Blog: Physical Therapy & Chiropractic

Pre and Post-operative Physical Therapy for Total Hip Replacement

Total hip replacement (THR) is a surgical procedure to replace a damaged hip joint with a new artificial/prosthetic implant. Physical therapy is essential before and after surgery in order to minimize complications. Therapy also reduces recovery time and restores hip joint function as quickly as possible.

Musculo-skeletal conditions that may require THR

An impaired hip joint can result in pain and motion restriction for daily activities like sitting, standing, walking and commuting. Some of the conditions that could potentially damage the hip joint include:

Trauma
Tumors
Osteoarthritis
Rheumatoid arthritis
Osteonecrosis

Signs and symptoms include moderate to severe hip pain and joint stiffness. Since the hip is a weight bearing joint, pain and discomfort in this region can interfere with the ability to walk and result in gait imbalances.

This can trigger several biomechanical adjustments in the lower body and lead to low back pain, knee pain and ankle pain. Over a period, this can cause several limitations in function. It is important to consult with a physician and detect hip joint abnormalities as soon as possible to prevent long-term damage.

Benefits of Physical Therapy

In the event of a scheduled THR surgery, physical therapy can speed up healing and rehabilitation of the hip joint before and after surgery.

Before surgery

A baseline measurement of the strength and flexibility is performed. The patient is educated about precautions to take prior to the surgery and positions / movements to avoid after surgery. Objects and furniture may need to be re-arranged to make sure important objects are within reach.

After surgery

Several procedures and modalities can be used by the physical therapist to facilitate recovery after surgery. These include:

Ultrasound to heal connective tissue (tendons and ligaments).
Manipulative therapy that includes stretching and massage.
Resistance training to build muscle strength.
Cold compress and heat to relax muscle spasms.
Low-level laser use for muscle and connective tissue injuries.
Functional electrical stimulation to restore muscle strength.
The Importance of the Initial Evaluation
Your physical therapist understands that when it comes to your recovery, every little detail matters. That is the reason your therapist will conduct a detailed initial evaluation. This includes objective measurements of the strength, flexibility, and mobility of the hip joints.

The physical therapist will identify functional limitations of the patient and establish a gap between the prior level of function and intended level of function.

Once the physical therapist determines this gap and analyzes diagnostic tests like X-rays and MRI scans, an effective treatment program can be created. This consists of specific procedures and modalities.

Treatment for mild hip problems is generally conservative. It includes medications and physical therapy. Physical therapy can also help before and after THR surgery. After a brief period of hospitalization, the patient may need several weeks, potentially months of physical therapy to achieve full recovery.

If you or someone you know is complaining of hip pain, call our office today. We will do everything we can to help.

http://www.foresthillsrehab.com/Physical-Therapy-Queens.html

Role of Physical Therapy in the Female Athlete Triad

The Female Athlete Triad is a group of interrelated conditions that affect female athletes, particularly teenage athletes. It is widely believed that an energy imbalance is the cause, combined with competitive forces. This disrupts eating patterns and body image for female athletes. Despite the fact that this is common in athletes, several aspects of the triad are seen in non-athletes as well.

The three medical conditions associated with the triad are:

Disordered eating: anorexia, purging, induced vomiting
Amenorrhea: adverse impact on menstrual cycles
Osteoporosis: low bone mass/density
Causes

There are times when the athlete exercises excessively while the body is experiencing an energy deficit. A reduced caloric intake combined with malnutrition leads to a pattern of disordered eating.

The pressure to ‘be thin’ is compounded by a society that idolizes celebrities and pop stars. This can result in compulsive dieting and exercise. For a growing teenage athlete, bone density can compromised if there are deficiencies in protein, vitamins and calcium. For female athletes participating in figure skating, ballet and gymnastics in particular, awareness is critical.

Symptoms

Coaches, parents and guardians should be aware of the following warning signs:

Rapid weight loss or marked leanness
Obsession about weight, body image and food.
Shin splints that don’t heal
Reduced participation or loss of interest in sports
Exercise and Nutrition - A Healthy Foundation for Every Individual
Treatment involves:

Prevention of compulsive dieting by working with a sports nutritionist.
Increasing the strength of muscles, ligaments, bones and joints must be increased with a progressive exercise program designed by a physical therapist.

Physical therapy for athletes begins with a detailed evaluation of the flexibility, strength, range of motion and athletic goals.

The physical therapist is a critical member of the healthcare team and works closely with a coach and athletic trainer. The physical therapist may use a combination of the following treatments:

Ultrasound to heal connective tissue (tendons and ligaments).
Manipulative therapy that includes stretching and massage.
Resistance training to increase muscle strength.
Cold compress for acute injuries and heat to relax muscular spasms.
Low-level laser use for muscle and connective tissue injuries.
Functional Electrical Stimulation to restore strength in the muscles.
The use of tape to support muscles and assistive devices as needed to support joints.
Massage From Your Physical Therapist

Success Starts with the Right Attitude
Physical therapy can keep young athletes healthy, strong and safe, but success begins with the right attitude towards the inner and outer self. Every physical active female should take three simple precautions to protect against the triad:

Eat healthy meals at regular intervals. Use nutritional supplementation if necessary.

Discuss menstrual irregularities (or sudden fluctuations in body weight) with your physician.

Track exercise and calorie expenditure.

An environment that makes the female athlete feel safe and comfortable encourages honest conversations that help identify underlying problems. If you suspect that someone in your family has some of the symptoms associated with the triad, seek medical attention immediately. Physical therapy is an important part of long-term treatment of this condition. In fact, physical therapy can help most individuals to live a healthy, improved quality of life. Call us today to schedule an appointment. Your success is our success.

http://www.ForestHillsRehab.com

Health Update: Neck Pain

The Neck and Headache Connection

Patients with headaches also commonly complain of neck pain. This relationship is the rule, not the exception and therefore, treatment for headaches must include treatment of the neck to achieve optimum results. The term, “cervicogenic headaches” has been an accepted term because of the intimate connection between the neck and head for many years. There are many anatomical reasons why neck problems result in headaches. Some of these include:

The first 3 nerves exiting the spine in the upper neck go directly into the head. They penetrate the muscles at the top of the neck near the attachments to the skull and therefore, any excess pressure on these nerves by the muscles or spinal joints will result in irritation and subsequent pain.
The origin or nucleus of the 5th cranial nerve called the Trigeminal, innervates the sensation to the face and is located in the upper cervical region near the origin of the 2nd cervical spinal nerve, which innervates sensation to the back of the head up to the top. Therefore, problems located in the upper neck will often result in pain radiating up from the base of the skull/upper neck over the top of the skull to the eyes and /or face.
The 11th cranial nerve that innervates the upper shoulders and muscles in the front of the neck arises from the top 5 to 7 spinal cord levels in the neck. Injury anywhere in the neck can result in spasm and pain in these large muscle groups.
Other interconnections between the 2nd cervical nerve and trigeminal/5th cranial nerve include communication with the 7th cranial / facial nerve, the 9th cranial / glossopharyngeal nerve, and the 10th cranial / vagus nerve. These connections can affect facial muscle strength/movements, taste, tongue and throat movements, and stomach complaints such as nausea from these three cranial nerve interconnections, respectively.

When patients seek treatment for their headaches, a thorough examination of the neck, upper back, and cranial nerves is routinely performed for the above reasons. It is common to find upper cervical movement and vertebral alignment problems present in patients complaining of headaches. Tender points located between the shoulder blades, along the upper shoulders, on the sides of the neck and particularly, at the base of the skull are commonly found. Pain often radiates from the tender point over the top of the skull when pressure is applied in the upper neck/base of the skull area. Tenderness on the sides of the head, in the temples, over the eyes, and near the jaw joint are also common. Traction or pulling the head to stretch the neck is often quite pain relieving and this is often performed as part of the chiropractic visit and can also be applied at home with the use of a home cervical traction unit. Chiropractic adjustments applied to the fixated or misaligned vertebra in the upper neck often brings very satisfying relief to the headache sufferer. Exercises that promote movement in the neck, as well as strengthening exercises are also helpful in both reducing headache pain and in preventing occurrences, especially with stress or tension headaches.

courtesy: Forest Hills Rehabilitation
http://www.ForestHillsRehab.com

Chiropractic Treatments for Back Pain
As part of your overall back pain treatment plan, your chiropractor may use a combination of spinal manipulation, manual techniques, therapy instruments, and therapeutic exercises.

Example of spinal manipulation treatments are:

flexion-distraction technique, which is a gentle, non-thrusting type of spinal manipulation.
instrument-assisted manipulation is another non-thrusting technique. The chiropractor will use a hand-held instrument to apply force without thrusting into the spine.
specific spinal manipulation is an active, hands-on treatment that restores movement in the spine.
To treat your back pain, the chiropractor may also use numerous manual therapies. Examples of manual therapies are:

instrument-assisted soft tissue therapy, which is a technique that involves repeated strokes of the instrument over areas of restricted movement.

manual joint stretching and resistance techniques to ease back pain.
therapeutic massage to relieve tense back muscles.
trigger point therapy, which is a technique that helps the chiropractor identify specific tight, painful points on a muscle.
Various instruments may also be used to treat muscle inflammation. Examples are:

inferential electrical stimulation, which uses a low frequency electrical current to stimulate muscles.
ultrasound to reduce muscle spasms, swelling, stiffness, and back pain by sending sound waves into your muscle tissues. The specific treatment plan developed for you depends on your diagnosis; these are simply examples of what your chiropractor may do for your pain.
How Does Chiropractic Care Treat Back Pain?

Chiropractors treat the “whole person"—not just your back pain—so that you’ll be able to gradually increase your daily activities. Your chiropractor will also emphasize the importance of back pain prevention. With chiropractic care, you’ll learn how to prevent your back pain from getting worse as well as how to prevent future back pain.

Source - spineuniverse

http://www.ForestHillsRehab.com

Neat video I found on Spine Universe about degenerative disc disease. Our physical therapist and chiropractors treat disc herniation, disc injury, slipped disc, disc bulge and the video really shows what’s happening.

Copy and paste the url: http://webpagevidslarge.s3.amazonaws.com/DiscDisease.m4v

You can also go to our site and click on the “Disc Disease Video” link: http://www.foresthillsrehab.com/Conditions%20Treated/back%20pain/back_pain.html

Neat video I found on Spine Universe about degenerative disc disease. Our physical therapist and chiropractors treat disc herniation, disc injury, slipped disc, disc bulge and the video really shows what’s happening.

Copy and paste the url: http://webpagevidslarge.s3.amazonaws.com/DiscDisease.m4v

You can also go to our site and click on the “Disc Disease Video” link: http://www.foresthillsrehab.com/Conditions%20Treated/back%20pain/back_pain.html