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Physical Therapy: Well Care vs. Sick Care

March 30, 2021 – Below is some important information about the difference between “Sick Care” and “Well Care”. It is important to note that physical therapy’s role goes well beyond helping someone recover from a surgery or car accident. We can work on the smallest issues of pain and function to much larger concerns and issues that keep you from living your life as you normally would. We can also work to help you recognize your weaknesses and work on them before they become those bigger problems that end up costing you more money and time.

TRICARE has decided to waive the cost-sharing requirement of up to three visits to a physical therapist for low back pain. They’ve said that the goal is to encourage more use of “high-value” treatments for low back pain. TRICARE tells us in their summary of this demonstration what they mean by high vs low-value care: “Increasing the value of health care refers to improving patients’ quality of care and outcomes, improving patients’ access to care, and reducing overall costs of care. In contrast, low-value care refers to interventions that: are not proven to benefit patients; may harm patients; result in unnecessary costs; or waste health care resources.”

Well Care

High-value care leads to better outcomes, is easy to access and is cheaper for both patients and insurers. Physical therapy fits into this category, but looking at other high-value treatments helps us start to see a theme. In 2017 the American College of Physicians released widely endorsed guidelines for treating low back pain. Initial treatment recommendations include exercise, stretching, tai chi, yoga, progressive relaxation, heat or ice, cognitive behavioral therapy, and motor control exercise. These are all active treatments, where the practitioner and the patient are working together to improve. This is “well care”.

Sick Care

In contrast, low-value care tends to be “sick care” where the patient is a passive participant. TRICARE puts imaging before six weeks in the absence of red flag symptoms, surgery for non-specific low back pain, opioids as the first or second-line treatment, and bedrest in the low-value category. Spinal injections also fall in this category for most people.

This isn’t to say that imaging, surgery, or injections are always bad. For a small percentage of people with back pain, they’re the right treatment. But, most people should start with treatments that have the best outcomes for the lowest cost. If those treatments tend to focus on putting the person in pain in power to actively participate in their care rather than making them dependent on someone to “heal” them, that’s even better. Physical therapists know this and have been providing care that fits this model for years. TRICARE’s demonstration that waives cost-sharing clearly shows that insurers are recognizing the value of this type of care and that they are actively moving in this direction.

About The Private Practice Section of the American Physical Therapy Association

Founded in 1956, the Private Practice Section of the American Physical Therapy Association champions the success of physical therapist-owned businesses. Our members are leaders and innovators in the healthcare system. The American Physical Therapy Association (APTA) represents more than 85,000 physical therapists, physical therapist assistants and students of physical therapy nationwide. For more information, please visit www.ppsapta.org.

The above information comes from The Private Practice Section of the American Physical Therapy Association. They provided the resources for this article.

Athletic Training Month and Witte Physical Therapy

March 23, 2021 – As a part of National Athletic Training Month, we will be talking about athletic trainers and what they do! Witte Physical Therapy is fortunate to have an athletic trainer or two among its employees. Isabelle currently serves the Plattsmouth High School. The other trainers work as needed with various local high schools and events.  

The AT slogan of 2021 is “Essential to Health Care.” This is becoming more evident each year and is a big reason why Witte Physical Therapy has added athletic trainers to its team.

Athletic trainers are more than clinicians who work with sports injuries. Athletic trainers:

• Minimize the risk of injury and illness through education and promoting healthy lifestyles
• Implement evidence-based assessments to formulate clinical care plans
• Integrate practices in immediate and emergency care for the best possible outcomes
• Help to address injuries, illnesses, and general medical conditions with the goal of achieving optimal activity level through exercise, manual techniques and modalities

Athletic trainers are an integral part of an athlete’s healthcare team. They provide another level of healthcare that can help identify issues earlier and treat issues faster. When they work in unison with the physician, school nurse, physical therapist, parents, and coaches they can help to provide more efficient care to the athlete. Working with athletic trainers at Witte Physical Therapy allows us an avenue to get the athlete back to their sport faster and often in a more cost-effective way for the athlete and their family.

Witte Physical Therapy is proud to work with athletic trainers and we look forward to growing this partnership in the future. It is another way that we are trying to give back to our communities and provide them with the resources of bigger cities. By keeping the athlete and their family within the Witte Physical Therapy team is allows us to work in a more effective and efficient way to return them back to the game!

References: https://www.nata.org/advocacy/public-relations/national-athletic-training-month

Women’s History in Physical Therapy

March 16, 2021 – With March being Women’s History month we wanted to take some time to recognize their importance in the profession of physical therapy.

The physical therapy profession has grown and evolved significantly over the years. Physical therapy began during the polio epidemic and World War I. Mary McMillan, also known as the “founding mother” began working with World War I survivors in 1918. She later became known as the first re-aide. Later she began training other women to become re-aides. Once the polio epidemic took hold, McMillan saw the need to grow the PT profession and later formed the national organization called the American Women’s Physical Therapy Association now known as the American Physical Therapy Association. Today, women make up 70% of the PT profession.

https://www.google.com/url?sa=i&url=https%3A%2F%2Fblog.storyterrace.com%2Fus%2Fmeet-mary-mcmillan-the-mother-of-modern-physical-therapy&psig=AOvVaw0115mFubCJGtLK0NCYr35W&ust=1615991689522000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCMjZxKeEte8CFQAAAAAdAAAAABAD

We invite you to take the time to visit the following link: https://www.webpt.com/blog/8-famous-women-pts-from-history/ and take the time to read this blog. It shows the importance of women in physical therapy’s past and the foundation that they laid. At Witte Physical Therapy we employ 3 therapists, 2 therapy assistants, an athletic trainer, and a billing specialist that are all women. They continue to keep the profession moving forward today and into the future!

Since the beginning, PT has evolved to include clinical and non-clinical positions. The therapists at Witte Physical Therapy are clinical therapists who work with a wide variety of patients. Physical Therapists do not only treat patients with post-operative conditions. Outside of post-op conditions our physical therapists treat a variety of conditions including, but not limited to:

• Muscle strains and tension
• Spinal pain
• Headaches
• Vertigo
• Women’s health condition’s
• Pelvic dysfunction
• Parkinson’s and Huntington’s Disease
• Cancer
• Lymphedema
• Multiple Sclerosis
• Diabetes
• Cerebral Palsy
• Torticollis

Our therapists are trained to work with and treat all of these conditions. This list is not exhaustive, but provides some examples. Natosha Siemek, PT, DPT, can work with women’s health, pelvic dysfunction, lymphedema, cerebral palsy, and torticollis patients. Kayla Mammen, PT, DPT can work with headaches, vertigo, Parkinson’s and Huntington’s disease patients. The rest of our staff also have their specialties and can work with the above list and more!

Some of these conditions may come as a surprise. However, many disorders affect the body physically. Physical therapists are trained to work with disorders that effect the body’s physical function. Give us a call today in Louisville at 402-234-3333, in Plattsmouth at 402-298-4747 to ask questions and learn more!

What is Pelvic Health Physical Therapy?

March 9, 2021 – Did you know Pelvic Health Physical Therapy used to be commonly referred to as Women’s Health? Why the change you may ask? Pelvic Health Physical Therapy covers disorders of the pelvis and abdomen for both men and women. Previously, this area of physical therapy mainly treated pre-natal and post-natal disorders. Since then, pelvic PT covers so much more! Here are some common examples:

• Incontinence of bowel & bladder
• Constipation
• Pelvic Pain
• Diastasis Recti
• Hernias
• Pre and post-natal issues
• Pain with intercourse
• Breast Cancer

Many of these disorders are “common” but not “normal”. For example, if you are experiencing pre-natal or post-natal leakage, do not brush it off. This could be the start of a lifelong disorder and it is best to address these issues early on before they could persist or get worse. It you have a diastasis recti or abdominal hernia repair a physical therapist can help you learn proper lifting techniques and retrain the abdominal and postural muscles to help regain strength and prevent re-tearing.

Pelvic health physical therapy is for all ages and genders. Everyone has a pelvic floor and abdominal muscles that can experience dysfunction. If you are experiencing any of these issues or have any concerns give the therapists at Witte Physical Therapy a call in Louisville at 402-234-3333, in Plattsmouth at 402-298-4747. Pelvic health PT could be right for you.

March is Women’s History Month: Physical Therapy and Women’s Health

March 2, 2021 – The month of March is Women’s History Month. Let’s talk about women’s (health) history in Physical Therapy!         

• 1977 – The Academy of Pelvic Health Physical Therapy (formerly called Section on Women’s Health of the American Physical Therapy Association) was founded by Elizabeth Noble under the original name of Section on Obstetrics and Gynecology. The association served as a resource for continuing education for physical therapists who were interested in healthcare of women before, during, and after pregnancy.
• 1995 – members voted to change the name to Section on Women’s Health to mark specialized education to address women’s physical therapy needs
• 2001 – the organization updated its mission to recognize members to also treat males affected by incontinence, pelvic pain, fibromyalgia, and osteoporosis.
• Present – the professional association is now referred to as the Academy of Pelvic Health Physical Therapy to represent the goals of the group to address the abdominal and pelvic health needs of both males and females.

Pelvic health physical therapy has evolved and grown over the years to treat women in obstetrics and gynecology, to all women’s health needs, and eventually to include treatment of male’s abdominal and pelvic health needs as well. Pelvic physical therapy is helpful through all stages of life.  Abdominal and pelvic floor pain and dysfunction can affect men and women at all ages and for many reasons.

https://www.health.harvard.edu/womens-health/pelvic-physical-therapy-another-potential-treatment-option

Witte Physical Therapy is happy to share we have licensed professionals who have experience in the areas of pelvic health and would be happy to help you overcome challenges in the areas of women’s and pelvic health! Stay tuned to learn more about pelvic health and if it could be right for you! To consult with one of our women’s health specialists please contact us in Louisville at 402-234-3333, in Plattsmouth at 402-298-4747.

For more information visit APTA Pelvic Health | Professional Association for PTs, PTAs and SPTs

Source: https://aptapelvichealth.org/about/history/

Physical Therapy and COVID Recovery

February 23, 2021 – Just over one year ago the first COVID-19 case was reported in the United States. Since then, many things have changed, especially in the health care field.  By now, you have probably known someone who has been affected by the virus in some way. Whether that way be big or small, it is important to know that the therapists at Witte Physical Therapy are prepared to help you or a loved one get back to life as a part of recovering from illness. Our therapists have been preparing and educating themselves on the lingering effects from COVID-19 and what they can do to help. In today’s blog we will break down some of the effects that may linger after COVID-19 recovery and how Physical Therapists can help.

Below are some common signs and symptoms that may linger for a long period after COVID:

• Fatigue
• Shortness of breath
• Cough
• Joint pain
• Chest pain, muscle pain, or headache
• Fast or pounding heartbeat
• Loss of smell or taste
• Memory, concentration, or sleep problems
• Rash or hair loss

Source:  https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351

Physical therapists are trained to help with muscle and joint pain that can be caused from COVID-19 and possible deconditioning associated with hospital stays. With deconditioning comes muscle strength impairments, decreased heart and lung capacity, balance, endurance, and ability to walk and climb stairs effectively. Our therapists also have a good understanding of proper breathing techniques and training to assist with fatigue, shortness of breath, and cough. Physical Therapists are a good resource to have in case of any other symptoms you may be concerned about. Some examples of COVID-19 rehabilitation with physical therapy can include:

• Exercise and Strength training:
  • Whole Body strengthening
  • Aerobic reconditioning
  • Stretching
• Neuromuscular retraining:
  • Breathing, chest wall, and diaphragm retraining
  • Posture and core retraining for better balance and body awareness
  • Gait training
• Manual Therapy
  • Soft tissue mobilization to improve pain and soft tissue extensibility
• Education
  • Energy conservation techniques
  • Activity modifications
  • Relaxation strategies

            Furthermore, a recent study compiled information from various articles discussing COVID-19 rehab and physical therapy. It concluded, “…the physical therapy of COVID-19 patients will not only reduce the mortality rate of patients, hospital admission time and medical expenses, but also save medical resources, reduce personal and national economic losses, and the probability of adverse social stability events such as medical collapse. Therefore, physical therapy should be introduced into the mainstream treatment of COVID-19 patients as early as possible.”

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443542/:

J Phys Ther Sci. 2020; 32(8): 545–549.

Published online 2020 Aug 8. doi: 10.1589/jpts.32.545

                For more information about how the therapists at Witte Physical Therapy can help you or a loved one recover from COVID-19, or if you would like to schedule an appointment please give us a call in Louisville at 402-234-3333 and in Plattsmouth at 402-298-4747!

American Heart Month – A Physical Therapist’s Role

February 16, 2021 – As American Heart Month continues, we need to educate ourselves on how we can improve our heart health. There is so much you can do to prevent heart disease. If you read last week’s blog, you learned about risk factors. This week we will be covering different ways Physical Therapists can help you achieve a healthy heart.

Multiple studies have shown exercise improves heart health. Working with a PT can help you increase your exercise tolerance safely. Whether this means grocery shopping without losing your breath or getting back to running another 5K, PT can help you train appropriately to reach these goals safely while keeping your specific cardiac needs in mind.

The presence of a physical therapist to help guide you as you work toward your physical and cardiac fitness goals will help you reach a level of independence in a healthy routine. Physical Therapists have an educational background that includes cardiac anatomy, conditions, and the warning signs associated with cardiac distress just to name a few. This allows patients to work closely with a Physical Therapist to safely reach their heart health goals!

When it comes to improving nutritional health, Physical Therapists are qualified to offer resources needed to achieve nutritional health. Taking small gradual steps to improving diet can address multiple cardiac risk factors.

For more information about pursuing a healthier heart with a Physical Therapist, please reach out to your friends at Witte Physical Therapy! Call us in Louisville at 402-234-3333, in Plattsmouth at 402-298-4747!

References:

https://doi.org/10.1161/CIRCRESAHA.118.312669

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845247/

Understanding Risk Factors of Heart Disease

February 9, 2021 – In February, we are reminded that it is American Heart Month. So, what is the purpose of American Heart Month exactly? Many people understand it as “heart health” month when we are reminded to lead healthy lives to help improve and keep our heart healthy. Now, why should we be concerned about heart health? The #1 leading cause of death in America is heart disease. So many factors contribute to our overall heart health. During the month of February, we will be covering different topics to help you understand heart health and what it means for you.

Today we will be covering heart disease risk factors, what they are, and what we can do to improve our risk factor profile to be heart healthy! 

Below is some information on risk factors derived from the American Heart Association. https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack

Major Non-modifiable (those we can NOT change) risk factors for heart disease include:

            Increased age, male gender, and heredity

Major Modifiable (those we CAN change) risk factors for heart disease include:

            High blood cholesterol

            High blood pressure

            Physical Inactivity

            Obesity and Overweight

            Diabetes

            Smoking

Other contributing risk factors:

            Diet and Nutrition – poor diet and nutrition can lead to high blood cholesterol and obesity and even cause stress!

            Stress – stress can lead to a lack of desire to be more active and eat healthy and negatively affect high blood pressure.

            Alcohol – excessive alcohol consumption can cause high blood pressure and cholesterol. Binge drinking can also lead a                                      person to eat and sleep poorly which can lead to stress.  

Many of these risk factors can affect each other. For instance, if you are a tobacco smoker, this can lead to high blood pressure, poorly managed diabetes can cause high blood pressure, and physical inactivity causes weight gain – to name a few. So, what can you do to help improve your risk factor profile? Maybe it is eating healthier or exercising more. Physical therapists are trained to understand cardiovascular fitness training and have a basic understanding of nutrition as well!

Physical therapists are equipped with tools to help YOU achieve your best cardiovascular health! Show your heart some love and schedule a visit with your therapists at Witte Physical Therapy today! Contact us at 402-234-3333 in Louisville, 402-298-4747 in Plattsmouth! Stay tuned for more info on heart health!

Here came the snow

January 26, 2021 – After the historic snowstorm that fell on January 25^th I felt like I needed to take time to reflect on what information would be important for our communities to know about. With snowstorms there are several items we need to consider. Shoveling information, how to get around in the snow, how to condition ourselves for the wind and the cold, how to take care of ourselves after a heavy round of snow removal, and the list goes one. Today we are going to focus on a few of these items.

Scooping Snow: Unfortunately, scooping snow can lead to back injuries. Here are some tips from the American Physical Therapy Association for proper Body Mechanics to keep your body SAFE this winter!

1. 1. Push snow to the side (rather than lifting) when possible. If snow must be lifted, be patient and lift smaller load of snow, especially if it is wet, heavy snow.
   2. Do not twist at the low back when moving snow. Instead, bend your knees and keep your back as straight as possible, so that you are lifting with your legs. Step in the direction in which you are throwing the snow to prevent the low back from twisting. This will help prevent lumbar fatigue.
   3. Choose the right shovel. A shovel with a short handle will cause you to bend over repeatedly, while a shovel with a handle that is too long will create a heavier load when lifting the snow. Consider investing in an ergonomically correct shovel and test it out before buying.
   4. Take breaks when needed, especially if you are feeling fatigue or shortness of breath.
   5. Backward bending (also known as back extensions) while scooping snow will help reverse the excessive forward load on the body. Stand straight and tall, place your hands at the back of your hips and bend slightly backward for several seconds.

https://patch.com/connecticut/madison-ct/proper-use-of-snow-blowers-shoveling-techniques-and-winter-safety-tips-from-madison-ems

How to Move on the Snow and Ice: In short, “move like a penguin”. It really can be that simple. See the graphic below from https://studyinsweden.se/blogs/2015/11/27/winter-lessons-from-snowproblems/

Of course if you follow these simple tips and you still are experiencing pain or discomfort from snow scooping/shoveling or a fall you can always call Witte Physical Therapy. We offer free consultations to help you figure out your pain and what your next step needs to be, even if it is not physical therapy. Give us a call today in Louisville at 402-234-3333, in Plattsmouth at 402-298-4747.