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Ask an Expert: What is Vertigo?

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Q: What is vertigo, and how can a physical therapist help?
A: Vertigo is a condition when someone feels dizzy, off-balance, or unsteady. There are various types of vertigo with different causes. One common type of vertigo is benign paroxysmal positional vertigo (BPPV) which occurs due to tiny crystals, called otoconia, in the inner ear becoming loose or dislodged. This imbalance in the inner ear often causes patients to feel a room-spinning sensation with certain head movements or body positions.
Physical therapists can help differentiate what may be causing your vertigo and implement treatments to address your specific type of vertigo, whether that is related to BPPV or other factors.
By Sara Sermersheim, PT, DPT at Finish Line Health and Wellness Center

Fall Awareness: Protecting Independence and Preventing Injuries

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As we age, maintaining balance and preventing falls becomes increasingly important for staying healthy, active, and independent. According to the CDC, one in four adults aged 65 and older will fall each year. These falls often lead to serious injuries, including fractures, head trauma, and hospitalizations. In fact, falls are the number one cause of injury-related deaths in older adults. With increased fall awareness and prevention strategies, many of these incidents can be avoided.

Falls become more likely as we age, but with the right steps, they can be prevented. Below are some common risk factors for falls, along with simple solutions to reduce these risks:

  • Muscle Weakness and Poor Balance: As strength and balance decline with age, it becomes harder to stay steady.
    • Solution: Exercise regularly to strengthen muscles and improve balance. Programs like the Otago Exercise Program are specifically designed to reduce fall risks by targeting these areas.
  • Medications: Some medications can cause dizziness or affect balance, increasing the likelihood of falling.
    • Solution: Review your medications with your doctor to identify any that may be contributing to dizziness or balance issues and explore alternatives if necessary.
  • Vision Problems: Poor or uncorrected vision can lead to missteps and falls.
    • Solution: Get regular vision checkups and ensure you’re using the correct prescription glasses. Address any changes in your vision promptly.
  • Environmental Hazards: Cluttered spaces, poor lighting, and slippery floors are common fall hazards.
    • Solution: Make your home safer by removing tripping hazards, improving lighting, and installing grab bars in key areas like bathrooms and stairways.

Both physical and occupational therapy are vital for fall prevention. Physical therapists help improve strength, coordination, and stability, and can address vertigo through vestibular therapy. Occupational therapists focus on adapting environments and daily routines to reduce fall risks, such as making home safety modifications and teaching safe ways to perform everyday tasks. By offering personalized care plans and practical solutions, physical and occupational therapists empower older adults to maintain independence and reduce the risk of falls.

By understanding the risks and taking proactive steps, you can significantly reduce your chance of falling. If you or a loved one is concerned about falls, talk to a healthcare provider about fall prevention strategies. Awareness is the first step to staying safe and strong!

Welcome Bradley Austin, PT, DPT, COMT, CDNS

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We are excited to announce Bradley ‘Brad’ Austin, PT, DPT, COMT, CONS as Director of Rehabilitation for Riverview Health in Noblesville, Indiana.

Brad brings a wealth of experience and a passion for patient-centered care to Riverview Health rehabilitation. He earned his Doctor of Physical Therapy (DPT) and Bachelor’s in Movement Science from the University of Evansville. Education and continual growth are cornerstones of his professional philosophy. His dedication to advanced training is evident through his certifications as a Certified Orthopedic Manual Therapist (COMT), Titleist Performance Institute (TPI) Certified, and Certified in Dry Needling (CDN).

With 14 years of experience in rehabilitation services, Brad has established himself as a leader and innovator in the field. He has been a highly sought-after clinician in Hamilton County for the past decade as an expert in spine and hip therapy. His expertise in manual therapy and functional movement is complemented by a deep compassion for his patients and a commitment to their well-being.

Brad is a seasoned professional with a proven track record of leadership, innovation, and mentorship in the field of physical therapy. As a Clinic Director at multiple locations, he has successfully managed teams, mentored new therapists, and introduced groundbreaking programs. He has also served as a clinical instructor for multiple students and has assisted in university educational days in the field of orthopedics, demonstrating his commitment to fostering the next generation of physical therapists.

Outside of work, Brad, a Hamilton County resident, is deeply involved in the Carmel Dad’s Club, coaching youth sports for his two boys. His family enjoys being outdoors, golfing, and boating, reflecting his commitment to an active and healthy lifestyle.

In his new role at Riverview Health, Brad will leverage his extensive experience to lead the rehabilitation team, fostering an environment of innovation, collaboration, and exceptional patient care. His proven ability to build strong relationships with orthopedic surgeons and other healthcare professionals ensures a multidisciplinary approach that benefits every patient.

Please join us in welcoming Brad to Riverview Health and Tx:Team.

Stretching and Warm-Up Routines for Workers: PT Recommendations

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Most athletes perform some type of warm-up before their games or workouts. Warming up primes the body, boosts performance, and helps prevent injury. All that sounds great, right? So, why don’t we warm-up before our work shifts?

A short pre-work warm-up can prepare you for the workday. Exercise helps by…

  • Waking up your muscles. It increases blood flow, so your muscles get warmed up and ready for the day. This allows your muscles to work more efficiently and smoothly throughout your workday. Thus, making your work feel easier. Warming up your muscles can also help reduce pain and prevent injury on the job.
  • Decreasing stiffness. Often first thing in the morning our joints are a little stiff. “Motion is lotion” for our joints and can help reduce stiffness and improve mobility.
  • Improving brain function. Exercise increases blood flow and oxygen to not only our muscles, but also our brain! This helps boost cognition and memory which can improve job performance.
  • Making you happy! A little exercise can enhance your mood. As Elle Woods said in Legally Blonde: “Exercise gives you endorphins. Endorphins make you happy. Happy people just don’t shoot their husbands, they just don’t.” Plus, the workday is a little better when we’re in a good mood (and when our colleagues are too).
  • Reducing stress. Exercising can reduce stress, but specific breathing exercises like diaphragmatic breathing (or belly breathing) can really help calm down your body’s nervous system and reduce muscle tension. This can be great to focus on before a big presentation or anytime you are feeling a little overwhelmed in the workplace.

A short warm-up or movement break can benefit both manual laborers and desk-jockeys. If you need some exercise ideas or don’t know where to start, head over to our YouTube channel and check out the quick Tx:Team Movement Break videos (like the one featured below). I hope you give it a go and feel a little better for your workday!

Sara Sermersheim, PT, DPT

Sara earned her Doctorate in Physical Therapy from the University of Evansville, where she also completed her undergrad. During her studies, she explored healthcare systems in both the UK and the US. With over six years in outpatient physical therapy, Sara treats patients of all ages and specializes in orthopedic care. She’s certified in dry needling, vestibular and concussion rehab, and trained in the McKenzie Method for spinal treatment.

A Letter to the Frankfort Community from Tx:Team

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Dear Frankfort Community,

As you have likely heard by now, IU Health has elected to end our contract to provide physical and occupational therapy services at IU Health Frankfort Hospital. For the past 20 years, it has been our privilege to care for you, your family, your friends, and your neighbors. We take immense pride in the relationships we have developed with those who have sought therapy services from us during that time. Though we do not all live here, Frankfort has become our home. We cherish this community and the role you have allowed us to play in your lives since 2004. Thank you for trusting us.

Our last day of providing services at IU Health Frankfort will be August 29, 2024. After that date, Dan, Christie, Amy, Stephanie, Shawn, Lily, and Jenny will no longer be available for appointments at the hospital. Please contact IU Health directly at (765) 838-7522 with any questions about future rehab services at IU Health Frankfort.

While we will no longer be seeing patients at IU Health Frankfort, we are not leaving the Frankfort area.  Please look for more information coming soon about our new affiliation with Witham Health Services in both Lebanon and Frankfort.

Thank you again for choosing us for your physical and occupational therapy needs in Frankfort. We hope to continue to be your provider of choice.

Sincerely,
Tx:Team

Ask an Expert: What Are Energy Conservation Techniques and How Can I Use Them to Improve My Quality of Life?

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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

Ask an Expert: Why Do My Legs Swell?

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Question:  Why do my legs swell?

Answer:  There are many reasons why the legs can swell. Medical conditions such as decreased kidney function, lymphedema, congestive heart failure and pulmonary edema and obesity. You should see your physician to rule out more serious conditions before coming to physical therapy or occupational therapy for lymphedema treatment.

A primary cause of worsening swelling throughout the day typically is from having the legs in the dependent position such as sitting in a chair with the knees bent for prolonged periods of time. When the knees are bent that put some additional strain on the venous system to return blood to the circulatory system because of the cramping down affect with the knees bent gravity working against blood flow returning to the trunk region.

A few helpful tips to minimize swelling of the feet and lower legs are to not sit more than 20 to 30 minutes at a time, elevate the legs, pump your ankles back-and-forth, stand up more often and complete marching in place or heel raises.

Ask an Expert: How Do I Get Cleared to Return to Sport After My ACL Tear?

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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

Resuming Exercise After a Prolonged Break

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Engaging in physical activity offers both immediate and long-term physical and mental benefits. Exercise can enhance sleep quality and reduce the risk of depression and anxiety. Physically, it lowers the risk of cardiovascular disease, type 2 diabetes, infectious diseases, and certain cancers.

The United States Centers for Disease Control (CDC) recommends that adults engage in at least 150 minutes of moderate-intensity aerobic physical activity, such as brisk walking, each week. Additionally, the CDC suggests incorporating muscle-strengthening activities on two or more days a week, targeting all major muscle groups.

Beginning exercise after being inactive can seem like a daunting task. Follow these tips and advice to start your health and fitness journey on the right track!

Start Off Slow

  • Consult a Professional: Speak with a healthcare professional or physical activity specialist to determine suitable types and amounts of exercise, especially if you have a disability or chronic condition.
  • Proper Warm-Up and Cool-Down: Learn the importance of warming up and cooling down to prevent injuries. Spend 5-10 minutes stretching, stay hydrated with water and electrolytes, consume protein, and ensure you get adequate sleep.
  • Avoid Overexertion: Gradually increase your activity levels to avoid injuries that could hinder your progress.

Get Social Support

  • Join Groups: Participate in fitness classes or join walking, running, or hiking groups to stay motivated and engaged.
  • Lean on Loved Ones: Seek encouragement and support from family and friends to help maintain your motivation.

Utilize Technology

  • Use Apps and Devices: Leverage apps and activity monitors for coaching and guidance. For instance, the Nike Run Club offers guided runs by professionals. YouTube can also provide a wealth of workout advice and tutorials.
  • Focus on Form: These tools can assist you in maintaining proper form and technique, reducing the risk of injury.

Overcome Time and Energy Constraints

  • Integrate Activity: Incorporate physical activity into your daily routine by walking during lunch breaks or taking the stairs instead of the elevator.
  • Find Small Time Slots: Schedule short activity sessions throughout the day when you have more energy.
  • Move During Calls: Stand, stretch, or walk while on phone calls to stay active.
  • Consistency is Key: Maintaining consistency will help establish a sustainable fitness routine.

Reward Yourself for Reaching Goals

  • Celebrate Achievements: Recognize your accomplishments with rewards that benefit your mind and body, reinforcing positive behavior.

Do What You Like

  • Choose Enjoyable Activities: Engage in physical activities that you enjoy and avoid those you find unpleasant to ensure a more sustainable fitness routine.

By following these tips, you can create a balanced, enjoyable, and sustainable physical activity routine that fits your lifestyle and goals.

Source: Cleveland Clinic & United States Centers for Disease Control (CDC)

Ask an Expert: What Steps Can I Take to Avoid the Problem from Returning and Needing Further Physical Therapy?

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Question: Now that my condition has improved and I’m feeling much better, what steps can I take to avoid the problem from returning and needing further physical therapy?

Answer: During your physical therapy (PT) sessions, we conduct a comprehensive assessment to identify factors that may have led to your initial issue. These factors can include strength imbalances, posture issues, balance deficits, and ergonomic considerations such as workstation setup, and footwear choices. Additionally, we address sport-specific, lifestyle, and job-related factors that may contribute to your condition.

To prevent the recurrence of your issue, it is crucial to integrate the techniques and interventions learned during PT into your daily routine. This proactive approach significantly reduces the likelihood of a relapse. You’ll also receive a tailored home exercise program designed to help you maintain the strength gains achieved during your PT sessions. We prioritize designing a program that is both effective and manageable, ensuring it doesn’t become burdensome in your daily life.

Jennie Gaskill, PTA