Prehabilitation for success after surgery

Pre-operative Physical Therapy, also known as ‘Prehabilitation’, has shown to have positive outcomes on the recovery process of postoperative rehabilitation for individuals undergoing orthopedic surgery. Undergoing surgery with a poor preoperative functional status can increase the chance of complications postoperatively.

Here are some common questions asked about pre-habilitation, also known as prehab:

What can I expect from my prehab care?

Your therapist and clinical team will prescribe you targeted exercises to improve your overall strength and range of motion (ROM). The more ROM and strength you have prior to surgery, the easier it will be to reach these milestones after. Nutrition is vital before and after surgery. Your Doctor may recommend you meet with a nutritionist. This will ensure that you have a balanced diet needed for recovery.

Surgery is not only taxing on the body, but also on the mind. Working with a Physical Therapist who has helped individuals like yourself, may give you a better understanding of what to expect during the recovery process. You may be discouraged at first, feeling as though you are not progressing as quickly as you’d like. This is okay, recognizing that everyone progresses at different rates is part of the healing process.

Rehab is hard and should be challenging. Prehab with a Physical Therapist will help to place you in the right mind set to succeed. Exercise is going to be crucial in your recovery. Learning discipline and holding yourself accountable will help you recover more quickly.

Which population will find prehab most effective?

Typically, we have found that the elderly population benefits the most from Pre-hab. However, all ages typically do well and we have found that individuals who have sustained ACL tears do particularly well with prehab therapy.

What are the benefits of prehab?

Range of motion and strength appear to improve/ progress faster in individuals who utilize prehab as opposed to those who do not. Patients report reduced post surgical pain levels after working in a course of rehab prior to surgery. Your Physical Therapist can give you an accurate idea of what you need to do for a quicker recovery. Most importantly, having therapy prior to surgery helps you, the patient, set expectations following your procedure.

How long should I undergo prehab?

This will be up to your Surgeon and Physical Therapist. It will likely depend on the severity of the injury and what goals you would like to accomplish prior to your procedure.

Plantar Fasciitis and how Physical Therapy can help

I once had a patient, an older patient. She grew up on a farm. Her dad worked hard and would occasionally suffer from heel pain. For treatment he would lie on the trailer bed and have his wife hit his heel repeatedly with a mallet until the pain was gone. For all of you anchorman fans out there, in the words of Brian Fantana, “They have done studies, 60 % of the time, this works every time”. This sounds barbaric, I know, but it was a different time and medicine back then isn’t what it is now. Over the next few paragraphs, I’ll talk about what plantar fasciitis is, how someone can develop plantar fasciitis, as well as what we do in PT to treat this and how you can treat it yourself at home.

What is it?

Plantar fasciitis in its simplest terms is an inflammation of the connective tissue (fascia) along the bottom of your foot and heel. Typically it occurs as a result of overuse and poor biomechanics (things don’t move like they should) of the foot and ankle. Pain can be present in multiple areas along the base of the foot, but more often than not it occurs around the outside edges of the heel. Some people present with pain that is worse in the morning and gets better with weight bearing throughout the day, others experience discomfort as the day goes on and feel relief with rest. Typically the pain will improve within a year, but working with your Doctor and Physical Therapist, we can help make improvements within a shortened timeline.

How does someone get plantar fasciitis?

Typically, this will occur in individuals who spend a fair amount of time on their feet or if there is a sudden change in activity level within a course of a week, month or days. A person with plantar fasciitis will most likely have limited dorsiflexion, an ability to pull your toe up, as well as abnormalities within the arch of their feet. At the core of the problem, plantar fasciitis is an overuse injury, so you need to be consistent with your rest cycles if you are just beginning or have already established an exercise program.

How can Physical Therapy help?

At Gold Medal Physical Therapy, we use a combination of manual therapy techniques (massage, stretching, joint mobilization), corrective exercise and self management techniques to help reduce pain and improve function. It is recommended that you get fit for an appropriate pair of shoes, as proper footwear can help to decrease symptoms. Talking to your podiatrist or orthopaedic MD, they can help fit you for a night splint that can additionally help reduce your pain in the morning and throughout the day. It is recommended that you use Ice to help manage the inflammation, either through a direct cold compress or utilizing a frozen water bottle along the bottom of your foot.

Exercises to perform at home.

Standing calf stretch : Bent and Straight Knee

Plantar Roll out (golf ball or frozen water bottle)

Arch Raises (starting position)

Arch Raises (ending position)

Please consult your Doctor or Physical Therapy team prior to attempting any of these exercises. We sincerely hope this post helped to expand your understanding of plantar fasciitis and what you can do on your own to treat and manage your symptoms.

Headaches: Self Treatment Remedies

5 Tips to Reduce the Likelihood of Headache

Headaches can be quite a nuisance, especially when they escalate to painful migraines that practically incapacitate
you. Whether it’s from overexerting yourself during exercise or having high stress levels, it can be tempting to
eliminate it with the aid of an over-the-counter pill, such as ibuprofen or paracetamol. However, you might not always
have these pills on hand, which is where these other ways to avoid and alleviate headaches can come in handy!

1. Hot and Cold Applications

IMAGE CREDIT: Unsplash
Applying cold or hot packs to your head can help reduce the pain, especially for muscle tension headaches. Cold
packs can be applied for 10 minutes at a time before taking a break, while warm compresses are best placed on the
back of your neck and forehead for relief.

2. Hydrate

Have you ever wondered why your headache is so pronounced after having a few drinks the night before? This is an
example of a dehydration headache, which Medical News Today describes as something that can happen even
without consuming alcohol. Getting a glass of water or a hydrating beverage filled with electrolytes will help bring your
headache down in no time.
It’s also best to avoid headache-inducing beverages. Aside from alcohol, caffeinated drinks are also to blame for
headaches, especially if you have too much coffee, energy drinks, or soda. Try asking for a half-decaffeinated
beverage the next time you’re at a coffee shop. Be conscious of your alcohol intake as well, especially with drinks like
whiskey and red wine.

3. Proper Neck Posture

IMAGE CREDIT: Pain Free Working
Poor posture can cause aches and pains all over the body, including your head. Every inch that your neck bends
forward past its normal curve places a significantly greater amount of pressure on your muscles, contributing to
headaches. Unfortunately, slouching is very common these days, especially with remote work and the absence of
proper office equipment like office chairs and desks with appropriate heights
Those working from home can benefit from investing in an ergonomic chair, but be careful not to purchase just any
office chair. An ergonomically designed one should have a good seat height range, a seat pan with a waterfall edge,
and adjustments for backrests, armrests, and headrests. Chairs with adjustable neck lengths for customized support
cradle your head and prevent it from tilting too close to the computer screen, thereby eliminating the development of
headaches due to poor posture.

4. Reduce Stress Levels

IMAGE CREDIT: Pexels
While it seems like stress can’t be avoided these days, learning how to manage it is one of the best ways to curb
persistent headaches. These headaches are usually some of the most painful, escalating into migraines as the day
progresses. To address this, be more deliberate about removing stressors from your environment and practice deep
breathing or meditation techniques. Doing this removes the tension in your head and body, resulting in less head
pain.

5. Quality Sleep

IMAGE CREDIT: Pexels
A study from Biomed Central has found that sleep deprivation is linked to a loss of ion homeostasis in the brain,
contributing to migraines. Aside from getting a full eight to ten hours of sleep every night, improving the quality of your
sleep is also crucial. Having a relaxing routine to wind down before bed and sticking to your bedtime may seem
insignificant, but they contribute a lot to how well you sleep and reduce the likelihood of your headaches.

Headaches are never fun, whether it’s the low, persistent drum you feel or a sharp pain behind the eyes. Fortunately,
they typically don’t last long. Using these 5 tips and our webinar on headaches can help you get rid of them even
more quickly. So before you reach for that Tylenol, consider grabbing a glass of water first and mind your posture!

Written by Tracy Osborn for goldmedalpt.com

Ease Into Your Exercise Program With Ease!

Has the demarcation of the New Year have you setting new goals or starting a new routine? A popular one is embarking on a new fitness routine. This doesn’t mean you should join a gym or buy a treadmill, and to be truthful these big, sudden changes can have less staying power than small adjustments over time. Introducing exercise into your routine should be slow and steady, especially if it has been a while since you’ve worked out.

Starting an exercise program can feel overwhelming, and sometimes even impossible. It doesn’t have to be that way! Let’s break it down!

How do I start?

Stretch, always stretch. Make sure you are hydrated before and keep some water nearby while you exercise. Is there any type of movement or exercise you prefer? Are you a dancer? Do you need a low-impact workout? Does cardio or strength training appeal more to you? Don’t know? Well variety is the spice of life, so the more versatile your workouts, the more you challenge your body! Pick your favorite or find your preference, but we do recommend mixing things up every once in a while, at least.

How many times a week should I exercise?

In the first phase of your program start with 2-3 workouts and then increase the frequency every month by 1 more day a week until you are at 5-6 times a week. Your body does need at least one day of complete rest, but of those 5-6 days alternate more taxing workouts with lighter ones.

Grab a planner or a calendar. For someone with more fluid schedules it is easier to set a weekly goal, let’s say you plan on 4 workouts this week, write a 4 in the margin before the week, then each day you complete a workout put a symbol on the day to keep track. If you have a very structured schedule, carve out your workout time and schedule them out.

Also, mark down when you plan to increase your frequency so you can prepare! Listen to your body, if you’re not ready to increase your frequency don’t. It’s okay! Remember, everyone is going to adjust differently and it is so much better to take your time than to rush and feel burn out or get injured.

How long should I exercise for?

It can depend on what you are doing. A more intense cardio workout will be shorter, whereas, weight lifting can take more time because there are breaks between sets and you definitely don’t want to be speed lifting. General rule would be to set 20-30 minutes aside for a workout. Starting out this is a nice way to ease in both physically and mentally. If you build up your endurance and are handling it well, add a few more minutes to the end! If the goal is to move more than you were, than any increase is great!

What if I don’t have any equipment?

YouTube is a great resource to find all kinds of workouts! Search for body weight workouts, or workout from home. You can find cardio like kickboxing, aerobics, or dance classes. Second hand equipment can be a frugal way to get a low-impact cardio machine, or free weights. Resistance bands can be a cheap, versatile, and convenient option that you can find at Target, Walmart, or even Amazon. Even a brisk walk or bike ride outside would be a great choice! Walking is an easy form of exercise to track, whether by amount of time or distance. It can also help you get some time alone to clear your mind or destress.

How do I keep myself motivated?

Find a workout partner or a cheerleader to keep yourself accountable! Just having a friend or family member check-in with you to see how your workouts are going can help keep you on track.
Keep things interesting by finding new ways to exercise that you enjoy.
Don’t take on too much, too fast. Ease in and plan!
Reward yourself, find small rewards that you can allow yourself for when you reach goals or complete a number of workouts.
Don’t beat yourself up if you fall off your routine or have a string of subpar workouts. Just keep pushing, and jump back on the train, you will be happy that you did!

Physical Therapists can also help you to find and begin a great workout routine that is tailored just for you! Especially if you are unsure what you can do safely at home. There is a safe and effective way for every person to get exercise and your Physical Therapist would be the best resource to get you on the most successful path!

Physical Therapy and Jaw Pain (TMD)

Temporomandibular Disorders (TMD)

Temporomandibular disorders, TMD for short, is a musculoskeletal disorder that has a high prevalence but often goes overlooked. Women between the ages of fourteen and fifty years old are five times more likely to be diagnosed with TMD than men. Steven L. Kraus, a Physical Therapist that has over forty years experience in treating orofacial pain, states that TMD ranks only second to low back pain in the United States as a prevalent musculoskeletal problem.

Physical Therapy and Jaw Pain

Current research shows that there is an 85% success rate with conservative physical therapy care for non-surgical patients. While medications and oral appliances work well in the short term, research has shown that soft tissue mobilization, joint mobilization, dry needling, modalities, postural re-education, and education about contributing habits can be addressed with physical therapy and provide long term relief of symptoms.

Who is Appropriate for Physical Therapy?

Anyone who is complaining of jaw, neck, or face pain, clenching, headaches, and ringing in the ears as well as cervical pain. There is a 92% correlation for those who are suffering from jaw pain, also have dysfunction in their upper cervical spine which is evaluated and treated in physical therapy.

Is Physical Therapy Covered by insurance?

Most treatments are covered by insurance. We accept all major medical insurances including Medicare and Medicaid. We also offer cash options. We bill through your medical insurance and not your dental insurance.

What do I do next?

Kyle Jones is one of our physical therapists who has extensive training in diagnosing and treating TMD and works out of both the Perry Hall and Bel Air offices. If you have any questions regarding treatment or referral of a patient, please call either office and ask to speak to Kyle directly or contact him by email.

Kyle Jones, PT, DPT
KJones@goldmedalpt.com

Manipulations For Pain Relief

Manipulation is a technique we use in Physical Therapy that involves a quick stretch of a region of your body. It is sometimes associated with the feeling of a pop or crack, but not always. Some people can manipulate their own joints by “cracking” their knuckles or back. The biggest difference between a manipulation performed by you and one performed by a Physical Therapist is that a therapist can be very specific with the location of the manipulation. Self-manipulations aren’t very specific, and therefore sometimes can’t achieve the same effect as a manipulation performed by a therapist.

Physical Therapists use manipulation as a way to reduce pain and/or improve range of motion of a part of your body. Manipulation often creates a relatively short term change in the way you feel and move, so we use exercise as a way to try to maintain the improvements you can feel after manipulation. There is a growing body of evidence to suggest that manipulation and exercise used together can have a greater impact on the way you feel than just manipulation alone.

A common question people have about manipulation concerns whether or not it is a safe thing to do. Research shows that it is absolutely safe to do, particularly considering the fact that your Physical Therapist will know what questions to ask to determine whether or not you may be a candidate for this type of treatment.

We’ve filmed some videos of our Physical Therapist Chad Blomquist performing various types of manipulations that you may experience during your plan of care in the clinic. Feel free to contact us if you have any questions about manipulation specifically or Physical Therapy in general!

Help! I’ve fallen and I can’t get up!

Read on to see how to best avoid a fall, and how to get yourself back up!

Most of us have probably known someone who has fallen. Whether it be a relative, neighbor or yourself. Either slipping on the ice, or tripping on thick carpet, falls can lead to both physical and mental damage (the fear of falling can be greater than falling itself.) With October being national falls awareness month, we here at Gold Medal PT felt it would be useful to give you a few tips to prevent falls and show you how to get up after you have fallen. You’ll see attached at the bottom of the page a free falls self-assessment tool, this will give you an idea of your risk for falling.

Here we go…

1. Monitoring your environment is crucial in preventing falls. Making sure you are keeping your living area and walkways clear of debris. The more obstacles you have in the way creates a greater chance of you going down. Understand that different floors require different footwear and walking strategies. If you have thick carpets, focus on picking your feet up, this helps to prevent your feet from catching. If you have hardwood floors, make sure you are not walking around in socks, as this could lead to slipping. Can’t see a thing? Proper lighting is very important and often overlooked. Our vision is one of the main systems that helps to keep us upright, poor lighting takes this out of the equation and leads to tripping or bumping into objects.
2. Do you exercise each day? As we age our muscles atrophy (waste away) making it harder for your legs to keep you upright. A good exercise program that focuses on building your leg strength will help prevent your knees from giving out, and help you stand up straight. Get in the habit of maintaining and improving your flexibility. Having tightness in your hips and legs can cause altered walking patterns and make it difficult for you to recover if you begin to lose your step. Work on your balance with exercises that challenge your base of support. Drills such as standing on one leg or standing with your eyes closed, challenge your internal systems more, thus making daily ambulation and standing much easier.
3. Invest in your posture. Do a self assessment and check your posture. Are you standing upright? Are your shoulders rounded? Is your head tilted down? Changes in our posture even on the top end can change how various forces are interacting with our body. If you’re naturally leaning further forward, the tendency to fall forward will be greater, because that is the direction your body is naturally leaning.

I hope these tips help, please share them with friends and family members. Please don’t hesitate to reach out to us if you’d like a customized exercise program or need some guidance on improving your balance.

We are here to help you!

Access the Falls Risk Assessment here:

https://https://https://www.physio-pedia.com/Falls_Risk_Assessment_Tool_(FRAT):_An_Overview_to_Assist_Understanding_and_Conduction

Here is a link to a video we have found helpful to teach you how to get up after you have fallen:

https://youtu.be/JJxpLidlgvQ

Thoracic Mobility and You

Is it just back pain?

If there’s one universal ailment in the world, it’s pretty safe to say that it’s probably back pain. Whether it’s your low or upper back, you’ve probably experienced back pain at some point in your life. Today we’re going to take a look at upper back pain — in particular how mobility of your thoracic spine contributes to upper back pain, and its effects on your overall well being.

First thing’s first, let’s talk about the anatomy of our spine. Our spine is broken up in three parts: cervical, thoracic, and lumbar. Under normal conditions, the cervical spine (neck) and your lumbar spine (lower back) should be functionally stable. While your thoracic spine (upper back) should be mobile. What we see all too often is the exact opposite; gross instability in both the lumbar and cervical spine, which leads to compensations. These instabilities send our brain and central nervous system in a panic. Our body is constantly trying to maintain some form of homeostasis. This more often than not results in the normally mobile thoracic spine to become rigid as to support ourselves.

Why is having a mobile thoracic spine important?

Well, it’s all a balancing act. We want to maintain optimal spinal health throughout our daily activities, without the need to compensate for the lack of mobility. Having an adequately mobile thoracic spine will allow you a greater quality of life within your daily activities. If you’re experiencing a knot after a long day at the office, for example; a more mobile thoracic spine will keep your back feeling like new. For athletes, greater spinal mobility will allow you to train harder, squat deeper, or even out drive your friends on the golf course.

Where physical therapy is concerned, a detailed evaluation can determine why exactly it is you have restricted mobility in your thoracic spine. Once we find the cause — which could be muscular, or joint related — we can apply the appropriate manual therapy techniques to allow you to restore that missing mobility. With increased mobility, and reduced pain as a result, we can tailor an extensive exercise program to address your specific needs, and allow you to progress towards meeting your personal goals and prevent your back from tightening up on you again.

Below, we’ve prepared some mobility self-tests, as well as a sample of some exercises that we use in the clinic, that you certainly can use at home to work on your thoracic mobility.

Thoracic Mobility Self Test

Thoracic Mobility Exercises

It’s not this position…It’s the “Next” positon

I’m uh…working from where now?

It’s a peculiar thing; the entire workplace dynamic has really been shaken up in the past few months. Millions of people around the world suddenly find themselves in a completely new work environment— their home.

Home is where the heart is, and working from home certainly does not come without benefit. In fact, a 2017 study suggests that adding 20 minutes more to your work commute each day is the equivalent of taking a 19% reduction in pay. So certainly one could infer that taking it away entirely — well, that sounds like it would be great. But on the other hand, working from home can have its fair share of cons as well. Your habits change and, all of a sudden, you find yourself, more often than not, sitting around more.

Okay, but what about back at the office?

There exists this certain stigma regarding desk jobs. This constant need to “maintain correct posture; an overwhelming focus on proper ergonomics. Over the years this has spawned many trendy office concepts. There’s the physioball in lieu of an office chair; the standing desk, which is slowly but surely becoming more pervasive. They’re great—don’t misunderstand. But we want to place a greater emphasis on keeping the body moving. It’s not necessarily that any one position is healthier than the other, but prolonged time in any posture can negatively affect the body.

Think about this way: is it realistic to spend eight hours or more holding yourself in what’s considered “correct posture”. Absolutely not. It’s much more reasonable to plan time to get up and move around. Take a lunch break, walk outside; sit down, relax if you’ve been on your feet all day. It’s okay to slouch. Because it’s not about the position you’re in, it’s about what you plan on doing next. Keeping your body moving is the answer.

As always, we at Gold Medal Physical Therapy sincerely hope the information in this blog helps you. If you find yourself in need of more assistance, do not hesitate to reach out to your doctor or a trusted medical professional.

Headaches: The Webinar You Can’t Miss!

It’s just a headache…Right?

I’m sure we’ve all been there at some point. You had a long, stressful day at work — and almost as if to add insult to injury, you find yourself with a nagging headache. It really just makes everything miserable, doesn’t it?

Headaches are incredibly common and have an almost unlimited repertoire as to why they happen. It could be that stress; you may have even taken a blow to the head! Or maybe your blood pressure is a little high? Some headaches come and go without much impact on a person’s life. A good night’s sleep, proper hydration, and exercise can often clear up those “low level” headaches.

But what about those Chronic Headaches? Now those can be downright debilitating! They may linger around, or even continually come back; they can be felt alongside neck pain and/or jaw pain as well. It can be difficult to figure out why you’re having headaches in the first place, which is something a Physical Therapist can help you understand. If you are at a point in which headaches are making it hard to concentrate at work, making it tough to spend quality time with your friends and family, or making it tough to relax at the end of your work day you should consider reaching out to a Gold Medal Physical Therapy for an evaluation.

How can Physical Therapy Help Me?

Physical Therapists are qualified to help people with certain types of headaches to overcome their pain. They can perform an evaluation to determine whether or not someone is appropriate for treatment in Physical Therapy, what kind of headache a person is experiencing, and relevant limitations that are contributing to the pain. As such, we have the ability to determine if there are any “red flags” present that would warrant a referral to another type of medical practitioner. And by coming in for a Physical Therapy evaluation, if you need referral to another type of medical provider, we can help get you in front of the right type of person that can help and save you a lot of time and energy. Our goal is to understand why you’re in pain, help improve your pain, and teach you about things you have control over that can improve your pain and function over the long term. During treatment for headaches, we use patient education, specific exercises, and hands-on techniques to help people get past pain.

The good news is that people can get relief from headaches, there is a lot that you have control over that can help, and our therapists at Gold Medal Physical Therapy are here for you!

Tune in for the Webinar!

Gold Medal Physical Therapy will be holding a Headache Webinar next Thursday, 6/11/2020 at 5:00 p.m.

Click the link below to reserve your spot now!

https://go.mywebinar.com/lbrp-xwdv-ztvk-qebj

More Resources

https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-headaches

https://www.choosept.com/resources/detail/3-ways-physical-therapist-can-help-manage-headache