Meet our new physical therapist

Scott Ringle PT, DPT


Scott is our new physical therapist.  He graduated from Ohio Northern University in 2006 with a Bachelor of Science degree in Biology while having a minor in Psychology with a pre-physical therapy emphasis. He worked two years as a rehab technician in Kenton before returning to graduate school. While in graduate school he continued to work part-time in this position. Scott graduated from the University of Findlay in 2011 with a Doctorate of Physical Therapy degree. He has completed clinical rotations in a variety of settings including acute care, neurological rehabilitation, as well as outpatient orthopedics. Scott has worked with a wide range of patients in regards to age (adolescent through geriatric) and condition (sports injury, post-stroke, back pain, post-surgery, and many others). He has special interest in the areas of sports injuries, orthopedic surgery, and spine care.  Scott is focused on delivering evidence based care in order to provide each patient with optimal outcomes including injury prevention, improved mobility and motion, reduction in pain, and overall restoration of function.


Welcome Scott, we are so happy to have you here.  

Really, your kid is having back pain?

I just finished reading a few posts about kids and back pain.   Jeff Cubos writes that children should not have back pain.  He gives 3 reason why he thinks kids have back pain now.  Facebooking, skinny jeans and inactivity.  No surprises here.

Facebooking or sitting at computer, video game, or watching TV:

Prolonged sitting is one of the most deleterious activities most people engage in. After only 3 minutes of full flexion of the spine ligamentous creep or laxity occurs which persists even after 30 minutes of rest!

What this means is, after sitting for 3 minutes the ligaments that support the spine continue to stretch.   This is why bending over to pick something up after sitting leads to low back pain.   Also, watch how your kids sit with the big hunchback of their upper spine and their head forward.   (C posture)   If you look from the side they look like a C.  How do you think they spend most of their day?  Sitting in classes, standing hunched over, head down walking and texting, playing video games, and sitting at a computer.  They spend most of their day in this position. This is the posture we typically associate with being old.   Remind your kids that is what they look like now.   Take a picture of them and show them how they look.  What do you think it will look like in 5, 10, 20 years?

Skinny Jeans or baggy jeans that are too low:
Why does this affect back pain?

Typically, when a client compensates we see a dysfunction at the joint either below or above the joint that is painful (remember, a symptom is nothing more than a presentation of a problem. It tells us something is wrong but it does not tell us what is wrong)….When one presents with low-back pain…an evaluation of the hip (for both strength deficits and mobility restrictions) should also be performed.”

If the hips cannot move, something has to compensate for that lack of movement, usually that is the spine.  This is why with so many of our low back patients we look at the hip and work on moving and strengthening the hips as much as we work on the spine itself.

Inactivity:
This really is self explanatory, but Jeff chalks it up like this:

For one reason or another, kids just don’t move these days. Maybe its because of “facebooking” or maybe its because their jeans are so tight, but for whatever reason, kids are inactive. Can’t blame school. School has been around for a long time. But after school? If you’re child is complaining to you of low back pain, simply take a picture of them while they tell you it hurts. More often than not their speaking to you in this position:

Make it a point to get your kids active.   Even better, go out and get active with them.

Back to School

Well, it is that time of year again.   The school year is starting.   It seems like wonderful time for parents as they get the house back again.   The kids are not quite so happy, as they have to return to school.  As you return your children to school they will be looking to get a nice new back pack.   Make sure not to overload them.  Improper backpack use can cause injury, especially to children with young, growing muscles and joints. A study found that 55 percent of the children surveyed carried backpack loads heavier than 15 percent of their body weight,the maximum safe weight for children recommended by most experts.  Mke sure they use both of the shoulder straps

Recommendations from the American Physical Therapy Association include:

Wear both straps. Using only one strap, even with backpacks that have one strap that runs across the body, causes one shoulder to bear the weight of the bag. By wearing both shoulder straps, the weight of the pack is better distributed, and a symmetrical posture is promoted. A backpack that has padded, contoured shoulder straps will also help reduce pressure on the chest and shoulders.

Make sure the backpack fits. It is important to pay close attention to the way a backpack is positioned on the back, and the size of the backpack should match the size of the child. Shoulder straps should fit comfortably on the shoulder and under the arms, so that the arms can move freely. The bottom of the pack should rest in the contour of the lower back. The pack should "sit" evenly in the middle of the back, not "sag down" toward the buttocks.

I hope everyone has an enjoyable and safe return to school this year.  

Gardening in the near future?

Well, with all the rain we have had, I'm not sure many people have been able to get their gardens started.  It seems like it has rained everyday since April 1.  (I did read that it rained 25 of 30 days in April).  Anyway, if you are anxious to get started with your gardening, remember that all this rain may take its toll on you.  By not properly warming up and being ready to peform gardening activities, you may injure yourself if you are not ready.  Here are a few tips I wrote a few years ago.  Always good to refer back to these.

Warm Up: You wouldn't play sports or work out without warming up, so it makes sense to warm up before doing something as physical as gardening. A quick walk and some gentle stretching can work wonders before hunkering down to the flower bed.

Change Position Frequently: Prolonged static positions can be damaging. When doing a lengthy task, change positions frequently. If you're working close to the ground, as in weeding, you can sit, kneel, half-kneel, and get on all fours. Vary your position to give your back a break.

Shift Tasks or Take Breaks: Rotate through your tasks so you're not doing any one thing for too long. Weed for 10 minutes then switch to raking, then to clipping, then back to weeding, etc. If you've only got one job to do, then just make sure you take a stretch break and/or change position every 10-15 minutes.

Use Good Body Mechanics: Always make sure to avoid bending in your back, especially when lifting. Keep your back straight, tighten your abdominal muscles, and bend at the hips and knees. Don't lift too much at once. Break large loads up into several smaller loads. Use a smaller spade when digging. And move your feet to avoid unnecessary twisting in your back.

Use Ergonomic Tools: Lighter-weight tools ease the load on your back, and tools that allow you to stand instead of bend over are back savers as well. A quick search can find websites that sell ergonomic gardening tools, like Gardeners.com.

Happy Gardening

Early Physical therapy for back pain. Yes it really helps!!!!

Well, not that I needed more literature to bring to you about PT and back pain, but here is another article that supports early physical therapy for back pain really helps.
This was a thesis project that was completed in Sweden, so the terms may be a little different, but the results speak loudly.   Her thesis was written to look at immediate treatment by a physiotherapist (PT) with or without referral from a physician compared to being on a waiting list for 4 weeks. 

"We saw that both groups improved after the treatment ended. The group that had been given early access to an examination and individualised treatment maintained their improvement after six months, while the group that had been held on a waiting list were more likely to suffer with recurring back pain," says Nordeman, who draws the conclusion that early examination and treatment by a physiotherapist as soon as a patient asks for care could be important for reducing low back pain in the long term.

Early treatment for low back pain is important as this can help alleviate pain sooner and for a longer duration of time.   Low back pain affects 80% or more of the population.  Many time low back pain is recurrent and this typically stems from multiple injuries to the same area.  

Even though this was a thesis study, the results are similar to what physical therapists have been saying for a long time.   Back pain is a common problem in society.  Check with us to see if you need to see your physician prior to coming to therapy.   Ohio law does not require a prescription to be evaluated by a physical therapist, but your insurance company may.  Let us check for you.  See a physical therapist to help with your back pain!

Golf Fitness Update

So over a month ago (more like 2 months ago), I started working harder on my golf fitness.   I have been placing my emphasis on improving hip motion, middle back motion and improving my hip rotation strength, core strength and shoulder blade or scapular strength.   I was able to finally get to the golf course last week, hitting balls on Sunday at the range, and playing 9 holes on Thursday.    Needless to say, I need to work on my short game!!!!   I actually felt pretty good on the course.   My emphasis on posture has improved the consistency of my swing and ball contact.   I notice no real change in distance, but accuracy has improved.   I also had no back pain after playing. 
The golf swing is a dynamic human movement.   Repeated golf swings can take it toll on the body.   Most golf injuries in the professional golfer come from overuse.   Most injuries for the rest of us are in the form of poor mechanics.  Body mechanics, swing mechanics and no regular customized exercise program are three of the biggest causes of injuries.  
Poor body mechanics includes hip limitations, mostly rotation, thoracic or middle back rotation and extension limitation, poor core stability, and shoulder motion limitations.  
There are 3 components  that are necessary to have an improved golf swing. 
1.  Strength, and specifically core strength is necessary to keep your body from having extra movements during the golf swing and maintain spine angle during the swing.  If you lack core strength, you will have difficulty with consistent contact.  This would include early extension, sway and slide.  
2.  Flexibility is important for the golf swing.  Soft tissue restrictions in your hips, spine and shoulders can alter the swing plane immeasurably. If you are unable to rotate properly on the back swing or the follow-through, your body will compensate for the loss somewhere else, causing stress and strain on joints that cannot handle those loads. 
3.  Balance, is directly related to deficiencies in both stability and mobility. Poor strength and/or flexiblity, will affect weight shift, which may cause golfers to fall forward or rock back on their heels. This leads to poor position of the club head at impact and you spray the ball all over the course. 

All of these components can be addressed in physical therapy.    This entire chain can be affected because of poor mobility or stability in certain areas.   How can physical therapy can help?   Physical therapy will help find the different areas at fault.  Then, starting a treatment program to address these areas will help improve you golf swing mechanics.   Better mechanics means a more consistent swing.   A more consistent swing, means better direction and more greens hit.  Then, work on your short game and putting to improve your scores.   (I cannot help you with that)   As a matter of fact, that's what I need to work on myself.  Golf pro, here I come!  Here's to lots of fairways and greens!!

It's time to start. Are you ready?

Well, I'll be honest.   I have been lazy, Lazy for awhile now.    I blame it on not golfing.  Since I have not been on the golf course in months, (since September) my workout routine disappeared probably about as quickly as my golf game disappeared.   After the warm weather over the weekend, I realized, golf season is coming quickly.  Hopefully, within the next 4-6 weeks.   (yes I'm optomistic that by late March, I will be playing a few holes working into rounds of golf by early to mid April.)  Anyway, I have found that with lack of workout routine, my strength and flexibility has disappeared.  I have to start getting back in the swing (sorry couldn't resist) of some sort of exercise routine.  In previous years, I have been doing core performance exercises.   They are great for strength, stability and flexibility of the spine and hips.   I found that I was hitting the ball further and was without pain when I was done walking 18 holes.  But, like most exercise routines, I get bored, and am looking for something new.   Luckily, I found something else to work on at TPI (Titleist Perfromance Institute).  Exercises very specific for golf, with some video, and tips to help.  There are specific exercises for mobility, stability, posture, balance, strength, cardio-vascular, and power.   Knowing where my specific problems are with golfing, (poor starting posture, flexibility, poor transition balance), it gives me some options to start working on the weaknesses of my golf game. 
The other nice part about TPI is they offer different levels of certification to become an instructor for them.  Level 1 is basic, and Level 2 more advanced.   I am considering going to the basic course, but it will not be until later in the year (August or September), so I will not be much help to teach the TPI program now, but can still help with other strength and flexibility issues that you may have now.  I am planning on bringing TPI to our clinic next winter. 
I will keep you informed how my routine works.  For now, I need to get motivated to get started.   I plan on doing that tonite.