therapy Archives - Freedom Physical Therapy

1 in 3 Seniors Will Fall This Year. Physical Therapy Can Make Sure You’re Not One of Them!

Falls are a big deal.
They can cause injuries and make it hard to live on your own. They can also make you afraid of
falling again. This fear might make you less active, which can make you weaker and more likely
to fall. It’s a tough cycle to break. Falls aren’t a normal part of aging. Physical therapy can reduce your risk and help you stay
independent. Here are 5 ways your PT can help.

Creating a personalized exercise plan
Being active helps prevent falls. Your PT will make an exercise plan just for you, based on what
your needs and what you like to do. This should be fun! Think about going on walks, dancing,
aquatic exercise, or practicing yoga.
Making Your Home Safer!Many falls happen at home. Simple changes like removing tripping hazards and using night
lights can make a big different. Your physical therapist can help you with these and recommend
other modifications to make your home safer.

Strength and Balance Exercises
Strong muscles and good balance are key to preventing falls. Your PT will show you specific
exercises that help with both.
Addressing underlying health issues.
Falls are often the result of multiple factors. Your PT can work with your other doctors to address things like vision problems, heart issues, incontinence, or diabetes that might make you more likely to fall.
Help you find community programs
Staying active is easier and more fun with others. Your PT can help you find group exercise classes or other programs in your area that will help you stay strong and independent.
Take the first step.

If you’re worried about falling, or if you’ve already had a fall, don’t wait to get help. Talk to your
PT.

Falling isn’t a normal part of getting older. With the right help, you can stay strong, keep your
balance, and keep doing the things you love. Physical therapy is a great way to make sure you
stay on your feet and stay active and independent.
Take that first step towards better balance and a more active life. Your future self will thank you!

References
1. Exercise for falls and fracture prevention in long term care facilities: a systematic review and
meta-analysis. J Am Med Dir Assoc. 2013;14(9):685-689.e2.
a. https://pubmed.ncbi.nlm.nih.gov/23860265/
2. Preventing Falls in Older Persons. Am Fam Physician. 2017 Aug 15;96(4):240-247. PMID:
28925664.
a. https://pubmed.ncbi.nlm.nih.gov/28925664/
3. The Effectiveness of Physical Therapist–Administered Group-Based Exercise on Fall Prevention:
A Systematic Review of Randomized Controlled Trials. Journal of Geriatric Physical Therapy
36(4):p 182-193, October/December 2013.
a. https://journals.lww.com/jgpt/fulltext/2013/10000/the_effectiveness_of_physical.5.asp
x?casa_token=r5fLfvxztA0AAAAA:9yaeibFmZiCeIZiQcSOVcbWkWpA_8spTG-bNT2UFaD2Dc7tljHsv3VW5XfmnvIySLNwrJDd7aqnJTsfdHmRqK8
4. Exergame technology and interactive interventions for elderly fall prevention: A systematic
literature review
a. https://www.sciencedirect.com/science/article/abs/pii/S0003687016302265
5. Reducing the Risk of Falling and Injuries From Falls: Research on the Value of Physical Therapy
a. apta-handout-falls-research.pdf
6. Physical Therapy Guide to Falls
a. https://www.choosept.com/guide/physical-therapy-guide-falls
7. Fall Prevention Starts with a Conversation
a. https://www.ncoa.org/article/falls-prevention-conversation-guide-for-caregivers
8. Balance and Falls
a. https://www.apta.org/patient-care/public-health-population-care/balance-and-falls

Finding Balance: Dizziness and PT

Dizziness is common in people over 20 and it can be a big problem in your daily life. Feeling
unsteady, lightheaded, or like the room is spinning is alarming, and makes day to day tasks
difficult. The good news is that dizziness often has treatable causes, and your physical therapist can be the perfect person to help.

Understanding Dizziness

Dizziness isn’t a specific problem – it’s a symptom that can come from a lot of different issues. Feeling dizzy most commonly comes from issues with your inner ear, but it can also come from your vision, joint or muscle issues in your neck, migraines, changes in blood pressure, head injuries, or other neurological problems.

How Physical Therapists Help

To understand dizziness and how a PT can help, you have to know a little about how balance
works. Your brain uses information from your inner ears, your vision, and input from your joints about their position and movement to keep you balanced and stable. Typically all of this information paints the same picture for your brain. If your brain gets conflicting information – say your inner ear sends different information than vision and your joints – that often results in a feeling of dizziness, unsteadiness, or vertigo. Your physical therapist will ask questions about your history, then perform testing on all of the systems that help you stay balanced to figure out the cause of your dizziness.

Your treatment plan will vary depending on what your PT finds. Some typical examples include:

● Exercises: Your PT may prescribe specific exercises to improve your balance, strengthen or
stretch specific muscles, or to help retrain your brain to interpret sensory information. These can include gaze stabilization exercises which help your eyes and inner ears work better together, habituation exercises that help your brain get used to different types of input, and balance training on different surfaces.

● Canalith: repositioning maneuvers (CRM): If your dizziness is caused by benign
paroxysmal positional vertigo (BPPV), a specific type of inner ear problem, your therapist
may perform maneuvers to reposition tiny crystals within your ear canal, alleviating your
vertigo. They can also teach you how to do these at home.

● Education: Your therapist will educate you about your condition, how to manage dizziness,
and exercises you can perform at home. They may also help you modify activities that cause
dizziness, or train you on ways to work through it. Dizziness doesn’t have to interfere with life. Physical therapists can help reduce your dizziness, improve your balance, lower your risk of falls, and improve your confidence in your daily activities.

PTs Fuel Healthy Movement With Nutrition

Physical therapy and nutrition are often seen as separate, but the truth is, they are deeply
intertwined. To get the most out of PT, especially after an injury or surgery, integrating both is
crucial. Here’s why:

Food Fuels The Body
During recovery from an injury or surgery, your body is working to heal itself. The activities and
exercises you’re doing in PT are designed to help it along. To take advantage of all the work
you and your body are putting in, proper nutrition is critical.
Protein provides the building blocks for tissue repair and muscle growth. Carbohydrates provide
energy and help support your immune system. Your body also needs healthy fats to regulate
inflammation and to build certain cells. Being short on any of these critical components will slow
your recovery down.
You also need enough micronutrients, like vitamins and minerals. For example, vitamin C is
needed to make collagen, which goes into bones, skin, and connective tissue. Vitamin D helps
your body absorb calcium, which is important for healing fractures, or surgeries involving bones.
Iron helps your blood cells carry oxygen throughout your body, which is needed for healing in
general. Again, being low on any of these micronutrients will affect your healing.

Your Weight Affects Your Health
Being overweight directly affects your health. It puts you at higher risk for cardiovascular
disease, stroke, osteoarthritis, back pain, diabetes, sleep apnea, and more. All of these are
conditions that you might see a PT directly for, or that will impact your healing. Eating a healthy
diet is the most effective way to reduce body weight. Combining a healthy diet with exercise is
even better for your health.
As an example, an 18-month study of 450 people with knee osteoarthritis showed that the group
that lost weight through a diet and exercised had less pain, better walking speed, and lower joint
forces in their knees than groups who either only lost weight, or only exercised.

How can a physical therapist help with nutrition?
While PTs are not authorized to provide individual diet plans or medical nutritional advice, they
can still help with your nutrition.

• PTs can screen for potential nutritional deficiencies or imbalances that may impact your
progress in PT or your overall health. This might involve screening for malnutrition,
sarcopenia (muscle loss), or assessing dietary habits affecting energy levels, healing, or
muscle building.
• Your PT can educate you on the importance of nutrition for various aspects of
rehabilitation and recovery. This includes explaining how specific nutrients like protein,
vitamins, and minerals contribute to tissue repair, muscle building, energy production,
and pain management.
• They can offer general guidance on healthy eating patterns, portion control, and
choosing nutrient-rich foods to support reaching your specific physical therapy goals.
• PTs recognize that overall health and well-being involve various factors, including proper
nutrition. They can encourage you to adopt healthy lifestyle habits that include a
balanced diet alongside regular exercise and proper sleep hygiene.

Finally, your PT can recognize when your nutrition needs exceed what they are able to provide.
In that case, they can refer you to and collaborate with a registered dietician or other qualified
healthcare professional for help in dealing with complex nutritional needs or recommending
specific dietary changes.

By combining the power of physical therapy and nutrition, you can achieve your
recovery goals faster and feel your best!

References:
1. Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and
Clinical Outcomes Among Overweight and Obese Adults With Knee
Osteoarthritis: The IDEA Randomized Clinical Trial Effects of Intensive Diet and
Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among
Overweight and Obese Adults With Knee Osteoarthritis: The IDEA Randomized
Clinical Trial | Obesity | JAMA | JAMA Network
2. Ottawa Panel Evidence-Based Clinical Practice Guidelines for the Management
of Osteoarthritis in Adults Who Are Obese or Overweight Ottawa Panel
Evidence-Based Clinical Practice Guidelines for the Management of
Osteoarthritis in Adults Who Are Obese or Overweight | Physical Therapy |
Oxford Academic (oup.com)
3. Strategies for optimizing nutrition and weight reduction in physical therapy
practice: The evidence Strategies for optimizing nutrition and weight reduction in
physical therapy practice: The evidence: Physiotherapy Theory and Practice: Vol
25, No 5-6 (tandfonline.com)
4. Body mass index and risk of knee osteoarthritis: systematic review and metaanalysis of prospective studies Body mass index and risk of knee osteoarthritis:
systematic review and meta-analysis of prospective studies – PMC (nih.gov)
5. Nutrition: A Portion of PT’s Menu of Services Nutrition: A Portion of PTs’ Menu of
Services | APTA
6. Considerations for PT’s Role in Nutrition Considerations Related to the PT’s Role
in Nutrition and Diet | APTA
7. Nutrition and PT a Powerful Combination – Nutrition and Physical Therapy: A
Powerful Combination | APTA

Physical Therapy is a Tree With Many Branches

Starting a career in physical therapy is like climbing a tree. Everyone starts with the same trunk, but pretty quickly, you have to make some decisions about which way you’re going to go. What kind of people do you want to work with? Where do you want to practice? And how far up the tree do you want to climb? You’ll get to grow professionally – learning more, getting better clinically, and maybe even improving your sales and business skills, but that’s not all. Physical therapy gives you a chance to grow personally too.

Pick your people

You can pick the type of people you want to work with – sports physical therapists work with athletes, helping them recover from injuries and improve performance through exercise and hands-on techniques. Geriatric physical therapists work with elderly patients on mobility problems, pain or managing chronic conditions. Pediatric physical therapists work with infants and children providing developmental assessments and helping them improve their gross motor skills.

Pick your place

You can also pick where you work – there are physical therapy jobs in nursing homes, hospitals, outpatient clinics and schools. Physical therapists provide care wherever people need it. So far, we’ve only mentioned the more common places you’ll find PTs – if you want to specialize further, you may find yourself working only in the ICU with critical care patients, in a factory doing industrial rehabilitation and ergonomics, in a women’s health clinic, or even working in a preventative, public health role.

Grow professionally

Most physical therapy careers start in a general role, working with all types of different patients. If you work in a large health system, you may even rotate between settings. But as you find the type of people you like to work with and the setting you prefer, you have the option to improve your skills and focus on a specialty area of practice. Again, you have lots of options on how to do this. You could:
● Take an internship position or join a fellowship program
● Attend workshops or conferences
● Read journals and textbooks
● Collaborate with your colleagues and mentors
● Take courses in other areas of medicine
● Study abroad or take courses online

Grow personally

Your clinical skills aren’t the only thing a career in physical therapy can grow though – you’ll grow personally as well. You have to learn to have compassion and empathy when you work with ill or injured people. You have to work as a part of a team. You need sales skills – most people aren’t going to want to make changes in their routines, or do the exercises you prescribe at home. You’ll learn to work with people who have different opinions and different viewpoints from all kinds of cultures and backgrounds.

You may also have a chance to improve your business skills. You could advance out of the clinical setting and into a management role. Some PTs start their own practices, or a company in a field related to physical therapy like wellness, performance, injury prevention or population health for large corporations.

Wherever you start in physical therapy, you’ll have a lot of options on where you end up. Chances are you’ll explore more than one branch of the physical therapy tree. That’s OK, having the chance to grow and change is part of what makes PT so exciting!

Will COVID-19 Change the Typical PT Patient?

People usually see a physical therapist for pain or loss of function. Think of the person who has
back pain, the injured athlete or the person who’s had a stroke. They all want to improve how
they move and complete tasks. Now, there is good reason to wonder if physical therapists will
start seeing more people who are not in pain or having difficulty moving. Why would these
people come to a PT? To improve their overall health and wellness.

There is strong evidence suggesting that movement is a valuable predictor of future health
and resilience against disease. Physical therapists are movement specialists, so taking
advantage of their expertise makes sense if your goal is to become healthier and live longer.
Here are some examples of the power of movement when it comes to predicting future health:

Gait Velocity

Gait velocity is how fast you walk. Studies have shown that if your typical walking speed is over
1 m/s or 3.3 ft/s, you’re likely able to complete typical daily activities independently. You’re also
less likely to be hospitalized and less likely to have adverse events like falls.

If you’d like to test yourself, measure out a straight, flat course to walk between 10′ and 30′ long.
You’ll also need 5′ or so at the beginning and the end for acceleration and deceleration. Walk
the course at your typical speed and divide the length of the course by how long it took you to
walk it (distance/time). That’s your gait velocity.

Get On and Off the Floor

A series of studies suggest that if you can go from standing to sitting on the floor and back to
standing without using your hands, you’re a lot less likely to die than someone who can’t. It’s
called the sitting-rising test. Here’s how it works:

You start standing, and without support you sit down on the floor, then stand back up. You start
with a score of 10. Every time you put a hand, knee, forearm or the side of your leg on the floor
you lose 1 point. Putting a hand on your knee or thigh to help also costs a point. In a sample of
over 2,000 people, they found that scoring less than 8 points made you twice as likely to die in
the next 6 years when compared to people who scored higher. Score 3 or less and you’re 5
times more likely to die in the same period. Overall, each point in the test is worth a 21%
decrease in mortality from all causes.

Notice that both gait velocity and the sitting-rising test aren’t specific to any one thing. The risk
of hospitalization in the gait velocity studies was hospitalization for any reason. Death in the
sitting-rising studies was death from anything. So while we know that exercise and healthy
lifestyle reduce your risk of specific diseases like heart disease or diabetes, it appears that
being able to move may provide much more wide ranging protection than we previously thought.

Insurers Are Moving From “Sick-care” to “Well-care”

TRICARE has decided to waive the cost-sharing requirement of up to three visits to a physical
therapist for low back pain. They’ve said that the goal is to encourage more use of “high-value”
treatments for low back pain. Understanding what they mean by “high-value” vs “low-value”
treatment can help us see the direction healthcare payers are moving and how physical therapy
is a part of that.

TRICARE tells us in their summary of this demonstration what they mean by high and low-value
care: “Increasing the value of health care refers to improving patients’ quality of care and
outcomes, improving patients’ access to care, and reducing overall costs of care. In contrast,
low-value care refers to interventions that: are not proven to benefit patients; may harm patients;
result in unnecessary costs; or waste health care resources.”

High-value care

High-value care leads to better outcomes, is easy to access and is cheaper for both patients
and insurers. We already know that physical therapy fits into this category, but if we look at
other things that fall into this category, a larger theme starts to emerge. In 2017 the American
College of Physicians released guidelines for treating low back pain that have been widely
endorsed. Initial treatment recommendations include exercise, stretching, tai chi, yoga,
progressive relaxation, heat or ice, cognitive behavioral therapy, and motor control exercise.
These are all active treatments, where the practitioner and the patient are working together to
improve. This is “well care” or “let me help you get better.”

Low-value care

In contrast, low-value care tends to be “sick care” where the patient is a passive participant and
the practitioner is saying “let me make you better.” TRICARE puts imaging before six weeks
without red flag symptoms, surgery for non-specific low back pain, opioids as the first or secondline treatment, and bedrest in the low-value category. We would also place spinal injections in
this category for most people. They’re expensive, only offer temporary relief, usually have a long
wait before they’re available and include the risk of serious infection and damage to surrounding
soft tissues like skin, cartilage, and ligaments.

This isn’t to say that imaging, surgery, or injections are always bad. For a small percentage of
people with low back pain, they’re the right thing. But, most people should start with treatments
that have the best outcomes for the lowest cost. If those treatments tend to focus on
empowering the person in pain to actively participate in their care rather than making them
dependent on someone to “heal” them, that’s even better. Physical therapists have known this
and have been providing care that fits this model for years. TRICARE’s demonstration that
waives cost-sharing clearly shows that insurers are recognizing the value of this type of care
and that they are actively moving in this direction.

80% of Americans Experience Back Pain, But 100% of PTs Know How to Prevent It

Got back pain? You’re not alone. Eighty percent of Americans suffer from low back and neck pain at some point in their lives. Let that sink in. With such great odds that you—or someone close to you—will one day become a statistic, wouldn’t it make sense to arm yourself with preventive strategies and knowledge? Physical therapy is a good place to start.
By performing a thorough evaluation, a physical therapist can identify the muscular, postural and skeletal limitations that could one day lead to an episode of back pain. As part of the assessment, she will observe as you perform a series of exercises and then gather an account of your daily activity level and environmental factors like operating machinery or working at a desk 40 hours a week.
The PT will then use all of this knowledge to design a personalized exercise program and teach you a few APT-approved strategies to prevent back pain:
Use good body positioning at work, home and during recreational activities.
Keep the load close to your body during lifting.
Ask for help before lifting heavy objects.
Maintain a regular physical fitness regimen— staying active can help to prevent injuries.

Lifestyle can play a big role in back pain. In fact, inactivity and incorrect body mechanics while participating in certain activities are two of the biggest contributors to back pain. In addition to the strategies listed above, it’s also helpful to pay attention to little things throughout your day. That could add up to bigger problems down the line. Let’s go back to that desk job for a minute: How often do you get up to walk, stretch and move throughout the day? A good rule of thumb is to stand up or move every 30 minutes. You may get bonus points with your boss, too, as your productivity soars due to the increased activity.
While low back pain rarely becomes serious or life-threatening, it can be quite painful and interfere with our daily lives. Working with a physical therapist can help patients identify the factors that might contribute to back pain and help to develop a prevention plan. But the healthcare professionals are also a great place to turn when you’re seeking treatment for back pain or hoping to prevent a recurrence.
With such good odds that you could one day become a low back pain statistic, why not do everything in your power today to change your trajectory? Seems like another good reason to find an activity (or better yet, two or three activities) that you enjoy, make it a regular part of your day and stick to it!

ARTHRITIS & FIBROMYALGIA & AQUATIC THERAPY

Relaxation is one of the most important aspects of controlling arthritis and fibromyalgia pain. Therapeutic warm water provides sensory stimulation, which encourages relaxation and stress relief. Combining this warm water with our deep penetrating massage system can greatly reduce the stress and pain on aching muscles and joints.
Walking on the underwater treadmill or exercising against the resistance jets can also help manage your pain. When standing chest deep in water, the body is 80% weightless, bearing only 20% of its body weight. This weightlessness significantly reduces the stress on joints and muscles.
BENEFITS OF AQUATIC THERAPY FOR THOSE WHO SUFFER FROM ARTHRITIS AND FIBROMYALGIA:
-Relaxation
-Increased joint range of motion
-Pain relief
-Enhanced mobility
-Improve flexibility
-Mobility and strength
-Removes weight from joints and bones
-Strengthens muscles and joints after surgery
-Decreased side effects

Call Freedom today to set up your appointment OR ask about our free 30 minute session.