Posts tagged physical therapy treatment
Getting By vs. Getting Better After An Injury

1 in 2 people in our country suffer from a chronic muscle, joint, or tendon injury.  These injuries create pain and lost time from life, work, and sport.  We can assume every one of these patients has sought out information or care on the management of these conditions.  From their first google search to consultations with multiple healthcare providers including Physical Therapists each person is seeking relief from their current condition.  In my experience, patients can be led down two different paths of either getting by or getting better.    


In our "I want it done yesterday" society there are multiple interventions each provider can offer to help a patient get by and feel better.  These treatments are intended to reduce symptoms in the short term and can include rest, medication, manipulation, dry needling, or massage.  Many patients will start their care here when pain and symptoms in the short term are their main concern.  Their are two main limitations of this treatment option.  The main drawback of this approach is a creation of patient dependency on the provider for relief of their current symptoms.  Patient's must continually return to their provider for relief of their symptoms.  Secondly, these treatments when used in isolation provide only short term (2-3 days) relief.  Patient's utilizing this approach often get stuck in a pattern of symptomatic ups and downs leading to future recurrence and chronicity.  


Conversely, patients get better when they are empowered to become a team member in their recovery.  Patient's are rapidly transitioned from dependent to independent care with the Physical Therapist functioning as a guide on a patient's pursuit of their goals.  The vast majority of muscle, joint, and tendon injuries require time and effort to not only heal the tissue but also resolve the underlying reasons for the initial injury.  Getting better depends on the gradual loading of the body through exercise to return to optimal functioning.  The length of this process is dependent on the nature of the injury, the body's capacity to recover, and the team work of the patient and Physical Therapist.    


Patients who achieve a full recovery and return to 100% of their prior activities have a few traits in common.  First and foremost they want to be an active participant in their recovery.   They wish to gain a better understanding of their diagnosis, as well as, the role both the provider and patient will play in the recovery process.  Secondly, patients are willing to put in the time and work required to provide an optimal healing environment for the injured tissue.  The vast majority of these injuries do not return to 100% without gradual loading.  Finally, patient's utilize the education and guidance of the Physical Therapist to become independent in the management of their symptoms and recovery.  At this point in the recovery, the Physical Therapy acts as a resource available by call, text, or email and the patient takes the lead with the education they have received.  

In short, injuries are common and no one moves through life without sustaining one.  When an injury occurs seek out a provider who can not only make you feel better, but show you the path to a complete recovery.  Stay fit and contact the experts at MEND when you are ready to begin your path to recovery.  


Does Leg Weakness Lead to Knee Osteoarthritis?

Knee arthritis is a common, costly condition affecting a large percentage of middle aged and older adults.  Physical Therapy remains the gold standard of care for knee arthritis due to its' ability to delay or prevent the need for a total knee replacement.  One of the foundations of Physical Therapy care includes strength training for the knee and lower extremity joints.  Improving strength and coordination in these joints reduces the loads placed on the knee allowing individuals to return to the sports and activities they enjoy.  Until now it was less clear how weakness increases the risk for the development of arthritis or loss of function due to this condition.

A recent systematic review in the Journal Arthritis Care and Research evaluated 15 prior research studies of over 8,000 participants (Culvenor et al. 2016).  The authors noted a higher risk of symptomatic osteoarthritis and loss of function in the individuals with the weakest quadriceps.   Of note, there was not an increased risk for the development or progression of knee arthritis among those with the weakest knees.     

This review article highlights the importance of Physical Therapy to improve lower extremity strength and preserve or restore an individual's functional ability to live, work, or play.

Predicting Lasting Symptoms After An Initial Ankle Sprain

Ankle sprains are one of the most common orthopedic injuries we see in our Boulder Physical Therapy practice.  These injuries create local pain, swelling, loss of motion, weakness, and balance difficulties.  In past years these injuries were treated with R.I.C.E. (rest, ice, compression, and elevation), but more recent research has demonstrated improved outcomes and faster recovery with a more active approach.  Athletes treated with manual therapy and exercise by a Physical Therapist demonstrate superior outcomes than those treated with R.I.C.E.  The greatest limitation of the R.I.C.E. and wait and see approach involves prolonging treatment which may lead to lasting chronic symptoms throughout the lower extremity.  

A recent article in the American Journal of Sports Medicine attempted to identify predictors of chronic symptoms and balance difficulties among athletes after an ankle sprain (Doherty et al. 2016).  The authors followed 82 patients who sustained a first time ankle sprain.  The athletes were examined at 3 times points: 2 weeks, 6 months, and 12 months post injury.  At 12 months patients with lasting, chronic symptoms were identified and their data was analyzed to determine if prior clinical data could predict their lack of recovery.  The authors noted patients who were unable to complete landing and jumping tasks at 2 weeks post injury and/or were unable to demonstrate balance in multiple planes of movement demonstrated the greatest risk of lasting pain and symptoms.  

Individuals who sustain an ankle sprain are advised to contact their local Physical Therapist as soon as possible to accelerate recovery and prevent chronic symptoms. 


Physical Therapy Reduces Need for Total Hip Replacement

Over 200,000 Americans undergo a total hip replacement often as a result of severe hip osteoarthritis.  Patients who enter the surgery in a weakened, less functional state have worse outcomes up to 2 years post operatively compared to their higher functioning peers (Fortin et al. 1999, 2002).  This is concerning because the most rapid recovery after surgery occurs in the first 3 months with slower recovery up to 1 year.  A patient with more difficulty entering surgery would have limited success in this crucial window in their recovery.  Conversely, pre operative Physical Therapy for patients with limited flexibility, strength, balance, and endurance can improve surgical outcomes, but similar to research in knee osteoarthritis may delay or prevent the need for the surgery.  

A recent study was conducted to determine the long term impact of PT interventions on patients with hip osteoarthritis (Svege et al. Ann Rheum Dis. 2015).  Patients were randomized to either an education or PT group and followed up to 6 years after the treatment.  The authors reported the average time to a total hip replacement was 5 and a half years in the Physical Therapy group compared to 3 and a half years in the education group.  In addition, twice as many patients in the Physical Therapy group did not require surgery reducing the need for surgery by 44%.  

This evidence adds to our knowledge on the beneficial effects of Physical Therapy on patients with hip osteoarthritis.  Patients with hip pain are advised to see a Physical Therapist to postpone or prevent the need for a total hip replacement. 

Hip Osteoarthritis and the Impact of Exercise

Currently, in the state of Colorado patients can access their Physical Therapist without a referral from another healthcare provider such as primary care physician.  This model of care has been utilized since the 1950's throughout the country and is most notable in our military where our soldiers have direct access to their Physical Therapists.  In both the civilian and military worlds seeing a Physical Therapist first is both clinically and cost effective for patients, saving an average of $1000 per plan of care.  For the majority of musculoskeletal conditions exercise is the key intervention to reduce pain and improve function.  There is no better healthcare profession than Physical Therapy for the design and implementation of an exercise program for patient's in pain.  A new research paper was released demonstrating the importance of exercise in the management of hip osteoarthritis.

Hip osteoarthritis is a common condition leading to pain, loss of motion, weakness and loss of function in many middle to older aged adults.  Prior research has shown exercise therapy's ability to reduce pain and improve function in patients with hip osteoarthritis.  A recent study compared the cost of exercise therapy and primary care to primary care interventions alone (Tan et al. Osteoarthritis Cartilage. 2015).  Over 200 patients were followed over the course of a year and their medical expenses were collected.  The authors reported exercise therapy was a less costly treatment option compared to primary care alone.  

To learn more on how Physical Therapy and exercise can save you money and improve your quality of life contact your local Physical Therapist.