A few weeks ago, I wrote a short blog about Musculoskeletal ultrasound and introduced it as a new way imaging can be obtain aside from X-ray or MRI. I talked about how versatile it can be when it comes to delivering results in timely manner as well as easing the burden of long wait times at multiple doctor sites.  Over the course of the last 3 weeks, I have been able to perform several ultrasound scans and produce images for patients on site. I have also been able to gain much needed familiarity so that I may bring you guys more information and blog posts describing my experience. 
     Recently I have had the opportunity to scan a shoulder and offer the patient an anatomical reason as to why they were unable to elevate the arm after a short period of uncomfortable rehabilitation. For the patient, our musculoskeletal ultrasound was the only piece of inside information accessible which really cleared the air because now this patient was fully updated about the condition of the shoulder from an anatomical perspective which made them feel at ease.   Fortunately, the results were more on the positive side and our patient was able to make a recovery with skilled physical therapy.  
     The example I presented is an unfortunate, but common experience that everyday people have in which there arises sudden and unexplained pain accompanied by swift functional decline. This can be a frightening experience especially when our mind starts wondering off on terrible thoughts about surgery and disability.   This is the very reason musculoskeletal ultrasound has been an important adjunct to our delivery of care. Remember folks, our goal is to provide you the best clinical experience possible. Having visuals to go along with our clinical assessment has now become a crucial step to delivering exceptional care.

-Anthony Durant PT, DPT   ​

"The best way to help prevent back, neck, and shoulder pain is by sitting upright. One of the ways the population can work on strengthening the postural muscles is by simply DOING IT! As per Robin McKenzie himself, slouching is considered the "kiss of death" and leads to a variety of musculoskeletal problems. Strengthening posture muscles takes time and it isn't easy. Most people are so used to slouching and have never been taught how to sit properly. Here are three tips to correct your posture:




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1. Stick your butt out
2. Bring your shoulder blades toward the spine without lifting your shoulders up
3. Push your head back as if a super-duper ugly person was leaning in to kiss you"

All joking aside, posture is very serious as it can cause a lifetime of pain. take these tips and do your best to apply them to your daily activities. You might be surprised the impact good posture could have on your life!

-Jose Gutierrez, PT, DPT

     The Centers for Disease Control (CDC) estimates that 1.6 million to 3.8 million people experience concussions during sports and recreational activities annually in the United States.  In order to stay safe and avoid permanent damage, it is important to know the warning signs and treatments for concussions. 

      Our PT Anthony filled us in on some important facts about concussions. 

     "Symptoms may be presented as dizziness, trouble with balance, loss in concentration, changes in mood or behavior, loss of memory, blackouts, headaches, neck pain and sensitivity to light and environmental noise."

     "New research of CTE, chronic traumatic encephalopathy, shows long-term consequences of changes in neurodynamics of brain tissue can cause changes in our internal wiring. This results in accelerated mood changes, depression, memory loss and even death."

     "There is no such thing as mild concussion. Insult to brain causes symptoms (you do not have to black out to receive a concussion) that should all be taken seriously. This includes terminating athletics until further notice and consultation with the appropriate health professionals."

     If you have suffered from a traumatic brain injury, WE CAN HELP! With out baseline testing, balance exercises, vestibular training & the care of one our talented therapists, we can help you get "better today for a healthy tomorrow!"

     -Jose Gutierrez, PT, DPT

     Just like any other Tuesday morning I wake up, a little later than usual, knowing I don’t have to go into work until 2pm. Pulling the covers away I swing my legs over, proceed to stand, and then it happens. I’m stuck. My name is Joe Hernandez, I am a Physical Therapist, and I have neck pain. 
The irony. Someone who has worked on dozens of necks at this point and can’t even move his own. Pain sears where my neck attaches to the rest of my body. Lights are brighter than usual; I can barely open my eyes as the pressure building behind them makes me feel as if they are about to pop out. What do I do? I quickly begin the exercise I generally prescribe in these instances. Ow. Okay. Ow.

     Wait, that really hurts. Ow. This is what they’ve been feeling? 

     Eventually I manage to get my head turning again but not all the way. I attempt to get through the day as my head feels so heavy, I can barely hold it up, and then it happened. My arm starts to go numb. I was getting worse. I was becoming afraid. 
That knife in the back of the shoulder blade I’ve heard patients describe so many times has now found its way in mine. I continue with my exercises. They weren’t making it worse, but they weren’t making it better. I needed help. 

     Luckily, I was surrounded by a handful of other therapists. Finding time out of his schedule, my colleague offered me help. “How’s your pain?” he asks. I ponder on the pain scale. What even is the difference between a 6 or a 7? How do I even choose? “Like a 6,” I mutter, wondering if that was the right answer. “And your headache?” Wait…how did he know I had a headache? And so, the treatment begun. 
     
     He did the things I usually do with my neck patients. A massage here, a stretch there. I could feel my trust build as I could finally completely rest my head into his hands. The pressure began to gradually increase, taking me to my threshold of pain, but never going past it. A few minutes later, with my head fully extended off the treatment table, he lifts my head up. “Take it for a spin,” he remarks. My pain was gone. 
     
​     Now, almost completely healed as I write this (yes it came back later that day, don’t worry, it’s normal) I can’t help but reflect on what this experience has given me. I now had a personal understanding of what some of my patients are going through. Neck pain isn’t the only thing I treat, and even my neck pain may not be your neck pain, but the best thing from all of this, I knew I was not alone, and neither are you.  

​     Pain is frightening. Having someone move you is uncomfortable. Questioning if you’d ever get back to doing the things you love is depressing. But there is support, and the people here at Spine and Rehab Specialists can provide it. I know this, because I’ve received it. If you’re struggling with neck pain, back pain, shoulder pain, or any type of pain, I’d invite you to reach out to us. If you can’t walk very far, your balance isn’t very good, or you just can’t move the way you used to, I’d invite you to reach out to us. If you simply want your pain to be known, and have someone trustworthy offer you support, please, reach out to us. We may not have experienced what you are going through, but we can absolutely make sure that you don’t have to experience it alone. 

     -​Joseph Hernandez, PT, DPT

     I am almost certain if you are reading this you probably have had at least one MRI or X-Ray scan in your life. Whether that was because your weekend warrior spirit resulted in a knee sprain after that pickup basketball game, or somehow magically you developed some random shoulder pain for no reason that really hurts. Either way how long did it take to receive your imaging results? Or better yet, how many appointments did you have to make and how long did it take to have the imaging performed.  Yes, this can be a rather drawn out process especially if you are in unceasing pain. 

     With that said, I would like to drive your attention to some new tech that can potentially ease the process and quickly deliver the answers you seek as to why on earth you are having pain. That tech is called Musculoskeletal Ultrasound (MSK US) and yes, it is basically the technology they use at the gynecologist but in a much different practice and scope of use.  Try to imagine using the same methods but geared towards looking at the body’s musculoskeletal system directly and in the clinic.  For example, with MSK US, we can scan for any injuries in the shoulder, knee etc. We will be able to determine in combination with our regular physical therapy evaluation the causes of your pain which will enable us to create a more accurate diagnosis and follow up exercise plan. 

     This is just the first of a series of blogs that are to come about MSK US and its role on how we can use this technology to develop a clearer insight when it comes to our diagnosis. Certainly, this capability will help ease your questions of what is really happening in your specific case and injury.  

​     -Anthony Durant PT, DPT   

     COVID-19 may have drastically changed the way we see the world and possibly impact decisions we make about our own health for the future. Many of you may have begun the new year with fitness goals in mind and were poised to fulfil these ambitions this year. Maybe some of you were already engaged in some sort of fitness training and felt unstoppable. Maybe you had that unbreakable gym schedule, that routine of work, school, gym, home in whatever order suited you. It seems unreal now, but in the not so distant past, gyms were loaded with people. It was either very annoying or quite enjoyable, pending if you’re the type of person that can handle the crowds.  

     Now we are faced with one of the most severe global health crises the world has seen in 100 years. As the county trickles with re-opening, I’m sure you cannot help but grapple with the question of “is it safe to go back to the gym”?  Should we risk bring infection back to our families? How will I stay fit and healthy if I cannot go to the gym? And how can I work out with a mask on my face?  I believe people may have become used to the idea that in order to maintain a healthy and fit lifestyle, we had to lift dumbbells in front of a mirror and watch ourselves grow, or that we needed to run on that beefy treadmill in order to lose weight. Although if you spend enough time at the gym that may be apparent, it is another thing to realize that maybe it is ok to skip the gym and with small adaptations you can grow into a new fitness regimen free of risking the health of you or your family. 

     Again, as the world tackles the pandemic and provides us with timetables of potential vaccines being ready at years end, that does not mean your physic must wait a year either. With a little creativity, a couple YouTube videos, or a chat with a physical therapist, you can learn how to exercise minus the fancy equipment. It doesn’t take much really, other than the mentality of - that’s how they used to train in the old days.  Take a minute and evaluate your own residence. Is there a place to thrown down an exercise matt and crank out some pushups, abdominal work, or squats? Is it all unusual to think that we can become stronger with just the use of an exercise matt (or carpet) if we only adapt our thinking and utilize our own resources? 

     Here are some thoughts for you. Number one, I believe you can! I truly believe that you can adapt your normal routine outside of the gym and still achieve your goals. You are fully capable to engage in active and fit lifestyle. Number two, use the environment around you, for example maybe use a chair to work on some dips. Use a matt while you plank, or lunge down your hallway. Maybe speed up the routine and challenge your cardio fitness. Number three, be resourceful and creative with what you have when you want to add some resistance. Weights are expensive now if you can even find any!  Think outside the box and try lifting a gallon of water during your squat routine. Don’t forget inexpensive resistive bands are very helpful and just as challenging to work with.

     In conclusion, I do not think need to give up your exercise routine and healthy lifestyle during these challenging times. Personally, for me exercise was a way to vent the everyday stress of life away and I know that was the case for many of you as well pre-COVID. Now among the many challenges and adaptations we are facing, I challenge you to adapt your exercise lifestyle today. This maybe something you do temporarily, or it may start you on the path of something new in the future.
     
​     -Anthony Durant PT, DPT