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.
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.
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.
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.
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!
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.
Your hands are an extension of your personality often allowing you to show your skill set including sewing, work working, farming or painting for examples. Hand therapy specifically is geared toward restoring the function in your fingers, hands and wrists and sometimes shoulders to allow you to continue with the things you love to do. Participating in hand therapy can result from a surgical procedure, non-operative injury or be part of preventative measures. We assess the strength and range of motion of your fingers, hand, elbow and shoulder along with your nerve sensation to determine a plan specific for you. After assessing your current deficits, we can use techniques such as manual therapy, use of various equipment ranging in textures and shapes along with use of ultrasound or e-stim to help you return to pinching, griping, finger dexterity, with less pain. We alter our plan based on your specific lifestyle and personal goals. Participating in hand therapy can get you back to buttoning your favorite shirt or completing your favorite hobby with less pain.
Research has shown that positive expectations increase the chances of a good outcome. It’s the old self-fulfilling prophecy; your attitude determines your approach to situations. If you believe you’ll be successful, you’ll likely put in more effort. You’ll be more willing to try new things, take some risks and keep trying after failures or setbacks. A negative attitude will likely mean that you’ll take your first failure or setback as confirmation that what you’re trying won’t work or isn’t possible and you’ll give up. Why waste time and effort on something that’s doomed to failure anyway?
YOUR EXPECTATIONS INFLUENCE YOUR RESULTS
There’s some research to prove that positive thinking and expectations make a difference in rehab settings too. A review of 23 articles looking at outcomes for shoulder pain found a few interesting things. First, patients who expected to recover and believed that they had some control of the outcome, ended up doing better than those who didn’t. Second, optimistic patients were found to have less pain and disability after completing rehab. Third, patients who believed they’d have pain and disability after surgery tended to have – you guessed it – pain and disability after their surgery. Research says that you tend to get what you expect.
SO DO YOUR THERAPIST’S
Your attitude is important, but what about your therapist’s? There isn’t much research specific to PT, but there is a study done in elementary schools that might give us some clues. Two psychologists – Rosenthal and Jacobs did a study showing that teacher expectations had an influence on student performance. They told teachers that randomly selected students in their classes were tested and found to be “late bloomers”. These students were expected to show large improvements in academic performance during the school year. When the students were tested 8 months later, the students the teachers believed would improve the most, did.
Why? When teachers think students have a lot of potential to improve, they hold them to higher standards. They teach more complex materials, don’t settle for simplistic answers and are more willing to spend time instructing and working with those students. It’s pretty easy to see how this could cross over into a PT clinic. If your PT thinks you can get better, they’ll probably put more effort into designing your program, spend more time with you and push you harder than someone they don’t believe has a lot of room for improvement.
To have the best chance for a good outcome, you and your therapist both need to expect one. You probably will.
References
De Baets L, Matheve T, Meeus M, Struyf F, Timmermans A. The influence of cognitions, emotions and behavioral factors on treatment outcomes in musculoskeletal shoulder pain: a systematic review. Clin Rehabil. 2019 Jun;33(6):980-991. doi: 10.1177/0269215519831056. Epub 2019 Feb 22. PMID: 30791696.
Rosenthal, R, and L. Jacobsen. Pygmalion in the classroom: teacher expectation and pupils’ intellectual development. New York: Holt, Rinehart and Winston, 1968.
The ongoing COVID-19 pandemic is responsible for a lot of bad stuff. But, if you look really hard and maybe squint just right, there are a few less-than-terrible things to be found. The pandemic forced society to quickly adapt. It pushed forward the adoption of new technologies like Zoom and new ways of doing things, like working from home. There were changes in rules, regulations, and payment related to telehealth. A lot of patients and providers experienced their first virtual health appointment in the past 2 years, and many of them see the benefits. The pandemic forced the telehealth genie from the bottle. Now that patients and providers have seen the benefits, it’s not going back.
Why telehealth is here to stay
Telehealth isn’t going to replace in-person rehab, but it’s likely going to complement it heavily. Research has shown that telehealth is as effective as in-person rehab for a lot of conditions. It’s also shown high satisfaction rates from patients – up to 94% in some studies. For a lot of people, telehealth makes sense. Think about people trapped at home because of a snowstorm or those who are at high risk of falling on the ice. Before the wide adoption of telehealth, these patients didn’t get to see their PT during the winter. Now, they can stay connected virtually and continue healing through the bad weather. Telehealth can also work well for busy people. Patients can check in or have a visit with their PT on their lunch break, or while their kids are at practice.
Where telehealth could go
Even though there have been big advances in telehealth, we’re still in the early phases. It’s hard to predict how telehealth will be used in the future and how it will evolve, but expect it to look a lot different in 5 years. The software being used for telehealth will continue to get better. Expect a more engaging user experience with educational content and maybe some gamification – levels to achieve, points or badges to collect, or some other metric. Hardware will also continue to advance. Maybe the fitness tracker you already have will integrate into your telehealth app, letting your PT track your activity, heart rate, and other metrics. Remote stethoscopes, scales and other medical equipment already exist and will continue to become more common as prices decline.
While telehealth has certainly seen a big advance because of the pandemic, most people still see it as an adjunct to in-person visits. Right now, telehealth tends to be used because it’s more convenient than a visit in real life, not because it’s better. With advances in software platforms and hardware options, telehealth could evolve into something just as good as in person rehab that makes high quality rehab available to everyone.
Obtained from the PPS group of the APTA: https://ppsapta.org/marketing/blog/browse.cfm?recID=17A7D20F-DB83-81B9-8C7902600C3CCF3A&utm_source=Informz&utm_medium=Email&utm_campaign=PPS%20Informz
With the pandemic there have been changes in our way of life. Telehealth is just another one on the list. Telehealth allows for you to visit us through your computer. We use video and audio platforms to communicate visually and audially with you to provide your physical therapy treatments. While we cannot perform any manual therapy or palpation, we can watch how you move and what issues you are having at home. We can show you how to complete your home exercise program and work through some movement quality issues. Telehealth is a very reasonable option for many who cannot or do not want to leave the house to come into the clinic.
At Witte Physical Therapy we use a secure, HIPPA compliant platform. Once your appointment is scheduled, we email you the instructions you need to securely log in and start your treatment time with the therapist. We can also communicate via email with your exercise plan, and you can communicate with your therapist securely through our patient platform.
