balance Archives - Freedom Physical Therapy

Relief Through Movement

Physical Therapy for Chronic Pain

Chronic pain can be a debilitating condition, limiting your mobility and impacting your daily life. The CDC estimates that around 50 million Americans experience chronic pain, and 17 million have substantial reductions in activity because of pain. Beyond limiting activity or your ability to work, chronic pain has been linked to depression, Alzheimer’s disease, and substance abuse.

Chronic pain is complex. There’s no single intervention to treat it, but physical therapy should be part of the mix. Here’s why:

How PT Approaches Pain:
Physical therapy often provides relief that’s just as effective as medication but without the potential side effects. Here’s a breakdown of how PT tackles pain and its effectiveness:

Identify the Root Cause: PT goes a step further than medication that masks pain. Therapists assess your posture, muscle strength, flexibility, and joint mechanics to pinpoint the source of your discomfort.

Address the Underlying Issues: Based on the evaluation, PT focuses on strengthening weak muscles that support your joints, improving flexibility for a better range of motion, and correcting any imbalances or postural problems that might contribute to pain.

Use A Multi-Faceted Approach: A PT treatment plan will be customized based on the evaluation. In addition to therapeutic exercise, a PT might use various techniques. Examples include:
• Manual Therapy: PTs use massage, joint mobilization, and trigger point therapy to address muscle tension, improve circulation, and alleviate pain.
• Modalities: Techniques like ultrasound, heat therapy, or electrical stimulation can reduce inflammation, promote healing, and manage pain.
• Aquatic Therapy: A warm, therapeutic pool supports your body and joints while offering gentle resistance. This can often make it easier to start moving again after being in pain for an extended time.

Educate and Empower Patients: PTs equip you with the knowledge and tools to manage your pain independently. This might include learning a new exercise routine, how to modify activities, or how to modify your daily schedule when you’re feeling better (or worse) than normal.

It’s also becoming increasingly likely that you’ll learn how pain works. Research shows that combining pain education with physical therapy is an effective treatment.

If you’re struggling with chronic pain, call your physical therapist. They might have the key that will unlock a pain-free life.

References:
1. Chronic Pain Among Adults — United States, 2019–2021 | MMWR (cdc.gov)
2. The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials, Physiotherapy Theory and Practice, 37:4, 461-472 DOI: 10.1080/09593985.2019.1633714
3. Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis, Physical Therapy, Volume 102, Issue 9, September 2022, pzac081 Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis – PubMed (nih.gov)
4. The Influence of Cognitive Behavioral Therapy on Pain, Quality of Life, and Depression in Patients Receiving Physical Therapy for Chronic Low Back Pain: A Systematic Review https://onlinelibrary.wiley.com/doi/abs/10.1016/j.pmrj.2018.09.029

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

How Does Physical Therapy Benefit Children With Autism?

What Is Autism?

Autism, or autism spectrum disorder (ASD) describes a range of developmental conditions that affect how a person communicates, interacts, and behaves. ASD is called a spectrum disorder because the symptoms and severity can vary widely from one person to another.

Typical signs and symptoms of autism include:

• Having difficulty with communication and social interaction
• Restricted or repetitive patterns of behavior such as repeating words or phrases, lining up objects, or having intense and narrow interests
• Sensory issues, such as being over- or under-sensitive to sounds, lights, or textures

How Can PT Help?

Children with autism also often have difficulties with motor skills, which affect their daily functioning and quality of life. For example, they may have trouble with balance, coordination, motor planning, and body control. They may also have low muscle tone, which can make them appear floppy or weak. These challenges make it hard for them to participate in physical activities like playing games or on playgrounds with peers, which are important for both their physical and mental health.

Physical therapy can help children with autism overcome these difficulties and improve their motor skills. Using individualized and structured interventions, pediatric physical therapists help children with autism learn new skills and practice them in a fun and motivating way. Physical therapy can also help children with autism develop a positive attitude toward physical activity and enjoy the benefits of exercise, such as improved mood, energy, and sleep.

Improved gross motor skills and increased physical activity can also support the development of other areas that are affected by autism, like social and emotional skills. Physical activities can provide opportunities for children with autism to interact with their peers and family, express their feelings, and follow rules and directions. Physical therapy can also help children with autism cope with sensory issues, such as hypersensitivity or hyposensitivity to touch, sound, or movement, by exposing them to different stimuli and helping them regulate their responses.

How Do I Find a Qualified PT for my Child?

If you think your child with autism may benefit from physical therapy, you should consult with your child’s pediatrician, who can refer you to a physical therapist who specializes in working with children with autism. You can also search for a physical therapist near you using the American Physical Therapy Association website.

References:
• Research (peer-reviewed)
o Physical Activities for Children with Autism – https://pubmed.ncbi.nlm.nih.gov/32192008/
o Exercise for children with autism – https://pubmed.ncbi.nlm.nih.gov/31615098/
o Physical activity effects on sleep and executive function – https://pubmed.ncbi.nlm.nih.gov/30663324/
• Articles and Content
o Recognizing Autism in Healthcare – https://pubmed.ncbi.nlm.nih.gov/34983217/
o Autism – diagnosis and management – https://www.nice.org.uk/guidance/cg142
Supporting people with autism 19 or under – https://pubmed.ncbi.nlm.nih.gov/34283415/

How Physical Therapy Helps People with Parkinson’s Disease

Parkinson’s disease (PD) is a progressive neurological disorder that affects movement, balance, posture, and coordination. It can also cause non-motor symptoms such as pain, fatigue, mood changes and cognitive impairment. While there is no cure for PD, there are treatments that can help manage the symptoms and improve the quality of life of people living with PD.

Physical therapy is one of these treatments. PT can help restore or maintain physical function, mobility, and independence. Physical therapists are trained professionals who can assess, diagnose, and treat movement problems related to PD. They can also provide education, advice, and support to people with PD and their caregivers.

Benefits of Physical Therapy for People with PD

Physical therapy can help people with PD in many ways, such as:

Improving muscle strength and endurance. Both age and PD can weaken and decondition muscles. A physical therapist will prescribe exercises using light weights or resistance bands to improve strength. More strength helps with balance and mobility.

Enhancing amplitude of movement. PD can cause people to reduce the size and speed of movements. This can affect walking, speech, facial expressions, and gestures. Physical therapy can help increase the amplitude of movement by teaching overexaggerated physical movements, such as high steps and arm swings. This is a way to retrain the muscles and brain to compensate for the reduced movement that Parkinson’s can cause. The LSVT BIG program is a specific set of exercises and activities that has been shown to improve mobility and quality of life.

Reinforcing reciprocal patterns. Reciprocal movements are side-to-side and left-to-right patterns, such as swinging your arms while taking steps as you walk. PD can affect these patterns, which makes walking slow and unstable. Physical therapy can help to reinforce reciprocal patterns by using machines like a recumbent bicycle or elliptical machine. Practicing walking with arm swings is another activity that can help restore reciprocal movements. This can improve coordination, rhythm, and fluidity of movement for people with Parkinson’s. Dance and tai chi are other activities that involve reciprocal patterns.

Improving balance and posture. PD commonly impairs balance. Your brain uses a complex mix of what you see, your inner ear and sensations from your feet and joints to maintain balance. Physical therapy can help to improve balance using exercises that challenge stability, such as standing on one leg or walking on uneven surfaces. PT will also focus on specific components of the balance system by doing things like having a person close their eyes to focus on the sensations from the feet and joints. Physical therapy can also improve posture by correcting any muscle tightness or weakness that may cause stooping or learning sideways.

Increasing flexibility and range of motion. PD also often causes muscle stiffness and rigidity. Physical therapy can help increase flexibility and range of motion with stretching exercises that target specific muscles. Common areas of issue are the hip flexors, hamstrings, and calves. Stretching regularly can also help to reduce pain and spasm.

Providing education and self-management advice. Physical therapy can help people learn more about PD and how it affects their movement. A physical therapist can provide tips on how to maintain safety when exercising, how to cope with fatigue or pain, how to use assistive devices if needed, and how to prevent or manage complications such as falls or freezing.

Sounds Great. Is There Proof?

Yes. Research backs up all these claims. One meta-study (a study that combines the results of many other studies) that covered 1827 participants found that when compared to no intervention, PT significantly improved:
• gait speed
• two- and six-minute walk test scores
• Freezing of Gait questionnaire
• the Timed Up & Go test
• Functional Reach Test
• and the Berg Balance Scale

These results indicate improvements in mobility, endurance, strength, and balance. Gait speed is an especially important measurement. Physical therapists often consider gait speed a “vital sign.” This is because low gait speed has been linked to:
• declines in functional mobility
• higher rates of hospitalization
• higher fall rates
• cognitive decline
• increased disability
• and higher risk of death

A larger meta study that included 191 studies with 7998 participants found that PT significantly improved motor symptoms, gait, and quality of life. Specifically:
• Resistance and treadmill training improved gait.
• Strategy training improved balance and gait.
• Dance, Nordic walking, balance and gait training, and martial arts improved motor symptoms, balance, and gait.

Conclusion

Physical therapy is a valuable treatment option for people with PD, as it can help to improve or maintain their physical function, mobility, and independence. Physical therapy can also enhance their quality of life, confidence, and well-being. If you have PD or know someone who does, consult with a physical therapist who specializes in PD to see how they can help you.

References

(1) Physical Therapy for Parkinson’s Disease – Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/physical-therapy-for-parkinsons-disease.
(2) Physical Therapy and PD | Parkinson’s Foundation. https://www.parkinson.org/library/fact-sheets/physical-therapy.
(3) Physical and Occupational Therapy for Parkinson’s: What to Expect. https://bing.com/search?q=physical+therapy+for+parkinson%27s+disease.
(4) Parkinson’s Disease Treatment Physical Therapy. https://www.parkinsonsdaily.com/parkinsons-disease-treatment-physical-therapy/.
(5) Physical, Occupational & Speech Therapies | Parkinson’s Foundation. https://www.parkinson.org/living-with-parkinsons/treatment/physical-occupational-speech-therapies.
(6) Physiotherapy in Parkinson’s Disease: A Meta-Analysis of Present Treatment Modalities – https://pubmed.ncbi.nlm.nih.gov/32917125/
(7) Physiotherapy versus placebo or no intervention in Parkinson’s disease – https://pubmed.ncbi.nlm.nih.gov/24018704/

Have You Scheduled Your 2023 PT Exam?

Haven’t thought about having an annual PT exam? We’re biased, but we think you should. You see your optometrist and dentist regularly because your eyes and teeth are important. You get an annual physical from your family physician. You might even be getting ready to see your accountant to get your yearly taxes done.

But what about the rest of your body? Have you lost range of motion, or strength? How’s your balance and coordination? These all affect how you move. You might not notice small changes until you have problems like trouble lifting a heavy load, joint pain, or a sprained ankle from a stumble. An annual PT exam can catch problems early, then correct them before they lead to something bigger.

What to Expect

An annual PT exam is quick and easy. Your annual visit may include:
● A history of your injuries, as well as a health history
● Assessment of your strength, balance, flexibility, etc.
● A review of your movement goals (do you want to run a marathon? Get on and off the floor easily playing with your grandkids?)
● A review and update of your exercise program

How Important Is Moving Well?

There is strong evidence suggesting that movement is a valuable predictor of future health and resilience against disease. Moving well can keep you healthier and help you 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.

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. You can find the instructions and examples with a quick internet search.

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 science says that moving well is incredibly important to your overall health. It’s also important for your quality of life. We think moving well is just as important as your teeth, eyes, and taxes. If you agree, get that annual PT exam scheduled!

References
Why provide an annual physical therapy visit – https://www.apta.org/patient-care/interventions/annual-checkup

Physical Therapists’ Role in Prevention, Wellness, Fitness, Health Promotion, and Management of Disease and Disability – https://www.apta.org/apta-and-you/leadership-and-governance/policies/pt-role-advocacy

Ability to sit and rise from the floor is closely correlated with all-cause mortality risk — ScienceDaily

Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older – PubMed (nih.gov)

Physical Therapy Isn’t Just For Pain. It Can Keep You Healthy For Life.

You know that physical activity is good for you. The benefits are well researched and the list is impressive.
Here’s just a sampling:

● Releases endorphins to make you feel good and fight depression
● Helps control weight
● Prevents diseases like stroke, diabetes and some forms of cancer
● Improves sleep
● Helps you live longer

Recent studies even show that physical activity strengthens your immune system, with a protective effect against COVID, and that staying active through middle age protects your brain as you age.

Physical activity is a wonder drug. If it was a pill, you’d buy it and take it every day. But even though activity is free, less than 25% of Americans meet the CDC recommendations for activity. We clearly need help.

Physical Therapists Are The Experts in Human Movement

To be active, you need to be able to move. Physical Therapists do more than help you recover from surgeries or major injuries. They are the experts in human movement. Sure, you could see a strength coach to lift weights, hire a personal trainer, go to a yoga class to work on your flexibility and balance, and see a chiropractor for adjustments. But that seems like a lot of people when a PT can help you with all of these things and more. Nobody knows more about human movement or looks at your health the same way a PT does. Your PT can help you with every aspect of movement including strength, range of motion, flexibility, endurance, balance and coordination.

As medical professionals they can help you with injuries or other issues. Your PT can work with your doctor to help use activity to manage things like diabetes, cholesterol levels or blood pressure instead of prescriptions. Your PT is also trained to work with people of all ages, so you can develop a long-term relationship and they can continue to adjust and modify your routine as you age or your goals change.

Stay Healthy For Life

Staying active has a long list of benefits both now and in the future. But chances are you’re not moving enough to make the most of those benefits. Most people need help. Physical therapists are the most qualified professional in existence to help keep you healthy now and in the future. So don’t think of your PT as someone you see when you need help with pain or an injury. Think of them as your partner and coach working to help you stay healthy for life.

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

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.