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ABOUT PHYSICAL THERAPY
ABOUT PHYSICAL THERAPY
Have you ever heard physical therapists referred to as the “Movement Experts”?
Physical therapists have earned the title the “Movement Experts” over the years due to certain aspects of their education and career. Like many other health professions we study human anatomy, but for physical therapists, there is also a large focus on the study of human movement and how it relates to how someone functions.
Because of this, physical therapists are particularly keen on identifying movement dysfunctions and treating them. For example, if you are having pain in one area we won’t just look at that specific area, but we will need to take a big picture look at everything. We are trained specifically to look at how everything is working together in your body. We look at how you are performing specific movements that you need to perform, and we see how everything is working together in your body.
We are trained to identify those issues and movements that are contributing to your pain or whatever problem you are having. Then we treat that so that you are able to get back to what you want to do. It’s not just about reducing pain but also about being able to function better.
- Marlene Gomez, PT, DPT
Happy New Year, I hope everyone is enjoying their 2023 so far!
As a physical therapist, I like to promote physical activity. And one thing that I see holding a lot of people back from physical activity is obesity. Not only here in El Paso, but also nationwide.
The main problem with obesity preventing physical activity in my opinion, is the negative stigma that comes with being obese. I’ve heard many times from many patients “I’ll never be the same.” “I’m older.” “I used to play sports in high school.” Many of my patients used to be active. The thing that gets me is the “used” to.
Why not go back to it? It’s never too late.
The biggest problem over all is that mental component. We hear so much about exercising, eating right, and that’s all great, but what if your mind is not totally ready for these big lifestyle changes?
There could be things from your past preventing you from taking those steps forward, and no matter the obstacle, it’s important to spend time recovering and getting your mind fully ready before starting a new chapter in your life.
In many ways it can be difficult to wake up early and exercise and still go about your day. Or choosing a meal when it’s between $15 for the healthier option or $5 for a burger and a coke. It’s easier to make the unhealthy decision and most of the time, I don’t blame you!
As a matter of fact, I just heard recently that Burger King is launching something called a suicide burger. Why? And chances are, it’s probably a lot cheaper than a salad. So it can be very very difficult to live and think about living a healthier lifestyle.
I challenge you all to try and work on the mental component first. Get yourself ready.
It’s going to be hard, but you can motivate yourself to set your alarm early. Set 3 if you have to. Just start by getting up and doing at least 15 minutes of exercise. 15 minutes is all you need to start and it doesn’t have to be lifting weights or using all this crazy equipment you spent a bunch of money on. Just start by getting up and walking around the living room. Put some headphones on and go up and down your garage step for a few minutes.
Anything you can do is important. As long as you get started, you will get the hang of things and it will become easier and maybe even more enjoyable. Once you’re more comfortable in your routine you can then start adding in some simple equipment like maybe an affordable fitness tracker to track your steps. The 10,000 steps a day challenge is a great starting point just to see your progress and how much further you can go every day. Even if you are not meeting the 10,000 steps, by furthering yourself just a little every day you can get there, and that is an amazing feat.
Being able to motivate yourself is one of the most important parts of your fitness journey and is what’s going to help you get through those bumps in the road we all experience. You are not alone in this struggle, it’s hard for many other people and even for me as well.
It can be even harder with things like social media. I see a lot of individuals posting about their fabulous life with their washboard abs and diced bodies, and that can be very unmotivating. At a certain point you have to realize, you are probably not going to look like that. Everyone’s genetics are different, you are built different than other people and there is nothing wrong with that, you just need to learn to work on you. Motivate yourself and block out all of the negative social media and negative societal expectations so that you can focus on what your specific body needs.
I promise that once you get your mind through that barrier and you start being active, it will become automatic. You’re not going to want to sleep in or take the elevator, being active will become a more important part of your life. Try it for 4 weeks straight. It takes around that time for someone to form a new habit so by the end of that 4 weeks, you just might be an exercise enthusiast!
I challenge you guys and I know you can do it!
- Jose Gutierrez, PT, DPT
Staying Active in the New Year
The New Year is a new beginning for many people. One of the most common goals people set for the New Year is to lose weight or get in shape, and that’s an area we can definitely help with!
Here at Spine & Rehab Specialists we like to promote health in all of its forms. This is physical therapy after all so we enjoy putting the physical, into physical activity.
Did you know that the recommended amount of cardiovascular exercise per week is 150 minutes? Plus 2 days of resistance training on top of that! But what does that really mean?
It sounds like a lot but it can be as simple as taking the dog out for a walk every day or taking the stairs instead of the elevator when possible. Doing these little things start to add up and next thing you know, you’re reaching your goals and getting closer towards your next fitness accomplishment! Park your car a little farther, go outside with your kids, play basketball at a park with friends, you don't need to lift weights and go to the gym every day to be active and healthy!
So make sure to be mindful and be aware of when you can fit in these quick but meaningful segments of exercise and stay active!
- Chris McMillen, MAIS
Haydee's AlterG Success Story
The AlterG Anti-Gravity Treadmill is a resource we utilize every day in our clinics at Spine & Rehab Specialists. We love using this piece of technology to help our patients get better and we know they enjoy it as well! One of our patients in particular, Haydee, has taken a liking to the AlterG.
Haydee suffered two brain hemorrhages in late 2017 and came to us in early 2022 after having been without physical therapy since 2019. Since being out of physical therapy, Haydee and her brother have practiced different exercises for her legs like squats and routine walking. Haydee uses a wheel chair and while she is now able to walk with walker, she still required the assistance of another person at the time or else she would lose her balance very easily.
When she came for her first visit, her goals for her physical therapy included improving her balance and hip strength. We are more than happy to say that because of the hard work from Haydee, her physical therapist and our other staff, and the use of the AlterG, she has been able to accomplish that and more!
“With Haydee’s condition she has some limitations with her legs, this makes it hard for her to place one foot in front of the other. It’s a big part of why her balance was off” Haydee’s physical therapist, Anthony Durant, PT, DPT, Cert. MDT, FMSK, said. “The AlterG has allowed us to place her in a secure environment so that she doesn’t have to worry about falling. It also allows us to sort of “unweight” her to a certain percentage so that she can walk freely and really concentrate on her coordination.”
Haydee’s favorite part of the AlterG Anti-Gravity Treadmill is pretty obvious, the Anti-Gravity! She also enjoys utilizing the gait training and camera features to monitor and make adjustments to her walk. When asked about the Anti-Gravity aspect of the AlterG, Haydee responds “that’s the best part. That’s what makes me walk better.”
Haydee has used the AlterG on almost every visit she has had with us and is most definitely a fan, not only of the Anti-Gravity Treadmill, but of a certain technician here at Spine & Rehab Specialists as well. “It’s been about five months since we’ve been coming and she uses it [the AlterG] every time,” said Haydee’s brother Carlos. “She loves working with Roger on it too, he always has really good exercises for her.” “He pushes me” said Haydee. “I like it [and] feel stronger, I’m going to keep coming.”
“She always tries to use the gait because it shows the levels and it can tell her when something is wrong, and she switches between that and the camera to see what the problem is” her brother Carlos recalls. Haydee also uses the weight displacement and stride features to make sure she is walking correctly, she never hesitates to take full advantage of all the features the AlterG has to offer!
After a few months of being consistent in her therapy and her use of the AlterG, Haydee started to get stronger and was getting closer and closer to accomplishing her goals. She’s now progressed to the point where she’s able to walk with her walker without any assistance, which proved to be a challenge for her before. “It’s [the AlterG] really propelled her walking and she’s gotten to the point where her family now feels safe with her walking with the walker by herself where before it was a bit more complicated,” said Durant, PT, DPT, Cert. MDT, FMSK. “Now you can just watch her and she can pretty much do it on her own. Without the AlterG I don’t think it would have been possible to achieve that kind of feat” he continued.
We are more than proud of how far Haydee has come and we feel lucky to have been able to provide her with the right tools to help her achieve her goals. Thank you for trusting us Haydee, we will always have a spot for you in the AlterG and our hearts!
As Physical Therapists, most of the patients that come to us are in a lot of pain. The biggest part of our job is to bring that pain level down but contrary to popular belief, it doesn't end there. Relieving the patient’s pain is only step one. In reality the healing process has three different steps the patient must go through to complete their Physical Therapy.
Now, I’m not going to go through the physiological part of healing, that's a whole lot of class that we don’t have time for. Regardless, these three stages of healing are very important. Patients may end up missing out on some of the benefits Physical Therapy when they are not completed.
So first off in the process like I had said before, is bringing that pain level down.
While reducing pain we also work on maintaining, and even gaining some range of motion and flexibility. A lot of times after a patient completes this first stage they think they are better and done with therapy, but this is far from the truth. They think “my pain is gone, do I really still need Physical Therapy?” This is when we start seeing patients drop out or show up less which can cause more harm than they are aware of. We want our patients to be completely recovered. Not just having less pain or being pain free, but really fully recovered and able to go back to their normal life without the risk of injury.
So now that the patient is pain free we can begin the second phase.
This is where we really start working on improving their range of motion, improving their flexibility, and working on strengthening. All through exercises tailored to their specific needs. We show them how to properly perform their exercises and provide a home program for them to follow as well. Little by little we progress the patient and their exercises so they can continue to grow stronger and feel better. I think other Physical Therapists will agree with me when I say this is a very important part of the recovery process.
We need to properly educate our patients; yes their pain is better but restoring range of motion, flexibility, and strength is just as important for their recovery.
This last phase I feel is often forgotten, even by some Physical Therapists. In my opinion this is where the fun really begins.
The third stage is all about getting the patient back to doing the things they love. For some that may be playing sports, carrying their groceries, playing golf, even lifting their grandchildren. Whatever their pain has been keeping them from doing, we want to get them back to. This is when we come up with fun exercises beyond the straight leg raises and things of that nature that are specific to what the patient is trying to accomplish.
Want to be able to golf with your buddies again? Let’s bring in your golf club and see what we need to do to get your swing back and make it even better.
We can get creative with our treatment to really engage the patient and make sure they are meeting their goals. We want patients to leave us feeling proud of their achievements and happy with our care; but they have to go through all three stages to get to that point.
For any other Physical Therapists or Doctors out there, make sure you educate your patients on these three stages of healing. And for any patient out there, make sure you successfully go through them all and get the care you deserve! All patients deserve to feel fully confident in doing what they love without hurting themselves. With these steps, we hope to accomplish that with every single patient that crosses our path.
- Harry Koster, PT, Cert. MDT
Anthony here! So, I just recently got certified and credentialed for MDT and I wanted to take some time to talk to you guys a little about what it is and what it means for me as a physical therapist. First let’s talk about the credentialing process.
The process to get certified in the McKenzie Method consists of a few different components and classes. The classes are divided into five different sections, A, B, C, D, and a recently added section, E. Once those classes are completed the next step is signing up for the credential examination. The exam has three different parts, a written test, a lab form, and then a skills practical, after passing all that the last step is to claim your certification!
So mechanical diagnosis and therapy, or the McKenzie Method, involves understanding a method of treatment and applying that in its form to patients. The reason I like the McKenzie method is because it’s a hands-off approach, I know that sounds counterintuitive to what we do as physical therapists but if we can train a patient on how to understand their pain and find a movement that works for them, they can practice that movement in repetitions at home on their own and get better even when they’re not in the clinic.
Sometimes what happens is patients begin to rely on us doing manual therapy or stretching them out directly as their main source of getting better, this creates a dependency and while we will always be here for our patients, we want them to get better so they can live pain free independently and not need our constant help.
With the McKenzie Method we can train to minimize dependency, we always do manual therapy and stretching and massaging in our clinics but once we find that movement that works for them, they can work on relieving their pain at home and can continue even after they are finished at our clinic.
I’ve seen it work miracles; there are many different and effective forms of treatment don’t get me wrong, but with the McKenzie Method I’ve seen tons of results with neck and low back treatment. It’s why I wanted to get credentialed.
Come see me in the clinic or call if you have any other questions on the McKenzie Method and how we use it in our clinics!
- Anthony Durant, PT, DPT, Cert. MDT
Hello everyone, I’m Joey, a physical therapists here at Spine & Rehab Specialists and I wanted to talk to you guys about the home exercise programs we give out to each of our patients. In my opinion, these home exercise programs are one of the most important aspects of the rehabilitation program.
Now it should go without saying that when you come to physical therapy, it’s going to be a little physical. I wanted to address this because often times I get the look on my patient’s face when I tell them a part of their program is going to be based on them doing some exercise on their own time but trust me, it’s not as bad as you may initially think! Often times exercise can be scary to a patient with an injury especially if they’ve never really exercised before in their life. Well never fear, I’m here to tell you that exercise doesn’t necessarily mean lifting heavy weights or using a bunch of different equipment, exercising can be as easy as lying down on your stomach! If you don’t believe me come see me, I promise it’s an exercise that I often prescribe for low back pain.
So basically, you don’t always have to be putting an excessive amount of effort into your home program okay? Your exercises may consist of something as simple as keeping an eye on your posture but exercising at any level is always important. The word exercise should not be intimidating when it comes to physical therapy, yes it is going to be physical, yes you are going to do some exercise, but there’s a lot of science behind this okay? A combination of some exercise, some education, some hands-on manual therapy, that’s what’s going to help you get better.
That’s what we do right? We want you to live a better life, whatever that means for you. Let us know how we can help you and let’s get active!
-Jose Gutierrez, PT, DPT
How Posture Can Cause Pain In The Thoracic Spine (mid back) and What You Can Do To Fix It
This blog is the written form of two of our weekly video series, Wellness Wednesdays and Thirsty for Knowledge Thursdays. Our Wellness Wednesdays go over great exercises that can help relieve pain from a specific injury, and our Thirsty for Knowledge Thursdays go over exactly what that injury is and how it happens. Click the "Our YouTube Channel" button on the right side of this page to head over to our YouTube Channel or check out the videos above!
This weeks video topics were on Thoracic Sprains and Strains, Earl and Chris showed some great seated exercises that can help treat the pain and Harry and Anthony talked about Thoracic injuries in more detail and explained how they occur. First, let’s start off with talking about exactly what Thoracic sprains/ strains/ pains are and see how people usually get these kinds of pains.
The Thoracic spine is the longest part of the spine and lies between the Cervical spine and the Lumbar spine. The Cervical spine is the neck area and the Lumbar spine is more of the lower back area, so the Thoracic spine would be right in the middle in that mid back area. The Thoracic spine is not necessarily an area of a lot of problems, we normally see more neck and low back problems but it can still be an issue for someone who does not practice good posture on a regular basis. When sitting or standing with proper posture our spines will generally have an inward curve in the Lumbar/ lower back, a more outward curve in the Thoracic spine/ mid back area, and ending with an inward curve at the Cervical spine/ top. When someone is sitting or standing with bad posture, their spines form one big “C” shape which is not its natural position and therefore can cause some pain and discomfort in the Thoracic spine region.
When we are in this position it might feel good or comfortable to us in that moment, but sitting in this position often enough or for long periods of time will start to give someone serious problems. We have been seeing these problems more and more in the clinic due to the Covid-19 pandemic causing many people to have to work from home. People are sitting on their couches or beds rather than their normal desks or work spaces resulting in more bending over and less sitting up straight, causing these issues in the Thoracic spine. We usually hear our patients with these issues report having a kind of stabbing pain in the mid back that will be present for one moment and gone the next. What they are probably not realizing is that when they are sitting with correct posture the pains disappear, but those pains always return when they revert back to sitting incorrectly. Even though having good posture is not normally a big area of concern, doing this long enough can lead to pain between the shoulder blades and even low back and neck pain in the future.
So the secret to avoiding those pains and strains in the Thoracic spine? Listen to all those times your mother told you to sit up straight and practice good posture! If you are already starting to get those pains though don’t worry, we have some tips and easy exercises you can do to help relieve those pains and get your back, back (pun definitely intended) to it’s natural pain free state. One quick tip we always give patients who have trouble figuring out how they should position themselves to have good posture can be done in three easy steps:
1.First slouch, then over correct your posture by squeezing your shoulder blades together and pushing your chest out
2.Do this movement 10 times
3.On the last one, overcorrect by about 15-20 % less and find where you feel balanced the most, this should be the correct posture for you
Another way to relieve pain and correct the posture some is to put your hands behind your head and stretch out the opposite way. Stretch backwards and make a “C” shape in the opposite direction of when slouching forward, that should help reset your back and posture a little.
Other than those two tips, there are also some easy exercises that can be done while seated that can help relieve Thoracic pains and strains, here are 6 to start off with.
The first exercise is called External Rotation Series and the only equipment you will need for this are some weights. In the video, Earl and Chris used two one pound weights but for someone doing these at home a simple can of corn or soup is a great substitution, or these can be done without any weight if needed. Once you have your weights, you start by raising your arms at a 90 degree angle in front of you, and then lifting your arms straight up towards the ceiling. Bring your arms back down to a 90 degree angle, keep them at that 90 degree angle but now open your arms so that they are in a straight line with your shoulders and then push your arms straight up to the ceiling again. Once you have that movement down, do about 3 sets with 10 to 15 repetitions.
The second exercise is called a Swimmers Press. This exercise will also require a one pound weight in each hand (or soup can or nothing if you don’t feel like it). With a weight in each hand you will start off by doing a basic bicep curl, once your hands are positioned close to your body in the bicep curl you twist your wrists so that your palms are facing outward. Now that your palms are facing outward, you push your arms straight up to the ceiling, bring your arms back down to the bicep curl position, twist your wrists back to facing your body and lower your arms back down to your waist. When doing this make sure to not drop your arms after you lifted them up above you, slowly bring them down in the correct movements. Once you got that movement down this can be done for about 3 sets of 10 to 15 repetitions as well.
The third exercise is called Seated Middle Trapezius. For this one you have your arms at waist level with your weights in your hands, your palms facing up, and your thumbs pointed out. Next you squeeze your shoulder blades together as you move your arms outward. While you are doing this never let your elbows leave your ribs, your elbows should be touching your ribs even as you squeeze your shoulder blades and move your arms outwards. Once you got this movement down you can do about 3 sets of 10 to 15 repetitions.
The next and fourth exercise is called the Kayak. For this exercise you can use a number of different items, Chris is using a towel and Earl is using a stretch out strap, but you can easily use maybe a t shirt or a dog leash or anything of that nature. To start you position you hands about a shoulder length apart from each other on your rope (or rope substitute) and hold it with both of your thumbs out and facing the same direction, one hand should be facing palm up and the other palm down. Once you are holding it correctly you stretch your arms straight out in front of you, and move it up and down diagonally across your body, you should reach up to your head and then back down to your knees all while keeping your arms perfectly straight. When moving you move up in the direction that your thumbs are pointing then when you have done a few sets on that side, switch your hands around the other way so that your thumbs are both pointing in the other direction and repeat the movements for that side. Make sure you are twisting the upper body well and squeezing that core. Once you have the movement down this can be done for 3 sets of 10 to 15 reps.
The fifth exercise is called a Seated Dead Bug. For this exercise you won’t need any equipment at all, just you! Start by putting your arms out in front of you and your feet planted firmly on the ground about shoulder width apart. Next you lift one knee up and touch it with your hand that is opposite to the knee you lifted. Continue this motion switching between each side. As you are lifting your knee make sure you are twisting good and strengthening your core, it should look somewhat like a march as you are tapping with the opposite hand. As you are tapping your knee, the hand that is not in use should be lifted in the air and stretched behind you following your twisting body. Once you are good with the movement you can do this for about 3 sets of 10 to 15 reps.
The sixth and final exercise is more of an extension, so once you feel pretty good with doing all those exercises, you want to make sure you can move in all directions that your upper back is supposed to move (bending backwards, bending forwards, rotation etc). One way to do an extension is to start by having your arms crossed against your body with your hands on your shoulders and sitting at the end of your seat. Next lean forward a little and then start arching your back and pointing your elbows up to the ceiling while they are still crossed. If this causes some shoulder pain another way it can be done is by uncrossing your arms and putting your hands on your shoulders. Once you’ve done that you can arch your back and lift your elbows up to the ceiling while keeping your arms in front of you, don’t let your arms open up while you are arching your back. Once you have that down you can do that for about 15 repetitions.
Those are some different exercises you can do if you do have any Thoracic sprains or strains, we gave a general recommendation of doing around 3 sets of 10 to 15 repetitions for each exercise but that part is definitely up to you and how you are feeling with the exercises. If you are still having problems or if you have any questions for us, give us a call at either of our locations and take advantage of our free consultations so we can help you guys with whatever you need.
This blog was transcribed from our 13th episode of our Spine & Rehab Specialists podcast series featuring Harry Koster, PT, Cert. MDT and Marlene Gomez, PT, DPT. Scan this QR code or click the button on the right side of this page if you are interested in listening to this, or any of our other episodes!
The word Arthritis can be broken down into two parts. The first part “artho” means joint and “itis” means inflammation so putting it all together Arthritis can be a number of different conditions that affect and cause inflammation in the joints. The majority of the time people assume Arthritis is just an “old age” thing and one day we will all have to accept it, but that is definitely not the case. There is a specific kind of Arthritis that does progress over time with age but that is specific to Osteoarthritis and there are many different types of Arthritis that are not associated with older age. One of the most common types of Arthritis is Rheumatoid Arthritis, it is more systemic and a little bit more severe but it is not one that automatically comes with old age.
Osteoarthritis tends to develop over time progressively and causes what some people call “wear and tear” to the cartilage surrounding the joint. Most of the joints in our body have a thin lining of connective tissue called cartilage. Cartilage surrounds the ends of the joints and its function is t help reduce friction when the joints are moving, it helps everything move smoothly. Compare it to ice for an example, a smooth layer of ice is ideal for gliding smoothly across but if you were to take some tool and crack the ice it becomes rough which is what’s happening to the cartilage. There’s some damage and wear and tear in the in the cartilage it’s not as smooth as it used to be, so the joints won’t move as smoothly anymore which causes those symptoms like stiffness and joint pain. Normally cartilage is very smooth but over time it can get sand-papered out.
Genetics play a part in causing Arthritis, some people might genetically be more prone to getting it than others but there are multiple different things that can contribute to it beyond just genetics. Things like injuries, bad habits, and more can contribute to that wear and tear that’s happening. Arthritis is typically seen in joints called weight bearing joints so we see a lot of people who have it in the knees and the hips because they carry a lot of load but it can affect other joints as well. We take into consideration what the patient does throughout the day, we need to know what their occupation is or if they play any sports or anything of that repetitive nature where they would be using the same joint over and over. For example, a baseball pitcher uses the shoulder over and over they might get arthritis in the shoulder or someone who has a very labor-intensive job that requires a lot of bending or picking up that’s when we see it in the knees, the hips, the back/spine, and places like that.
When most people find out they have Arthritis they automatically think they are going to have to choose between living with it and the pain or getting some kind of replacement surgery or something of that surgical nature, but that is usually not the case. There is a lot of evidence that Physical Therapy does reduce a lot of the pain and symptoms and also improves function. A lot of what we target is improving mobility in the joint, reducing the pain and reducing the symptoms. When people have arthritis they typically tend to not want to move as much and that is what contributes the most to the stiffness in the joints, the less you move you the weaker and tighter your muscles get. Although the part of the body that has Arthritis is the main point of the pain and discomfort, it is not the only part of the body we look at.
For example, if someone has arthritis in the knees we will not only address the muscles immediately around the knee, we will also take a gool look at the hip to see if there is any weakness or lack of mobility that the knee has to take the extra load for. It’s a matter of us taking a look at the whole body not just that one joint, we need to identify what deficits and problems there are and then really address them. As Physical Therapists we can’t go in there and replace the cartilage or try and fix everything but the benefits people experience from trying Physical Therapy as a treatment are phenomenal.
Surgeries are a big deal they are not just expensive, the recovery process is a big long process to deal with as well and it can be very painful. Some people come into our clinic looking like they are heading towards a total hip or total knee replacement and they end up not needing it or at least postponing it by a couple of years because of the care and education we provide through Physical Therapy. Plus, if you have a surgery you are going to need Physical Therapy afterwards either way so it definitely can be beneficial to start at therapy first. PT beforehand is going to be beneficial as far as strengthening the muscles and gaining some joint range of motion back so that the recovery is a little easier on your body, and also in the aspect of educating the patient on exactly what is going to happen to their body and how they should go about taking care of it after.
When treating Osteoarthritis specifically the most common treatment options are pain medications for the pain and anti-inflammatory medication to help if there is some inflammation or swelling which is often present with Osteoarthritis. Other than that there’s more invasive treatments like surgeries or certain injections to help the cartilage but even then these are all temporary solutions. And there is obviously also, Physical Therapy. So far for people with Osteoarthritis, Physical Therapy has proven to be very beneficial. It’s really a matter of the earlier you do it the better and more effective it will be as a treatment. After a certain point with Osteoarthritis there can be major issues inside the joint that can be harder to treat but if someone with that kind of damage had come in maybe a few years earlier that damage could have been majorly slowed and even prevented.
Physical Therapy for someone with Osteoarthritis would consist of a few different things. Education is one of the most important things we do here for our patients, we can educate patients on techniques they can use to preserve the joints and on how to do things and move in a better way that doesn’t put as much strain on the joints. Modifying certain activities helps a lot, we have seen patients that are trying to kneel but have a hard time getting up for an example, and when we watch them get up we notice they do it in a way that is putting more force through their knees than necessary. We look at things like this so we can modify the way patients move and show them a better way to get up from a kneeling position for example to help them protect their joints in the long run. They aren’t necessarily moving incorrectly but there is definitely a better way.
Treatment options for Rheumatoid Arthritis is a little different. Rheumatoid is different from Osteo Arthritis because it’s systemic, which means it’s a chronic and inflammatory condition. It’s inflammatory in that it’s the immune system that is attacking the joints in the body, it can even involve multiple joints and it tends to progress and become a little more debilitating over time. People with Rheumatoid Arthritis tend to experience not only pain and inflammation in the joints, but joint stiffness, redness and warmth in the joints, and the joint stiffness in the morning tends to last longer. Osteoarthritis can cause inflammation too on some occasions but with Rheumatoid Arthritis it is a much bigger deal.
Patients who suffer from Rheumatoid also tend to get flare ups where there’s even more inflammation and symptoms and joint stiffness and pain and even in extreme cases, joint and bone destruction. And because it’s systematic the patient during the flare up will feel just generally unwell, they might be tired or have a low grade fever even. There can be some erosion of the bone itself and that’s where you start seeing the damage and the deformities in the joints. For example Rheumatoid in the hands over time may look like bent and stiff fingers and just completely different. It’s definitely a more sever condition than Osteoarthritis and not necessarily related to wear and tear, almost any age can be affected its not just specific to the older population.
The important thing to remember when treating Rheumatoid is that its systemic and chronic so early on you really do need to see a specialist to prevent the eventual damage and try to slow the progression of the joint damage. A doctor might offer treatments such as cortical steroids and anti-inflammatories but also specific medications that are used to suppress the immune system because that is what is attacking their joints. These different medications and disease modifying drugs often come with a lot of side effects and at times can stop working when the patient’s body becomes accustomed to it causing the patient to switch often between a number of different medications. Cortical steroids can often weaken the bones as a side effect as well when the patient is already at risk of that just by having Rheumatoid.
When working with a Rheumatoid patient we also take into consideration the fact that their medication is suppressing their immune system so they might be more prone to infection that some of our other patients. We also have to consider if the patient is a fall risk and address their balance so they don’t end up suffering a bone injury on top of all the other pains that come with Rheumatoid.
There are many different kinds of arthritis but these are two of the most common and the teo we probably see the most of in our clinic.
This blog was transcribed from our 8th episode of our Spine & Rehab Specialists podcast series featuring Harry Koster, PT, Cert. MDT and John Moreno, PT, DPT. Scan this QR code or click the button on the right side of this page if you are interested in listening to this, or any of our other episodes!
Our legs are important as they help us to walk, run, drive, navigate stairs, move objects, kick, as well as perform a variety of other functions. When we injure our legs, it can have a heavy impact on our lives. The rehab process to get better from an injury does not always go very smoothly as putting pressure through and injured area can be painful and cause further damage and/ or inflammation. Unfortunately, that’s the only way one’s legs can get back to full function, but with one of our amazing pieces of equipment we have here, the AlterG, it doesn’t have to be as difficult or as painful as you think.
Essentially, the AlterG is a treadmill, however, what sets it apart from a standard treadmill is the sort of space bubble it has wrapped around it. The “space bubble” allows the machine to control the amount of air that’s within the environment. What this does for you is offload the pressure that you are applying through your legs. With some adjustments to the settings the AlterG can remove up to 80% of your body weight, which will basically feel like you are walking on clouds!
So now that the patient is lighter, what’s next?
We have the patient go through an exercise regimen at the reduced pressures, once their body becomes accustomed to this, we can start adding the pressure on slowly over time in a controlled manner. That way the patient can slowly but surely get back to full weight bearing without having to go through so much pain. It’s useful not only for walking, but for squatting, running, jumping, standing on one leg, balance, as well as other types of exercises.
There are many different conditions or injuries in the lower extremities that could benefit from rehab with the AlterG, anyone who has trouble or pain with walking, standing, climbing stairs, running, or any pain related to the lower extremities could benefit from spending some time in the AlterG. The possibilities go beyond just basic lower extremity pains, things like neurological disorders, general injuries, post-surgical injuries, sprains, and many more can also see significant results from using the AlterG; essentially any injury from the hip down is a candidate for rehab on the AlterG. We may use it for some lower back pain rehab but not for every case.
The AlterG is a great device that can help us help our patients in the lower extremity rehabilitation process. It provides an environment that will help patients get back to their prior level of function in a much less painful way. Therefore, if you are experiencing any disfunction or pain in your legs/ lower extremities and need help, give us a call here at Spine & Rehab Specialists so that way we can evaluate you and get you started on your road to recovery!
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w/ Chris McMillen, MAIS
6358 Edgemere Blvd
El Paso, Texas 79925
Phone: (915) 562-8525
Fax: (915) 566-3889
Mon-Fri 7:30 AM to 6:30 PM
(by appointment only)
11855 Physicians Dr.
El Paso, Texas 79936
Phone: (915) 855-6466
Fax: (915) 855-6181
Mon/Wed/Fri 7:00 AM to 7:00
Tue / Thu 8:00 AM to 7:00
(by appointment only)