Blog: Physical Therapy & Chiropractic

Nutrition for Your Joints

It’s well known that that nutrients in certain foods can boost immunity, improve heart health, and promote well being. However, did you know that nutrition can play a role in bone and joint health as well?

Joints serve an important function in the human body. Movement at the joints allows you to bend, reach, turn, and rotate.

As an individual gets older, more sedentary, and gains weight, arthritic changes can set in. Joints begin to degenerate, resulting in pain and discomfort in daily life.

The best way to build strength and stability of the joints and the surrounding ligaments, muscles, and bones is through a combination of exercise, healthy eating, and nutritional supplements.

Exercise - The Right Stimulus for Healthy Joints
Exercise is one of the best ways to keep your joints healthy and improve well being. On the other hand, sedentary individuals are at a higher risk for joint pain. The less you move, the more stiff your joints will be, so it’s important to move around.

“Getting up and moving” can be as simple as going for a brisk walk or using the vacuum. If you work in an office, you can increase your mobility by talking on the phone while standing up instead of sitting at your desk. You can also stand up and and stretch at regular intervals.

The weight of your body is supported by your lower back, knees, and hips. Loss of excess body weight will help ease the strain on your joints.

Adding resistance increases muscle strength around your joints and ligaments. It is very important to consult your physical therapist before beginning any resistance training program. You want to make sure you don’t overdo anything and hurt yourself.

Nutrition plays an important role in joint health. Eating a diet rich in nutrients contributes to bone strength. The consumption of diary and foods such as broccoli and kale facilitate calcium intake. If you can’t tolerate milk, ask your physician if calcium supplements are right for you.

Foods rich in Vitamin C and antioxidants may contribute to immunity and joint health. Eat plenty of colorful fruits like oranges, berries, and melons to take in an excellent supply of both nutrients. Salmon is an excellent source of calcium and omega-3 fatty acids. Omega-3 fats have several benefits, and may boost joint health, heart health and decrease pain and swelling. Please note that these are general guidelines, and are not meant to replace or constitute the advice of a registered dietician or nutritional consultant.

The Role of Physical Therapy in Joint Health
Your physical therapist is a licensed health care professional trained to help you improve joint health. For best results, use a combination of diet and exercise. A well-designed, simple, yet progressive exercise plan will help strengthen muscles surrounding the joints and improve mobility.

Although joint pain can limit your quality of life, your physical therapist will stand by your side and help you. The therapist will design simple, achievable goals and teach you the right techniques to help you regain full function and resume the things you like doing.

We are here to help you. We don’t want you to be limited with your daily activities - not on our watch! If your joints hurt, it’s time to talk to us. Physical therapy (along with healthy nutrition) may be exactly what your joints need.

Forest Hills Rehabilitation

Phone:718-520-8480

How To Maintain Great Posture As You Age

Your posture reflects your level of confidence and the condition of your health to the individuals around you. Good posture demonstrates confidence, vitality, and overall well-being. As we age, our posture tends to deteriorate, resulting in drooped shoulders and a rounded back. However, it is possible to prevent bad posture (and possibly improve it) as one grows older.

A neutral spine is the foundation of good posture. It means the spine is not rounded forward or arched back too much. A sedentary lifestyle associated with too much time sitting in front of a computer in addition to certain diseases like osteoporosis can cause you to develop a rounded spine that can result in poor posture.

A healthy diet combined with regular physical activity is essential for healthy bones and normal alignment of the spine. Osteoporosis prevention requires an adequate supply of key vitamins and minerals. Calcium is an essential mineral that is best absorbed from food sources. Dairy products, green vegetables, and nuts are excellent food sources of calcium. Most healthy individuals can get enough calcium from diet alone, but elderly individuals may need a calcium supplement. Talk to your doctor about whether a calcium supplement would be beneficial for you.

In order to absorb calcium, the body needs Vitamin D. Vitamin D helps the body to utilize the calcium from food sources. The best way to increase vitamin D product is to spend time outdoors and enjoy sunlight, or get a sunlight inducing lamp if you spend most of your day indoors. Living in a climate controlled, indoor environment can lead to a Vitamin D deficiency in otherwise healthy individuals. Have your Vitamin D levels checked and ask your doctor about the best way to maintain proper levels of Vitamin D as you grow older.

Exercise for Better Posture
Modern lifestyle has forced us to become more dependent on machines and technology than we have ever been. As a direct result, we are more sedentary than we should be. Spending hours on a computer or hunched over a desk is bad for your posture. This can lead to a myriad of problems including neck pain, shoulder pain and low back pain.

Improving posture is not as difficult as you might think. For starters, try to sit up tall and straight at your desk at all times. It may seem challenging at first, but with time and practice it will become more natural. Take frequent breaks to get up and move; walk around and stretch to keep from sitting in the same position for more than an hour at a time. The shoulders can become rounded from leaning forward, so take the time to open up and stretch them back every once in a while, trying to pinch your shoulder blades in together. Your physical therapist will teach you exercises to stretch and strengthen your abdominal muscles, and breathing exercises to engage your diaphragm muscles and utilize your full lung capacity.

Your bones and muscles work together to maintain optimum posture. Weight-bearing exercises are excellent for muscles as well as bones. Individuals who walk regularly have greater bone density than those who are sedentary. Resistance training can also keep your spine strong and help prevent osteoporosis. Strengthening your core muscles will make it easier for you to stand in an upright position for long periods of time without discomfort. Besides, you’ll inspire more confidence in individuals with better posture and you’ll feel better!

Unlocking The New You
If you have chronic back, neck, or joint pain, you may benefit from physical therapy. Your physical therapist will evaluate the overall alignment of your body, from the head to toes. The presence of any variations from the ideal postural alignment can help your therapist determine regions that may be weak or tight. Your therapist will work with you to develop customized techniques to improve your posture. Some of these techniques may include massage, manual therapy, gentle stretches, core strengthening exercises and advanced techniques to re-train your body and muscles in simple patterns of movement. Your body will ‘relearn’ what it was always meant to do.

Ask yourself - what does your posture project to the world? Improving your posture will help you look and feel great. This will help your personal, emotional and physical health. It’s time to call us and ask us exactly what we can do to help you improve your posture and be the best you can be. Improving your posture is important, and there is no better person in the world than your physical therapist to help you with this. We look forward to serving you.

Email: [email protected]
Phone:718-520-8480
Web:http://www.ForestHillsRehab.com

Everything You (Didn’t) Know About Headaches

The common response to a headache is “Let me pop a painkiller and hope the pain goes away”. While this isn’t necessarily a bad idea, it’s not a long-term solution for headaches, particularly the ones that that have a musculoskeletal origin.

Most patients are unaware that physical therapy can play an important role in the treatment of headaches. Did you know that a physical therapist can evaluate symptoms and create a plan to reduce headache by restoring muscle balance? With certain types of headache, this has the potential to reduce or even eliminate the need for medication. For example, did you know that strengthening of the muscles surrounding the neck and jaw helps in the treatment of headache? It’s true; physical therapy can restore balance and relieve strain on muscles and joints in the head and neck region.

After a complete evaluation, the physical therapist may decide to use manual therapy, which includes joint mobilizations and massage to provide welcome relief to overworked tissues. The result is relief from the pain of headache and a smile on your face.

A migraine is a severe headache that may require medical attention. It is a disorder of the central nervous system involving blood vessels and nerves, resulting in intense pain. Once the cause of the migraine has been identified and treated by a physician, a physical therapist can facilitate a quick recovery to help the patient resume a normal, healthy life.

Pain Relief at the Source
One of the objectives of physical therapy intervention is adjustment of soft tissues and correction of mechanical dysfunction associated with the headache. There are several ways that a physical therapist can help achieve this. If sensitive tissues (blood vessels, nerves) in the neck are compressed, the physical therapist can use mechanical or manual traction procedures to facilitate decompression, improve circulation and relieve pressure around the affected tissues.

The prescription of a home exercise program to improve posture and movement patterns can be another part of the treatment process. Unknown to most patients, poor posture contributes to head and neck pain.

Depending on the severity of your headache, physical therapy can be a valuable adjunct to medications prescribed by a physician. While medications help control the pain of headache, a regimen of physical therapy improves the body’s inherent ability to fight factors that trigger headaches.

Physical Therapy and Referred Pain

One of the causes of headache is referred pain (from other parts of the body). When the muscles and joints in the upper back, neck and shoulder are under stress, they become inflamed and cause pain. Due to the complex and interconnected network of nerves and blood vessels in the upper body, this pain often spreads upwards, triggering a headache or a debilitating migraine.

This is exactly where a physical therapist can help. With a precise combination of exercises, manual therapy and relaxation techniques, the therapist can facilitate pain relief. If you’ve been suffering from headaches, a viable, drug free option is available to you. You don’t have to live with pain any longer because physical therapy is a viable, scientific treatment option. Just call us and we’ll get you started. We’ll do everything we can to put that smile back on your face.

http://www.ForestHillsRehab.com

In network versus out of Network Insurance

What does “in network” and “out of network” insurance mean when talking about visiting your physical therapist?

In network means that your physical therapist has agreed to accept a reduced rate for services from your insurance company. It also means that the provider will follow any necessary guidelines created by the insurance company such as getting pre-authorization for care, or limiting your care to a certain number of visits, or services.

Out of network generally means that the physical therapist does not accept the reduced rate, and restrictive guidelines imposed by the insurance carrier.

So which is better?

Well there’s no simple answer to this, because there are a lot of variables to consider. Each situation must be examined case by case, but let’s take a look at a few scenarios.

In network plans are most commonly associated with a copayment for each visit. This means that the patient will pay a set fee each visit, no matter how many services are provided for that visit. (This is not always the case, but it is the most common).

When talking about physical therapy, it is also quite common to require “preauthorization” for treatment. What this means is that you will need to visit your physical therapist for an examination, and pay a copayment for this service. The physical therapist would then have to submit the exam findings to the insurance carrier in attempt to get authorized for a certain number of sessions which may take a few days.

It is important to note that even if authorization is granted, the insurance carrier is not guaranteeing payment for these services and may still reject the claim for any number of reasons. The authorization simply states the most the insurance carrier will pay for a certain case.

The authorization is often limited to only a few sessions over a short period of time, and “by code” or individual service, such as one unit (8 minutes is the threshold) of exercise or manual therapy for example.

So, in this case, the insurance company would authorize 8 minutes of exercise per session, for which the patient would pay a set copayment.

Look at a few specifics:

GHI in network allows a maximum of 16 physical therapy visits per calendar year, before requiring pre-authorization. GHI will pay a Maximum of $27 each visit minus the copay (example if you have a $20 copay, GHI will pay $7 maximum per session). GHI will not pay anything past the first code which is met at 8 minutes.

Most other carriers like Blue Cross, Aetna, Oxford for example will require some type of preauthorization after the initial exam, carry a set copay, and limit to a maximum payment of one code per session as well (8 minutes). These carriers generally also require ongoing authorizations at least every 30 days. (some plans vary, but this is a very common scenario).

In each of this situations, the physical therapist is not going to get paid past the first 8 minutes of therapy.

I don’t know of too many conditions that a patient would consult a physical therapist for that would respond well to 8 minutes of care.

So in-network may provide a slightly lower out of pocket cost for the patient in the short term, but may likely result in very limited care. Over a longer care plan, or more involved case, a patient may find it more beneficial to use out of network benefits.

Out of network plans work differently.

Typically if your insurance carrier offers out of network coverage, you can use any physical therapist you like and do not have to follow all of the restrictive guidelines of in network (although even this is changing).

With out of network plans, you will typically have a deductible (which varies widely plan to plan). The patient will pay for each visit out of pocket, and this amount paid will be applied to the deductible until the deductible is met. For ease of calculation, assume a $1000 deductible, and a visit to the physical therapist is $100. The patient will pay the physical therapist $100 each session for 10 sessions.

After the deductible is met, the insurance carrier will often cover a percentage of the physical therapy bill, typically 70% or 80%. This means the patient is responsible for the remaining percentage. In the above case of a $100 per visit cost, and 80%/20% coverage, the patient would pay $20 each session (20% of $100) after the deductible is met.

However, the physical therapist would not likely need to get preauthorization for the first visit, so the patient would be able to receive treatment that day.

Additionally, the physical therapist would not be limited to a set number of codes per session, and would often not be limited to a set number of sessions.

Let’s take a look at a more detailed example.

Assume the physical therapist’s fee is $100 per session, during which time he/she will provide electric stimulation with hot pack, manual therapy and therapeutic exercise. The patient’s condition requires 24 visits.

The in network copayment is $30 (common) and the out of network benefit is 80/20 with $1000 deductible.

In network authorizes 10 visits. In this case the patient will be allowed 10, 8-minute sessions (hot pack for example) for $300. The next 14 would be paid out of pocket (since not authorized) for an additional cost of $1400 (14 X $100). Total cost: $1700

If the patient utilized the out of network benefits, he/she would likely be able to receive full treatment day one, and therefore likely finish the care plan sooner. This patient would pay $1000 for the first 10 sessions, then $280 for the next 14 ($20 X 14). Total cost: $1280.

In this case the out of network is not only less expensive, but would allow significantly more comprehensive treatment that the in-network plan.

Although this is not always the case, the patient with out of network insurance will often find that they will be able to receive more care, at a similar cost to the in network benefit when it comes to physical therapy especially for more involved cases, and cases requiring longer term care.

It is important to discuss your benefits with your physical therapy billing specialist and compare the long term costs of in versus out of network before beginning a physical therapy program.

For more information about your specific insurance benefits give us a call today at (888) 595-7282. We will be happy to verify and discuss your insurance benefits prior to starting care.

Forest Hills Rehabilitation
108-14 72nd Ave, 4th Flr
Forest Hills NY 11375
(888) 595-7282
(718) 520-8480

http://www.ForestHillsRehab.com

How To Get The Most From Your Physical Therapy Appointments

An appointment with a physical therapist is an excellent step towards improved function and injury prevention. To make the best use of your time, please use the following guidelines:

Wear comfortable clothes. Jeans or long sleeves are not advisable during your initial evaluation since the therapist may need to evaluate your joint stability.
Make sure to arrive on time or a few minutes prior to your appointment in case you need to fill out some forms.
Elaborate on the things you are unable to do, or the level of function you would like to achieve with the physical therapist. This will help the therapist to serve you as effectively as possible.
Provide information about when the pain started, the nature of pain (sharp or dull), what caused it, and what aggravates it.
Remember that you and your physical therapist are part of a team with a common goal - to get you better as quickly as possible. Do your home exercise program exactly as instructed and try not to miss any appointments in an effort to reach that goal.

Preparing for Physical Therapy
When you visit a physical therapist for the first time, we understand that you may not know what to expect. Here are some things to consider before you seek physical therapy:

Ask your physician about your condition and if physical therapy is right for you.
Talk to your friends and ask if they have worked with a physical therapist and what their experience was.
If you have health insurance, contact your provider and educate yourself about your benefits and physical therapy coverage.
Become familiar with your medical history and medications and discuss them with your physical therapist during the first appointment.
If possible, try and define your goal. Ask yourself what you want to accomplish and share them with your therapist.
Remember, a physical therapist is an expert on strength and mobility so if you have any questions related to aches and pains, it’s likely that your physical therapist may be able to assist you quickly and effectively.

Physical Therapy Instead of Surgery?

There are several conditions in which physical therapy is a good treatment option, and knee osteoarthritis is one of them. Individuals who experience knee osteoarthritis respond well to physical therapy, especially in the early stages. A well planned physical therapy program has been shown to improve the body’s ability to function by improving strength and coordination. This may reduce the need for surgery.

The President of the American Physical Therapy Association, Scott Ward, PT, PhD has said, “Physical therapy is effective and should be considered not only by patients themselves, but also the primary care doctors and orthopedists that are treating them.”

Physical therapists recognize and correct abnormal movement patterns, and create a comprehensive treatment approach each patient.

This was just one example of what physical therapy can do for you. For more information on how we can help treat bones and joints (and improve wellness), please contact us. We’ll answer any questions you have about what physical therapy can do for you, and if you need to come in, we’ll see you as quickly as possible.

If you or someone you know is considering surgery, ask your physician if physical therapy is right for you. In some cases, physical therapy can indeed be a viable alternative to surgery.

Forest Hills Rehabilitation
108-14 72nd Ave, 4th Flr
Forest Hills NY 11375
(888) 595-7282

Health Update: Neck Pain

What Is This Pain in My Neck!

“When I woke up this morning, I couldn’t move my neck! Every time I try to move it, I feel sharp pain on the left side of the neck shooting down into the shoulder blade. It just came out of nowhere!”

Chances are, you are suffering from a common condition called torticollis, which literally means, “twisted neck” after the Latin terms of “torti” (twisted) and “collis” (neck). The common name for this is “wry neck,” and it’s basically a painful muscle spasm, like a “Charlie-horse” but located in the neck muscles. Usually, a person wakes up in the morning with this and the cause is often related to sleeping with the window being open or a fan or air conditioner blowing on you. It can also relate to a “cold settling in the muscle” after a cold or flu virus. Trauma such as falling or a car accident can also cause torticollis. However, most of the time, patients with torticollis are not sure what caused the abrupt onset of symptoms.

Usually, torticollis will gradually improve over a 2 week time frame. However, it only takes a few days to a week (at the most) if you receive chiropractic adjustments. Most importantly, without treatments, the sharp pain can last a week and can severely limit your activity, often prohibiting work as well as your desired “fun” activities. Hence, most people prefer having this treated as opposed to “waiting it out.” In some cases, it can last longer than a month and in rare cases even longer, so getting this treated is highly recommended. Also, try to get in for a treatment immediately before the muscle spasm really sets up. We find this to be the most effective approach. Here are a list of symptoms and treatment suggestions for torticollis:

Acute Torticollis Symptoms
Muscle spasms
Neck and shoulder pain
Neck and spine contortion (neck twisted to right or left side of body)

Pain Relief Treatments for Acute Torticollis
Chiropractic neck and spinal adjustment
Physical Therapy
Stretching
Analgesics
Heat packs
Muscle relaxants
Rubs and ointments (Icy Hot, BioFreeze)
Massage with essential oils

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