Physical Therapy and Back Pain

I treat back pain on a regular basis. I have known for a long time that early physical therapy led to better results with less intervention. Finally, I have additional research to back me up from a recent APTA news release.

The study, published in the journal Spine, showed Medicare patients who
received physical therapy in the acute phase following an episode of low
back pain were less likely to receive epidural steroid injections, lumbar
surgery, or frequent physician office visits in the year following their
initial physician visit as compared with patients who received physical
therapist treatment later.

The study shows a decrease use of services for those who receive physcial therapy early after an episode of low back pain. This study was guided towards Medicare patients but applies to everyone. The earlier you start to treat your back pain, the better recovery with less use of services. When you have back pain, you will search high and low for treatment options. There are many out there, but few take the approach that a good physical therapist will. Investigate the problem, find the source of the problem, and treat the problem. Too many people want quick fixes for their back pain, and typically, quick fixes don't work over the long run. Massage may be helpful at first to decrease the muscle guarding that goes with back pain. Manipulation may be helpful only for the areas in the spine that are not moving correctly. These are good ways to initiate treatment, but are only a part of the problem with back pain.

Most people that I see have weakness in the legs, hips and spine that contribute to their back pain. A combination of massage, manipulation, and exercise is truly what is needed to treat back pain. To reduce the amount of services people with back pain must also understand that more testing does not reveal the need for different treatment options. Many times it leads to more treatment. An MRI may be recommended, but is it really something you need. A previous post on the number of MRI machines in your area, increases you chance of back surgery. An MRI that shows degenerative disc disease or a bulging disc, is probably considered normal for most people. The spine is poorly taken care of by the owner (yes, that is you). Generally, most people that I see have chronic dysfunctions (weakness, flexibility, posture, etc) that lead to increased back pain. Finding and treating the dysfunctions in the spine is what physical therapists do. There is no magic wand to 'fix' back pain. It takes some effort, a little time, and a physical therapist to help you get to feeling better.

Do yourself a favor the next time you have back pain, find your physical therapist! Even better, if you have had back pain recently that seemed to go away on its own, call your physical therapist and set up an appointment to find what is wrong and how you can best treat it.

Small Changes for Big Results

In my last post, I was talking about posture and how it affects everything we do. Today, I was reading One Small Change, a blog that we refer to here quite often. The Core Performance website has great exercises that I use not only for my patients but also for myself. In the blog, they are making the challenge to start working on posture and give a great quick workout you can do to get started.

A great activity to start working on your posture is to lay on your back with knees bent and feet on the floor. Try not use a pillow under your head. Place your arms at your side and turn your palms up. Lay in that position for 5 minutes 2-3 times a day. This is a great way to use gravity to stretch those muscles that are problematic for you.

Work on sitting better. Sitting better means lifting your collar bones. Pulling your shoulders straight back is not the answer to better sitting posture. Think of lifting from the top of the sternum (breastbone). Women pretend you have a huge diamond necklace and you want to show it off, men lift the knot from your tie. This will place the head, neck, shoulders and spine in best position for posture. Hold that position for 1 minute and do that once an hour throughout the day. One minute per day is a goal you can accomplish. This also makes you more aware of your posture throughout the day.

The post goes through some other quick ideas you can do to work on your posture throughout the day. Posture is something that takes time to change. To improve your posture, you need to be aware of how you sit and stand now, and what needs to be done to improve it. The exercises to get started are great beginners, and will really help to make a difference in your posture.

Early Christmas, Posture Presents

As I was getting caught up on some reading, I revisited some articles on posture. I started reviewing some of my treatment plans and how much posture plays in the problems that I treat as a physical therapist. Poor strength, flexibility and stability all contribute to poor posture and it's effect on our body's performance. A recent post from Joe Kita on "One Small Change" on CorePerformance.com discusses postures effects on athletes.

"Posture doesn’t get much respect from athletes because they think it’s the
domain of prissy etiquette experts. But I’m not Miss Manners, and this
program isn’t going to entail walking around with books on our heads.
Posture is the secret weapon to enhancing performance and—no
exaggeration—life itself.

“About 75 percent of my work with athletes is spent helping them improve
posture, whether they realize it or not,” says Sue Falsone, PT, CSCS, the
director of performance physical therapy for Athletes’ Performance. “The body
needs to have some element of stability in order to produce mobility. When that
foundation isn’t there, you’re going to have a hard time doing just about
anything well.”

So what does this all mean when it comes to the average person that does not think they are an athlete. The last part of the quote tells you everything. "you're going to have a hard time doing just about anything well." This may including standing, walking, doing laundry, performing you job, reaching, lifting, pushing and pulling. Sound like anything you do during the day? Most of these activities are included in our daily lives.

There are exercises that can help you to improve you posture, core strength and stability. Changes in posture can happen in 4 weeks or less with some time spent on correcting the muscular imbalances that happen from poor posture. Who needs help with posture? Just about everyone. Most (read between the lines, ALL) of my patients need some work on posture and core stabilization. Core Performance has an excellent program that I try to incorporate into a program of strength and flexibility for everyone I treat. From the high school athlete with shoulder pain to the truck driver with back pain to the grandmother that had a knee replacement, they can all benefit from some sort of core stability.

Stop in to Hardin Rehabilitation and Wellness to find out how core strength and flexbility can help improve your posture and help you feel and look better. Give yourself an early Christmas present! Work on your posture!

I have a top 10 (really top 4) best job in America

Found this article online earlier this week about top 10 jobs in America.


http://money.cnn.com/magazines/moneymag/bestjobs/2010/index.html

I really do enjoy my job and can understand why physical therapists are rated in the top 5. It got me thinking, why do I enjoy my job? Wow, there are so many reasons. You know, I have been a PT since July of 1993. Yes, you read that correctly, 1993. That does make me old, and I'm okay with that. So the question of job satisfaction has to start with, why did I decide to become a PT. Really, it was a decision I made after 2 weeks in college. I had started off with an engineering major at UT. Changed that real quick. I transferred from UT to Ohio University, when I was accepted into the PT program. What led me to that decision? When I was a freshman in high school I watched my sister have a stroke and the recovery she went through. That was where I started to have some interest in watching PT's work with patients to improve their function. During my sophomore and junior years in high school, I injured myself playing football and was treated by a wonderful PT that really sparked my interest in becoming a therapist. I ended up doing volunteer work with him, and watched as he used his expertise and hands on treatment to help people get better. Now after being a PT for all these years, I hope I can mentor high school students to become PT's, like he did for me.

So I have been a PT for a while and the question is, "what is the best part of your job?" I think it is the satisfaction of when a patient or family member comes up to me years after I treated them or their loved one, and thank me for all the work I did to help them. Or when I someone recommends their friend or family member to come see me for their therapy. The trust they must have to recommend me, is extraordinary. I get so much satisfaction from the thank you's it reminds and energizes me to work harder to help more and more people.
I used to joke with a therapist that was a few yeras older than me that he believed he could help everybody that came through the door. Now, I understand what he was talking about. I really find that I can help everyone that comes to see me, sometimes with just encouragement, other times with lots of tough love and hard work.
Now it's time to go back to working on paperwork. (The part of the job I hate. I know that you shouldn't hate, but, I really hate the paperwork) Hopefully, you love what you do, as much as I love doing what I do. Looking back on it, I really wouldn't change much. Make sure you thank those that take care of you (therapists, nurses, physicians, etc.) Sometimes you never know how much it helps keep them going.

Social Media and PT

I recently read a blog from the APTA questioning if I was a social media holdout or addict? http://movingforwardapta.blogspot.com/2010/10/are-you-social-media-addict-or-holdout.html This was more a post to have members compelte a survey about the amount the do or plan on using social meida outlets in their practices. As I read through this post, I wonder what I am? I follow quite a few blogs that are related to PT, politics, wine, cigars (2 of my vices), and small business ideas. I have been trying to do my own blog (this) with poor results. I find I dont have enough time to get this done nearly as often as I would like. Maybe I am spending too much time reading everyone else's blogs. Anyway, I know Hardin Rehab and Wellness will be in the process of starting a website, and possibly a Twitter page. We already have a Facebook page. 'Like' us on Facebook and get updates as we progress into more social media. Hopefully will continue to increase my posting here also.

2-A-Days begin

This week was the beginning of high school football and 2 a days. Most of the fall sports begin this week or next with their practices. This year we will contract with 3 schools to have athletic trainer coverage for games. We will provide coverage for Kenton High School, Ridgemont Local Schools, and Upper Scioto Valley Schools.

As a benefit to all the schools, we provide a walk in injury clinic from 7am to 5 pm Monday through Friday. Any school age athlete can have an injury assessed by a physical therapist or athletic trainer. Recommendations are made based on the findings.

We have done this for many years, and continue to provide this for our local student-athletes.

Stop out and see us if you have an injury.

MRI abundance may lead to excess in back surgeries, Stanford study shows

MRI abundance may lead to excess in back surgeries, Stanford study shows

Take a look at the number of magnets there are in your city and surrounding area. The increased number of machines appears to lead to increased rates of back surgery.

This is not really a surprise to me as I treat many patients that come to PT reporting "I had an MRI and it showed a bulging disc. I'm not sure why I'm her since I will need back surgery." I realize there is a tie and place for back surgery, but there is a far greater incidence of lumbar surgery in the US that many other industrial nations. The US performs approx 1.2 million spinal surgeries per year, double the rate of other comparable countries. I also know that to many people are looking for a "quick fix" for their back pain. Research has shown that people with low back pain that go to physical therapy have less surgery, incur less costs, and have better outcomes than those that do not utilize physical therapy services.

If you have back pain, SEE YOUR PHYSICAL THERAPIST!!!!

Starting off

Well, I am about to take on something that I have been wanting to do for about 2 years now. Start writing about my experiences and how as a physical therapist (PT) I can change the world. I hear many stories from patients that want to get better, but don't seem to want to work at getting better. Our bodies are incredible machines. We need to take care of this machine. There is no one right way to improve this machine. As in many professions, there are different approaches and opinions on the best approach to treatment. Some PT's go with the old, this is what I've always done, or been shown to do. Others try different approaches. In the end, all PT's are trying to make changes, but some are more efficient than others.


I was that PT that did things because that what we always did. Over the past 5 years, I have furthered my education, looking for evidence to support my treatment plans, and working to improve how to communicate this to my patient. I recently completed my Doctor of Physical Therapy degree from the University of St. Augustine in Florida. This has only made my desire to improve my knowledge and help my patients grow more than ever. I hope that my desire to find research will help others to search out the best in PT.