Category: Physical Therapy Tips

Brrrrr! It has been cold! You know that feeling when you first get in your car early in the morning and you do all you can to get warmed up? I quite often find myself sitting in my car with shoulders shrugged up trying to survive until my heater kicks in. By the time I make it to work my neck starts to feel tight. Thankfully, I work with the experts in musculoskeletal tightness and pain. Visit First Choice and allow us to show you an easy to learn stretching program. We’ll also implement the appropriate strengthening exercises to treat all of your musculoskeletal issues.

Simon Haussmann, PTA

50°, 30°, 70°, 20°? Who know what the weather will be like this coming weekend, but for those of us that like to stay active by being outside it is important.

Here are a few tips to keep you illness and injury free in this fluctuating weather. Dress in layers that can be removed after you begin to warm up and sweat. Dressing too warm may lead to you being chilled by the end of your workout with sweat. When the temperature plummets, protecting your hands, feet, and ears is key. These are the most vulnerable and need to be protected from the cold. Be aware of the weather conditions, so that you can dress accordingly. Take the extra few minutes to warm up properly and stretch to prevent injury.

I personally love to be outside in the cold and clear days. I believe they are the best days for a long hike or bike ride, but if the cold just isn’t your idea of fun, then take this as an opportunity to try something new. A spin, yoga, other group fitness class may be the best way to mix up your routine. Keep warm, drink plenty of water, and remember to stretch to prevent injury!

Karen Mathers, PTA

Beds are one of the most important items you will use throughout your life. The right bed for you will support your body properly through the night to let your spine and surrounding muscles rest and recover from the previous day. Usually, the heavier you are, the firmer the mattress you need. If any of you have seen me, you can probably guess how firm my bed is.

Lately, I ventured into the task of buying a new bed for our bedroom. I went to my friend Jared at Lindsey’s Furniture Warehouse and ordered a new bed. After two nights of sleeping on the new bed, my back was sore each morning and took several hours in the morning to subside. Thinking it was just sore and would work out after a few more nights, we went to my In-Law’s house for Christmas and slept on a different bed. I had no back pain for five days while we there which made me begin to question my purchase. When, we returned home, the back pain resumed for two more days before I called Jared and asked him to order a firmer mattress for me.

It has been two nights now sleeping on the latest mattress and have had zero back pain. I can’t stress enough how important it is to spend the money on a quality bed that is right for you and that will let you rest comfortably through the night. At First Choice, we tell our patients to spend money on beds and shoes. The right bed and shoes will let you work and sleep comfortably and minimize injury to your entire body. Thanks to Jared at Lindsey’s Furniture Warehouse for helping me get the right bed for myself. Make sure when you buy a new bed that it’s the right one for you.

Stephen Peaden, PT, DPT
Doctor of Physical Therapy

As we start December and race towards the end of the year, many of you are trying to figure out just the right gifts to buy. Don’t overlook something for yourself as well. If you have an ache, pain, tear or pull that has been making you miserable, now may be the best time for you to get it taken care of. Many people have already met the deductible on their insurance plan for 2013. Why wait until January 2014 to get the care you need?

Remember that you do not need to have a prescription for physical therapy in the State of Florida.

This weekend I had the opportunity to attend a continuing education conference in Jacksonville, FL with focus on the lumbo sacral complex. Instructed by an outstanding speaker, I was educated on the most recent studies and findings on how to treat pain originating in the low back and pelvic area. I have been on staff at First Choice for a little over a year and have learned our approach to most aches and pains. This conference was the perfect experience for me to personally confirm the high standard of care and treatment approach at First Choice. Back pain? Pelvic pain? Other aches and pains? Schedule an evaluation with one of our physical therapist today to personally experience our state-of-the-art equipment and most of all, our healing hands on techniques.

Simon Haussmann, PTA

This is an article posted on www.MoveForwardPT.com which is run by the American Physical Therapy Association. We are a member of the association and it really has a great amount of information to help us keep up with everything new in physical therapy and supporting fields. This particular artice gives a great summary of our field and is really a breif introduction to an indepth report APTA has created. While it is directed at other health care professionals we thought it would be nice to make it available here for any of our patients who may be interested.

Information for Health Care Professionals

Are your patients struggling with pain and impaired motion? A physical therapist can be a valuable partner in helping your patients achieve freedom of motion and freedom from pain.

Learn more about the benefits of working with a physical therapist, in meeting your patients’ needs.

Health care professionals and those considering becoming a physical therapist can downloadToday’s Physical Therapist, a comprehensive review of the profession of physical therapy from the American Physical Therapy Association.

Benefits of a Physical Therapist

Physical therapists examine, evaluate, and treat patients who have conditions such as back pain, neck pain, burns, wounds, osteoporosis, developmental disabilities, carpal tunnel syndrome, and countless other conditions affecting an individual’s ability to move freely and without pain.

How Physical Therapists Practice

Physical therapists and other health care professionals have a shared goal of creating healthier, satisfied patients. They collaborate with other health care professionals to develop treatment plans for patients using the latest research and proven approaches to ensure positive outcomes.

Practice Areas

Physical therapist education includes an extensive background in the sciences, focusing on physics, anatomy, physiology, biomechanics, and kinesiology. With this background, physical therapists are able to restore and maximize mobility.

Research and Interventions

Physical therapists apply the latest research related to restoring function, reducing pain, and preventing injury. As a health care professional, you may be interested in some of the latest research on the impact a physical therapist can have on specific conditions and injuries.

During the recent downpours and thunderstorms, a significant number of our patients reported increased join and musculoskeletal pains. Some arthritis sufferers claim that they can predict weather conditions with accuracy surpassing local meteorologists. In spite of widespread beliefs in weather change-induced pain, scientific evidence on the matter is sparse and non-conclusive. During the conducted studies, some patients with chronic pain claimed increased pain on rainy days, some before the weather changes, while others have not experienced any correlation to the weather pattern.

Although there are limited clinical trials, and their data is not statistically significant, physicians and physical therapists working with patients who have arthritis have to consider changes in pain behavior in their clinical treatments. One leading theory points out how atmospheric conditions, such as barometric pressure and humidity, can affect symptoms of painful conditions such as arthritis, fibromyalgia, or migraine headaches. Barometric pressure is the pressure exerted by the air around us. To illustrate the phenomenon, imagine the barometric pressure as the compression stockings that are worn on our lower extremities. The high barometric pressure pushes against the body, and prevents tissues from expanding, similar to the way of a compression stocking. If the barometric pressure drops before a storm and the compression subsides, the internal expansion around an arthritic joint may irritate the nerves, causing pain.

According to J. Parvizi, MD., PhD, director of clinical research at the Rothman Institute at Jefferson, and associate professor of Orthopedic Surgery at Jefferson Medical College of Thomas Jefferson University in Philadelphia, the pressure change in the environment causes the pressure inside of the join, and the amount of fluid to fluctuate. This especially effects patients with arthritic joints, as they have less cartilage to provide cushioning. Change in barometric pressure may also cause loss of equilibrium in body pressure, which can result in sensitization of nerve endings.

Psychosomatic nature of pain complaints should also be considered. On rainy and gloomy days, we lack vigor and fell more anxious and depressed. With the return of the sunny weather, spirits tend to rise and we start to feel better. By going outdoors and resuming our activity level, we produce more endorphins, and our brain tends to override an unpleasant sensations of pain. During weather changes, some patients will need to increase their pain medication, but they should still try to take proactive steps to manage their pain with alternative measures. So, to our patients, our advice is to keep moving, go to the gym, or exercise at home to loosen up stiff joints. Always try to prevent swelling by using compression stockings, make sure to elevate painful joints, and use ice to reduce inflammation. If the rainy weather keeps you indoors, lighten up your diet, reduce sodium intake, and don’t let the weather affect your mood! Be patient, the sun and barometric pressure are both going to be up soon!

Maggie Garbiec, PTA

Thomas Jefferson University Hospital (2008, June 3). “People With Joint Pain Can Really Forecast” Retrieved July 2.

[caption id="" align="alignnone" width="150"]It is common knowledge that stretching your muscles for athletic and fitness activities is an immensely important part of the exercise process. What most people don’t know however, is that prolonged stretching after properly warming up is just as important a factor, especially when it comes to improving flexibility and reducing incidental muscle and tendon injuries. For years, the standard instructions for stretching muscles prior to athletic/fitness activities was to hold the stretch for ten to thirty seconds, without any type of warm up beforehand.

Dr. Brett Frank is a graduate of the University of South Florida’s Physical Therapy Doctorate Program. He has had extensive training in orthopedics, and is highly experienced in orthopedic diagnosis, spinal manipulations, as well as Golf Specific Sports Enhancement. Brett has been at First Choice since 2003.[/caption]

Research done over the last thirty years or so has consistently shown that prolonged stretching is the key to improving muscle and tendon flexibility and length. The body’s tendons are charged with the task of attaching muscle to bone, with your fascia binding together muscle fibers. Tendons and fascia are made of a connective tissue known as collagen, which is a viscoelastic tissue. A viscoelastic tissue is a type of tissue made up of “Viscous” and “Elastic” properties, meaning it has the ability to stretch and lengthen, and then return to its normal form slowly. If a constant load or stretch is placed upon a viscoelastic tissue, it will lengthen and maintain that length for a certain amount of time even after the load has been removed, depending on how long the load was present. The tissue will stretch, and then it will stay stretched for awhile before returning slowly to it’s original length.

For the increased length to be maintained, the tissue must reach what is known as “Creep.” “Creep” is a phenomenon in which the connective tissue deforms and “creeps” in length, typically occurring after stress relaxation of the muscle has taken place. During those ten to thirty second stretches that many people consider to be efficient stretching, the only tissue lengthening that occurs is due to stress relaxation of the tissue, and does nothing to improve flexibility and decrease injury risk.

When it comes to stretching, the rate of deformation is load, frequency, and time dependent. Low Load prolonged stretching is considered ideal because it is more comfortable, and the tissue will elongate without causing tissue breakdown. To properly perform a low load prolonged stretch, one should begin the stretching motion until you feel the initial stretching sensation, holding the stretch in that position. As that stretching sensation lessens, you should gradually increase the stretching motion until the mild stretch sensation returns. An effective duration of a stretch is anywhere from three to five minutes per stretch, but can be maintained for as long as thirty minutes. (Some research indicates that these thirty minute stretches can help to achieve greater tissue elongation in a shorter period of time.) Remember that stretching is time and rate dependent, so the less time the stretch is held, the more frequent the stretch will have to be performed in order to increase flexibility. The opposite is also true, that the longer the stretch is held, the less frequently the stretch must be performed. You should consider performing a warm up at least eight minutes prior to stretching; but keep in mind that stretching is also ideal during or after a work out as well, because your tissue temperature is peaked during these times.

Here at First Choice Physical Therapy, our patients are instructed to perform their injury specific stretches for at least three to five minutes, twice a day, in order to improve their flexibility. Our patients are also educated on why this particular length of stretching is ideal, along with the notation that stretch durations less than three minutes require more frequent stretching sessions.

If you currently have an injury, or history of a reoccurring muscle or tendon injury, poor flexibility is likely one of the factors contributing to the problem. If you think this sounds like you, any of our Doctors of Physical Therapy would love to help heal and treat your injury, all the while instructing and educating you on how to reduce the occurrence of these injuries and the disruption they cause in your every day life!

Brett Frank, PT, DPT

[caption id="attachment_475" align="alignleft" width="150"] Brent Holtgrewe is a board certified Athletic Trainer from St. Louis, Missouri; with extensive knowledge and training in orthopedic assessment, sport specific injuries, and sports enhancement training. Brent runs First Choice’s MVP Sports Enhancement program, and has been an employee since 2004.[/caption]

It is the year of 2013, and the marvels of developing technologies, as well as the knowledge accompanying these developments is breathtaking if not slightly overwhelming. Take, for example, the astonishing developments in modern medicine, and the velocity of speed at which it continues to adapt and develop along with the times, and the ever present human need for medical care and attention. Modern medicine is helping us to live longer, it is curing diseases that consumed entire nations of people and were once thought to be in-curable, and those who practice medicine are able to perform spectacular surgical feats; such as total joint replacements and the use of prosthetics for those who lose an appendage, allowing them the ability to return to things like running or simply walking their dog.

However, even with such amazing technology and extensive knowledge of the medicinal process, athletes still manage to get injured. Injuries as simple as a muscle strain, or an ankle sprain, along with injuries that are as complex as they are devastating like an ACL tear, often require the work of an orthopedic surgeon, effectively plaguing our youth and ending careers that never really even began. Even with the progress in bio-mechanics, kinesiology, physiology, and the perfection of proper techniques for the body, we cannot, for some reason, keep our athletes healthy.

Twenty years ago, it was unheard of for a twelve year old to have an elbow injury that required surgical intervention, or surgery to replace a torn ACL due to sports at such a young age, but unfortunately across our country, this has become commonplace. Why? As a people we are smarter and more informed than we have ever been before; with fancy gadgets and flashy toys marketed specifically for younger athletes, promising to give them the upper hand, and make them the best possible player for their chosen sport as quickly as possible. This leads to injuries for an athlete, which are being treated, but what about prevention?

One issue that has been recognized by many is the new competitiveness of athletics, even at the beginning levels of a sport. There is a demand placed on our children to compete at high levels, forcing them to play their sport year round without a break, without a change of pace, and without an off season, all in an effort to never lose the upper hand. Our kids no longer play to just play the game. During my childhood, summers consisted of riding bikes for hours, jumping off ramps and over ditches, playing pickup games of basketball, soccer, hockey, and football; and that was all in one day! We jumped rope, played dodge ball and hop scotch, and swam in the local rivers. This “Play time” is what allowed us to develop naturally into athletes, teaching us to climb, jump, cut, dodge, hang, and run, creating the building blocks from which an athlete is formed and injury prevention begins. In our modern age however, children seem to be losing this “play time”. As a result, the “Multi Sport” athlete has faded away, and our children are forced to choose what their sport “identity” will be (a soccer player, a baseball player, a football player, and so on), as young as the age of ten. Children are losing the basics of athletics and injury prevention by losing their inherent ability to be children; instead spending their summers playing multiple games in tournaments every weekend, attending weeks long camps and grueling practices, losing the chance to naturally gain those building blocks necessary for an athlete.

Instead of trying to make our children into the next Tiger Woods, Peyton Manning, or Alber Poujols, we need to instead encourage our kids to “play”, and not consume themselves into one sport. Too many kids never learn basic things like how to jump rope, skip, bound, or gallop until they are in high school. These activities are vital building blocks that a child needs to help them develop and prevent many potential injuries along the way of their athletic career. One of the key components in developing a successful training regimen is muscle confusion. If all a child does from the age of six is play baseball four seasons a year, the muscles never get a chance for such muscle confusion, but rather become over used, leading to a high risk of injury. Urge your children to play a sport that is out of their comfort zone (and perhaps even yours!), to just play something for fun, or taking the season off to be a kid. Even Professionals have an off season, and for good reason. Preventing an injury is a much better treatment than having to rehabilitate one, so find an off season, actually take if OFF, and play!

Brent Holtgrewe BSC., ATC, LAT, PES

Its summertime!! Now that everyone is outside being more active, it’s time to be careful when beginning new endeavors. When you begin to walk, run or jog for exercise, make sure you stretch to loosen up those muscles you haven’t used in a while. Rest days are also important for your body to recover from the previous days’ activities. Also, listen to your body.

If you feel any aches or pains that don’t ease up after the usual 2-3 days after you participate in any new activities, you might have pushed too far initially. Back off and put some ice on for 20 minutes, 3 to 4 times per day. If it goes away on its own, ease back into that activity. If it continues, it might be time to see someone about it.

Physical Therapists are excellent at identifying muscle and joint issues caused by repetitive activities. They can help you return to your pain-free lifestyle with helpful tips and advice to keep you pain-free for years to come.

Dr. Stephen Peaden, PT, DPT