A lot of people know what a concussion is, but don’t know how it is treated. A concussion is a “brain bruise” and can cause a range of symptoms. These symptoms can be mild to severe and can last for several hours to several months. Knowing that concussions and their severities are found within a wide range, how would you work to treat these issues.
Treatment starts with rest and recovery. The intensity of the rest and the schedule that it requires can be managed by your PT. This rest period, along with the actual brain injury, can cause issues with muscle strength and overall activity tolerance. Your PT can set up a plan to help you improve these deficits without causing any increased stress to your injury. Often patients have a balance issue and/or an issue with dizziness. Therapy will work to improve your coordination, vestibular, and balance deficits to return you safely back to all activities. PT can also work on the headaches that often accompany your concussion. As you are improving in all these areas a home exercises program will be provided and adjusted based on your needs and what stage you are at in rehab. Finally, a return to play program will be provided so that you can safely return to work, school, sports, etc. As with the varying degrees of the concussion severity the treatment program and duration will vary between patients based on a variety of factors. Your PT can help answer these questions and work through these stages as efficiently as possible.
Most people think of home health therapy as receiving therapy at home from an agency. They often think that they need to go through a home health company to access this care. They are often told that their insurance does not cover it or requires additional requirements to be able to use it. However, did you know that you can receive therapy at home from Witte Physical Therapy?
We are not a home health company and we do not bill as a home health company. However, many insurances, including Medicare Part B, allow for you to receive therapy at home using the same insurance benefits that you would use in our clinics. This means that if you are worried about the spread of COVID, fresh off a surgery or injury that limits your mobility and ability to drive, or if you are just more comfortable in your home you can obtain the same great physical therapy service from Witte PT without leaving your house.
A therapist will come to your house, evaluated your condition, and needs, and work with you to develop a plan that fits your goals and lifestyle. This allows for flexibility for your needs and does not prevent you from moving to the clinic as you feel better. If you are interested in learning more about receiving outpatient physical therapy from Witte Physical Therapy in your home, please contact us at any of our clinics or through our website, www.wittephysicaltherapy.com.
Physical therapy can be used for a variety of things and one of the more important items is working on fall prevention. Falls are a leading cause of hospitalizations in the United States. Fall can cause sprains and strains, or more concerning fractures, head injuries, and life long lingering deficits. It is important that we do all we can do to decrease our risk of falling. Physical therapy utilizes a variety of tests of measures to determine what your most likely cause or causes of a fall could be. Therapists look at your motion, strength, balance, vestibular function, eyesight, environmental factors, home setup, etc, to ensure that we are getting the total picture of what your life is like. From these assessments we then start a plan tailored to your needs and your life to make sure that we are addressing all the factors that could cause you to fall. Utilizing in clinic treatments, a home exercise plan, and adjustments to your lifestyle and environment we can help you keep your risk of falling as low as possible.
With New Year’s Day right around the corner, we need to take some time to reflect on 2021, set our resolutions for 2022, and work on our own goals for the next year. It is important to celebrate the new year in your own way, but we cannot lose sight of where we have gone and what we have done over the past year.
At Witte Physical Therapy we have moved into our new space in Plattsmouth, we have expanded our staff and services, and we have worked to become more involved in our communities. We continue to work with our staff to better their skills and knowledge to enhance the patient experience. We have added more space and improved the functionality of our clinics. We are also adding a golf simulator for our patients and the community to rent out starting in 2022!
The purpose of this blog is two-fold. First to talk about the importance of reflection. Reflection gives us the time the stop our busy lives and schedule, to think about how our activities and situations have played out over the past year, to review how we handled ourselves in these areas, and to begin to learn how we would or would not make changes in the future.
The second purpose of this blog is to learn how to set SMART goals for the upcoming year. These goals could be personal, such as financial, spiritual, healthy, family, etc; or they could be related to our career. Whatever your goals are and however you want to set them it is important to follow the SMART goal framework to ensure that they are specific and attainable.
S – Specific: We need to make sure our goal is spelled out. This includes who or what it is for, who is responsible for it, and what needs to be done to accomplish it. For example, I want to lose 20 pounds in 2022.
M – Measurable: How are you going to make sure that you are meeting your goal? Is it measured in pounds lost, money gained, the number of times you are going to go to the gym, etc? For example, I want to lose 20 pounds in 2022 by going to the gym 7 days per week.
A – Attainable: We all want to win a million dollars in 2022 but is this achievable. Can you expect to make it to the gym 7 days a week when you are busy with your work and your kid’s activities a few days a week? Setting high goals is great, but if you cannot reach them then you will not follow through. For example, I want to lose 20 pounds in 2022 by going to the gym 4 days per week.
R – Relevant: If you have a goal of losing 20 pounds in 2022, then why set a goal that is not related to that. This means that if you want to look good in a swimsuit in 2022, a goal to lose 20 pounds is relevant. If you want to earn more money in 2022 then it is possible that there are more relevant goals for you to set than to lose 20 pounds. For example, I want to lose 20 pounds in 2022 by going to the gym 4 days per week so that I can look better in my swimsuit this summer.
T – Timeframe: We must have an end date on our goals. If our goal is to lose 20 pounds in 2022, how likely are you to follow that for 12 months. Goals don’t need to set for 12 months, but they can be set in steps for 2022. A goal to lost 10 pounds by Easter is achievable. Once that goal is met then set a goal to lose the next ten. For example, I want to lose 20 pounds by Memorial Day 2022 by going to the gym 4 days per week so that I can look better in my swimsuit this summer.
By using the SMART goal framework, you will find that you can set specific short and/or long term goals to help you meet your resolutions for 2022. Set a goal for health, a goal for family, a goal for finance, and a goal for your career. Write them down, work hard to follow and achieve them, and then reflect on your progress next December 28, 2022!
Last month we introduced you to Long COVID and all of the challenges it brings. This month we’re going to talk about what physical therapists can do to help people living with Long COVID. Early in the pandemic, therapists started seeing people with what would later be known as Long COVID. They noticed that some of the symptoms people were describing overlapped with conditions they had treated before. Specifically, Myalgic Encephalomyelitis and Chronic Fatigue Syndrome also caused severe fatigue and delayed symptoms after activity. Because of this overlap, the current treatment for Long COVID is heavily based on what we know works to manage these diseases. Here are a few of those strategies.
Pacing
The first strategy that can help manage Long COVID symptoms is pacing. This is simply doing less activity than you have energy for. By keeping bouts of activity short with lots of breaks, pacing can help avoid severe fatigue immediately after activity. It can also avoid the delayed “crash” of PESE. A useful metaphor is to think of your energy level as a battery. When you do activities, you drain your battery. When you rest, you charge it back up a little bit. Physical therapists can help patients learn how much energy is in their “battery” and work to teach them strategies to conserve it. When used effectively, pacing can help patients with Long COVID accomplish more with less fatigue and less bouts of PESE.
Heart Rate Monitoring
Another strategy that comes from ME and CFS management is heart rate monitoring. With the huge number of wearable devices that monitor heart rate, this is becoming an easier strategy to use than ever. Heart rate monitoring uses your heart rate as a gauge of how hard your body is working. It’s based on your resting heart rate, which should be taken after you’ve been lying down, relaxed for at least 20 minutes. First thing in the morning before you get out of bed is a great time to measure your resting heart rate. Once you have your baseline, the goal is to keep your heart rate within 15 beats of your RHR while you’re doing activities. This keeps your heart rate below the threshold at which your muscles start to produce lactic acid. Build up of lactic acid is what gives you “the burn” when you’re working out really hard. It also causes your muscles to fatigue more quickly – by keeping activity light enough to avoid lactic acid, we can also reduce fatigue.
Exercise
What about exercise? Sure, lots of people think about exercise when they think about PTs. But exercise can make some diseases worse. For people living with Long COVID, CFS, or ME, “toughing it out” or “pushing through it” won’t make them stronger. It will cost them days of their lives – leaving them barely enough energy to get out of bed or complete basic tasks. For long-term, sustainable recovery, the first goal of rehabilitation of these folks is to stabilize and manage their symptoms. Using pacing, heart rate monitoring and other strategies like breathing exercises can stop the fatigue cycle and start to get the body responding to activity more normally. Only then can we very gradually and cautiously introduce exercise into the mix, monitoring symptoms during and after activity to make sure we don’t overdo it.
As we learn more about the pathology behind Long COVID’s symptoms, rehabilitation will surely change and improve. But people who are living with Long COVID can’t afford to wait until science figures everything out about their disease. Fortunately physical therapists have training and strategies that can help improve their lives right now.
Manual therapy is one of the many tools that we use at Witte Physical Therapy to improve your pain, form, and function so that you can return to living your best pain free life. Manual therapy consists of many tools to improve your symptoms. Soft tissue mobilization and instrument aided soft tissue mobilization are used to decrease tone and improve soft tissue extensibility. Joint mobilizations are used to increase the joint mobility and range of motion of any joint in your body. Trigger point and active release therapies can be used to decrease the tone and symptoms of “knots” in your body. Functional dry needling is another tool we can use to improve your tone, extensibility, and to decrease trigger points. Cupping is using suction cups to increase blood flow and decrease inflammation. All these interventions fall under the category of manual therapy. These are just a few of the manual therapy tools that Witte Physical Therapy can use to improve your function. When manual therapy is used in conjunction with exercise, modalities, and a home exercise program your chance of success is much greater and Witte Physical Therapy offers all of these and more!
Your spine is a very important part of your anatomy, but you probably knew that. Taking care of your spine is a very important part of your overall heat, but you probably knew that too. However, do you know how to take care of your spine? Physical therapy can help you with your aches, pains, stiffness, radiating pain, weakness, and several other spinal issues that you could encounter throughout your life.
Physical therapy can use several tools to help your spine health improve. Hands on techniques such as soft tissue mobilization, joint mobilization, and strategies to improve range of motion can help improve your overall mobility. Modalities could include ultrasound, electrical stimulation, and traction can be used to decrease muscle tone and trigger points, decrease pain, and to decrease nerve symptoms down your arms or legs. Interventions to improve strength, stability, coordination, and function can be provided in the clinic and at home to improve strength and stability and provide you with the lifelong tools that you need to avoid further spinal issues in the future.
Physical therapy after a surgery is a very important step in the process of becoming pain free and getting back to all the activities that a patient possibly can. Post-surgical therapy can start the same day of the surgery or several days after. The start date of the therapy is often determined by the type of surgery and the physician that performs it. After an evaluation and a plan of care that is set up per the individual patient’s needs the real work can begin! Therapy after surgery initially consists of decreasing the pain and swelling, improving tissue healing and recovery, and improving the patient’s range of motion and mobility. As these things improve, we work on improving strength, stability, and overall function. The speed and prognosis of therapy depends on the type of surgery that was performed. Several research studies have shown that after a surgery physical therapy helps to improve the speed of the initial recovery and the overall prognosis of the recovery process.
This Blog has been supplied by the PPS section of the APTA:
You may have heard about people who got a COVID-19 infection and have symptoms for weeks or months after. This is now referred to as Long COVID. In this post we’re going to dive into what Long COVID is, what the symptoms are and who it affects. Next month we’ll talk about strategies that are helping people with Long COVID and where physical therapy fits in. Let’s get started.
What is Long COVID?
Long COVID is generally defined as ongoing signs or symptoms lasting 12 weeks or more after a COVID-19 infection.
What is it like?
Like all things COVID-19, we don’t fully understand Long COVID and new information is being discovered all the time. Long COVID tends to involve more than one system and currently has a list of over 200 possible symptoms. The most common are:
Fatigue
Post-exertional symptom exacerbation (PESE)
Problems with memory or concentration, often referred to as “brain fog”
Other common symptoms are shortness or breath, chest pain or tightness, insomnia, muscle or joint pain, depression/anxiety, and stomach problems like stomach aches, loss of appetite or diarrhea.
What’s the fatigue like? Does rest help?
Long COVID fatigue is an extreme exhaustion that isn’t relieved by rest or sleep. It’s not fatigue after some physically demanding task. People experience exhaustion for no obvious reason. The fatigue is so severe that it impacts the ability to complete daily tasks.
What about this PESE thing?
Post-exertional symptom exacerbation is a disabling and often delayed exhaustion disproportionate to the effort made. Patients are referring to this as a “crash”. PESE is very common in people suffering from Long COVID. 75% of people who have Long COVID have PESE after 6 months. The activity that brings on the crash is something that the person could easily tolerate before their COVID-19 infection. Things like taking a shower, walking, attending a social activity, or even being in a high sensory environment with flashing lights and loud noises may all now trigger a crash.
Who does Long COVID affect?
This is difficult to answer. We still don’t understand what causes some people to have symptoms long after their initial infection. What we do know is that about 25% of people who get COVID have symptoms that last at least a month. Around 10% of the people who get the virus will experience Long COVID. Long COVID isn’t related to how severe your initial symptoms were, or if you were hospitalized. It also doesn’t appear to be related to your previous health as it affects children and people who were previously fit and healthy.
Now that you know what Long COVID is, in our next installment we’ll talk about what’s being done for it and how physical therapy helps.
The following blog is being posted from the PPS section of the APTA:
When you think about a person going into intensive care, you probably picture someone who’s very ill and likely fighting for their life. They may be on a ventilator or other equipment that’s keeping them alive. When you’re in that situation, surviving would be a win. But what happens after these people survive? Do they recover and go back to life as it was? What’s the road to recovery look like?
Fortunately, medical advances have led to higher survival rates for people who end up in intensive care units – it’s now between 71% and 90%, which is great. But, survival is not the end goal, and getting out of the ICU is not the end of the battle. Many patients show significant losses of physical, mental and cognitive abilities after discharge. It makes sense – if you don’t use it, you lose it! This cluster of problems is called Post-Intensive Care Syndrome or PICS.
PICS is now recognized as a public health burden. Interventions against PICS need to start in the ICU. Then they need to continue after discharge.
Physical declines often include significant losses of strength, endurance, and mobility. These can lead to serious difficulty completing basic daily tasks like getting to the bathroom, preparing a meal, or walking to the mailbox. This may keep some people from returning home. For others, it means they need a caregiver to safely return to their previous setting. 50% of ICU survivors have limitations in daily activities 1 year later, so this is a serious and long-lasting problem.
Mental health is also a very real concern for ICU survivors. They show significant rates of depression – the mean is 28%. 24% of survivors have anxiety and 21% report PTSD. Again, these conditions have a real impact on the quality of life after leaving the ICU.
Last, declines in cognitive abilities are very common in ICU survivors. 77% have cognitive impairments at 3 months post-discharge and 71% have impairments 1 year out. Cognitive issues after discharge can include poor memory, slower thinking, problems making decisions, or difficulty concentrating.
Physical therapists play a significant role in the fight against PICS. PT typically begins while the patient is in ICU, focusing on getting the patient up and walking early. Patients begin a progressive exercise program as soon as it’s safe for them. We expect a rise in PICS due to the number of people who COVID-19 has put into critical care and/or on a ventilator.
While we can’t prevent every problem that critical illness causes, recognizing the losses that remain after discharge from the ICU is an important step. Physical therapists play an important role in combating the effects of PICS and helping people return to higher-quality lives.
