With the weather changing and the rain coming in many people start gearing up for the fall and winter. When getting out to clean your gutters or pack away your patio set make sure to do some warming up. Something as easy and walking around the yard, touching your toes and arching your back can go a long way to keep your body a lot happier while doing your tasks. Now the kids are back in school, it’s a perfect time to come visit us about that nagging injury you got over the summer and get ready for the holidays!
Spring is finally upon us! The days are longer and the sun shines more often. It’s this time of year many people get back into running or start up for the first time. Too often we see patients who have the exact same situation that leads them into our clinic. They bought a pair of running shoes that looked good and just started running. But sometimes they push too far too fast. A few simple concepts can help you begin your running journey without major setbacks.
First thing any runner needs to do is to start with the right shoe. Are you going to run on the roads? Are you going to run on trails? What sort of mileage will you be doing each week?
A store that specializes in running shoes is a logical spot to find the best shoes for your specific foot type. Our favorite local running store is the Balanced Athlete at the Renton Landing. Top to bottom they have the best trained staff and always help you find the right shoe. There are other good options depending on where you live. Here is a link to a list of some other Seattle area running shoe stores. At least at first, we do not recommend that you order running shoes online since it is so important to try them out and have someone help you select the best option for you.
Once you have found the right pair of shoes it’s time to start thinking about training. Slow, steady, and consistent is the concept you want to think about when building a running base. To start with, use duration and not distance. So use minutes instead of miles. The reason for this is that it’s easier to stick to minutes and not push too far too quickly. If you have never run before, I recommend starting with a walk/run interval starting with 20-30 minutes total. The beginning interval should ideally start at walking 2 minuets and running 1 minute. Then working over the next 3-4 weeks building up to where you are running 2 minutes and walking 30 seconds, eventually building up to where you can run for 30 minutes without the walking intervals. If you need to continue with the walking intervals, then by all means do so. During this time period, you want to track the miles you run so when you are finished with the first month of intervals you will have a good starting point to then transfer from using minutes into mileage.
We always recommend people pick a running event such as a 5K race to work towards. This will give you a tangible goal to work towards and achieve. Nothing is worse than a vague goal that’s hard to pin down. Once you choose an event then it’s time to start planing your runs. Some people get caught in what is commonly called the “black hole” of training. What this means is that you are working out just hard enough to feel it, but not hard enough to produce adaptation and continue improving. Take for example a three day a week running program. You won’t want to run the same distance, time, and mileage each run. You have to vary your training in order to avoid boredom and also to continue progressing. Splitting your runs into pace, speed, and distance will challenge you and you should begin to see your runs getting faster and longer. But a word of caution: Never make a sudden increase in your mileage such as going from 2 miles to 8 miles one run to the next and also avoid suddenly adding a lot of difficulty such as hills or uneven surfaces. If you would like more information and for an in-depth analysis of your running form and training loads, schedule a full running analysis with us at Advance Physical Therapy & Sports Rehabilitation where we will prepare you for your race event or just help keep you running injury-free.
Musculoskeletal issues affect more than 50% persons over the age of 18 years old in the United States and nearly 75% of those age 65 and over. Trauma such as motor vehicle accidents, back pain, and arthritis are the three most common musculoskeletal conditions reported, and for which health care visits to physician’s offices, emergency departments, and hospitals occur each year. Many of these issues get over-treated with unnecessary imaging, medication, and a lack of early referrals to Physical Therapy. In a Meta Analysis of 14 accepted studies, the Journal of Orthopedic Sports Physical Therapy in June of 2016 stated:
“Current US practice guidelines suggest an initial “wait-and-see” approach following onset of musculoskeletal pain, particularly for spinal pain. Several studies suggest that early initiation of Physical Therapy for musculoskeletal conditions may decrease health costs and improve outcomes compared to delayed use of Physical Therapy.” During this study they found, “Preliminary evidence suggests that early physical therapy may decrease cost without compromising outcomes.”
Another study in the same journal looked at the cost difference between direct access to Physical Therapy and the medical referral model. The direct access group saved an average of $1,543 per person and a total cost savings of over $400,000 compared to the medical referral group over the course of the study. What this demonstrates is that earlier access to Physical Therapy not only improved patient outcomes but also lowers cost across the board. Many people see a prescription to Physical Therapy like a prescription for ibuprofen, just fill it at any clinic since it’s the same product.
Physical Therapy, however, varies greatly depending on the clinic you choose. Some clinics use a very “cookie-cutter” approach where every knee gets the same exercises and stay on the same machines. Others take a more holistic and individualized approach, treating every patient as a whole person and not just as a diagnosis. Being an independent clinic and taking a more individualized approach with our patients allows us to utilize our wide verity of certifications, advanced technologies, and extensive training to treat each patient more effectively. We pride ourselves on keeping up to date with the most recent research to ensure that each treatment utilizes the most current information to help you achieve your goals faster.
Starting Physical Therapy sooner often times leads to faster resolution of symptoms and patients do not require as many total visits in order to get there. So please consider Advance Physical Therapy & Sports Rehabilitation for recent onset pain or even pain that has been hanging around for a long time. We’re here to help!
Written by Joshua C. Anderson, PTA/L, CKTP,
Edited by Brad L. Bentley, DPT, OCS, Cert. MDT, CMP, Cert. ASTYM
Gearing up for the Holidays
Every year as holiday parties and festivities approach, we see an increase in the number of painful conditions related to preparing, cleaning, and cooking for their parties and guests. With a few simple steps you can help keep yourself healthy, happy and enjoying your holidays without pain. First and foremost, make a list of all of the things you need to do to prepare and get your home ready for company. By doing this you can have a specific amount of items that need to be accomplished by a certain date. Take a moment and look at your list, which tasks involve lifting, which ones have you twisting, or which ones have you standing in one place. By asking yourself these questions you can set out a plan to not overstrain your body, potentially resulting in pain. This may sound like advice from physical therapy nerds, but remember to take time to stretch out and warm up before you begin cooking, cleaning, or decorating your home. (Note from the Editor: That is advice from physical therapy nerds.) Try to break up tasks so you are not doing the same activity for an extended period of time. Vacuum one room, then dust in the next. The more you can vary what you do the better your body will tolerate it. If you approach housework like you would a game or exercises at the gym you will be more prepared to withstand the potential strains on your muscles, joints, and nerves from working around the home. Doing a series of light stretching and warm ups before you vacuum, dust, clean, or cook should help reduce overuse injuries and strains in addition to reducing the chance of next-day soreness.
When it comes to large family meals, you can try bringing a higher chair such as a barstool into the kitchen so you can still do a few tasks while taking a bit of pressure off of your knees and feet. This will allow you to cook longer and still enjoy the rest of the day without the increased pain. In general, if you have been standing too long you should sit, if you’ve been sitting too long you should stand and move around, and if you’ve been upright too long you should lie down at least for a few minutes then get back to it if need be. Also, remember to gently draw-in your abdominals every few minutes while standing and definitely when lifting the turkey out of the oven!
When it comes time to clean up, first and foremost it should be a group effort. I grew up in a home that if you cook, you don’t clean. That way everyone contributes and no one is stuck doing all the work all day. Another way to approach the cleanup is to clean while you cook and then break up the tasks of scrubbing and general rinsing so you can take rest breaks as needed.
If you make a list, remember to warm up before bouts of activity, vary your tasks, and take time to stop and enjoy your holiday’s you will be set up for a happy and healthy holiday season. (Another note from the editor: Sadly, putting schnapps in your hot cocoa does not count as a “warm up”.)
Season’s Greetings from all of us at Advance Physical Therapy & Sports Rehabilitation!
Joshua C. Anderson, PTA, CKTP, Cert. ASTYM
Bradford L. Bentley, DPT, OCS, CSCS, Cert. MDT, CMP, Cert. ASTYM
Strokes are serious and potentially fatal events that can happen at any time. Strokes are very common more than 750,000 occurring every year in the United States. There are two main types of strokes. The first is an ischemic stroke where the blood vessels carrying blood to the brain and is blocked, usually via a clot. These strokes are the most common and usually not fatal but may have long-term effects. The second is a hemorrhagic stroke, in which there is a rupture to the blood vessel causing blood to leak around the brain. Depending on the severity, these may become fatal very quickly. This happens when someone has a brain aneurysm or a weak blood vessel begins to leak in the brain. For those people who survive a stroke, a return to a normal life may or may not be possible depending on severity. However, for many Physical Therapy and neurologic rehab are key to returning a patient to their life and what they love to do.
There are a handful of corresponding disabilities that are most common with stroke. Partial or complete paralysis, increased sensory pain, challenges with memory and the ability to focus. You may also have problems understanding and using language as well as a variety of potential emotional disorders. With the variety of complications after a stroke, it is imperative that the patient and their doctors identify the best types of therapy.
The primary goal of Physical Therapy is to restore as much function as possible. When someone suffers from a stroke, there may be permanent damage to that area of the brain. This damage can be minor and have a minimal impact on a person’s quality of life or it can be quite debilitating. One potential side effect is that motor skills become difficult or impossible because of the stroke. It’s also possible that other body parts learn to compensate for the reduced level of functionality.
After a stroke and an assessment of the damage, rehabilitation starts rather quickly. The shorter amount of time between the stroke and rehabilitation, the better the odds are for a greater recovery. Rehabilitation usually starts in the hospital within a day or two of the incident. The patient can then expect in-home therapy, skilled nursing facility and finally progression to outpatient clinical Physical Therapy.
Your typical orthopedic injury may require one to three different types of specialists. But with a stroke, you will likely engage with your physician, neurologist, physical therapist, an occupational therapist, a social worker, and speech language pathologist. Because of the wide variety of necessary therapists, it is important for the patient’s support team to have regular communication and agree on what “success” looks like.
Unlike a lot of injuries that follow the similar protocols, each person we work with who has suffered from a stroke requires their own unique rehabilitation plan. Extreme patience, flexibility, and a strong desire to succeed are all paramount. Studies have shown that people suffering from a stroke may show improvements at least into their 3rd to 5th years after. We are committed to working with you, your physician, and your entire recovery team in order to maximize functionality and return you to the most normal life possible. If you, or someone you know has recently experienced a stroke and is curious about rehabilitation process, do not hesitate to give us a call or stop by for a visit to find out how we may help.
Written by: Joshua C. Anderson, PTA, CKTP, Cert. ASTYM
For your body
- It’s always best to go to a specialty running store and go through their fitting process. As I always tell my patients, a good running store can “get you into the stadium but they can’t find your seat.” Meaning, never go somewhere that shows you only one pair. You should always have 3-4 different pairs to try.
- Proper fitting of running gear is key, make sure your shoes are the correct size. Most people’s running shoes tend to be a half to full size larger than their street shoes to account for the foot spread during your run.
- The shoes you wear can make a world of difference. As we age the shape and size of our feet changes. The pressure distributing fat pads on the bottom of our feet can degrade. Ask to try a more “cushioned” version of your go-to shoe.
- For your performance
- Perform a Dynamic Warm-Up before every run. Every run. Do light static stretching after your run to reduce soreness.
- Pay attention to your intensity/mileage. Mild-moderate muscle discomfort during runs, especially with hills, and mild-moderate delayed soreness after runs is acceptable. Actual pain during or after runs is not.
- Plan for rest days and active recovery days. If you don’t give your body time to recover and are always breaking it down through running without time to recoup, it will most likely lead to injury and signs of overtraining such as general fatigue.
- Cross training is key. Running is amazing but adding time for yoga, swimming, cycling, and weight lifting will increase your injury resistance. This in turn will help your performance and avoid overuse injuries such as tendonitis.
- When training, NEVER change more than one variable per run. Meaning, don’t add speed AND hills or Distance AND speed on the same day.
For your mind
- Running releases endorphins, your “feel good” chemicals, meaning you feel happier and satisfied after runs.
- Think about occasionally signing up for a race to keep you motivated and focused.
- Joining a running club can be great to meet new friends and people to join the fun
- My favorite plan for running is what I call an “Adventure Run.” Get away from your normal route and explore a new trail or route.
There are a million reasons to take up or keep running. Some run for fun, some for fitness and others for adventure. Remember that the slowest mile is still a mile and laps everyone on their couch!
If you have specific running questions or any aches, pains, or injuries please contact us and let us help you Advance Beyond Expectations.
Written by: Joshua C. Anderson PTA, CKTP, CCI, Cert. ASTYM
In the world of medicine, there is no topic more frustrating, aggravating, and confusing as health insurance. Every insurance company has more than one plan option and this information is rarely laid out in a way that is easy to understand. Knowing what plan you have and what is actually covered is the first step in navigating the waters of health insurance coverage. No matter where you stand on the political, cultural, or economical spectrum, dealing with and understanding health insurance is in the your best interest.
What can you do as a patient to ensure your best shot at the fullest coverage? The health insurance market seems to offer a greater variety of plans today than it has in the past. While this means a little more homework on your part, it also means that you can find a plan that suits your particular needs. The first thing you should always do is check to see if your plan covers some level of physical therapy. If your plan doesn’t cover physical therapy or if you have a large deductible, then a therapy provider who offers a reduced cash rate for services would be a smart choice for treating pain or movement dysfunction. You would also not need a referral script and can simply schedule your own appointment. This literally bypasses insurance authorizations, denials, appeals, etc. and puts you in control of your own healthcare!
Of course this approach works even if you don’t have insurance. Reduced cash rate physical therapy visits for an evaluation will undoubtedly be one of the least expensive choices you can make when it comes to receiving skilled healthcare.
If you do have usable insurance benefits, you may run into some authorization “speed bumps” in the process. Insurance companies often ask for documentation and notes from your Physician and Physical Therapist. Be sure to work with healthcare provider offices willing to help through the process of referrals, authorizations, appeals. This includes them communicating with other provider offices to make sure the right paperwork has been done and sending chart notes when needed.
If you are planning on surgery and know that you will need physical therapy, check with the potential providers to find out which coverages are accepted. This could be the difference between in-network and out-of-network coverage and result in dramatic differences in cost to you.
You pay hard-earned money for your insurance coverage. We understand the frustrations you feel when things don’t seem right. Take time to understand your policy and your coverage. As always, we encourage you to talk to us and let our billing team help out. We navigate these rough seas every day and are here to help you.
So you just received a Physical Therapy referral from your healthcare provider. There is a lot of misinformation out there on just how much you, as the patient, may dictate where and what providers you see. A prescription for Physical Therapy is just like a prescription for anti-inflammatories, you can fill it wherever you choose. Just because your doctor may have given you a referral for their “in house” Physical Therapy does not mean you MUST go there. That would be like your doctor telling you that you can only fill your prescription at a CVS pharmacy.
A lot of people also think that their insurance controls which healthcare providers they can see. If you have an insurance plan with a low deductible and the provider is in your network, then it may make sense to go to them. Ahh, but only if you are also getting the best care. If you have a high deductible, have a community health plan (bronze plan, Medicaid), or are not insured then it might still make sense to see a Physical Therapy provider who can customize your treatment to meet your needs at a reduced cash rate.
In regards to your own health and well-being, you are your own best advocate. Don’t waste your precious time at a big box P.T. clinic that uses cookie cutter treatments and you only spend 15 minutes with a licensed provider. Come see us at Advance Physical Therapy & Sports Rehabilitation where you know you’ll get the best care, the most cutting edge treatments and get back to doing what you love faster! Call or message us for more information. We want to help you advance beyond your expectations!
Physical Therapy is often only considered after an orthopedic surgery. However, there is mounting evidence pointing to the benefit of pre-operative Physical Therapy. In the case of an impending total knee replacement, recent studies have shown as little as 1 or 2 visits decrease post-operative care by 29%, or a cost savings to the patient of more than $1000.00 per individual. Preparing the area around the damaged tissue prior to surgical intervention leads to faster recover times, better muscle recruitment, less pain, fewer visits, and a faster return to your life. Pre-operative therapy allows us to better understand the movement patterns or injuries which produced the need for surgery in the first place.
Some orthopedic surgeries that may benefit from pre-operative Physical Therapy include total knee arthroplasty/replacement, total hip arthroplasty/replacement, anterior cruciate ligament (ACL) repair, rotator cuff repair, labral tear procedures, total shoulder arthroplasty/replacement, and any non-emergency back or neck procedures. The physiological benefits of the therapy include decreasing swelling, increasing circulation, decreasing pain, strengthening surrounding muscles, and beginning the process of tissue remodeling including neuroplasticity to improve function between the brain and the affected area.
Many times patients don’t fully understand the surgical procedure they are about to undergo. Often times visiting a surgeon is a scary proposition. You usually have to wait up to a few months and when you do have the consult, so much information is thrown at you that not all of it may stick. Patients want to know how involved the procedure will be and what to expect from the post-op recovery process. Recovering from an injury and surgery has a psychological component in addition to the obvious physical aspect. As we like to say, “there’s a brain attached to the person,” meaning, your emotional state after surgery and how you are able to process and proceed while in pain is a key to recovery that is often overlooked.
So it would be a good idea to build report with your Physical Therapist and Assistants before the surgery. If you have the opportunity to work with your providers for at least a few sessions, when you return to therapy after the procedure it will put you at ease and allow you to progress more quickly. A lot of Physical Therapy is built on trust. If you can establish trust between you and your Physical Therapist before the surgery then you should expect less stress, less pain, and a better outcome.
Physical therapy before a surgical procedure can be of great benefit to your recovery. Talk with your physician about pre-operative Physical Therapy and feel free to call or email us any questions. We are here for you, before and after your surgery. Let us help you advance beyond expectations!
Joshua C. Anderson, PTA, CKTP, CCI, Cert. ASTYM
Bradford L. Bentley, DPT, OCS, CSCS, MDT, CMP, Cert. ASTYM
When most people think of injuries, something traumatic or sudden comes to mind. However, in our Physical Therapy practice we see just as many patients with work related conditions as we do from construction sites. Most people do not view their work at their desk and computer as putting the same level of strain on their bodies as building something or lifting heavy objects. The truth of the matter is that while most injuries at construction sites tend to be sudden, office injuries typically arise from repetitive motions or positions sustained for many hours every workday. Repetitive strain or cumulative micro-trauma can develop over long periods of time, often with a gradual onset. This can make tracking down the exact mechanism of the injury a bit more difficult. We specialize in getting to the root of the problem, not just chasing symptoms. Many times office patients present with pain in their wrists or forearms. While it is necessary to examine the area of symptoms, it is even more important to check and see if this is actually coming from the neck/cervical spine. The same goes for sciatica like symptoms into the leg which people often get from prolonged sitting while at work. These symptoms can be produced by the low back/lumbar spine. Looking at a patient’s symptom presentation in a more holistic manner guides treatment for these conditions and allows for the best outcomes. Here are some common office injuries and tips on how you can keep yourself healthy and happy:
If your posture is bad, there is a likelihood of developing multiple sources of pain. Your neck may begin to get sore. You may feel tightness in your shoulders and pain in your elbows and wrists. You could experience sciatica and even numbness in your feet and toes. These are all signs and symptoms of issues that when addressed with your Physical Therapist may resolve quickly. However, the longer a pain cycle continues the longer it takes to break that cycle and return to a pain-free life. Pain in your neck and shoulders will likely either start due to, or will result in muscle tension. When muscles are strained over time, they don’t have the opportunity to relax, and will eventually become tense and painful as a response. As muscles tense up they don’t get the proper blood flow and lymphatic drainage which then makes them even more likely to become painful! These conditions can result in tension headaches and spasms which can lower productivity. If your neck and shoulders begin to hurt, take a moment and sit up tall with your shoulders relaxed down and gently pulled back.
One of the best ways to keep your posture correct is to ensure that your elbows, hips, knees, and ankles are at 90° angles. Your feet should be resting on the ground or on a footrest. If you are a bit vertically impaired in height, your feet may dangle when the rest of you is lined up with your keyboard and desk at the right height. So having a footrest is an excellent way of maintaining good posture and taking pressure off your lower body while working at your desk. Consider adding a keyboard tray if needed in order to modify your workstation so that you can be in the optimal 90 degree angle posture. Be sure the keyboard tray also has a spot for the mouse at the same level as well. Reaching out to use the mouse can lead to repetitive strain and injury so keep your elbow in close to that 90 degree angle when using it. This may take some getting used-to but will quickly be added as one of your many good habits. If you have the option at work to have an ergonomic assessment for your workstation, take advantage of it.
Many office injuries and conditions are avoidable by paying attention to what your body is telling you, as well as learning the proper relief techniques to use throughout your day. If you feel uncomfortable or out of position, you probably are! You should re-evaluate your working environment and position. Take a picture or a video of how you work and bring it in with you. We will give you some creative ideas to help you be comfortable and productive. Use time in your physical therapy sessions to practice and get comfortable with your new routine. You’ll likely end up in a better position both physically and mentally which will go a long way towards a long and happy life. We look forward to helping you relieve your pain and improve your life.
Joshua C. Anderson, PTA, CKTP, CCI, Cert. ASTYM
Brad L. Bentley, DPT, OCS, CSCS, Cert. MDT, CMP, Cert. ASTYM
Advance Physical Therapy & Sports Rehabilitation, Inc.