is an issue in a particular area. As a result, it attacks and damages healthy tissue. In the case of RA, it causes your body to attack the tissue surrounding the affected joints. Your immune system will produce antibodies that will attach themselves to the joints. Your body will then attack these joints which then cause inflammation, swelling, and pain in the area.

Degenerative

Being a degenerative disease, OA is one that affects you as you begin to age as well as prolonged wear and tear on your joints. Over time, the protective cartilage that pads and protects the ends of your bones begins to wear down. As this cartilage begins to wear down, the bones within the joint will start to rub together, resulting in pain and stiffness.

Osteoarthritis Symptoms:

Pain and stiffness within the joints are the most common symptoms of Osteoarthritis. These two symptoms typically appear in the morning or after a period of rest.

Some other symptoms that you will notice with OA: 

  • A limited range of motion or stiffness that tends to go away after activity.
  • Clicking or cracking sounds when bending a joint.
  • Mild swelling in the joint area.
  • Tenderness to touch.
  • Pain in the joint that gets worse with activity and at the end of the day.

The most common areas that are affected are hands, fingers, knees, hips, and spine. Over time these symptoms will increase and build up rather than show up suddenly and out of nowhere. However, if the stressors that are causing the wearing and breaking down of the joint cartilage are continued, you may notice a sudden increase in the symptoms.

Rheumatoid Arthritis Symptoms:

Like Osteoarthritis and other forms of arthritis, pain and stiffness will be associated with Rheumatoid Arthritis. Besides this, RA will bring with it: swelling; tenderness; and more than one joint that is affected or the same joint on either side of the body is affected. Fatigue and loss of appetite can also be symptoms of RA.

Other areas of the body can also be affected when dealing with RA besides your joints. The prolonged inflammation that comes with the disease can cause the following:

  • Dryness, pain, and redness in your eyes.
  • Dry mouth.
  • Gum irritation.
  • Small lumps under your skin called rheumatoid nodules.
  • Shortness of breath.
  • Anemia.

Osteoarthritis Prognosis

The prognosis for those with Osteoarthritis will vary from person to person and case to case. There are some cases where patients will not be adversely affected much at all by OA while others are severely affected. The fact that it’s a degenerative disease carries the assumption that the condition will continue to get worse over time.

While this is the case with some patients, other times the disease tends to stabilize at a certain point. While some patients will eventually need to undergo some sort of joint replacement surgery, it’s rare for the condition to progress enough for this to be the recommended course of action.

Osteoarthritis is not a condition that can be reversed. However, it is a condition that can be treated. When experiencing symptoms of OA, limiting the activity in those joints and the amount of stress you put on them will help. The most effective strategies you can take are to maintain a healthy weight and exercise regularly.

Rheumatoid Arthritis Prognosis

In the past, Rheumatoid Arthritis carried a more negative prognosis than it does today. Typically, patients can now live a productive and healthy life while continuing to go to work, school and partake in social and physical activities.

Like most conditions though, the prognosis will vary from case to case. In some patients, the symptoms will go through periods of dormancy while others will experience chronic symptoms. In some severe cases, life expectancy can decrease but this is not as common.

Common prognoses associated with RA include: persistent joint inflammation; a decline in mobility/range of motion in the affected area; and pain and stiffness that does not improve with treatment.

Like OA, it can affect other areas of the body as well, outside of the joints. Some patients will experience psoriasis; heart disease; eye inflammation; osteoporosis; anemia; respiratory complications; and depression. Patients with RA will need constant medical care and should be in contact with their primary care physician as well as a rheumatologist regularly.

Treatment

While both of these conditions are chronic and neither can be cured, both are treatable. Treatment can make living with the disease more comfortable (and in some cases, normal).

Reducing inflammation is an important part of treatment. A doctor may suggest anti-inflammatory drugs which will also alleviate the pain and stiffness in the joint. Other forms of treatment are physical therapy or injections depending on your specific area of pain.

Increasing the mobility and range of motion in the affected area will help slow down the progression of the disease. It’s important to be in contact with your doctor if you are experiencing any of these symptoms. There are always options to improve your quality of life.

For more information on RA and OA, please refer to Q and A: Exercises Beneficial to Managing Rheumatoid Arthritis and 4 Key Strategies for Preventing and Treating Osteoarthritis.

About Dr. Matthew Crooks

Dr. Matthew Crooks is a double board certified, fellowship trained interventional pain specialist. He has had the distinction of training with leading experts in pain medicine at two of the nation’s top hospitals, with extensive training in acute and chronic pain management, completing residency in Anesthesiology at Johns Hopkins Hospital. While at Johns Hopkins, he had the honor of being selected Chief Resident of the Department of Anesthesiology and Critical Care Medicine for the 2008-2009 year.

 

How Neurological Conditions Affect Body Movements

While basic movements may appear simple, any movement is the result of a complex process involving communication between nerves, muscles, and several parts of the brain.  Nerves of the spinal cord modulate the constant flow of information between brain and muscles, regulating all the elements associated with smooth action.  Movement disorders result from changes to specific regions of the brain or nervous system.  An assortment of neurological conditions affects body movements, and many of them worsen over time.

If troubling symptoms are present, it’s important to see a doctor as soon as possible.  Early treatment can slow disease progression.  Specialists help patients to manage pain and symptoms in order to improve their quality of life.  To help you determine if you or a loved one might need to visit a specialist, we’ll take a look at the characteristics of some of the most common movement disorders.

Parkinson’s Disease 

Parkinson’s Disease is a progressive disorder caused by a combination of genetic and environmental factors.  Degeneration of nerve cells in the substantia nigra, a part of the brain controlling movement, causes cells to die or become damaged, losing their ability to produce dopamine.  The symptoms of Parkinson’s include rigidity, bradykinesia, akinesia, tremors, and postural instability.  Rigidity and the ensuing jerky movements occur when muscles are resistant to movement.

One of the classic symptoms of Parkinson’s is bradykinesia or slow movement.  Bradykinesia is characterized by a slow, shuffling walk.  Eventually it leads to akinesia, the loss of movement.  Tremors are frequently rhythmic and can briefly disappear during movement.  Postural instability manifests in stooped posture and sometimes a forward or backward lean, which can potentially lead to falls.

Huntington’s Disease 

Huntington’s Disease is a progressive, degenerative, and fatal condition caused by deterioration of nerve cells in the brain.  It causes uncontrollable jerking movements in the arms, legs, torso, and face.  Other difficulties include rigidity, abnormal eye movements, impaired speech, and trouble speaking and swallowing.  Huntington’s is an inherited disease.

Lou Gehrig’s Disease / ALS (Amyotrophic Lateral Sclerosis)

Lou Gehrig’s Disease is a rapidly progressing disease that attacks nerve cells controlling voluntary movement in the arms, legs, and face.  It leads to difficulty with walking and posture, tripping, weakness, slurred speech, and muscle cramps.  Eventually, the patient loses strength and the ability to move arms, legs, and body.

Tourette Syndrome 

Tourette Syndrome is a hereditary neurological disorder characterized by tics, which are repetitive, involuntary movements and vocalizations.  Examples of motor tics include blinking, grimacing, and shoulder shrugging.  Common vocal tics are throat clearing, grunting, coughing, and sniffing.

Tardive Dyskinesia 

Tardive Dyskinesia results from prolonged use of medications prescribed for the treatment of psychiatric conditions, including some types of antipsychotics and neuroleptics.  It’s characterized by involuntary movements such as grimacing, lip smacking, eye blinking, and rapid limb movements.  In some cases, tardive dyskinesia can be reversed after usage of the drug is terminated.

Ataxia 

Ataxia is a degenerative disorder caused by damage to the cerebellum, a part of the brain that controls voluntary movement.  It results in loss or decrease of control over fine motor skills.  Patients frequently display an unsteady gait, clumsiness, poor coordination, and eye twitching.  Walking, writing, and eating with utensils may become challenging.

Spasticity 

Spasticity occurs when injuries or a neurological disorder damage the pathways controlling voluntary movement.  Frequent culprits include multiple sclerosis, cerebral palsy, spinal cord injuries, strokes, and traumatic brain injuries.  Spasticity manifests in increased muscle contractions that cause stiffness, which then interferes with movement, speech, and walking.  Symptoms may not always be present; they can be brought on by rapid movement or sensory stimulation.

Essential Tremor 

Essential Tremor is an uncontrollable shaking or trembling, typically in one or both hands or arms.  It worsens with movement and can be absent at rest.  While Essential Tremor isn’t life-threatening, it progresses over time.  If symptoms become severe, they can interfere with holding things, eating, putting on makeup, shaving, writing, and even talking.

Dystonia 

Dystonia is caused by abnormal functioning of the basal ganglia, a deep part of the brain that helps control the coordination of movement.  Prolonged bursts of electrical activity create sustained, directional movement, which differs from the rhythmic back and forth nature of tremors.  Symptoms include uncontrollable twisting, repetitive movements, and abnormal posture.  Dystonia can affect the arms, legs, torso, eyelids, and vocal cords.  Its intensity increases during periods of stress and fatigue.

Restless Legs Syndrome 

Restless Legs Syndrome is a disorder of the nervous system that causes abnormal, uncomfortable sensations in the legs while lying down or relaxing.  Only movement relieves the itchy, pins and needles feeling.  While symptoms can come and go, they’re generally worst at night, leading to sleep issues.

Multiple System Atrophy (MSA) 

Multiple System Atrophy is a rare disease, a progressive and degenerative disorder that affects movement and involuntary bodily functions such as blood pressure.  MSA shares many characteristics of Parkinson’s, such as slow movements, rigid muscles, and poor balance.  Other symptoms include loss of coordination and difficulties with speech and swallowing.  MSA is eventually fatal.

Myoclonus 

Myoclonus, a muscle twitch, is a symptom rather than a disease itself.  It occurs when a muscle or group of muscles suddenly begins to twitch or jerk.  While hiccups are a completely normal, healthy form of myoclonus, episodes can be much more serious when caused by an underlying condition such as epilepsy or nervous system disorders.

If you suspect a movement disorder, a diagnosis can be made through magnetic resonance imaging (MRI), positon emission topography (PET), electromyography (EMG), and movement neurophysiology.  While there may be no cure, specialists can minimize symptoms and relieve pain.  Treatment options include medication, physical or occupational therapy, Botox injections, and a surgical procedure called deep brain stimulation.

Physical therapists assist patients by working with them on fall prevention, mobility, balance, walking, transfers, and posture re-education.  Occupational therapists help with daily activities such as dressing, feeding, grooming, bathing, and using the toilet.  An occupational therapist might work with a patient on skills including handwriting, computing, housework, and phone usage.  The goal of both physical and occupational therapy is maximum independence and quality of life.

This post was written by GSC Therapy and highlights many of the most common neurological conditions that may affect body movements.  Physical and/or occupational therapy can be a critical component in assuring that you maintain a maximal level of function and independence in order to age well even if you’re experiencing complex neurological conditions.

For more information on how to age well and how to self-treat and self-manage many of the most common musculoskeletal, neurological, and mobility related conditions, be sure to subscribe to my e-mail list and follow me on Facebook by liking The Physical Therapy Advisor!

About GSC Therapy

GS Consulting Group, LLC, was founded in 1997 by Gilbert Smith to provide vocational rehabilitation, job development and placement services and to consult with industry on services including job analysis and pre-employment testing.  In 2000, Kris Smith joined Gilbert and GSC Therapy Services was added to provide outpatient orthopedic therapy and industrial rehabilitation services.  GSC Therapy’s goal is to provide all of our patients with a positive therapy experience.  Feel Better.  Be Healthy.  Live Life.  www.gsctherapy.com

Outsmarting Dementia: 5 Techniques for Giving Your Brain a Boost

No matter your age, it’s never too early to begin the fight against dementia. The good news is that it’s easier than you might think. The better news is that there are all kinds of ways to do it, no matter what your interests are! Here are just a few ways you can make the most of your mental workout:

If you’re active (or want to be), combine physical and mental workouts.

Physical exercise is a vital component to total health, and it can even have positive effects on your mental wellness. If you’re already an active person or want to start getting more exercise, combine your efforts! Try going for a walk in the park and issuing yourself mini challenges: how many trees have moss — now what’s the percentage? The ratio of moss to barren trees? If you’re more on the creative side, find objects in nature and find the most accurate color: is that bird in the tree periwinkle, or is it more of a deep sapphire? Maybe it reminds you of the color of the ocean, or of a favorite piece of clothing from long ago. Try thoughtful and engaging challenges.

If you’re bored, play a game.

Some people enjoy having an activity to do every afternoon, evening, or in whatever spare time they find throughout the day. There are lots of card games you can play that can boost memory, require strategic thinking, and many require basic addition and math skills. You can play a game of memory or solitaire on your own or invite some friends over for a group game. Board games are another great option if you have plenty of people to play, but cards tend to be an easier, more portable option.

If you’re a problem-solver, try a puzzle.

Classic jigsaws are a fun, quiet way to work your brain, and like cards they can be done on your own or with loved ones. If dexterity is a problem, there are easier versions you can play online or on a tablet. If sudoku is more of your style, you can find endless options online, and often in local and national newspapers. Try to devote a little time each day, even if it’s just 15 minutes on the puzzle every afternoon.

If you’re on the curious side, learn something new.

For many people, learning is the greatest experience of them all. You probably have a giant list of things you’ve been meaning to research, skills you’ve wanted to acquire, and interests you’ve wanted to pursue. So try one! Maybe you want to learn another language, or take an art class down the street. Even taking a class at a local college could be a great way to get a fresh lesson, and local community centers might offer free or low-cost options.

If you’re adventurous, try a completely foreign experience.

Maybe you’ve always been a thrill-seeker, or after a lifetime of being cautious you’re ready to break out of your comfort zone. Research has shown that you can get maximum mental benefits if you become open to new experiences. Try going to an art show of someone you’re unfamiliar with or sampling a new cuisine. If there’s a cultural fair, grab a friend and go explore as much as you can. If you have the means, traveling is another great way to expand your cognitive horizons and boost your mental health.

Any combination of these techniques can be beneficial, so start with what will be easiest to work into your schedule. From there, you can make adjustments on what activities you enjoy, trips you want to take, or even nightly activity nights you want to hold. Keep challenging yourself, and your brain will thank you for it!

About George Mears

George Mears is a brain fitness expert whose major area of interest is how brain exercises like games, puzzles, and memory activities help people to minimize the brain health deterioration that can lead to Alzheimer’s disease and dementia. Brainwellness.info

Chronic Pain: Is There Hope?

By Jerry Henderson on October 7, 2015.

It is clear that to me that there is a chronic pain epidemic in this country. My belief was confirmed by some disturbing results from a cross sectional survey of over 27,000 people on the prevalence of pain. The study was conducted by Johanne and associates in 2012[i] and it showed:

  • Approximately 30% of the respondents had long lasting chronic pain or recurrent pain, and:
    • Most had either lower back pain (8%) or pain from other osteoarthritic conditions (4%).
    • Half had daily pain.
    • About 1/3 of those reported their pain as severe (at least 7 on a 0/10 verbal pain rating scale).
  • Prevalence increased with age, lower socioeconomic status, and unemployment.

An Institute of Medicine report estimates that 116 million Americans suffer from chronic pain and that the combined medical and financial cost due to lost productivity is $635 million per year,[ii] which is more than the annual costs of cancer, heart disease, and diabetes.

Describing Chronic Pain

There are many definitions of chronic pain, but one of the most widely accepted is any pain lasting longer than 12 weeks. Experiencing pain for longer than 12 weeks is simply not normal. In contrast, acute pain, that is, pain lasting for a shorter period of time, is our internal warning system about serious tissue damage.

Think about the difference between the qualities of the pain you experience from a minor skin cut compared to the pain you have probably experienced at some time in your life from your lower back.

The pain from a skin cut feels sharp. You can tell, without looking where the cut is on your skin, and you can estimate whether or not the cut is serious. The lower back pain may initially feel like a sharp, stabbing pain, but after a few days it often develops into a deep aching. You don’t have a good idea of how badly you are hurt, and you have a hard time describing where it hurts. In fact, the location of the pain may change over time.

Rear view of shirtless man with hand on hip over white background

As the skin cut heals, the pain resolves quickly. As the low back heals, the pain may resolve quickly, but (for reasons that are not well understood) it may not. That deep, aching pain may just continue for weeks, and it may cause complex changes in your brain chemistry that make it even worse. Over time, this type of pain builds on itself to the point that in the worst cases it becomes completely disabling and is often associated with clinical depression.

I often told my patients that pain of this sort is a liar. It may provide important clues about the source of the problem, but that’s all–just some clues. Other than clues, we shouldn’t rely too much on this type of pain to tell us much of anything.

“If I Had a Hammer….”

The old saying, “If you have a hammer, everything looks like a nail,” holds true for chronic pain treatment. The physician tool chest (which includes narcotic medications, injections, surgery, and imaging studies) seems to be woefully inadequate at treating this type of pain.

Use of narcotic medications works great for acute pain, but they are dangerously addicting and have other perverse side effects like making clinical depression associated with chronic pain even worse in some cases. In my experience, the term “Pain Clinics” is often code for drug rehabilitation for patients who have been addicted to narcotic pain medications for their chronic pain.

The dismal record of surgery, particularly spinal fusion, for low back pain is well documented. The New York Times reported on a recent study from the Journal of the American Medical Association indicating that injections for non-specific lower back pain are ineffective, even though they are done routinely[iii].

What is the Answer?

Chronic pain is pervasive, disabling, and costly. It causes untold suffering. It can rob patients of their livelihoods. Typical care for chronic pain isn’t very effective. I believe that physical therapy is the best treatment available.

I find this excerpt from an article published by the National Institutes of Health very telling:[iv]

Self-management of chronic pain holds great promise as a treatment approach.  In self-management programs, the individual patient becomes an active participant in his or her pain treatment—engaging in problem-solving, pacing, decision-making, and taking actions to manage their pain. Although self-management programs can differ, they have some common features. Their approach is that the person living with pain needs help learning to think, feel, and do better, despite the persistence of pain. Improving communication with the healthcare provider is part of that empowerment.

Through NIH-supported research, starting successful self-management programs has reduced many barriers to effective pain management, regardless of the underlying conditions. Individuals who participate in these programs have significantly increased their ability to cope with pain. They improve their ability to be active, healthy, and involved members of their communities. In fact, new research suggests that the best self-management programs teach people different ways of thinking about and responding to pain, making their actions to relieve it more effective.

Read that excerpt carefully. Doesn’t that sound like physical therapy?

Physical therapists need to take the lead on being the providers of choice for these types of problems. No one can do it better.

[i] http://www.ncbi.nlm.nih.gov/pubmed/20797916

[ii] http://www.amednews.com/article/20110708/profession/307089996/8/

[iii] http://well.blogs.nytimes.com/2013/07/18/looking-for-alternatives-for-back-pain-relief/

[iv] https://www.nlm.nih.gov/medlineplus/magazine/issues/spring11/articles/spring11pg5-6.html

 

JerryHenderson_HeadshotAbout Jerry Henderson

Jerry Henderson has been a physical therapist for over 25 years and is passionate about providing his PT colleagues with proven processes and state of the art systems to enable them to excel in delivering excellent patient care. He currently serves as VP for Clinical Community at Clinicient, Inc. http://www.clinicient.com/