Choose PT First for Low Back Pain

in ,

Around four out of five people have low back pain at some point in their lives. Low back pain is one of the most common reasons people visit their healthcare providers.  

What Can Cause Low Back Pain?

  • As people age, bodies change. Being less active can accelerate changes including reduced flexibility and strength, which can result ini pain and stiffness.
  • People who are carrying excess weight are more likely to suffer from low back pain with the added weight increasing pressure on the joints of the body.
  • Repetitive lifting and bending as part of your daily work can increase the risk of injury.
  • Acute injury from overexertion including lifting a heavy object or performing several hours of activity that your body isn’t prepared for.

Evidence has shown that most patients with low back pain can recover faster when the patient chooses physical therapy first. PT is a less costly alternative to medication, surgery, and other invasive medical procedures. This is why states have passed legislation allowing patients to go directly to a physical therapist without a physician’s referral.  

Don’t Be a Statistic

  • $50 billion is spent on back pain annually
  • There are 31 million people with back pain
  • 50% of working Americans admit to back pain
  • Only 7% of low back pain patients go to see a physical therapist

For the senior population, Physical Therapist Thad Poitevint goes by the mantra, “Check yourself and correct yourself before you end up with pain.” He adds, “Go heavy on the emphasis on good body mechanics and positioning with the senior population. I tell them to check their posture and make corrections in real time. Small changes that are made consistently over time can help prevent low back pain and other spine issues.”  

How to Prevent Low Back Pain

You can’t prevent all lower back pain, but you do have control over some aspects in your life that can help.

  • Maintain a healthy weight.
  • Get regular exercise to maintain flexibility and strength.
  • Reduce risk of injury when lifting by testing the weight, keeping the object as close as possible, engaging your core, and using your legs.  
  • Avoid bending and twisting at the same time.  

Physical therapy can help determine the cause of your back pain and design a treatment plan that is specific to you and your goals. If back pain is changing how you move, impacting daily function, or limiting the activities you enjoy, contact a physical therapist to schedule an appointment.

Ask an Expert: Do I Need to Stop Running?

in ,

I have been diagnosed with Osteoarthritis (OA). Do I need to stop running or participating in sports?

This is a question that we are asked regularly during physical therapy sessions! A recent 2020 meta-analysis by Zampogna et al on of the effects of activity in people with OA concluded that, “compared to controls, aquatic exercise, land-based exercise, tai chi, and yoga showed a small to high effect for improving pain, physical function, quality of life, and stiffness. Active exercise and sport are effective to improve pain and physical function in elderly people with osteoarthritis.”

Furthermore, a 2018 study by Lo et al. in The Journal of Clinical Rheumatology concluded that, “among individuals over 50 years old with knee OA, self-selected running is associated with improved knee pain and not with worsening knee pain or radiographically defined structural progression.”

That being said, I recommend avoiding contact sports which have a higher risk of orthopedic injury, such as tackle football and rugby. I also recommend a well-rounded exercise program which incorporates mobility, balance and strengthening exercises into your regular routine.

When progressing activity, it’s a good idea to gradually increase intensity or duration of activities by no more than 10% per week. For example, if you normally run for 20 minutes on the treadmill at 7 mph and you want to progress this activity, you can either increase the time to 22 minutes or increase the speed to 7.1 mph.

If you are limited in your daily life and recreational activities due to pain, stiffness or weakness then consider making an appointment with a physical therapist to help you get moving again!

Get Your Family Moving: Rake Leaves!

in

Autumn is a beautiful season with the changing of the leaves, but it also brings about some hefty yard work in removing them. Raking leaves is actually very hard work and good physical exercise at the same time. Your equipment needs are simple: your body and a rake.  Raking burns about 300 calories an hour while toning your arms and strengthening your back and legs.  Just be sure to stretch first and, to avoid muscle pulls, don’t try to do the whole yard at once.

Regular exercise no matter what type can boost energy, build strength & stamina, improve balance and even help to reduce some signs of aging.

Tips for Safe Raking

Do a pre-rake warm-up. It may not seem like a workout, but you can burn nearly 300 calories during an hour of raking!

  • Walk around a bit before you start so your blood gets flowing.
  • Do a couple of stretches to prevent straining the muscles of your shoulders, neck, and back.
  • Side bends and knee-to-chest lifts help open you up and ready you for all of the raking, bending, and lifting you’ll be doing.

Practice proper raking posture.

  • To keep your neck and back happy, stand upright and rake leaves to the side of you, alternating your dominant hand now and then.
  • Bend at the knees – not the waist – when picking up piles of gathered leaves.
  • Keep the rake mostly perpendicular to the ground (i.e. between 65 to 85 ) That will give your body easy leverage on the rake, making it easy to   move, and easy on your body.
  • Avoid twisting to toss leaves. Instead, step to the side so your whole body switches position, not just your shoulders and back.
  • Switch sides now and then and take breaks, especially if you haven’t raked since last fall.
  • Take it easy on your back. Move your whole body and not just your spine.

Take rake breaks. The repetitiveness of raking can become painful after a while.

  • Only rake small sections at a time as this will save energy. Take breaks when you get tired every 10 to 15 minutes.
  • Sip on water to stay hydrated.
  • Stretch to release tension you may have built up.

Using the proper techniques is essential. If part of your body is sore, it is probably telling you that you have overdone it or you are using the wrong technique. Rake so it’s natural and comfortable with the power of your movements coming from your legs.

So, get your family or even some of your friends involved and get your bodies moving. Also, don’t forget to look out for your pets or small children who may jump into your pile of leaves!

Meet Mitch Parsons

in ,

Tx:Team turns 40 in 2023!

Founded in 1983, Tx:Team will celebrate a big anniversary in May, 40 years in business. Because it is such a major milestone, we felt we should celebrate this achievement throughout the year.

Thank you to all Tx:Team associates throughout the decades for his or her part in our success.

Meet Mitch Parsons, Manager of Employer Based Clinics, and hear his story of his time with Tx:Team!

Static Vs. Dynamic Stretching

in , ,

When I was initially tasked to write about stretching, I got excited because as a former athlete and now physical therapist for more than 16 years, I thought I understood the evidence and rationale to easily address this topic. However, like the evidence-informed therapist that I am, I decided to first perform a literature search in order to check my preconceptions. This would prove to be pivotal in how I decided to tackle the subject matter.

What is Static Stretching?

Static stretching is when you take a body part to a point where a “stretch,” or pulling sensation, is felt and hold that position for a length of time, generally less than 60 seconds in duration (position based). ​An Example of a static stretch for the arm would be a cross body stretch – holding the arm directly across the chest.

What is Dynamic Stretching?

Dynamic Stretching can be classified as a large/gross movement pattern that involves multiple joints and muscles groups moving in and out of various ranges of motion (movement based). An example of a dynamic stretch on the arm would be performing arm circles – moving the arms forward and/or backwards in various degrees of motion.

What are the Benefits of Stretching?

For years it was thought that static stretching prior to activity would help decrease injury, prepare the body for activity, improve range of motion (ROM), and even enhance performance. However, does stretching do any of these things?

  1. Reduce Injury: Most of the recent data suggests that static stretching alone is inefficient at reducing the likelihood of sustaining an injury with a sporting activity. In fact, depending on the sport, in an article recently reviewed pertaining to golf, adding static stretching seemed to increase in the likelihood of injury. However, if static stretching is incorporated into a comprehensive warm-up program, it may actually help reduce musculotendinous injury in sports that require sprinting/making sharp cuts, i.e., soccer, football, basketball, etc.
  2. Prepare Body for Activity: The idea of a “warm-up” is to increase blood flow to the muscles that we intend to use for the given activity we are about to perform as well as increase the body’s core body temperature prior to competition. Static stretching alone does not satisfy these goals, which is why many professionals would recommend dynamic stretching.
  3. Improve ROM: It has been shown that static stretching does increase ROM of the hip and knee with hamstring stretching, but there are very few research studies that have shown the same amount of change in other body areas. To observe these changes in ROM, the static stretch needs to be done consistently for no more than 45 seconds at a time for no fewer than three reps for a minimum of eight weeks.
  4. Enhance Performance: Initially, I was confident that there was indeed research that supports the notion that static stretching had been shown to reduce strength, power, and muscle performance. While that is not entirely false, the evidence is not as consistent as I had once thought. a 2013 Systematic Review of 104 studies concluded that there was a decrease in strength, power, and explosive performance (to varying degrees). However, when looking at how they did the analysis the individual study designs and the tests they used to measure strength, power, and explosive performance varied greatly, which makes it much more difficult to make blanket statements with regards to performance deficits that may exist after static stretching.

What is the Goal or Purpose of Stretching?

If your goal is to gain range of motion in a specific muscle group or joint, keep the stretch to less than 45 seconds. Dynamic stretching is preferred as it is more efficient and better prepared the body for an activity or sport.

If you want to warm up before an activity, work, or to help reduce injury, consider a Comprehensive Warm-Up (CWU). A CWU should include light aerobic activity (walking, jogging, cycling, jumping rope/jacks, etc. in which you can still speak comfortably), dynamic stretching, and a sport/activity/job specific tasks. For a sport or activity that requires sprinting/quick changes in direction, adding static stretching of less than 45 seconds in a given position may help reduce musculotendinous injury.

 

Josh Anderson, PT, DPT has over 15 years of diverse experience in both the on-site and outpatient settings treating patients by providing Injury Prevention Services and Early Intervention Screens, as well as utilizing a variety of Physical Therapy techniques to get patients back to work as quickly as possible. His professional interests include Balance and Vestibular Orthopedics, Sports Physical Therapy, and Manual Therapy. Josh is certified in Sports PT through Evidence in Motion, Selective Functional Movement Assessment (SFMA), and Rocktape Level 1. He is also a Certified Clinical Instructor via the APTA.

 

Bibliography:

1. K Small, et al. A Systematic Review into the Efficacy of Static Stretching as Part of a Warm-up for the Prevention of Exercise Related Injury. Research in Sports Medicine, 16:213-23, 2008
2. A Ehlert and PB Wilson. A Systematic Review of Golf Warm-ups: Behaviors, Injury and Performance. Journal of Strength and Conditioning Research, 33(12): 3444-3462, 2019
3. DG Behm, A Chaouachi. A Review of the Acute Effects of Static and Dynamic Stretching on Performance. European Journal of Applied Physiology, 111: 2633-2651, 2011
4. DM Medeiros, et al. Influence of Static Stretching on Hamstring Flexibility in Health Young Adults: Systematic Review and Meta-analysis. Physiotherapy Theory and Practice, 32(6): 438-445, 2016
5. DG Behm, et al. Mechanisms Underlying Performance Impairments Following Prolonged Static Stretching Without a Comprehensive Warm Up. European Journal of Applied Physiology, 121: 67-84, 2021
6. L Simic, et al. Does Stretching Improve Performance: A Systematic and Critical Review of the Literature.Scandinavian Journal of Medicine and Science in Sports, 23(2): 131-148, April 2013
7. Yamagichi, et al. Effects of Static Stretching for 30 seconds and Dynamic Stretching on Leg Extension Power. Journal of Strength and Conditioning Research, 19(3): 677-683, Aug 2005
8. DG Behm, et al. Effect of Acute Static Stretching on Force, Balance, Reaction Time and Movement Time. Med Sci Sports Exercise, 36(8): 1397-1402, 2004
9. AD Kay, AJ Blazevich. The Effect of Acute Static Stretch on Maximal Muscle Performance: A Systematic Review. Medicine & Science in Sport and Exercise, 44(1):154-164, 2012
10. I Shrier. Does Stretching Improve Performance: A Systematic and Critical Review of the Literature.Clinical Journal of Sports Medicine, 14(1): 267-273, 2004
11. DG Behm, A Chaouachi. A Review of the Acute Effects of Static and Dynamic Stretching on Performance. European Journal of Applied Physiology, 111: 2633-2651, 2011
12. H Chaabene, et al. Acute Effects of Static Stretching on Muscle Strength and Power: An Attempt to Clarify Previous Caveats. Frontiers in Physiology, 10 (1468): 1-10, 2019

Can the Value of Physical Therapy Be Measured?

in ,

October is Physical Therapy month, and the American Physical Therapy Association (APTA) has deemed the theme for 2024, “The Value of Physical Therapy.”

Value: noun – (val-ue) relative worth, utility or importance; consider (someone or something) to be important or beneficial.

Can the value of physical therapy really be measured?

We have tools to measure our patients’ outcomes, but can we measure the actual value of services?  Physical therapy provides a variety of benefits, including reduced pain, improved function, increased range of motion, proper alignment and more.

Physical therapists are experts at movement who are trained to optimize function, improve motion, and ultimately, live better!  They will assess your condition and help you regain maximum functional mobility and independence. Physical therapists will also  use a variety of treatment modalities and techniques to help you move better and feel better.  Treatment is highly individualized, cutting edge, and research-based to return patients to their optimum functional level and live life to its fullest.

Again, we ask, can the value of physical therapy be measured?

The answer to that question would depend on each individual patient.

  • How valuable is it to be able to walk across the room pain free?
  • What does is it worth to be able to play with your grandchildren in the backyard? Or go on a walk with them?
  • Does your pain or inability to function at your best hold you back from taking that dream vacation?
  • Does your desk set-up at work cause you to go home at the end of the day with headaches?
  • Are there any extra-curricular activities that you are passing up because your back, neck, or another body part is holding you back?
  • How much do you value a pain free life to participate in any activities you enjoy?

Physical therapists treat people across the entire lifespan. Many therapists have certifications or specializations to treat a certain population, like children, the elderly, or athletes. Regardless of age or population, if you have a condition that is keeping you from the activities in your life, a physical therapy evaluation may be warranted to offer treatment and a strategy to improve function.

The benefits of physical therapy include:

  • Prevention of the onset and/or slow progression of conditions resulting from injury, disease, and other causes
  • Pain management with reduced need for opioids
  • Avoidance of surgery
  • Improvement in mobility and movement
  • Recovery from injury or trauma
  • Recovery from stroke or paralysis
  • Fall prevention
  • Improvement in balance
  • Management of age-related medical problems

From the APTA:

“A recent study also examined the overall value of choosing physical therapy over other options. Researchers calculated the economic impact of choosing physical therapy for the following eight conditions, representing a broad spectrum of physical therapist treatment: Cancer Rehabilitation, Carpal Tunnel Syndrome, Falls Prevention, Stress Urinary Incontinence, Osteoarthritis of the Knee, Low Back Pain, Tennis Elbow, and Claudication (leg pain when walking due to restricted blood flow).  They found that physical therapy is effective and saves on all the hidden costs of your time, pain, missed life events, and the dollars paid for services.

Find a physical pherapist

If you have an injury or illness that results in pain, physical impairment, limited movement, or a loss of function, a physical therapist can help.  Some patients are referred to physical therapy from his or her physician, and others seek therapy directly. Find out how valuable physical therapy can be to you.

Meet Ann Hightower

in ,

Tx:Team turns 40 in 2023!

Founded in 1983, Tx:Team will celebrate a big anniversary in May, 40 years in business. Because it is such a major milestone, we felt we should celebrate this achievement throughout the year.

Thank you to all Tx:Team associates throughout the decades for his or her part in our success.

Meet Ann Hightower, Vice President of Internal Operations, and hear her story of her time with Tx:Team!

 

Falls Prevention Week

in ,

Each September, we recognize Falls Prevention Week to raise awareness of the impact of falls. The good news is that most falls are preventable.  Tx:Team’s Teaming Up Against Falls Program incorporates the components of the Otago Exercise Program including balance, strength, flexibility, vestibular, and proprioception evaluation and treatment to tackle balance issues and help prevent falls.

According to HealthyAging.org:

  • Falls are the leading cause of injuries in older adults. One out of five falls result in a significant injury such as broken bones or a head injury.
  • Each year, three million older adults go to the emergency room because of falls. Over 800,000 need to go into the hospital.
  • Older women are twice as likely to fall and break a bone as older men. Men have a higher risk of dying after a fall. 

Prevention

What can I do to decrease my risk of falling?

  • 75% of falls occur in the home. You can decrease your chance of falling by keeping your home safe for you to move around.
  • Make sure you have good lighting in every room. Include night lights in your bedroom, hallways, and bathrooms.
  • Rugs should be firmly fastened to the ground, especially at the corners. Electrical cords should be kept off the walking areas.
  • Add handrails to your bathrooms for support for your bath, shower, and toilet use.
  • Always use the rails on stairs on both sides and ensure that each stair is well lit or has a visual cue.
  • Wear shoes with firm, nonskid, non-friction soles. Avoid wearing loose slippers that could cause you to trip.
  • Keep kitchen items within easy reach to avoid using step stools.
  • Place the bed at a proper height to allow for feet to be flat on floor while sitting at bedside.

Taking good care of your body will also keep you strong, mobile, and more independent.

  • See your eye doctor once a year.
  • Care for your feet and see a doctor if you have pain or corns.
  • Use assistive devices if they are recommended to you.
  • Sit on the bed for a few minutes before getting up to go to the bathroom at night. This will prevent dizziness in the dark.

If you notice that you may have some trouble with your balance or mobility in general, talk to a physical therapist and find out how they can help you to stay on your feet and prevent falls.

Balancing Act: Keeping You On Your Feet

in ,

Do you find you are less confident than you used to be when walking in a crowded environment or on an uneven surface? Are you avoiding certain activities, or perhaps gripping the handrail a little tighter these days? If so, you’re not alone. Up to 85% of older adults are afraid of falling, and with good reason. One out of every five falls results in a serious injury and falling once doubles your likelihood of falling again.

Most people don’t even think about their balance until it starts to deteriorate, but there’s a lot going on behind the scenes to keep us on two feet. Our brain uses sensory input from our feet to adapt to the surface, and proprioceptors on our joints to know where we are in space. Our eyes and ears give us information about our environment, and our inner ear, or vestibular system, keeps our equilibrium. These systems work together to tell our motor system how to make corrections and keep us upright.

These corrections are typically fairly automatic and start with engaging our ankles, then bending at the hips, and eventually a quick step in order to recover. If these reactions aren’t strong enough or quick enough, we end up on the floor. Unfortunately, many medical conditions, as well as general deconditioning, can have a negative impact on your ability to both identify and correct a loss of balance. The good news, however, is there are things you can do to not only maintain your stability but gain it back! Some of these strategies include:

  • Strengthening your hips and thighs. These large muscles are responsible for keeping you upright and shifting your weight into your base of support
  • Stretching out your calves. Flexibility in your ankle actually plays a big role in whether your body can effectively right itself when you start to wobble.
  • Getting your eyes and ears checked regularly to maintain optimal function.
  • Wearing properly fitting footwear with good traction and reviewing your home for possible trip hazards.
  • If you’re struggling with dizziness, have your doctor review your medications with you for possible side effects.

The fear of falling may be a healthy fear at times. After all, it often keeps us from doing unsafe things. However, studies show that a fear of falling is associated with higher risk of falls, partly because individuals reduce their regular mobility and avoid activities that would normally challenge their system. This results in increasing weakness and perpetuates the cycle of instability.

Programs that target balance, like yoga and tai chi, are great, but the key to staying committed is to pick something you really enjoy. Activities like golf or gardening can be just as effective at challenging your system. Even going for a walk with a friend will require you to turn your head and hold a distracting conversation while picking your feet up and avoiding obstacles! If you’re unsure where to start, talk to a local physical or occupational therapist. They can do a specialized assessment to determine where your specific problems lie and recommend strategies to address them. Most importantly, keep moving! As they say, a body in motion stays in motion!

Rachel Hett, PT, DPT is a graduate of the University of Florida where she received her Bachelor of Health Science as well as her Doctor of Physical Therapy.  She is an experienced physical therapist as well as Team Leader in the senior living setting.  Her professional interests lie in Falls & Balance, Vestibular, Dementia, and Neuro programming.  Rachel is also a Certified Dementia Capable Care Specialist.

You Take that First Step and OUCH

in , ,

You get out of bed and go to take that first step. OUCH! 

A sharp pain hits your foot. You limp a few steps but before you are out the door, the pain is gone. After sitting at work for a couple hours, you get up for another cup of coffee and the pain returns. 

It’s possible you are dealing with plantar fasciitis.

But what exactly is plantar fasciitis and what can we do about it? 

The suffix -itis indicates inflammation. Plantar fasciitis is inflammation of the plantar fascia. This leads to the next question, what is the plantar fascia? Plantar is the bottom side of the foot and fascia is a thin casing of connective tissue. Putting those two together, the plantar fascia is a band of connective tissue that runs from your heel to your toes, and it helps support the arch of your foot, stability of the foot, and is involved with normalized foot mechanics. Unfortunately, through a series of microtears from overstress and over stretch, the fascia can get inflamed and plantar fasciitis occurs.

Why exactly does plantar fasciitis occur is a great question. There are a few common risk factors to look at first. Generally, it will occur in people 40-70 years old. Activities such as running and dancing can increase the risk of developing plantar fasciitis. Occupations that keep you on your feet also increase the risk for developing it. People who are overweight or obese place more stress on their feet and this can cause plantar fasciitis. Lastly, if you have abnormal foot posture or walking pattern, e.g. flat feet, high arches, this can increase risk as well.

Now what to do about it? 

  • It is important to keep your calves loose. When the calf muscles become tight, they will pull up on the achilles, which pulls up on the heel, which stresses the plantar fascia.
  • Improving the strength of the arches of the feet can also reduce stress placed on the plantar fascia.
  • Stretching your big toe backward (toward the top of your foot) can provide an excellent stretch on the plantar fascia and rolling your foot on a lacrosse ball is another great option.
  • Orthotics can also help to normalize your foot if you have high arches or flat feet, thus reducing the stress on the plantar fascia.

Although plantar fasciitis can be a painful way to start the day, it is certainly treatable through a variety of stretches, exercises, and lifestyle modifications. If you feel you are suffering from plantar fasciitis, make an appointment with your local Physical Therapist and get back on your feet and  walking pain free.

Alex Strahle, PT, DPT, CSCS graduated from the University of Evansville with a Bachelor of Science in Exercise Science and a Doctor of Physical Therapy.  He is currently a Physical Therapist in the Employer-Based Clinic setting for Tx:Team.  Alex enjoys seeing patients return to an active lifestyle after treatment for their pain and dysfunction.