Blog

Get PT First During the COVID-19 Pandemic

Because of the closures of physician’s offices, stoppages of elective surgeries, and social distancing guidelines resulting from COVID-19, many people with pain or joint issues have had appointments or surgeries delayed. If you’re one of them and you haven’t seen your PT yet, you should. Here are some reasons why:

Early PT leads to better outcomes

Studies have shown that people who receive PT sooner have better outcomes, lower costs, are less likely to have surgery, use opioids or have unnecessary testing. Because back pain is so common, there is a lot of outcome data from people with back pain. 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. Unfortunately, only 2% of people with back pain start with PT, and only 7% get to PT within 90 days.

Early PT saves money

The rising cost of healthcare is well known and early PT is something that has been shown to reduce costs without reducing the effectiveness of treatment. A study published in the Journal of Orthopaedic and Sports Physical Therapy showed that patients who obtained physical therapy via direct access had significantly lower medical costs—an average of $1,543 less per patient than those who chose referral from a physician. They also had significantly fewer visits and spent significantly fewer days in care.

Surgery may not be as effective as you think

Many patients look to surgery as the fix for their pain, but surgeries aren’t always as effective as patients believe. A large study looking at worker’s comp patients with back pain found that people who have surgery have a 1 in 4 chance of having a repeat surgery, a 1 in 3 chance of a major complication, and a 1 in 3 chance of never returning to work again. Recent large studies of arthroscopic surgeries for meniscal tears have shown no difference in outcomes between people who have surgery and those who don’t. Other procedures with questionable effectiveness include kyphoplasty, vertebroplasty, and injections for nonspecific back pain.
So, if you were planning on seeing your PCP or a specialist for an orthopedic condition or pain and you haven’t seen a PT yet, you should consider making PT your first stop. You could end up getting better faster for less money and you might avoid riskier treatments like opioids or surgery.

Physical Therapy and Quarantine – Managing Your Physical Health

The coronavirus has changed the way many of us go about daily personal, social and work routines. The CDC is recommending social distancing and depending on where you live you may have lost access to in person visits with your physical therapist. While our daily lives have changed, good physical health should remain a priority and your physical therapist can help you stay on track with the following guidelines.

1. To not lose progress, it is recommended you stay in touch with your physical therapist and continue with home exercise programs which you and your physical therapist have discussed. This way, you can pick up again where you left off when access to your physical therapist returns. 
   
2. Checking in with your physical therapist via telephone on a weekly basis will make sure you stay on track and your home exercise program is adjusted based on your status.
   
3. Many people have been asked to work from home. You may have to adjust to a new workstation which is not set up the same as your desk at the office. Poor ergonomics can lead to decreased productivity, decreased motivation to work and increased neck pain, low back pain or shoulder pain. Making sure your computer and desk chair are set up at the right height are initial adjustments your physical therapist can help you with. Neck and upper back exercises such as chin tucks and rows can help you offset pain created by poor posture.
   
4. Due to social distancing and many health clubs temporarily closing their doors, you may feel lost with how to get daily exercises in. By contacting your physical therapist, you can get recommendations to keep up with your health goals or just to stay active.
   
   1. Walking: Walking 30 minutes a day, 3 times a week has been shown to improve cardiovascular endurance, reduce blood pressure and weight
      
   2. Physical activities you enjoy: Exercise causes the brain to release chemicals that can lead to a feeling of accomplishment and relaxation. Research shows exercise can be very effective in the treatment of depression and elevating your mood. In addition, exercise can boost your immune system.
      
   3. Eight minutes of strength training per day can lead to many health benefits and can all be done without any equipment. Always check with your physical therapist if these exercises are right for you. A routine could consist of planks, pushups, the bridge, lunges, heel raises and squatting.

It is important to stay active during these uncertain times. Exercising will help improve your mood and stress from the coronavirus. Your physical therapist can help you enhance an exercise routine with creative exercises to keep you engaged and excited. 

Are Your Workouts Giving You What You Want?

How much thought have you put into the exercises you’re going to use for your next workout? Did you choose them yourself, or did you find them on the internet or in a magazine? What’s your workout designed for? Do those goals match yours? Are the exercises even safe for you? Using the wrong program can lead to wasting time in the gym, frustration, plateaus in progress and injury. Let’s take a closer look at what goes into program design and the cost of getting it wrong.

Exercise Selection

There are many things to think about when choosing specific exercises. Machine vs. free weights, isolation vs. compound lifts, number of reps and sets, etc. Each one of these factors affects the results, so making the wrong choices could lead to wasting time working on the wrong things, limit your results or lead to injury.

Technique

If you choose the right exercises, but don’t know how to do them properly you will again limit your results, or worse, end up injured. Poor technique leads to inefficient movement and limits the power your muscles can create. It also changes the load on your muscles, joints, and ligaments which can lead to pain and injury.

Volume

Volume is a way of thinking about how much work you’re doing during a workout. Doing a few reps with a heavy weight or a lot of reps with a light weight could end up being the same volume. Same goes for running a shorter distance quickly uphill vs a longer run at a slower pace on flat terrain. If your volume is too great you won’t recover well between workouts and create the possibility of injury. Too little volume and you won’t see results.

Progression

If you’ve been doing the same exercises with the same weight and the same number of reps and sets, you’re not progressing. Same goes if you jump on the treadmill for the same amount of time with the same settings each time. To make progress, things have to change and the program that works for your first 6 months won’t work for you 2 years down the road.

Designing an exercise program is a complex challenge with a lot of factors to consider. Most people have a history of injuries and don’t have perfect movement in every joint which further complicates things. If you’re not making progress or just want to make sure your workouts are as effective as they can be, have your physical therapist take a look at your program. Your PT can help design an individualized program to help you reach your goals while keeping you safe and injury free.

Comeback Players: Will Whitehead

We love to post Comeback Players! Comeback Players are our student athletes (from school or other places) that have worked hard to graduate from physical therapy following an injury and return to their sport. We wish them all the best in their upcoming seasons!

This post is dedicated to…

Will Whitehead from Madison County High School (with Charlie Jones, DPT)

Fitness, with a Side of Dysfunction?

This time of year, many people are focused on fitness so it’s worth taking a look at what fitness really means. The dictionary defines fit as “sound physically and mentally, healthy.” Using that definition, many “fitness” routines fall short of the goal. If you don’t enjoy running and dread every workout, you’re probably falling short of the “sound mentally” portion. Exercise should be enjoyable, reduce stress, and leave you feeling better, not worse.

NO PAIN NO GAIN?

Exercise should also leave you feeling better physically. If you can run a good time in a 5k, but have aches and pains for days after, you’re not “sound physically.” If you are increasing your PR in the squat rack, but your joint pain is increasing right along with it, you’re not “sound physically” either. Sure, some muscle soreness and fatigue after a hard workout is normal. But if you’re having pain that doesn’t go away, sore joints, or trouble moving after exercise, you’re probably developing movement dysfunction along with your fitness.

MOVEMENT DYSFUNCTION

Go back to the dictionary and you’ll find that dysfunction is “impaired or abnormal functioning.” So movement dysfunction is impaired or abnormal movement. When someone has a movement problem like a sore joint, limited range of motion, or strength loss, the brain finds a way to get the body to do what it wants. That usually means moving in a way that is less than optimal. For a while, it works. But eventually it leads to injury. As a concrete example, think of someone who has trouble bending one knee doing squats. When one knee bends further than the other, it will cause one side of the pelvis to drop lower than the other. Now that the pelvis isn’t level, the spine bends towards the high side to stay balanced. When that one side of the pelvis drops lower than the other one, it also usually rotates. Now the spine has to bend to the side and twist to keep you upright. This works for a while, but as weight gets added to the squat, and the repetitions add up so does the risk for a back injury.

PREVENTATIVE MEDICINE

Pain during workouts, or pain and soreness that don’t go away after can be warning signs of a movement dysfunction. If you’re experiencing any of these, your physical therapist is a movement expert who can help. PTs are trained to analyze movement, and figure out the root cause of problems. They can then design a program to treat the cause and correct the abnormal pattern. There is no need to wait until you’re injured to see your physical therapist. In fact, it’s preferable not to. Getting minor problems fixed early means fewer visits to the PT, less pain, and not having your workouts put on hold by injury.