Category: Therapy

What A Pain In The……Elbow!

June 14, 2022

Golfing can be a fun leisure activity unless it causes you pain. If you experience pain you may be experiencing a condition referred to as medial epicondylitis or golfer’s elbow. This often presents as pain from the inside or medial portion of your elbow to your wrist and is caused by excessive or repetitive force to bend your wrist toward your palm. This force and motion cause tiny tears and inflammation in the tendons of your forearm. Other activities that can cause similar diagnosis include carrying a heavy suitcase, chopping wood, operating a chain saw or using hand tools in a repetitive manner. Common symptoms include pain along the inside of your elbow or forearm that can worsen with certain directions, stiffness, weakness of your elbow, wrist or fingers and in some cases numbness and tingling.  

If golf isn’t quite for you tennis is another activity you may enjoy. Similar to golfer’s elbow too much tennis can cause lateral epicondylitis or tennis elbow as it is commonly referred to. Instead of pain along the inside or medial portion of your forearm you experience pain on the outside or lateral portion of your elbow and forearm. Frequent bending or straightening of your arm while keeping your wrist straight can cause rubbing of your muscle on bony aspects of your elbow causing tears and inflammation in the muscle. Common causes of tennis elbow include weak shoulder and wrist muscles, improper backhand stroke, painting with a brush or roller, operating a chain saw, frequent use of hand tools or professions that require prolonged repetitive movements like a butcher, painter or plumber for example. Symptoms often associated with tennis elbow include achiness, burning or pain along the outside of your forearm that with time or repetitive motions gets worse. Another symptom can include weak grip.

Both conditions are often diagnosed by your doctor through a physical examination however sometimes an X-ray or MRI may be required. Treatment can include physical therapy, rest, ice, gentle strengthening and stretching exercises or anti-inflammatory medications. Other alternatives can also include bracing, steroid injections and rarely surgery. Ways to prevent injury include strengthening your forearm muscles, proper warm up and cool down, fixing your form, using the correct equipment, knowing when rest is required to allow for recovery and using proper mechanics when lifting objects or weights. It is important to keep your hands, wrists and elbows strong and flexible to prevent potential injury.

Resources:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/medial-epicondylitis-golfers-and-baseball-elbow#:~:text=Medial%20epicondylitis%20is%20also%20known,the%20wrist%20toward%20the%20palm.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/lateral-epicondylitis-tennis-elbow#:~:text=Lateral%20epicondylitis%2C%20or%20tennis%20elbow,become%20sore%20from%20excessive%20strain.

https://www.mayoclinic.org/diseases-conditions/golfers-elbow/symptoms-causes/syc-20372868

https://orthoinfo.aaos.org/en/diseases–conditions/tennis-elbow-lateral-epicondylitis/

How to Properly Hydrate

June 7, 2022

Drinking fluids such as water play a vital role in your overall health. Not drinking enough fluids can lead to dehydration, increased joint stiffness, muscle cramps, mood changes, kidney stones and memory loss to just name a few. Benefits of improved hydration include improved memory, digestive harmony, improved energy, weight management, heart health and improved mood. We get most of our daily hydration from the fluids we drink so it is important to opt for drinks with less sugar, better alternatives include plain water, sparkling or flavored water, plain tea or plain coffee to improve overall health and function of your body. Other beverages that can aid in hydration however should be consumed within recommended dietary caloric intake include low or fat free milk, 100% fruit juice or vegetable juice and in some instances sports beverages. These alternatives to water can include nutritional benefits including vitamin D, calcium or potassium.

It is even more important as the summer months approach to increase your fluid intake to account for increased body temperature and sweating. Increased hydration is also important in instances when you may be running a fever or have been ill. Some tips to improve your water intake could include a new water bottle, serving water during your meals, adding fruit such as lemons or vegetables such as cucumbers to add flavor or freezing a bottle of water you can drink all day long. A good rule of thumb for maintaining proper hydration recommended by most physicians is six to eight, eight-ounce glasses a day. It is important to discuss your health history, needs and medications with your physician to discover an intake goal that will best meet your needs.

Resources: https://www.ncoa.org/article/10-reasons-why-hydration-is-important

https://www.cdc.gov/healthyweight/healthy_eating/water-and-healthier-drinks.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthywater%2Fdrinking%2Fnutrition%2Findex.html

https://www.nutrition.va.gov/docs/UpdatedPatientEd/PreventingDehydrationinOlderAdults2018.pdf

Keeping Time…

May 31, 2022

As I was doing some research for this post I noticed something noteworthy about this date. On this day in 1859 the Great Clock housing Big Ben starts keeping time. Now, some of you may think that this is an odd thing to find in a blog on a physical therapy website. However, as I was reflecting on my day I was reminded of how many conversations I had with patients today involving time. How long do I need to do this exercise for? How long do I need to follow my home exercise program? How long will I be in therapy? These are all great questions and ones that come up nearly every day.

First, how long do I need to do this exercise for? It is important to work with your therapist to understand why you are doing an exercise and how that affects how you are doing it. Sometimes we do exercises for time (holding a stretch for 30 seconds), or for reps (3 sets of 10), or for endurance, balance, stability, etc.

Second it is important to understand that therapy works best when it is done daily. If you want to be done with therapy as soon as possible it is imperative that you participate at home. This could be with a home exercise program or modifying your activities at home or following an icing regimen. If you follow your therapist’s instructions you are more likely to decrease your time in therapy.

Finally, how long will I be in therapy. This was somewhat addressed above, but you should have a good idea after your first visit how long your therapy plan of care could be. You should work with your therapist to address and assess this plan of care regularly. You more you understand what therapy is and the more you buy into the plan the shorter your time with therapy will be!

Want a Bargain? Try Physical Therapy!

May 24, 2022

It’s no secret that prices have been going up. Gas is expensive. Food is expensive. The housing market is crazy. If you’re looking for ways to pinch some pennies or stretch your dollars, physical therapy might be just what you’re looking for.

Physical Therapy Saves Cost

A study that looked at the claims data of 472,000 Medicare beneficiaries with back pain found that when PT was the first treatment, costs were 19% lower than when people got injections first and 75% lower than for people who were sent straight to surgery. The study also found that in the year following diagnosis, people who got PT first had costs 18% lower than those who got injections, and 54% lower than those in the surgery group.

Another example happened in 2006 when Virginia Mason Health Center in Seattle teamed up with Aetna and Starbucks. They sent workers with back pain to see both a physical therapist and physician for their first treatment. Use of MRI dropped by 1/3, people got better faster, missed less work and were more satisfied with their care. The cost savings was so great that Virgina Mason was losing money on treating back pain, so Aetna ended up paying them more for PT treatments because they were saving so much money.

Physical Therapy First Means Fewer Visits…

A paper published in Physical Therapy looked at outcomes when patients went to a PT first vs. seeing a physician first for back pain. It found that patients who went to their physician first needed 33 PT visits on average, while those who went to their PT first only needed 20. Seeing a PT first saves money, but it also saves time.

It Also Means Better Outcomes

A study of 150,000 insurance claims published in Health Services Research, found that those who saw a physical therapist at the first point of care had an 89 percent lower probability of receiving an opioid prescription, a 28 percent lower probability of having advanced imaging services, and a 15 percent lower probability of an emergency department visit.

High quality research consistently shows that taking advantage of direct access and getting to your physical therapist quickly leads to better outcomes in fewer visits with lower costs. We think that’s a deal worth taking advantage of.

References

1. https://ww1.prweb.com/prfiles/2010/11/03/4743604/0_ANovelPlanHelpsHospitalWeanItselfOffOfPriceyTests.pdf
2. https://pubmed.ncbi.nlm.nih.gov/33245117/
3. https://www.apta.org/news/2017/07/26/study-says-cost-savings-of-physical-therapy-for-lbp-are-significant#:~:text=Researchers%20say%20that%20not%20only,over%20treatments%20that%20begin%20with
4. https://academic.oup.com/ptj/article/77/1/10/2633027?login=true
5. https://newsroom.uw.edu/news/early-physical-therapy-benefits-low-back-pain-patients

How to Avoid “Bleacher Butt”!!

May 18, 2022

We all love to cheer on our loved ones or favorite sports teams however we also all know how sitting for those long games can cause pain in your low back and bottom. “Bleacher Butt” is a term caused by increased pressure through wooden or metal bleachers for prolonged periods of time on your sit bones (ischial tuberosities). Often these types of bleachers do not have back support either. Typical bleacher posture results in a slouched forward manner causing increased pull on your low back muscles as your hips often drop below your knees.

 Some tips that may be helpful at your next sporting event while cheering on a love one cane include:

1. Posture: Try to engage your core muscles to allow you to maintain straight back positioning to avoid increased unnatural curves of your spine. Gentle rocking from side to side of your bottom can help alleviate pain and pressure through this region.
2. Location: Depending on your sporting venue some bleachers back up to wall which can help provide some support to your back. Sitting at the top or bottom of the bleachers also allows you more access to stand up or walk around when needed.
3. Stand up and stretching: Avoiding prolonged seated “bleacher” posture can reduce strain through your low back and glute region. A good rule to follow would be to stand or walk following each quarter, half or inning. Performing gentle stretches can reduce tension in these muscles that are working harder to support you.
4. Bring your own chair: Bleacher pads or bleacher seats that attach to the bleachers are great alternatives to reducing the compression on your glutes while sitting for longer periods of time. Depending on your venue you could also bring your favorite lawn chair to sit in to reduce aches and pains. A good supportive lawn chair has a firmer seat and back rather than using a sling chair.

Pic taken from: https://swimcoachingblog.com/2017/05/22/save-yourself-from-bleacher-butt/

GRADUATION!!!

May 10, 2022

It is an important milestone in everyone’s life. Graduation! Whether you are graduating from kindergarden, 5th or 6th grade, high school, college, or physical therapy, it is important to celebrate the end of one chapter and the beginning of another. 

We often give patients the opportunity to celebrate their last day in therapy in a variety of ways. Some like to share snacks, some like to have some new music played during their final workout, and some like to have their picture taken with our graduation sign.

However, I want to focus this post on the high school graduations that are currently taking place.

We have been blessed at Witte PT to treat several high school students, especially this year high school seniors. While going to therapy is not everyone’s first choice we are glad that so many trust us with their care. This year’s group of seniors have put in a lot of time, sweat, and tears to get through their injuries and get back to living their life. Many of these students athletes want to return to their respective sports and many have exceled in doing so. However, it is this group of students and caliber of their character I want to comment on. Whether they have been from Plattsmouth, Weeping Water, Conestoga, Elmwood Murdock, Logan View, Scribner Snyder, West Point, Papillion, Gretna, or Louisville the character of these kids has been outstanding. All of these districts are losing great young men and women who help to set a culture of positivity and success. Success in the classroom, success on the field or court, and success in how they treat their fellow students and teachers. That is what I will miss the most. They were hard working and a great group of student athletes for our younger students to look up to. I have no doubt they will be successful in their future endeavors!

Thank you from Witte PT for all your hard work and what you have done for the classes below you!

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