Q: My pain is caused by arthritis and therapy can’t get rid of my arthritis. Why does my Dr. want me to do therapy?

A: Pain and stiffness arising from arthritis often causes you to be less active and even avoid certain movements. A tailored physical therapy program is targeted to help you move better and move more. The goal is to overcome weakness arising from being less active and to fight stiffness and pain with exercises and stretches to keep you limber.

Jaydeep Samant, PT, MHS, is a physical therapist and the leader of our therapy team at Putnam County Hospital in Greencastle, Indiana. Originally from Mumbai, Jaydeep received his Bachelor’s degree in PT in 2016 in India. In 2018, he graduated with a Master’s in Health Sciences degree from the University of Indianapolis and has been a practicing PT since graduation. Jaydeep specializes in treating orthopedic, neuromuscular conditions, sports injuries, joint replacements and any acute musculoskeletal conditions.

Question: What are energy conservation techniques and how can I use them to improve my quality of life?  

Answer: Energy conservation techniques can be used for a wide array of various populations and improve the quality of life for the aging adult.

Patients who have COPD, CHF, or just seem to fatigue quickly with activities for a number of reasons can benefit from energy conservation techniques. Below is a list of the 4 Ps for energy conservation that provides some tips to help with conserving energy. This table was taken from an article by Mimi Jacobs PT and Karie Angstadt OTR/L which I think gives great tips and insight on how to do this.

1. Planning

• Consider showering in the evening to conserve daytime energy.
• Consider using a bag, basket, or rolling utility cart to carry multiple items in one trip.
• Space difficult and strenuous chores evenly throughout the week.

2. Pacing

• Perform tasks at a moderate rate and avoid rushing.
• Allow plenty of time for rest and relaxation. Take a morning or afternoon nap prior to activities or outings to build up energy.

3. Prioritizing

• Look critically at your roles with work, family, and friends. Keep only those that are necessary and pleasurable.
• Eliminate unnecessary tasks, chores, or steps of an activity. Look for shortcuts.
• Ask staff to empty trash and clean your room if the service is available.

4. Positioning

• Store items at a convenient height to avoid excessive and prolonged stooping and stretching.
• Use lightweight wheelchairs with proper seat and arm rest height.

Shannon Fuller, PT, DPT

Q: As an athlete, how do I get cleared to return to sport after my ACL tear?

A: That answer is multifaceted and requires an assessment of both your mental and physical capabilities post-operatively. We have generalized guidelines and criteria with each phase of protocol, to move on to the next, including range of motion, strength, and functional performance of activities.

However, the battery of testing at the end stage of rehab, to demonstrate readiness for return to sport, has more variables. We utilize a variety of ROM/strength testing in comparison to non-operative limb, functional movement testing, sport-specific testing, and psychological readiness testing. We use comparative measurements to the non-operative limb for tools, including but not limited to, the Y-balance test, single limb hop testing, and drop jump testing. We also use self-reporting questionnaires such as Single Assessment Numeric Evaluation and Tampa Scale of Kinesiophobia, which have normative data and guidelines for comparison.

The determination of readiness for return to sport is not just passing one test or participating in practice. It is our job to maximize functional gains while diminishing risk for reinjury. No one single test is able to give a pass or fail for readiness for return to sport, but the battery of tests, as a whole, can determine readiness for return to play and risk assessment for reinjury.

Megan Baker, PT, DPT, CMPT

Question: What does the rotator cuff do, and how can therapy help if I have a rotator cuff tear?

Answer: The rotator cuff is a group of four muscles that work together to perform rotational movements of the upper arm, but also to maintain stability of the joint by preventing excessive sliding around of the “ball” (head of the humerus) in the “socket” (glenoid fossa) of the shoulder and scapula, and by keeping the ball centered in the socket.

There can be normal changes in the structure of the rotator cuff musculature, just as there are in the bones of a joint as we age.  Therefore, the rotator cuff is more susceptible to tears after age 50.

A partially torn rotator cuff can improve with Occupational or Physical Therapy intervention by providing treatment to reduce pain associated with a tear. Education in activity and postural modification, as well as instruction in therapeutic exercise and activity are also provided.  The purpose of this is to increase the stability of the shoulder joint, to keep the ball centered in the socket, maximize the space through which the rotator cuff muscles travel in the top shoulder joint to decrease pressure on the rotator cuff, and increase the ease of overhead reach and rotation. This can enable one to return to pain-free function of the involved arm, to perform activities such as fixing one’s hair, throwing a ball, playing golf, or casting that fishing line!

Erin Winters, OTR at Putnam County Hospital