Chances are that you probably haven’t given much thought to how your neck and back are faring in the era of the smart phone, but studies show that you most certainly should. It’s practically a reflex these days to pull out our smart phones when we’re standing in line, sitting at the airport or riding the subway. And while it’s great that we rarely need to venture beyond our pockets for entertainment, our bodies are beginning to retaliate—and mourn the pre-texting days.
So, what exactly are these contemporary conveniences doing to our bodies? A surgeon-led study that published in Surgical Technology International assessed what impact surgeons’ head and neck posture during surgery—a posture similar to that of smart-phone texters—has on their cervical spines. With each degree that our heads flex forward (as we stare at a screen below eye level), the strain on our spines dramatically increases. When an adult head (that weighs 10 to 12 pounds in the neutral position) tilts forward at 30 degrees, the weight seen by the spine climbs to a staggering 40 pounds, according to the study.
How pervasive of a problem is this? According to the study, the average person spends 14 to 28 hours each week with their heads tilted over a laptop, smart phone or similar device. Over the course of a year, that adds up to 700 to 1400 hours of strain and stress on our spines. As a result, the number of people dealing with headaches, achy necks and shoulders and other associated pain has skyrocketed. Trained to address postural changes and functional declines, physical therapists are well-versed in treating this modern-day phenomenon, widely known as “text neck.”
Over time, this type of poor posture can have a cumulative effect, leading to spine degeneration, pinched nerves and muscle strains. Scheduling an appointment with a physical therapist can help people learn how to interact with their devices without harming their spines. The PT will prescribe an at-home program that includes strategies and exercises that focus on preserving the spine and preventing longterm damage.
Exercise is an important part of taking care of our spines as we age, but what we do when we’re not in
motion matters, too. So next time you pick up your smart phone or curl up with your e-reader, do a
quick check of your head and neck posture. Your body will thank you for years to come.
Published on March 22, 2018 2:49 pm
Categorized in: Uncategorized
Imagine a scenario in which a patient learns he needs a dreaded root canal. The dentist’s plan of care requires four visits instead of the standard two and the patient will be on the hook for double the typical out-of-pocket costs. On top of that, the patient will receive a lower quality of care than if he went elsewhere. Should the patient stand for that? Of course not.
When it comes to the physical therapy needed following total knee replacement (TKR) surgery, a study published in the scientific journal Health Services Research says this type of scenario may be more common than you think. Where patients get physical therapy following TKR may affect how much the rehab costs, how many visits they need, and the quality of care they receive.
Led by Jean M. Mitchell, PhD, James D. Reschovsky, PhD, and Elizabeth Anne Reicherter, PT, DPT, PhD, the study examined whether the course of physical therapy treatments received by patients who undergo TKR surgery varies depending on whether the orthopedic surgeon has a financial stake in physical therapy services, often called physician self-referral. In reviewing 3,771 TKR patients, the study investigators concluded that physical therapists not involved with physician-owned clinics saw patients for fewer visits and provided more individualized care at a lower out-of-pocket cost.
Specifically, the study found that TKR patients who were treated in a clinic owned by their orthopedic surgeon received an average of 8.3 more (or twice as many) PT visits than those who were treated in a clinic in which their orthopedic surgeon had no financial stake.
Rehab professionals would like patients to know they have options and do not automatically need to see a physical therapist who works in the surgeon’s own clinic. Members of the PT profession are urging patients to seek out an evaluation by a physical therapist who specializes in orthopedics, ideally before scheduling a surgery consult. If that’s not possible, the public should consider seeing a PT outside of the physician self-referral clinics in order to receive more individualized care that is task specific to each patient’s deficits and impairments following surgery.
The rehab program in a physician self-referral clinic is often heavily focused on group therapy sessions. In such a setting, the PT may not be able to observe and address each patient’s deficits. Conversely, patients treated in an individualized physical therapy program will be better sooner and receive better care. Higher quality care correlates with more efficient and effective episodes of care.
The study, titled Use of Physical Therapy Following Total Knee Replacement Surgery: Implications of Orthopedic Surgeons’ Ownership of Physical Therapy Services, was partially funded by the American Physical Therapy Association’s Private Practice Section.
Published on March 13, 2018 7:53 am
Categorized in: Uncategorized
Patients can no longer be passive players in the game of health. Studies show that informed patients are not only more engaged during physical therapy but also reap the benefits in overall health and well-being.
Those who understand why they’ve been referred to physical therapy, are actively engaged in the process, and develop useful self-management skills are more likely to achieve lasting results. With a few pointers, building one’s health literacy doesn’t have to be an overwhelming prospect.
To get the most out of your rehabilitation, it’s important to keep an open line of communication with your physical therapist. Your physical therapist is a wealth of knowledge and is there to help
you regain mobility and relieve pain. The interaction should be positive, informative, and collaborative. Here are a few questions to ask your physical therapist so you may understand the
rehab approach and how it impacts your injury or illness:
- Why have I lost function/why do I hurt? Your physical therapist has been trained to
determine why a particular injury causes a loss of mobility or interferes with your ability to
complete a task. It’s helpful for patients to gather information and understand the body’s
mechanics as it relates to an individual injury.
- Did my lifestyle contribute to this issue? Your physical therapist will gather information
about your lifestyle in order to identify habits that might be contributing to the problem.
Perhaps the patient needs to wear shoes with support and limit time in flip flops. Or maybe
the patient is experiencing low back pain due to poor posture at work.
- How will physical therapy help me? Physical therapists work with patients to devise an
individualized and concrete care plan. You should feel comfortable asking your physical
therapist why a specific goal has been chosen, how it will help you, and what you personally
need to do to succeed.What can I do to make sure I get better? Showing up for appointments is only have the
battle. Being ready to participate and understanding what you should be doing in between
appointments is critical. You should be prepared to carry over goals at home and make
modifications to habits at home and work to change contributing behavior.
It’s important that you feel comfortable asking your physical therapist questions and continue to understand how you can contribute to your care plan. Advocating for your own care and
maximizing educational opportunities will give you the confidence and tools to succeed in physical therapy and beyond.
Published on February 27, 2018 8:54 am
Categorized in: Uncategorized
You just left the doctor’s office with a script in hand to see a physical therapist for an injury or illness that’s preventing you from moving properly. Even though the physician shared some background information on the services, you have never been to physical therapy before and don’t know it all works. What’s the next step?
Select a Physical Therapist. Deciding where to go for physical therapy can be a daunting process but with a little guidance, you can easily find the best fit for you. Start by talking to friends and family members about where they’ve gone for physical therapy, ask your doctor for a few recommendations, and search online for locations in your community. Once you have compiled a short list of potential physical therapy clinics, call each location to request more information.
Narrow Down the Playing Field. Making an informed decision about your rehabilitation will ensure you find the best physical therapist for your specific condition. Conducting a quick phone interview of a potential rehab professional is the best way to know what to expect from physical therapy. Here are a few essential questions you should ask a physical therapy clinic:
- What will a typical PT session involve? Each physical therapy clinic conducts sessions just a little bit differently so it’s important to settle on a place with practice policies that make you comfortable. For example, you may want to choose a clinic that allows you to work with the same physical therapist each time, or to know whether your care is provided by a physical therapist or physical therapy assistant. Others may select a physical therapy clinic based on session length or whether manual therapy is performed.
- What will be expected of me? Each physical therapist will have slightly different expectations for the role you play in your own recovery. However, all will expect you to participate in a home program to carry over goals established in your therapy sessions.
- How will you help me reach my potential? You’ll want to be sure that the treatment philosophy of the physical therapist you select meshes with your needs. Just like expectations vary from one physical therapist to another, so does the approach.
- What experience/training do you have in treating my injury/illness? No matter what brings you to rehab, you’ll want to find a physical therapist who specializes in treating your specific circumstance. Physical therapists may specialize in neurologic or orthopedic conditions, for example, based on interests, experience, continuing education, and professional influences.
- Do you accept my insurance? Physical therapy is often covered by insurance but some locations may not accept your plan, or may not accept insurance at all. Asking in advance can save a lot of headaches down the road and is an opportunity to find out if you need to contact your insurance company before your first visit.
Prepare for the First Day. Having a clear sense of what to expect on the first day of rehab can help avoid any confusion and ensure a successful initial meeting. The clinic you have chosen will likely provide information on its website or over the phone but have these questions handy just in case:
- What time should I arrive?
- Where do I park/enter?
- What should I wear to rehab?
- What if I need to reschedule my appointment?
Asking a few questions in advance will ensure you settle on the right PT clinic to address your
specific needs and position you for a successful recovery.
Published on February 7, 2018 6:15 pm
Categorized in: Uncategorized
Is back pain a common issue? Consider this:
- It is the leading cause of disability worldwide
- Approximately 50 percent of workers in the U.S. admit to having back pain symptoms in any given year
- Up to 80 percent of the population will experience back pain at some point in their lifetime.
- $50 billion are spent in America every year on back pain treatments and products
So yes, it’s quite clear that back pain is a common issue! While everyone knows someone with a “bad back,” it seems that many people aren’t up to date on their knowledge of back pain causes and treatment.
There are many myths out there surrounding this subject — some are due to outdated information, while others are just plain wrong. Below, I’ve rounded up the most common myths I hear and tried to sort the wheat from the chaff.
Myth 1: Rest is the best
If we look back 20 years, the advice given to a patient suffering from acute back pain was to lie flat on his back on a hard surface for a week — or two if you were lucky. While this is now an outdated approach, it seems the message regarding active recovery hasn’t been fully received.
Recommendations now center around keeping active within your comfort zone. Movement where possible is advised as it will prevent the back from becoming stiff, and movement encourages an increased blood flow to the area and drainage of the byproducts of inflammation.
It is important not to force the back to do something that causes severe pain to avoid doing any further damage, but certainly moving in any way comfortable is a good idea.
Myth 2: Sciatica is disc related
Let’s get this straight: Sciatica is a symptom, not an injury or condition. The thing with a symptom is that it can be caused by any number of issues.
Take fatigue, for example. Fatigue is a symptom of a large number of conditions including ME, pregnancy and viral infections — to name just a few.
Similarly, sciatica is a symptom of disc herniation, as well as spinal stenosis, facet joint irritation, sacroiliac joint dysfunction, myofascial trigger points and piriformis spasm. And this is not an exhaustive list, just the most common causes.
Unless you have an MRI scan with a clear spinal cord impingement — which matches the level of discomfort you are experiencing (see below regarding MRI scans) — don’t presume surgery is the only option.
Myth 3: An abnormality on my MRI is the cause of my pain
When suffering from acute or chronic back pain, many people will be referred for an MRI scan by their family doctor. Magnetic resonance imaging (MRI) is a great tool for looking at the back in detail as it will show us the bones, joints, discs, muscles, ligaments, tendons and so on.
But does an “abnormality” on your scan really tell you the cause of your pain?
A large majority of people without back pain will demonstrate some form of abnormality on an MRI scan. Minor disc herniation is a common finding as is degenerative wear and tear, but they do not always correlate with pain.
So before you go rushing off to surgery, make sure the abnormality on the scan really is the problem causing your pain.
Myth 4: Bending and lifting are the biggest causes of lower back pain
It is true that lifting with bad form is a common cause of back injury. The spine should remain straight while the knees bend to take the load. This is common knowledge, but so few implement it properly.
However, in my clinical experience, far more cases of back pain are less sudden in their onset. Far more common are cases where pain is caused by sacroiliac joint and facet joint dysfunctions, muscular strain and spasm, and postural issues such as lower-crossed syndrome (anterior pelvic tilt with associated muscle imbalances).
Myth 5: Back pain is genetic
Many people believe that because one or both of their parents suffered with back pain, then they will as well. In most cases this is just not true.
There are, of course, some conditions that cause back pain that are inherited from an individual’s parents — ankylosing spondylitis, for example. There is also some indication that a particular gene may be present more often in those with lumbar disc degeneration.
But for the most part, back pain is more frequently caused by mechanical injuries, movement dysfunctions and posture issues than anything genetic.
Myth 6: The spine is delicate and easily injured
The spine is an amazing structure. It is flexible enough to allow a wide range of movement, sturdy enough to provide attachment for countless muscles and strong enough to act as a protective casing for the spinal cord — damage to which can be fatal.
Going back to its strength, it is not easily injured. It takes a considerable force to injure or damage the spine by way of a fracture. It is more likely injured over a long period of time whereby repeated postures and movement patterns causes degeneration.
This is not a sign of weakness in the spine itself, but more the effect that issues elsewhere in the body will have on the spine.
Poor posture is mostly caused by muscle imbalance. The muscles that attach to the spine affect the positioning of the spine and may cause more stress on certain areas, resulting in an unnatural wear pattern. The same is true of repetitive movement patterns.
By Heidi Dawson. Heidi is a graduate sports rehabilitator based in the United Kingdom. She runs two successful sports injury clinics and the injury website Rehab4Runners.
Published on January 30, 2018 4:00 am
Categorized in: Uncategorized