Author: Dr. Dan Witte

Treatment for Plantar Fasciitis

May 3, 2022

We are starting to see signs of the weather turning. It seems slow but eventually summer will be here, and we will be in shorts and flip flops enjoying the warmer weather. Often our shoe choices turn “negative” as the weather improves. When we say “negative” we really mean less supportive. These less supportive shoe options can lead to increased heel and foot pain that most people refer to as plantar fasciitis.

What is plantar fasciitis?

Plantar fasciitis is the inflammation of the plantar fascia that is found on the bottom of your foot. This inflammation can cause pain with you first steps in the morning or after periods of sitting. This pain can cause abnormalities in how you walk, and those abnormalities can create other pains.

How can I prevent plantar fasciitis?

Wearing appropriate and supportive shoes is a great start. However, we understand that sometimes you want to wear shoes that go with an outfit or are specific to certain activity. Thus, what else can you do? Maintaining calf flexibility is one of the better things you can do to make sure you are “keeping plantar fasciitis at bay”.

First, the runner’s stretch for your gastroc and soleus muscles should be done at least daily. Links for those stretches can be found below. Ideally holding these stretches for 20 seconds and doing them several times per day.

Second, we want to work on our eccentric control of our calf muscles which will also provide a controlled stretch of these calf muscles. A link for this activity can be found below.

Finally, if you find that you are having heel pain the first step to relieve that pain is to wear more supportive shoes and to elevate your heel. This can be done by wearing shows with a thickened heel or by inserting a gel heel lift into your shoe.

If you have any questions about these steps or if you have tried these steps and they are not working for you, please give us a call at Witte Physical Therapy. It is important to remember that not all heel pain is the same, so treating it the same person to person will not help everyone. Witte PT can work with you to set up an individual treatment plan that will work best for you to optimize your results.

Links:

https://www.knee-pain-explained.com/calf-stretches.html (#1 and #2 for calf stretches)

https://www.verywellhealth.com/the-alfredson-protocol-for-achilles-tendonitis-2696560 (see Alfredson protocol)

National Kids and Pets Day and…..

April 26, 2022

On April 12, 2022 we posted our blog on how physical therapy can help with common pediatric issues. We highlighted our pediatric programs and how, Natosha Siemek, PT, DPT, can use her experience and expertise to help your child reach their full potential. Here we are two weeks later and now it is National Kids and Pets Day!

National Kids and Pets Day was created to highlight the bond between kids and their pets. Their pets can be an emotional support animal for the kids. Pets (depending on the type) can provide some companionship and love that is not tied or dependent on anything else. Their pet can provide an outlet for exercise and to burn energy. Pets can even serve as a companion for doing their physical therapy!

(the first person to email dan@wittephysicaltherapy.com and point out the error with this picture will win some Witte PT swag)

Whether we are treating them for coordination or developmental disorders, cerebral palsy, torticollis, pain, injuries, or sports injuries/dysfunction, pets can make that work more enjoyable. 

If you have a pet and/or a child please use today to help them bond and spend some time with them. If you notice your child is not moving well, having pain, or not developing as you would expect please let us know and we can help get them on the right path!

Also, is it a coincidence that tomorrow, April 27, 2022, is National Gummi Bear Day! 

How to Prepare for Spring Yard Work

April 19, 2022

Even though the weather hasn’t supported it, spring is here. And while the cold and wind make it feel like late fall or early winter, it is time to start working on those outdoor projects. With the drier weather we have had our landscaping and yard work has been delayed, but soon it will be time to get those areas cleaned up, fertilized and cut.

It is important as we start looking at outdoor projects that we make sure we are both ready to do them physically and then completing them safely. Here are some things to consider:

1. It is tough to start pulling weeds, lifting rock and mulch, pushing mowers, holding a weed eater, dragging hoses, etc, when we haven’t done anything all winter. Take some time to condition your body to be ready for these activities. Start a walking program working on improving leg strength and aerobic endurance. Take some time do some squats or sits to stands to improve leg strength and to work on proper squat form. Do some basic stretching for your arms, trunk, legs, and back before and after your yardwork.
2. Once we get into the actual work it is important to think about two main things. First, remember to use your core. Whether you are lifting a bag of mulch or using your weed eater, it is important to use your core to avoid any excessive strain on your lower back. Secondly whether you are bending over to pick up the rocks or pull the weeds we need to take the time to squat down by bending our knees and not flexing forward at our waist. By thinking about using our core and squatting properly we take the steps necessary to decrease the most stress through our back that we can.

Spring (and Summer) are great times to get outside, get active, and get those projects done. Just remember to prepare yourself properly for them. Utilizing physical therapy to help get ready for these seasons will keep you from getting injured and save you money on having to go through more therapy visits and forced down time after an injury.

Physical Therapy – Not just for adults!

April 12, 2022

Please read below for specific information on how Witte Physical Therapy can help treat your child!

When you think of physical therapy you might think of an injured athlete, someone recovering from surgery, or someone with a chronic medical problem. We’re here to let you know that you should think of kids, too. Physical therapists are trained to work with patients of any age. Some even specialize in pediatrics. Here are a few things PTs can help kids with:

Coordination Disorders and Gross Motor Delays

Some children are delayed in hitting their gross motor milestones – things like sitting up on their own, rolling, standing, walking, jumping and running. Other children show difficulty with coordination – activities like hand motions to “wheels on the bus”, feeding themselves with utensils, moving awkwardly or slowly, or even tripping or bumping into things a lot. Physical therapists can help encourage development of gross motor skills and coordination to help these kids get back on track.

Cerebral Palsy

This is the most common motor disability in childhood. The symptoms can vary from moving a little awkwardly to being unable to walk and needing assistance for almost all activities. There are also different types – the most common causes stiffness in the muscles, but other types affect control of movements, balance or coordination. No matter the type or severity of cerebral palsy, a physical therapist can help with things like stretching, exercise, bracing, and equipment like a wheelchair if needed.

Torticollis

Torticollis is a postural issue that usually becomes noticeable shortly after birth. Babies with torticollis typically hold their heads tipped one direction and rotated towards the opposite side. This is caused by a tight neck muscle. Research has shown that early referral to a physical therapist is a very effective treatment. The PT usually shows the baby’s caregivers ways to gently stretch the neck, and activities to encourage the baby to move his or her head into a more neutral position.

Pelvic Floor Issues

People don’t commonly think of pelvic floor issues in children, but you might be surprised at how common they are. The most common symptom is chronic constipation, but pelvic floor problems can also show up as urinary incontinence, bed wetting, or needing to go to the bathroom frequently. A physical therapist can help with education for the child and their family, exercise, and sometimes even the use of biofeedback to help the child learn to better control their pelvic floor muscles.

Pain and Injuries

Although kids have a list of problems specific to them, don’t forget about regular old pain and injuries. Your physical therapist can treat an ankle sprain, painful joint, or athletic injury in a child just like they can an adult.

Sometimes kids and even babies need some help with movement. From now on, when you think of your physical therapist, don’t leave kids out of the picture!

At Witte Physical Therapy we have therapists on staff that have the knowledge, extra training, and in some cases certifications needed to treat your child. Natosha Siemek, PT, DPT, has many years of experience in pediatric physical therapy and is a great resource for those families who want to keep their kids close to home for physical therapy. Dan Witte, PT, DPT, OCS, is a certified orthopedic specialists and can help to treat any child with a bone, muscle, ligament, tendon, and/or athletic injury!

References

https://www.cdc.gov/ncbddd/cp/facts.html

https://pubmed.ncbi.nlm.nih.gov/29087112/

https://pubmed.ncbi.nlm.nih.gov/30277962/

https://pubmed.ncbi.nlm.nih.gov/31096249/

https://pediatricapta.org/consumers/

https://www.youtube.com/watch?v=fq62vwyrcXs

Functional Exercise

April 5, 2022

Focusing on your entire body when rehabilitating an injured body part leads to greater recovery outcomes. One method to help you achieve maximum outcomes is by performing functional exercises. Functional exercises are specific exercises geared to each individual person that focuses on training your body to perform the activities you complete your daily life. These activities could range from walking, sitting, standing, pushing, pulling, rotating and climbing. Functional exercise helps to improve your body’s ability to work as one unit which can help to reduce injury, pain and to lead to longer benefits. Additional benefits can include improved balance, coordination, core strength along with improved body awareness. By knowing how to move your body in correct movement patterns and engaging proper muscles to complete desired tasks can lead to a happier and healthier you.

Geriatric Physical Therapy

March 29, 2022

Just as no total knee rehab is the same, we must look at patients differently too. A 25-year-old with low back pain cannot be treated the same as a 75-year-old with low back pain. It is important for your physical therapist to understand that pediatrics must be treated differently than geriatrics and geriatrics must be treated differently than someone who is in their forties.

Geriatric patients present with different concerns than other patients. These concerns may include lower bone density, altered work loads that are needed to gain muscle, center of gravity changes, and other medical issues and considerations.

The goals of the geriatric patient often include things such as improving balance, improving mobility, and improving your quality of life. These goals must be addressed by your therapist differently for each individual patient’s needs and goals.

Instrument Aided Soft Tissue Mobilization (IASTM)

March 22, 2022

Physical therapists have many tools at their disposal to help get their patients better, faster. Many of these tools fall under the umbrella of manual therapy. Manual therapy is defined as any hands-on interventions that are used to decrease tone, improve soft tissue mobilization, improve joint mobility, and to get you back to a pain free life.

Instrument Aided Soft Tissue Mobilization (IASTM) is using a hand tool with many different shapes and sides to help improve your soft tissue extensibility. Therapists will use these tools to better assess your soft tissues (muscle, tendon, ligament, etc) to see any abnormalities, trigger points, restrictions, or areas of increased tone that need to be addressed. Those same tools can be used to treat those abnormalities more aggressively and selectively when compared to a therapist using their hands only. These instruments can speed up your recovery, improve your blood flow, positively address chronic conditions, just to name a few.

Elevate Your Heart Rate with Physical Therapy

March 15, 2022

Heart disease is a leading cause of death and disability. This shouldn’t be a surprise – it’s been at the top of the list for years. You know that taking care of your heart is important. That means doing things like eating right, avoiding smoking, and exercising regularly. While all of those things can be difficult, today we’re going to focus on exercise.

How Physical Therapy Can Help With Your Heart Health

Cardiovascular exercise is anything that makes you breathe harder and your heart pump faster. That could be walking, running, dancing, biking, swimming or hiking. It strengthens your heart and blood vessels. It can help control weight, lower blood pressure, reduce stress, and prevent heart disease.

If you’re regularly going for a run or swimming laps, you don’t need help from your PT. But 3 out of 4 adults aren’t exercising regularly. If you’d like to get started, your PT may be just the person to help you. It’s not uncommon to get injured, then never get back to your old routine. Your PT can help you deal with the old injury and design a plan to get you safely back to regular activity.

It’s also not uncommon to try to be more active on your own, only to stir up pain somewhere like your back, hip, knee or shoulder. Your PT can help with that too. They’ll figure out why you’re having pain, help you correct it, and get you a plan to reach your goals.

Physical therapists can also help you safely increase your activity levels after major medical issues like a heart attack, stroke, or even cancer. Recent research has shown improvements in cardiovascular fitness, fatigue levels and even pain in cancer patients who participate in a personalized physical fitness plan from a PT.

Whatever your barriers to physical activity are, your PT can likely help you overcome them. As movement experts, physical therapists are trained to deal with a variety of conditions. They’ll help you work around whatever issues you have so you can safely elevate your heart rate and keep cardiovascular disease away.

Taken from the PPS Section of the APTA

Modalities and Physical Therapy

March 8, 2022

To help reach your physical therapy goals there are a variety of tools we can utilize to reduce your pain, your muscle tightness or inflammation.

Ultrasound is one of those tools we can use and there is variety of ways we can use it. First, therapeutic ultrasound utilizes sound waves to help speed up cellar processes to help injured tissue heal quicker. Therapeutic ultrasound can also be utilized to penetrate heat into deeper tissues including tendons, muscles, and ligaments to improve circulation, healing processes, tissue extensibility and pain.

Another tool in our toolbox includes electrical stimulation. Electrical stimulation is often referred to as IFC (Interferential current) or TENS (transcutaneous electrical stimulation) and it is the treatment of low voltage electrical currents utilized to block pain receptors leading to pain relief benefits. Patches or electrodes are placed surrounding your area of pain, the e-stim unit is turned on and a gentle tingling sensation is typically felt. Duration of treatment can vary depending on treatment area and intensity of pain.

Combination therapy is the use of ultrasound with electrical stimulation simultaneously which can be utilized to reduce muscular spams, promote improved circulation and to improve muscular activation.

Utilizing a vasopneumatic device is a machine that is attached to a sleeve or brace that is wrapped around affected body part that pumps ice cold water and air through the sleeve for compressive and pain relief benefits. Most commonly vasopneumatic devices are utilized postsurgical to reduce swelling and pain.

Talk to your therapist today to see if any of these treatment options would be beneficial to you!

Worker’s Compensation and Physical Therapy

March 1, 2022

Unfortunately, sometimes injuries happen while you are at your place of employment. When these injuries occur, it is possible that your employer may be liable for your medical costs. When they are this is called worker’s compensation. This means that your health insurance does not provide your benefits for your healthcare, but your employer’s does. This can be confusing as you often must work with a case manager, an adjustor, and a HR representative to get your care started, throughout your care, and to end your care. This can also include a disability rating at the end along with paying for your cost of care.

Physical therapy comes into play when it is needed after a worker’s compensation claim has been started. Your therapist will help you to improve your pain, get your mobility and strength back, improve your ability to return to work safely, and get you back to work as efficiently as possible. We will also work to help you understand the worker’s compensation process and we will work with your case manager and claims adjuster to ensure that you are taken care. This includes getting authorizations for your visits and ensuring that payments are made on your behalf. We work to be your advocate and your healthcare provider.