When a patient makes an appointment with a physical therapist to rehabilitate after a shoulder injury, for example, it’s because he wants to get better, right? Well, yes, but what exactly does that mean? As it turns out, “getting better” means different things to different patients. To some, proper recovery from a shoulder injury means being able to carry a golf bag and swing a club while to others, it means being able to lift their children in and out of their car seats.
Here’s the thing: Helping your physical therapist know and understand your own personal goals is the key to success. As a patient, that means speaking up early and often about how the injury is limiting the everyday activities that are most important to you. With this knowledge, your PT can adapt her approach and individualize aspects of the treatment plan to ensure that you meet your goals.
“Working with high school and middle school athletes, they always have a specific goal of return to sport. As Physical Therapists, Our PTs also work closely with weekend warriors, golfers, gardeners, etc. Knowing specific goals help us at East Athens Physical Therapy to tailor a specific exercise program for each individual patient”Jim Mike Hinzman, PT.
It’s part of a physical therapist’s job description to work with patients to reduce pain and to improve strength, range of motion, balance and mobility. Your PT will address these aspects of your treatment regardless, but if you return home to unload the dishwasher and realize that you still can’t reach to place the coffee mugs on the shelf, then that’s a problem.
Your PT can’t possibly know everything that’s important to you—or the obstacles that you face—unless you share that information with them. One way around this is to bring a list to your first therapy session of the chores that are most important to you in and around your home and the activities that you participate in that bring you the most joy.
To take it a step farther, whittling that list down to one main goal can give you something to focus on in therapy—and motivate you to keep showing up and following the home exercise program that your PT designed. That number-one goal may be different for each patient but the desire to attain it should be the same.
With a little of effort on both sides, patients and their PTs can work together to individualize the therapy sessions and select the most appropriate interventions. After all, physical therapists want nothing more than to help their patients return to previous levels of function as quickly and effectively as possible.
Published on August 20, 2019 7:51 am
Categorized in: Uncategorized
Most people think of heart rate or blood pressure when they think of vital signs. It is common to use numbers to quantify health and risk of disease. The American Heart Association encourages people to “know their numbers” referring to blood pressure, blood cholesterol, blood glucose, and weight. However, research is now showing the importance of moving properly for health. Let’s take a look at some of the numbers you can use to quantify your movement health:
Walking speed has been called the “sixth vital sign” in medical literature recently. It is easy to measure, and takes into account strength, balance, coordination, confidence, cardiovascular fitness, tolerance to activity, and a whole host of other factors. It has also been shown to be predictive of future hospitalizations, functional decline, and overall mortality. Normal walking speed is considered to be 1.2 to 1.4 meters per second.
Push ups are popular to build strength, but a recent study found that they can show us a lot about your heart too. Researchers found that men who could do 40 or more consecutive push ups were at a 96% lower risk for cardiovascular disease than were men who could do less than 10. The push up test was also more useful in predicting future cardiovascular disease than aerobic capacity measured on a treadmill.
Hand grip strength has been shown to be strongly correlated with health. The stronger your hand grip is, the less likely you are to suffer from cardiovascular disease, respiratory disease, COPD, and all types of cancer. In the study, muscle weakness was defined as grip strength <26 kg for men and <16 kg for women. Grip strength below these numbers was highly correlated with an increase in disease.
Standing From the Floor
If you can’t easily get down on the floor and back up your health might be in trouble, according to a study that looked at more than 2,000 people. The study asked people to go from standing to sitting on the floor and back up with as little support as needed. They found that if you need to use more than one hand to get up and down from the floor that you were 2 to 5 times more likely to die in the next 7 years than someone who can do it with just one hand, or even better, no hands at all.
Moving well is obviously important to overall health and longer life. These tests can give a snapshot of how you’re doing. If you’re having trouble with any of them, considering seeing a movement specialist – your physical therapist.
Published on August 1, 2019 7:57 am
Categorized in: Uncategorized
Think about the last time you made a big purchase, say $1,000 or more. Did you go out and buy the first thing you saw? Take one recommendation from somebody? Or did you research it, learn some things, compare it to other options, and select something that was right for you? Most people tend to be educated and research large purchases like cars, televisions, or the newest iPhone. So why do we so often fail to do this with healthcare?
By becoming more educated healthcare consumers we can go from passive patients who take the first recommendation that comes from a practitioner to an active consumer who weighs options and makes choices. Here are some questions to talk through with your practitioner the next time a healthcare decision comes up.
WHAT ARE THE BENEFITS OR EXPECTED RESULTS?
When a treatment or procedure is recommended, the patient often assumes that it will make them “better.” But what the patient expects and what the healthcare provider expects are often two different things. For example, a patient having back surgery expects to be pain free after surgery. The surgeon probably doesn’t expect that to happen. Outcomes from back surgeries are terrible. A large study of 1450 patients in the Ohio worker’s comp system showed that after 2 years 26% of patients who had surgery returned to work. Compare that to 67% of patients who didn’t have surgery. There was also a 41% increase in the use of painkillers in the surgical group.
WHAT ARE THE RISKS AND DOWNSIDES?
Patients want to hear about the benefits of a treatment, but they often don’t ask or care about the risks. To be an educated consumer, you need to. If one treatment has a 3% edge over another, but has a high risk of making you itchy or causing frequent headaches, do you want it? Going back to the back surgery study from before, the researchers found a 1 in 4 chance of a repeat surgery and a 1 in 3 chance of a major complication. With surgery you risk infection, blood clots, complications with anesthesia, and a whole host of other things. These risks need compared with other treatments. In the case of back pain, physical therapy is a valid alternative with a much lower risk profile. You might have some soreness with physical therapy, you might sweat some and be challenged with exercise, but the risks of PT compared to surgery are minimal.
WHAT ARE THE ALTERNATIVES?
Don’t feel bad asking about alternative treatments. If you were looking at a certain car you wouldn’t go out and just buy it. You’d at least consider the competitors and probably even test drive them. You should at least look at the other options in healthcare too. Maybe the first recommendation that your practitioner makes is the right one for you, but if you don’t consider the alternatives you’ll never really know.
WHY THIS TREATMENT OVER THE OTHER ONES?
This is the question where the rubber meets the road. You’ve learned about all the options, now you can see if your practitioner is balancing the risks and benefits to make the right choice for you. Staying with the back pain example, research shows that more than 40% of people who seek care for back pain will not receive a treatment of known effectiveness. Back pain is also the #1 reason for opioid prescriptions, despite a 2016 recommendation from the CDC to avoid prescribing opioids for back pain, and opt for non-drug treatments like physical therapy. By asking for the rationale and carefully weighing options, you can avoid being one of the people who gets an ineffective treatment.
WHAT’S IT COST?
This last question is becoming more important as patients bear an increasing share of the cost of healthcare. Even if you don’t have a high deductible plan or hefty co-pays, by being financially responsible today, you’ll probably see smaller price increases in your premiums down the road. That back surgery that we’ve been talking about? It’ll likely cost between $60,000 and $80,000. So if we put the whole picture together, a patient who takes the first recommendation for surgery will have a $60,000 procedure that leads to a higher risk of disability, and a higher risk of long term painkiller use, while risking infection, and blood clots. Don’t forget the 25% chance that you’ll get to do it all again in a repeat surgery. Seems like a bad deal. An educated consumer would learn that physical therapy is a viable alternative to surgery with comparable outcomes, much less risk and lower cost. In fact, a large study of 122,723 subjects showed that people with back pain who got physical therapy in the first 14 days lowered their healthcare costs by 60%. It’s easy to see why bargain shoppers love PT!
Published on July 23, 2019 7:33 am
Categorized in: Uncategorized
Recent research is showing that surgery might not be needed as often as we think. A large review estimates that 10% to 20% of surgeries might be unnecessary and that in some specialties such as cardiology and orthopedics, that number might be higher. The reasons for so many unneeded surgeries being performed are varied, but the most common are that more conservative options aren’t tried first, or lack of knowledge by the operating physician.
Physicians undergo long and rigorous training programs to become surgeons, but if they don’t work hard to keep learning, their knowledge often stops growing when they leave residency. Recent research is showing that certain common surgeries aren’t any better than a placebo. Two such examples are kyphoplasty – a procedure for spinal compression fractures, and partial meniscectomy – a procedure used to treat tears of the meniscus in the knee. If a surgeon hasn’t continued to learn, they won’t know that these surgeries often don’t offer any more benefit than a non-surgical treatment and will continue to perform them.
Every surgery, even “minor” ones carry risks. These include complications from anesthesia, blood clots after surgery, delayed healing of the incision, infection, and unintended damage to nerves or other organs near the surgical site. Some of these risks cause discomfort for a period after surgery and go away, but others can result in permanent disability or even death. For some patients and conditions, surgery is a great treatment option, but with all the associated risks, when surgery can be avoided, it should be.
For musculoskeletal problems like back and joint pain, sprains, and strains, seeing your PT before a surgeon can help keep you out of the operating room and get you back to life without surgery. Studies have shown that physical therapy is just as good if not better than surgery for a multitude of conditions and carries less risk. Some examples would include rotator cuff tears, meniscal tears, spinal stenosis, low back pain, and osteoarthritis.
Physical therapy can’t fix every problem, and for some patients surgery is the best choice. However, research is showing that surgery isn’t a cure-all, and is sometimes just a very expensive and risky placebo. In most cases, starting with physical therapy is the right choice, and for many patients, PT is the only treatment necessary.
Published on July 2, 2019 9:49 am
Categorized in: Uncategorized
If you’ve ever suffered from a bout of low back pain, then you know that finding relief is often any patient’s main goal. And with low back pain sending 2.5 million Americans to hospital emergency rooms every year, that’s a lot of patients seeking treatment options to relieve the pain.
Medications—or combinations of medications—are often the standard of care for low back pain, particularly in the emergency department setting. But according to recent research, including an Annals of Emergency Medicine study, certain commonly prescribed combinations of drugs proved no more effective in alleviating pain than non-steroidal anti-inflammatory drugs alone or no medications at all. Besides proving relatively ineffective in managing back pain, some commonly prescribed medications come with a long list of side effects from drowsiness to nausea for many patients.
What about surgery? As it turns out, researchers have found that some surgical procedures for back pain are no more effective than sham procedures (used as a scientific control in clinical studies, these faked surgical procedures omit the step thought to be therapeutically necessary). In fact, a study that published in the journal Pain Medicine revealed comparable long-term outcomes regardless of whether patients were assigned to the procedure or sham procedure cohort.
Luckily, patients are beginning to see the benefits of pursuing safe alternatives to medications and surgery. A physical therapy regimen for low back pain is designed to reduce soft tissue pain, improve function and build muscle strength.
“At East Athens Physical Therapy, we have a substantial case load of Low Back Pain patients. Our clinics use the McKenzie Methods for Diagnosis and Treatment of LBP. Often, we can decrease pain in the lumbar region quickly and offer long term relief with an extensive after care program.” stated Jim Mike Hinzman, PT, Cert. MDT.
Although studies show that the long-term outcomes of surgery and physical therapy are similar for the low back pain patient population, the short-term risks differ. Surgical procedures for low back pain are invasive and like any surgery, come with the risk of infection, nerve damage and blood clots. However, similar outcomes can be achieved with an active, standardized physical therapy regimen without the high price tag and prospect of complications. PTs design programs for low back pain that involve general conditioning, lower extremity strengthening exercises and postural education.
“Seeking out a physical therapist that specializes in LBP is often the key to success when rehabilitating the lumbar region. For example, all of our physical therapists at East Athens Physical Therapy are required to perform continuing education upon employment in the McKenzie Method for Diagnosis and Treatment of the Lumbar and Cervical regions.” stated Hinzman.
There is no one-size-fits-all solution for back pain so patients should work with rehab professionals, doctors and other healthcare practitioners to find the best course of treatment for them.
Published on June 25, 2019 8:59 am
Categorized in: Uncategorized