Blog

Why Does My Shoulder Hurt?

November 7, 2023

Lately in the clinic we have been seeing an increase in shoulder pain and issues. These issues can be caused by shoulder discomfort or pain leading to physical therapy or they can be due to rehab following a shoulder procedure or surgery. But why do our shoulders have the capacity to cause so many issues for us?

First, the shoulder is a very mobile joint. In fact, it is one of the most mobile joints we have in our body. If you think about all the ways, you can move your shoulder it becomes very clear about how important it is for use to be able to do our daily tasks. You can reach up, back, out, across, and forward with your shoulder. You can do these motions with or without rotation and within small ranges or across large ranges of movement. The ball and socket design of the shoulder provides for great flexibility and overall mobility of movement making many tasks much easier for us to complete them.

This movement is great, and it is from the design of the joint, but the design of the joint also can cause some major issues. With the ability to have great mobility also comes the lack of structural ability to achieve it. Because the shoulder is a ball and socket joint it allows for movements in multiple planes, but to allow for all that movement there must be minimal restriction within the joint itself. This means that statically and structurally the stability of the shoulder joint is very low. This low structural stability requires increased dynamic stability to keep the shoulder functional. The dynamic stability of your shoulder comes from your rotator cuff.

The rotator cuff is a group of four muscles with two functions. First the rotator cuff helps with moving your shoulder in the direction of internal and external rotation. The second function is the rotator cuff helps with stability of your shoulder or it helps to keep the ball in the socket of the joint. As you lift your arm away from your body the rotator cuff plays a vital role in preventing your shoulder from dislocation. You can see the importance this small muscle group plays in your function. Unfortunately, this small muscle group can easily become overwhelmed with its tasks. When it becomes overwhelmed it can strain or tear and cause other issues that need to be addressed medically.

The shoulder is an important joint to our daily lives. However if we don’t understand it and how to take care of it the lack of internal stability and the weakness of our dynamic stability can cause issues that will need to be addressed.

HAPPY HALLOWEEN!

October 31, 2023

Today is a very special day for lots people, children and adults. It is a day to hand out candy, to get candy, to dress up, to hang out with friends, to get into the spirit, and to have fun. 

It is a day to think about the pros and cons of Halloween on physical therapy.

Pros: 

A lot of people spend more time on their feet. Whether it is standing at a party or walking the neighborhood it is a day where our activity level generally increases. Recently, the saying “sitting is the new smoking” has become a more normal thought, but Halloween gets some of us more active. Standing, moving, and just being more active is better for our health and can be a good habit to start as winter approaches. 

It is just plain fun! Getting out of the house and mingling with our friends and neighbors all have positive effects on how we feel!

Cons:

Candy! It tastes great and is a delicious treat, but there really is nothing good that candy provides us. Its nutritional value is almost nothing and it has more things that rot our teeth, negatively affect our metabolism, and provides us many other poor health benefits.

We have to make sure who we are mingling with and what are we receiving are safe. Be aware of your surroundings, avoid large crowds of people you do not know, avoid people who may be feeling sick, and make sure to double check that any goodies you receive are unopened, untampered, and safe.

How Does Physical Therapy Benefit Children With Autism?

October 24, 2023

What Is Autism?

Autism, or autism spectrum disorder (ASD) describes a range of developmental conditions that affect how a person communicates, interacts, and behaves. ASD is called a spectrum disorder because the symptoms and severity can vary widely from one person to another.

Typical signs and symptoms of autism include:

• Having difficulty with communication and social interaction
• Restricted or repetitive patterns of behavior such as repeating words or phrases, lining up objects, or having intense and narrow interests
• Sensory issues, such as being over- or under-sensitive to sounds, lights, or textures

How Can PT Help?

Children with autism also often have difficulties with motor skills, which affect their daily functioning and quality of life. For example, they may have trouble with balance, coordination, motor planning, and body control. They may also have low muscle tone, which can make them appear floppy or weak. These challenges make it hard for them to participate in physical activities like playing games or on playgrounds with peers, which are important for both their physical and mental health.

Physical therapy can help children with autism overcome these difficulties and improve their motor skills. Using individualized and structured interventions, pediatric physical therapists help children with autism learn new skills and practice them in a fun and motivating way. Physical therapy can also help children with autism develop a positive attitude toward physical activity and enjoy the benefits of exercise, such as improved mood, energy, and sleep.

Improved gross motor skills and increased physical activity can also support the development of other areas that are affected by autism, like social and emotional skills. Physical activities can provide opportunities for children with autism to interact with their peers and family, express their feelings, and follow rules and directions. Physical therapy can also help children with autism cope with sensory issues, such as hypersensitivity or hyposensitivity to touch, sound, or movement, by exposing them to different stimuli and helping them regulate their responses.

How Do I Find A Qualified PT For My child?

If you think your child with autism may benefit from physical therapy, you should consult with your child’s pediatrician, who can refer you to a physical therapist who specializes in working with children with autism. You can also search for a physical therapist near you using the American Physical Therapy Association website.

References:

• Research (peer-reviewed)
  • Physical Activities for Children with Autism – https://pubmed.ncbi.nlm.nih.gov/32192008/
  • Exercise for children with autism – https://pubmed.ncbi.nlm.nih.gov/31615098/
  • Physical activity effects on sleep and executive function – https://pubmed.ncbi.nlm.nih.gov/30663324/
• Articles and Content
  • Recognizing Autism in Healthcare – https://pubmed.ncbi.nlm.nih.gov/34983217/
  • Autism – diagnosis and management – https://www.nice.org.uk/guidance/cg142

Supporting people with autism 19 or under – https://pubmed.ncbi.nlm.nih.gov/34283415/

Why I Chose to Become a PT?

October 10, 2023

October is National Physical Therapy month. During this month each year there are several themes that are usually addressed by the APTA and physical therapists throughout the country. Last week we talked about the cost benefit of physical therapy and how it can provide benefits to you for years to come, both physically and economically. This week I want to share why I became a physical therapist.

The first reason I became a physical therapist was due to my involvement in it. When I was in 5^th grade, I had surgery on both of my legs to correct my “pigeon toed” posture. This surgery included a few months in a wheelchair, followed by braces, and lots of rehab to get back to playing sports and being a typical 5^th grade kid. This surgery also prompted two more surgeries over the next 6 years. After that I tore my MCL my senior year of high school and then in my senior year of college I fractured a vertebra and ruptured a disc in my back. All these instances required varying degrees of physical therapy.

The second reason I became a therapist was that I wanted to help people. Because of this desire I knew from a young age that I wanted to do something in the medical field. I looked at being a physician or a dentist, but ultimately settled on being a physical therapist. This field allows me to see a patient at a low point in their life and provide them assistance to make it better. I get to see them at their lowest and then I get to see them improve and leave at a high point. Because of this I get to know my patients more on a personal level and often times I make lifetime connections to my patients.

These are my reasons for becoming a physical therapist. Therapy is a diverse field of professionals that come from a variety of backgrounds. We all have our own reasons and paths to becoming a physical therapist, but the common reason is to help our patients get better and achieve their goals. This is the most rewarding part of my career, and I am thankful for it.

Physical Therapy Month – Financial Benefits of Physical Therapy

October 3, 2023

October is Physical Therapy month in the United States. It is a month where we look at the benefits of physical therapy, define the scope of the profession, and celebrate those that work in the field and those that benefit from it. A focus of physical therapy lately has been its role in trying to help patients avoid complex and expensive surgical procedures, injections, or medications, such as opioids. Often when we are experiencing discomfort, we think of the what can be the quickest fix, but that fix is often only a band aid. Looking at how to fix the problem long term can provide some interesting cost effective savings for our patients. Let’s look at a few of our more common ailments that physical therapists can treat and how therapy can be a great “bang for your buck”!

When determining the value of physical therapy care it is important to look at four aspects of physical therapy services.

• Direct Benefits: reduced pain, increased mobility, reduced burden of disease, longer life expectancy, etc
• Indirect Benefits: reduced costs of other provider services, etc
• Costs: fees for visits, medications, procedure and equipment purchases, time spent at appointments, etc
• Avoided Costs: reduced costs of other provider services, reduced waiting time at a physical therapist vs a physician, etc

To determine if physical therapy has a positive economic value on your life we need to see if the direct benefits exceeds the net costs of indirect benefits, costs, and avoided costs added together.

The report that is listed in our references found that for these 8 common ailments the net economic impact to the patient was positive if you used physical therapy. This means that the benefits you attained from a physical therapy plan of care exceed the cost of your time, travel, other provider costs, etc. The bottom line is that physical therapy can save you time and money!

The positive economic impact of the 8 common ailments were:

• Acute Low Back Pain: $4160
• Vascular Claudication: $24125
• Stress Urinary Incontinence: $10129
• Carpal Tunnel Syndrome: $39533
• Cancer Rehabilitation: $3514
• Falls Prevention: $2144
• Tennis Elbow: $10739
• Osteoarthritis of the Knee: $13981

At Witte Physical Therapy we have treated all these conditions. If you have any of these or any other condition that physical therapy may help with please contact us to set up a free consultation with a therapist to discuss your situation and if physical therapy is right for you!

References:

https://www.valueofpt.com/globalassets/value-of-pt/economic_value_pt_u.s._report_from_apta-report.pdf

Physical Therapy for Dementia

September 26, 2023

Dementia is a group of conditions that affect the brain, causing problems with memory, thinking, communication, and behavior. Dementia has many forms, including Alzheimer’s disease, vascular dementia, Lewy body dementia, and more. It’s a big deal. According to the WHO, it’s the seventh leading cause of death worldwide and one of the major causes of disability among older people. While there is no cure for dementia, there are ways to manage the symptoms and improve the quality of life for people living with this condition.

Physical activity is one common recommendation. While exercise is certainly beneficial to everyone, the evidence for exercise’s effect on dementia symptoms is mixed. Most studies do show that exercise can help delay or reduce symptoms like depression, or apathy. Some studies also show a benefit in delaying or reducing cognitive declines. If you’re familiar with the benefits of exercise, this all makes sense. We know exercise has a positive effect on mood and depression. When your heart pumps harder during exercise, it increases blood flow throughout your body, including to your brain. 

Does Any Type of Exercise Work?

For people with dementia, it doesn’t appear as simple as “exercise and symptoms improve.” Studies have shown that the type of exercise, duration, and frequency all make a difference. For example, one study showed that people with dementia who engaged in dance movement therapy had less depression and better physical function. A second group who performed other types of exercise at the same intensity did not see those benefits. This is where a physical therapist can be incredibly beneficial. 

Physical therapy for dementia is tailored to each individual’s needs, goals, abilities, and preferences. The physical therapist will conduct a thorough evaluation of the person’s medical history, physical condition, cognitive status, functional level, and personal interests. Based on this information, the physical therapist will design a personalized treatment plan that includes specific exercises and activities that target the areas that need improvement.

The treatment plan may include:

• Aerobic exercises to improve cardiovascular health, oxygen delivery to the brain, mood, energy levels, and cognitive function.
• Strength exercises to build muscle strength and power.
• Balance exercises to challenge the person’s ability to maintain equilibrium and prevent falls.
• Functional exercises that mimic or practice daily activities that are important or meaningful to the person, such as climbing stairs, getting in and out of bed or a car, or using utensils.
• Coordination exercises or more complex movements like dance or tai chi. Evidence shows more complex movements like these have larger effects on more dementia symptoms than a simpler exercise like riding a stationary bike. 
• Dual – task or cognitive exercises like combining walking with doing math out loud, or solving puzzles while on a stationary bike or treadmill. Again, research shows that combining physical and cognitive challenges can have an effect on dementia symptoms. 

The physical therapist will monitor the person’s progress and adjust the treatment plan as needed. They’ll also provide feedback and encouragement. The physical therapist will also educate and advise the person and their family or caregivers on how to continue or incorporate physical activity into their daily routine and lifestyle.

Physical therapy is a safe and effective way to help people with dementia improve their physical and mental health, as well as their quality of life. Physical therapy can also provide support and guidance to people with dementia and their caregivers, helping them cope and adapt to the changes and challenges that come with this condition.

References:

• The effect of physical activity on dementia – https://pubmed.ncbi.nlm.nih.gov/31425142/
• Low & High Intensity exercise for people with dementia – https://pubmed.ncbi.nlm.nih.gov/32192537/
• Dance movement & exercise with dementia – https://pubmed.ncbi.nlm.nih.gov/30496547/
• Physical Therapy as Treatment for Cognitive Decline
• Physical Therapy for Dementia: How and Why It Helps Patients
• Exploring the Benefits of Physical Therapy for Dementia Patients
• Dementia and Physical Therapy – In Motion O.C.
• How Patients With Dementia Benefit From Physical Therapy – FOXRehab

Lumbar Strains and Physical Therapy

September 19, 2023

It happened to me! I was cleaning up the garage and moving some tables after a gathering. When bending down to lift the 5^th table to be moved I was worried more about what I needed to get done that day versus what I was supposed to be focusing on. As I lifted and turned I lost my lifting mechanics and tweaked my back. I had immediate spasms of my lower back and could not stand up with resting me hands and arms onto something to help hold me up. For the rest of the day I laid in bed and tried not to move too fast or in the wrong direction. I tried taking some meds to decrease pain and spasm, I used heat packs and warm water baths to try to relax the muscles. Both of these took the edge off but did not improve my symptoms overall.

The next day I started doing some basic therapy mobility exercises to get my back moving without increasing my spasms. I used a TENS unit to decrease the pain so that I could get up and move more effectively. I went to therapy and got some work done to decrease my spasm and tone and to improve the mobility of my back. By the next day I was back on my feet all day long and work and moving more normally, but not yet 100%. I continued to do these exercises and keep moving and by the third day I was back without any restrictions.

Often when we have acute back pain we take some meds and stay in bed. That is what I did the first day. However, that is not what experience and the research say is best for the immediate resolution of our symptoms and the long term benefit of our backs. Most of the time the faster you can access care for your low back the quicker it gets better. The research shows that starting physical therapy within a day or two of the back pain starting gives you a better chance of relieving the backpain without needing stronger prescription strength drugs, injections, or possibly surgery. This recent example of my issue and treatment helps to prove that theory. I was able to access therapy 24 hours after the initial injury and I was able to continue to do these activities for the next few days to get back on my feet at 48 hours after the injury and be back to 100% 72 hours after the initial injury.

I have the benefit of having physical therapy at my fingertips, but so do you. If you have an injury you can call Witte Physical Therapy and we can start to get you help right away. You have direct access to come directly to the clinic for care, meaning that you do not have to see the physician first. Sometimes it may be appropriate for you to see your physician prior to starting therapy and we can help you through the steps to make that process as efficient as possible. If you have any aches or pains, don’t hesitate to give us a call and we can help get you moving and back on the road to being 100% you faster!

Physical Therapy and the 9/11 Attacks

September 12, 2023

Yesterday we experienced the 22nd anniversary of the 9/11 attacks on our country. On this anniversary we remember those lost and look at the changes made to the former site of the World Trade Center. These changes include a museum, a memorial, and now a state of the art performance space. All of these physical buildings were built for different reasons and to remember different aspects of that day and the people who were affected. 

The people who were there that day and survived or worked to find the survivors and victims of the attack are still dealing with several different health issues from being at ground zero that day. These ailments could include upper respiratory conditions, GERD, cancer, PTSD, depression, anxiety and substance abuse. This is just a sampling of the problems they are dealing with and does not include the secondary conditions and issues that arise from this list. Chronic pain, inflammation, and heart issues can all be items that physical therapy could help with. 

Physical therapy can help with the deconditioning that comes from dealing with upper respiratory issues and cancer side effects. Physical therapy can help to decrease inflammation and improve pain free mobility. Physical therapy can help with chronic pain to retrain our bodies how to perceive pain and can help us tolerate more activities and become more functional with less pain. Not all of these issues are solely related to the 9/11 attacks, but they can been seen with a variety of patients with cardiovascular, respiratory, and cancer related issues. 

If you are not feeling 100% don’t take that feeling as being your new normal. Visit with a physical therapist about your next steps and how physical therapy may be able to help get you back on your feet and enjoying your entire life! 

References:

https://time.com/6096965/september-11-long-term-health-consequences/

https://www.giants.com/news/never-forget-new-york-giants-remember-9-11

Happy Labor Day!!!

September 4, 2023

We have just completed Labor Day weekend. This is a weekend of celebration of the annual accomplishments of the workforce and is noted as a federal holiday and a day off for many people. In many larger cities it often includes a parade to acknowledge the larger workforces of the area. Examples include many labor unions and city workers.

As we look at Labor Day and its history of celebration, I believe we can tie it in to physical therapy. Labor Day is a celebration of the work done by so many of the year. For our patients’ physical therapy is work. (Luckily for our therapists, physical therapy is fun!) We try to make physical therapy as fun as possible, but it takes the work and dedication of our patients to come to each appointment and to make the most of it. Our patients work extremely hard in the clinic and with their programs at home to get better as fast as they can. Our therapists work hard to provide a fun atmosphere for our patients to improve and be cared for.

I hope everyone used this past weekend as an opportunity to celebrate the work they have put in this year and to renew their dedication to continue to put in 100% effort moving forward. Our therapists will continue to work hard, train and educate themselves to give our patients 100% of their effort in developing plans of care that are specialized to each individual patient. I know our patients will do the same to follow that plan of care and complete their home exercise plan to maximize their results and efficiency.

We look forward to a great last few month of 2023 and for the opportunity to plan for an even better 2024!

Physical Therapy and Ankle Fracture

August 29, 2023

A freak accident or weird fall can result in a myriad of injuries. One of these injuries can be an ankle fracture. Your ankle is composed of three bones, the tibia, the fibula, and the talus. These three bones can result in a variety of fractures and injuries from a fall. Most of these fractures do require surgery and/or physical therapy.

After the injury you will be placed in a CAM boot. This boot has its pros and cons. It allows for earlier motion and mobility which can decrease your recovery time. However, it is hot, heavy, and can cause issues with being able to drive or be independent. Physical therapy can help to address all these issues. During your initial appointment we will work on evaluating how the boot and the restrictions of your injury are currently affecting your life and what needs addressed to get you back to 100%.

Initially physical therapy will focus on your mobility, flexibility, and non-weight bearing muscle strength. We will design a plan of care that works within your MD restrictions. These restrictions could include weight bearing status, a CAM boot wear schedule, etc. The more mobility and flexibility you can attain before the boot comes off the easier it will be to start walking as soon as you lose the boot.

Once you’re able to bear weight outside the boot we will start to work on weight bearing muscle strength. We often call this functional strength, and it leads right into your balance and proprioception. At this point you are often starting to feel better and working back to normal. However, it is important to address the balance and proprioception of your ankle to improve your overall stability. This step is often missed but can have lasting effects on the future of your ankle when on unstable surfaces or faced with another fall situation.

After you have completed all these steps you can get back to your normal life with renewed confidence and strength in your ankle and its ability to handle what you put it through!