Thursday, August 17, 2017

Cananda is getting Opiods right

The new Canadian Guidelines for chronic pain shift away from opiods!

The new recommendations are in sync with APTA’s #ChoosePT campaign, which has been adopted by the Canadian Physiotherapy Association in a collaborative effort to educate the public about physical therapy as a safe alternative to opioids for management of pain.

If your you are considering PT or opiod use, check this out from;;

The risks of opioid use outweigh the rewards.
  • Potential side effects of opioids include depression, overdose, and addiction, plus withdrawal symptoms when stopping opioid use. 
  • CDC guidelines and experts agreed that opioids should not be considered first line or routine therapy for chronic pain
Opiods just mask the pain.
  • Opioids reduce the sensation of pain by interrupting pain signals to the brain. 
  • Physical therapists treat pain through movement while partnering with patients to improve or maintain their mobility and quality of life. 
Finally, from the American Physical Therapy Association, we find:

      Opioids Largely Ineffective for Low Back Pain
      CDC Recommends Safe Alternatives Like Physical Therapy Over Opioids
      60% of Adults Prescribed Opioids Have Leftover Pills
      Nearly 1 in 3 on Medicare Received Prescription for Opioids in 2015
      One-Third of Long Term Opioid Abusers Say They're Addicted or Physically Dependent
      Using Opioids Could Lead to Depression
      Physical Therapy First for Low Back Pain Lowers Costs
      Physical Therapy First for Knee Osteoarthritis and Meniscal Tears is Effective

Consider Physical Therapy first if you are in pain, it may save you money, and in some cases, addiction to narcotics.  At The Physical Therapy & Wellness Institute, we can get you in within 24 hours to help you reduce your pain today.

Robert Babb, PT, MBA, is owner and practicing Physical Therapist at the Physical Therapy & Wellness Institute located in Lansdale, Montgomeryville, Quakertown, West Norriton, Glenside, Harleysville, and Souderton, Pa. 

Monday, July 24, 2017

Lasting Impressions

Lasting Impressions

As the July boards have just past, new graduate physical therapists anxiously await to find out their board results after months of preparation have come to an abrupt halt. During this time of year, I can’t help but reflect upon this past year when I was in their shoes just one year ago.

As a novice, I thought that test was the biggest hurdle I was going to have to overcome as a new physical therapist. Flash forward to July 23rd, 2017, where early mornings and late nights, finishing notes, and fixing billing errors is my new norm. But what I didn’t anticipate would be the lasting relationships I have made this past year. Relationships with patients, co-workers, patients, office staff, nurses, and doctors are what make me able to even have a job as a physical therapist.

I have learned quickly that in order for my patients to get the best care, I must be able to communicate with their other health care team members. I never anticipated that, in addition to my job duties of hands on treatment and documentation, that I would be going to meet doctors to carry out clinical discussions, all with the common goals to from new relationships in order to obtain patients and progress and successfully treating those patients.

So what have been some of the key concepts of this networking and relationship building experience? Well, for starters, establishing patient rapport and making sure my patients know that I am their listening ear, cheerleader, and health care provider is by far the utmost importance.  Then comes networking with physicians. I think of this like dating but in the health care profession. Learning about physicians on a personal and professional level. What do they like to do as hobbies? How do they communicate? Is it by phone, email, text? Which like detailed updates on patients? Which do not want you to contact them unless there is an issue?  All of this information helps develop relationships in order to have a smoother patient- doctor-PT relationship.

The past year have been one of meeting memorable patients, developing relationships with local physicians, and giving back to the community with health care related talks. I look forward to what the next year will bring and to see what new lasting impressions will be made. 

PTW’s Catie Grumbein, DPT is the Clinical Supervisor at our Montgomeryville clinic. For an initial evaluation, call Catie at 215 855 1160 today for an appointment as soon as possible!

Monday, July 3, 2017

The Truth Behind Concussions

More Than a Ringing Bell…
Within the last couple years, concussions have come to the forefront of injury prevention, especially in regards to sports. However, in addition to slamming into another person, you can get concussions from motor vehicle accidents and falls. As more research has come out, concussions are more than just a knock on the head; there are chemical and metabolic changes that occur in the brain.

Cascading Chemicals
A concussion occurs when there is a shearing or stretching of the axons of a neuron (see picture). When this happens, a number chemical changes occur in the brain and the normal balance in the brain is thrown off and some chemicals are concentrated in the wrong area. When those neurons try to fire later, those chemicals prevent normal function. So when you try to read, exercise, drive, work, etc., you get tired quickly and might experience headaches, fatigue, nauseousness, or dizziness. Think of your brain like a muscle: after an injury, both do not function properly and need time to heal before returning to normal activity.


What Can Physical Therapy Do?
Like muscle injuries, physical therapists can be essential in helping to recover from a concussion. About 80% of concussions resolve themselves within 10 days. It is the other 20% that require further care. Since our expertise is exercise, we are able to gradually re-introduce exercise in a controlled environment, monitoring symptom response and progress when patients are ready. We can also perform balance and visual-motor exercises; both systems can be effected concussion. As symptomatic response (headaches, fatigue, dizziness) decreases, we are able to slowly add in more complex activities to help the brain return to normal function. Over time, these activities can improve the balance of chemicals in the brain to the point where normal function levels are restored.

If you have questions on what else can physical therapists can do for concussions or think you might be a candidate for physical therapy, give any of our seven locations a call. Some links below are also great sources for more information on concussions and concussion physical therapy.

 PTW’s Sean Vanin, DPT is the Clinical Supervisor at our Quakertown clinic. For an initial evaluation, call Sean at 215 538 9911 today for an appointment as soon as possible!

APTA Article Beyond Rest: Physical Therapists and Concussion Management

UPMC Sports Medicine Center “Concussions Facts and Statistics”

Center for Disease Control and Prevention “Traumatic Brain Injury and Concussion”

Monday, June 26, 2017

My PTW Journey-Brandon Lewandowski, DPT

From Volunteer to Physical Therapist-
Brandon Lewandowski's PTW Journey

I knew very early on in my schooling that I wanted to pursue a career in healthcare. My mother was an Occupational Therapist and as I was gr
owing up, she would bring me into work to watch her change the lives of many patients. This experience allowed me to see how much change someone can make in the lives of those with disabilities and pain. In addition to seeing occupational therapists such as my mother help the lives of others, I also experienced first hand how much a physical therapist could effect the lives of others. Growing up I had many injuries playing sports and as a result I needed physical therapy. The combination of experiences both watching and receiving physical therapy care gave me the strong urge to help give others the same experience I had and help patients get back to doing the things they love.

My PTW journey started back when I was a student at Lansdale Catholic High School. I started volunteering at PTW Lansdale and later shadowed at PTW Quakertown location for two summers. My official employment at PTW started my freshman year of college. I was brought on board as a support staff member and worked consistently through my time at West Chester University and later Temple University. I was able to apply the lessons and methods I was learning in class directly to my work at PTW. I have recently graduated from Temple University with my Doctorate in Physical Therapy and returned to PTW in my new role as staff Physical Therapist.

I am very excited to begin my new role as Physical Therapist and help patients in the way my own Physical Therapists helped me many years ago. I am very grateful for the opportunities PTW has given me throughout the past eight years. I have experienced physical therapy and PTW in many different ways- patient, volunteer, support staff, and now Physical Therapist. I feel that the PTW community (employees and patients) has helped me grow both as a person and a professional and I am excited to help others get back to doing the things they love!

 PTW’s Brandon Lewandowski, DPT is one of PTW's newest PTs at our Lansdale clinic. For an initial evaluation call 215 855 9871 today!

Thursday, June 15, 2017

Couch to 5K-The Essentials

Couch to 5K –The Essentials 

The spring and summer months are popular times of the year when runners get out and run local races. This is also the time of year when we as physical therapists see a lot of overuse injuries. Make sure that when you are getting back into running or starting for the first time that you do it properly. This means that your couch to 5K program should include stretching, a gradual build up in your mileage, and rest/cross-training days. 

It is important to stretch when your start running program. Why?
 As your muscles get stronger they will also hypertrophy or get bigger. If you don’t stretch during this time then the muscles get tighter.  Some common muscles that you want to make sure that you stretch would include hip flexors, quadriceps, hamstrings, gastrocnemius, soleus, and piriformis.

A gradual build up to running is also important.
It can be different for everyone but it is recommended that you don’t increase your mileage by more than 10% per week. For very beginner runners, it is recommended that you don’t increase your mileage for the first 3-4 weeks and that you only go for runs 2-3 times per week.  It is also recommended that you start with some ¼ mile intervals of running and walking for the first week until you can comfortably run a mile or two in the next 2-3 weeks. Once you can then comfortably run 2-3 miles without stopping then you can start increasing your mileage by 10% every week or every other week.

For more advanced runners, that same principle works. If you are trying to increase mileage to be able to run your first half or full marathon you should be increasing your mileage by only 10% each week and only running 3-4 times a week with one of those runs being your long run for the week.

The days not spent running should be supplemented with cross-training or strengthening workouts.

Cross-training just means training by doing some other type of exercise to supplement their running program. These activities generally try to focus on building strength and flexibility in other muscles that running doesn’t utilize.  Some good examples of cross-training include swimming, biking/cycling, golf, barre or Zumba classes, BodyPump classes, yoga, kayaking, and strength training.  

If you start to have pain, first try some stretching and rest.  If it doesn’t get better in a couple weeks then it would be a good idea to make an appointment with your favorite PTW Physical Therapist!

Happy Running!

Stephanie McDougal, PT, DPT

Clinical Supervisor – Souderton

 PTW’s Stephanie McDougal, PT, DPT is the Clinical Supervisor at our Souderton clinic. For an initial evaluation, call Steph at 215 855 1160 today for an appointment as soon as possible!

Tuesday, April 4, 2017

Ear Infection or Is It Really TMD?

Ear Infection Or Is It Really TMD?

Forty million people suffer from temporomandibular joint disorder.  However, it often gets misdiagnosed with something else, like ear infection.  Most patients think that they have an ear infection because pain is in the ear.  However, the most common cause of ear pain in an adult is the temporo-mandibular joint (TMJ). The TMJ is located extremely close to the ear canal and middle ear.  The muscles that surround the TMJ, the fascia, and ligaments that hold the bones in place are intricately connected with the ear and the nerve that supports the ear. Frequently the pain (in one ear or both) has persisted for several weeks and may even come and go.  Very often, hearing hasn't been affected but there will be a stuffy or clogged feeling in the ear.  Ear pain is often worse at night or in the morning. Some patients even complain that their ear pain is worse when they chew or yawn.

Most people with TMJ disorder have some kind of predisposing factor. The most common factor is poor posture which consists of a forward head posture, “hunched” upper back, and rounded shoulders.  They will usually have tenderness along the base of the neck, jaw, and mouth.  In addition, the molar teeth do not fit together that well.

Whether it’s the teeth that do not fit together or tension of muscles from abnormal posture, increased force is applied at the jaw joint.  Very often, people with TMJ have what doctors call bruxism which means that they either clench or grind their teeth.  Tooth clenchers tend to clench during the day when they are concentrating or thinking hard about something.  The tooth

grinders tend to do it at night while they are sleeping.  This is a completely involuntary behavior which is mildly stress-related.  Ear pain can also be caused by a dental procedure such as root canal or gum cleaning.  During these procedures, the TMJ has been stressed because the mouth was held open for a long period of time. Interestingly, many people with this problem will also experience tinnitus or ringing in their affected ear.  We do not really understand why the tinnitus is more active during times of TMJ stress; however, because it is a higher brain function, it may be that problems with the ear simply bring the brain’s attention to this part of the body and tinnitus results. The good news is that after the posture and TMJ disorder is treated, the tinnitus and ear pain will usually resolve.

How to Treat Ear Pain

The conservative treatment for ear pain caused by TMJ disorder is very simple.  First, we recommend a soft diet which means no heavy chewing of foods such as raw fruits and vegetables, hard-crusted bread or tough meat.  We recommend soft foods such as noodles, scrambled eggs, well-cooked meat and vegetables to reduce the strain on the jaw joint during eating.  Of course, we recommend no chewing of gum or other recreational chewing.  We recommend the application of warm packs a couple of times a day to help relax some of the musculature in that area.   These measures should help resolve the initial TMJ flare.   After the initial flare, we recommend seeing a physical therapist that specializes in TMD to determine the cause of the problems, in addition to resolve any pain that’s still lingering. 

TMJ can cause other problems in the head and neck, as well.  Often, people who clench at night will awake with aches across their cheeks or in the lower jaw.  Inflammation of the fascia surrounding the jaw joint can also cause pain that radiates from the ear area up into the temporal muscle in the temple and/or into the neck muscles.  Sometimes, people will even think that they have a sinus infection because of the combination of facial pressure and ear pain that they experience.

Other common causes of ear pain are swimmer’s ear or excessive wax impaction, which are disorders of the ear canal.  Also, less common in adults is otitis media which is an infection of the middle ear. This is the same kind of ear infection that babies and young children often get.

If you are suffering from any of the symptoms listed above, we can help you! 

PTW’s Andrew Seo, DPT provides expert clinical care and is a manual therapy specialist PT at our Montgomeryville Clinic, located on Upper State Road.   For an initial evaluation, call Andrew at 215-855-1160 today for an appointment as soon as possible, no prescription needed!

Monday, March 27, 2017

The Dancer–Physical Therapist Relationship

The Dancer–Physical Therapist Relationship

Often when treating athletes who are on the competitive level, compliance becomes an issue. As a dancer myself for the past 15 years, non-compliance is an ongoing issue that is often misunderstood by not only the physical therapist, but also other medical providers. An article published in the Journal of Dance Medicine & Science discusses the reasoning behind this misunderstanding and provides opportunities of how we as physical therapists can improve dancer compliance and return our dancers to the studio with success. 

The dancer often brushes the consequences of continuing to dance aside due to inability to relate to their health care provider. Dancers fear being told to stop dancing completely in order to heal their injury. What dancers really needs is an explanation of their injury, how it was caused, and what they can do to modify their current dance practice to avoid re-injury.1 Dancers report that they are willing to alter techniques in the short term, but not long term and would rather decrease their dance intensity level than the frequency of practice.1 This is where we as physical therapists can make a difference. Physical therapists (PTs) are rated highest by dancers for the quality of information given during therapy when compared with family physicians, sports medicine physicians, chiropractors, or massage therapists.2

By providing opportunities to educate dancers using their terminology and offer alternative ways to practice that are safe will allow dancers will improve the dancer-physical therapist relationship. Alternative exercise such as mental imagery, floor barre that minimizing full weight bearing, marking choreography either upper or lower extremities, or Pilates and yoga can help with a faster recovery. Specific questions such as: "What corrections do you get in class?" "What about your dancing are you unsatisfied with, and what are you working on?" "What specific motions make the symptom act up?" will show you as the physical therapist has a similar goal of returning your patient back to their sport.1

Treating only their symptoms does not address the issue for their overuse problems. Compensatory patterns and muscle imbalances should be evaluated and impairments should be treated after analyzing specific dance movements that the dancer usually preforms and caused the injury.1 Dance floor type, costumes, schedule, frequency of dance class, partner work, and personality should also be considered.1

Communication is key when treating dancers.  By listening, observing, and providing the education to dancers, they will be back to their sport in no time.

Catie Grumbein, DPT is one of our newest PTs at PTW! To schedule an evaluation call 215-855-9871 today!

1) Sabo, Megin. "Physical Therapy Rehabilitation Strategies for Dancers: A Qualitative Study." Journal of Dance Medicine & Science, vol. 17, no. 1, Feb. 2013, pp. 11-17.

2) Ruanne L, Krasnow D, Thomas M. Communication between medical practioners and dancers. J Dance MedSci. 2008;12(2):47-53.