Posts Categorized: Rehabilitation

04
June 2015

Choose wisely!

in fact, these methods – including electrical stimulation and ultrasound – almost never help someone who requires physical therapy, and according to the APTA, can even cause harm. Schedule a consultation with a FIX physical therapist today and get back on the road to health.

 …..

The American Physical Therapy Association (APTA), which has joined the Choosing Wisely Campaign, is supporting an initiative designed by the American Board of Internal Medicine Foundation to encourage conversations between patients and health care providers with the goal of providing better treatment. Instead of resorting to the heating pad or ice pack, APTA contends an active treatment plan, including exercise to restore strength, will have “a greater impact on pain, mobility, function and quality of life.”

 

“The evidence for any beneficial effect is almost nil,” Dr. Tony Delitto, University of Pittsburgh, told NPR. In addition to his responsibilities as chairman of the UPitt’s department of physical therapy, Delitto assumed the role of chairman of the group that wrote the “what not to do” list — five physical therapy recommendations for the Choosing Wisely Campaign.“When I graduated with my physical therapy degree in 1979, these physical agents were a large part of practice,” explained Delitto for the benefit of NPR. “We’ve had a hard time getting rid of them.”

 

Of course you have! Anyone who has ever been comforted by a snug heating pad is not about to take this news lying down (or, um, they might). Consider, for instance, one Linda Nichols, a former patient, who added these comments to NPR’s article discussing the topic: “You can have my heating pad when you pry it from my cold, dead fingers!! Or from my warm cozy fingers.”

 

However, science is science and science is now saying no more heating pads or the like. “There is emerging evidence that passive physical agents can harm patients,” wrote Delitto and his co-authors in their number one recommendation for therapists. In particular, the authors believe “communicating to patients that passive, instead of active, management strategies are advisable” amplifies a patient’s fears and anxiety about being physically active while in pain. And this can prolong recovery, add to costs, and may even increase the risk of needing injections or surgery.

 

Certainly, no one wants surgery, so perhaps it would be wise to take a look at the new rules addressed to physical therapists and which, in their entirety, read as follows:

 

  1. Don’t employ passive physical agents except when necessary to facilitate participation in an active treatment program.
  2. Don’t prescribe underdosed strength training programs for older adults. Instead, match the frequency, intensity, and duration of exercise to the individual’s abilities and goals.
  3. Don’t recommend bed rest following diagnosis of acute deep vein thrombosis after the initiation of anticoagulation therapy unless significant medical concerns are present.
  4. Don’t use continuous passive motion machines for the postoperative management of patients following uncomplicated total knee replacement.
  5. Don’t use whirlpool for wound management.

 

Source

13
May 2015

Physical Therapy

Even if you aren’t in any pain – or pain that you think is unbearable – seeing a physical therapist can contribute greatly to a healthy lifestyle, and here’s why.

Book an appointment with a FIX Physical therapist today!



Why is it that superbly fit athletes can find themselves in as much back, knee, or neck pain as their flabby fans, who sit at desks all day long then watch sports from overstuffed sofas?

“When you do an activity over and over again, your body adapts to that activity,” warns Dr. Shirley Sahrmann, professor emerita of physical therapy at Washington University School of Medicine. “If you play tennis, your arm gets bigger on that side; if you do karate you get adaptations in your hip and leg. Even if you just sit, you lean, you slump, your neck goes forward.” Either your body fails to build up musculature to support itself, or it overbuilds certain muscles and throws off the symmetry your skeleton craves.

 

That’s why Sahrmann wants to see an annual physical therapy exam become as routine as a dental checkup. “We go to the dentist twice a year and spend thousands to straighten our teeth, and all we do with them is eat and talk. Meanwhile the rest of our body’s just hanging out there.”

 

People think of p.t. as something generic their doctor orders after an injury, she says. But by analyzing the way you walk, bend, sit, and carry yourself, physical therapists can prevent injuries and head off future surgeries and chronic pain.

 

“Kids don’t sit correctly, they slump, so they wind up sitting on the middle of their back,” she says. “We have these little bones on our bottom where we are supposed to sit and keep our spine erect. When you slump, the muscles get stretched out, and they’re not going to function optimally.”

 

A temporary phase? Maybe. But “bones adapt to the alignment that you keep them in,” Sahrmann points out, “and your spine becomes shaped like that.”

 

Continue reading at stlmag.com!

30
April 2015
Get your FIX on!

Now that you have your FIX Therapy Ball, try one of these 5 pain relief techniques to keep you pain-free and on the move!

 

1. Soothe sore feet. Place the therapy ball under the arch of your bare foot and begin rolling over it. The ball will provide instant relief from tight arches and also help those who suffer from plantar fasciitis. I recommend keeping a ball in a ziplock bag in the freezer for an after-work cold foot massage or storing one in your carry-on bag for your next flight.

 

2. Ease glute pain. In a standing position, rest the therapy ball between your glute and a wall with the ball directly over the area you are experiencing pain. Press your glute into the wall and begin performing circular motions in and around the area. Once the pain subsides, stop moving and increase pressure into the wall with the ball resting directly over the sore spot. Hold this position for up to 30 seconds.

 

3. Loosen tight hips. Lie on the side where you are experiencing tightness with knees bent 90 degrees and stacked on top of each other. Rest hands on the floor in front of your body. Raise your hip, place the ball directly under the stressed area, and slowly lower your weight back onto the ball. Begin moving your hips around to massage and release tension in the area. If the pain is too severe, stand up, place the tight hip closest to the wall, and place the ball over the tight area. Begin moving your hip around to massage the pain away.

 

4. Relieve shoulder stress. Positioning the ball in this area can be tricky, so place it in an old stocking or sock to give you more control. Stand tall with your back close to the wall. Hold the end of the stocking or sock with one hand and, allowing the ball to rest between you and the wall, position the ball directly over the stressed area. Press your back into the wall. You can rest the ball over the area or perform small circular motions until you start to feel relief.

 

5. Ease forearm pain. Sitting in front of a computer all day can wreak havoc on your forearms. If not properly stretched and strengthened, this can lead to carpal tunnel syndrome. Try these two ways to relieve the tension: Hold the ball in one hand and role it up and down the forearm, or place the ball on a desk or other flat surface and rest your forearm over the ball. Press your forearm into the ball and run it over the ball. I recommend doing this several times throughout your work day to relieve your muscles.

13
February 2015
ART is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles.
Active Release TechniqueHow do overuse conditions occur?
Over-used muscles (and other soft tissues) change in three important ways:
  • acute conditions (pulls, tears, collisions, etc),
  • accumulation of small tears (micro-trauma)
  • not getting enough oxygen (hypoxia).
Each of these factors can cause your body to produce tough, dense scar tissue in the affected area. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, tension on tendons causes tendonitis, and nerves can become trapped. This can cause reduced range of motion, loss of strength, and pain. If a nerve is trapped you may also feel tingling, numbness, and weakness. What is an ART treatment like?
Every ART session is actually a combination of examination and treatment. The ART provider uses his or her hands to evaluate the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.
These treatment protocols – over 500 specific moves – are unique to ART. They allow providers to identify and correct the specific problems that are affecting each individual patient. ART is not a cookie-cutter approach. What is the history of Active Release Techniques?
ART has been developed, refined, and patented by P. Michael Leahy, DC, CCSP. Dr. Leahy noticed that his patients’ symptoms seemed to be related to changes in their soft tissue that could be felt by hand. By observing how muscles, fascia, tendons, ligaments and nerves responded to different types of work, Dr. Leahy was able to consistently resolve over 90% of his patients’ problems. He now teaches and certifies health care providers all over the world to use ART.
If you believe ART can help you, don’t hesitate to book with one of our expert practitioners by clicking here.

13
February 2015
Here at FIX Body Group, our passion is getting you back to doing what you love to do, pain-free.  The Runner’s Box is the newest addition to our repertoire of tools for doing just that. Jonathan Pierce, our Soft Tissues Department Head has this to say about it.
“The Runner’s box is a foot strengthening tool for non-runners and runners alike, anyone with a foot condition or people who spend a lot of time restricted in shoes and on very predictable surfaces.  The box is filled with stones that when walked upon force the toes and foot to behave differently, to work harder and build up the small muscles deep in the bottom of the foot.  It also relieves the ligaments and joints of the foot as they have unusual pressure and stress placed on them.  Patients can do specific drills and protocols to build foot proprioception and strength.”
For more information on exactly what the Runner’s Box can do for you, give us a call!  You can also email Jonathan directly at jonathan@fixbodygroup.com.  Pictured below. Runner's Box

10
February 2015
If any of these sound familiar, raise the alarm and head to FIX Body Group to consult with one of our on-staff, professional physical therapists. It’s a runner’s worst fear: you’re running when it suddenly feels as if something jumped up and bit you in the calf. You tore a muscle. Do you need physical therapy?The good news is that with rest and rehab, you’ll be back on the road in no time. However, some injuries are not so obvious and can be trickier to treat — that nagging pain in your left glute or the ache in your right knee that starts 45 minutes into every run. How do you know when the injury is serious and requires a visit to a physical therapist? Ashleigh Bordwell, a PT at Rehab United in San Diego, offers six ways to determine when it is time to see a physical therapist. 1. Pain lingers after three or four days of resting and icing At the onset of any ache or pain, the best plan of attack is to take a few days off from the sport that brought on the injury and spend 20 minutes several times a day icing the affected area. “The best thing with any injury is to give yourself a few days off,” Bordwell explained. “And then get back into your sport to see if your symptoms have gone away or if they’re still occurring.” If you have taken several days of rest and the pain continues to come back, it is time to see a physical therapist. 2. Reoccurring dull pain Pain often subsides with rest and icing. But with more serious injuries, symptoms will repeatedly come back and linger until the underlying injury has been addressed. 3. One traumatic event Some injuries, such as muscle tears and broken bones, are easy to spot, as they are brought on by one traumatic event. “If you watched yourself roll your ankle and it swelled up, or after swimming, you slipped and fell getting out of the pool, you’re going to want to come in and get it checked out,” said Bordwell. 4. Meds don’t control the pain |Many endurance athletes are used to aches and pains. “It comes with the territory of being an endurance athlete,” Bordwell admitted. However, if over-the-counter anti-inflammatory and pain-relief drugs aren’t offering any reprieve, get it checked out. 5. Pain is acute and sharp Dull, lingering pain is most likely treatable with rest and ice. But if the pain is sharp and centralized, this can be an indication of a more serious injury such as a muscle pull or stress fracture. 6. Noticeable or visible changes You know your body best, and the more experienced you become, the more in tune you’ll become with your body. “If at the end of a day of training you notice your ankle is swollen or if you can’t pull as well on your left arm as your right when swimming, you’re going to cause one injury to get worse or cause another injury if you don’t see a PT,” Bordwell said. Source

01
October 2013
shin splints
A recent review on research of shin splints (or medial tibial stress syndrome) in the journal Sports Medicine has given many athletes suffering from the condition little hope. Dutch researchers concluded that, “no intervention has been proven to be effective for medial tibial stress syndrome.” In the study, groups of people received various common treatments for the injury in contrast with those who did not. Examples of the treatments used were leg braces, ice massage, ultrasound, extracorporeal shockwave therapy, and iontophoresis. The study concluded by recommending short periods of rest from weight bearing activity to allow the bone to heal. This is standard advice in the medical community, and the treatments studied in the article are also typical, if conservative methods for sports medicine practitioners. The problem with approaching this sort of injury with conservative, standard treatments and rest, is that it fails to decipher how the injury occurred, and if it will return once the activity is resumed. Most injuries don’t just come about in one location independent of everything else going on in the body. An injury like shin splints is the final product, which is the painful conclusion, but usually a progressive buildup of other developments in the body lead to it. This project also neglected to study whether other treatments such as A.R.T., Myofascial release techniques, massage, and changing of running mechanics, and corrective exercise would help heal the injury quicker. In my experience, this sort of injury when treated holistically and by addressing biomechanics, can be resolved very quickly. Weekly, we see runners in our clinic with shin splints that are resolved in a few treatments, and often can continue to train through the injury and treatment process. Here’s my standard approach to treating shin splints: 1. Look at the patient’s biomechanics: Often there is too much pronation, or external rotation of the legs. At what angle does their lower leg contact the ground? Often it will be an angle greater than 90 degrees. Often there is glute weakness and some tightness in the anterior hip. 2. Corrective exercises and strength training for the weak muscles done daily at home. Stretching and foam rolling for the tibialis anterior and posterior, soleus, and peroneals and quadriceps. 3. Myofascial release and A.R.T. for the lower leg and quadriceps, TFL, and psoas. 4. Running on soft surfaces only, depending on severity and treatment frequency 5. Address shoe choices and recommend changes depending on the type of runner, mileage, training surface, and biomechanics 6. Ice cup massage for the shin, compression socks if travelling or sitting a lot.

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10
September 2013
NSAID-List A recent topic in the athletic world is the role of inflammation in healing and adaptation to training. This is particularly of note to our running, cycling, and triathlete patient base that train many hours per week and are constantly at war with inflammation, pain, soreness, and fatigue. This topic is fleshed out in greater detail in an excellent blog linked here: If you don’t have time to read the article (which you really should take the time) I will outline some of the main points. 1. Inflammation is often a desired, and necessary response to injury or training. Without it, adaptation can be less effective. 2. NSAID’s (or Non Steroidal Anti Inflammatory Drugs) inhibit training adaptations in muscle according to research. 3. Recent studies show that anti-inflammatory drugs don’t always reduce pain. This flies in the face of what is commonly believed and thus brings into questions of placebo with NSAID’s. 4. Use of NSAIDs sparingly and in the acute injury phase is recommended. At Fix Body Group we often recommend the use of NSAID’s but the timing and types of issues always are brought into play in making these decisions. While this must always be dealt with on a case-by-case basis, we generally approve of the suggestions in this blog. Using NSAID’s (and let’s not forget ICE!) in the acute but not chronic phase of injury is recommended. Icing as done by many runners and endurance athletes such as ice baths, along with use of NSAID’s to treat general training soreness is not recommended. This goes hand in hand with what the elite athletes I’ve worked with for years are doing. Elite athletes often take doses of NSAID’s and use ice baths during competitions, so that they can prepare for the next round or day without care for training response from the event. In training they typically limit or avoid these practices to allow their body maximum adaptation to the training stimulus. Remember, soreness is a good thing in training, it means you have taxed the fibers and musculoskeletal system. Soreness can also be thought of as a governor, forcing your body to slow down for a few days until both the metabolic, nervous, and musculoskeletal systems are recovered and ready for more. If you acquire a simple ache, tendon injury or something that is more than general soreness consult with your health care professional and generally some advil for about three days would be a good idea. If you have questions about different kinds of soreness or what you should do in these scenarios please leave comments below or call to speak to one of our providers. Happy training!

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28
August 2013
The Fix team will be out in force at the Pacific Beach Movin’ Shoes store to provide injury screening and diagnostics this Saturday 8/31, from 9-11:30am. Our team of chiropractors, therapists, and trainers will analyze your imbalances and deficiencies and suggest action steps for improvement. Movin’ Shoes will also hold a labor day sale so if you need some shoes or would like to get recommendations for shoe choices make sure to come by also. Knowing your physical risks and limitations through our injury screen will be helpful when you go to purchase shoes. Thanks to Movin’ Shoes and we’ll see you all out there! Check out facebook here to get more information: https://www.facebook.com/events/430896390356516/438268076286014/?notif_t=plan_mall_activity

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29
July 2013
Dr. Robek and a few patients suffering with shoulder and lower back conditions attended a private aqualogix group class at FIT in Downtown.  A big thanks to Jon Edge who instructed the class and kept us motivated when we were starting to fatigue. This was tough!  Aqualogix is a great work out and a safe way to use water resisitance for rehabilitation of an injury, especially shoulder and hip. Water resistance is extremely effective for people of all ages and abilities, and is safer than traditional weight training.  You can visit aqualogix.com for more information. We have been treating a number of shoulder injuries lately such as frozen shoulder, rotator cuff tears and strains, trauma to the shoulder during contact sports, and subluxation/dislocations of the shoulder.  Often these injuries result when the patient has imbalances or instability in the joint due to dominance of certain muscles such as the Pec Minor/Major or Subscapularis and weakness of other opposing muscles of the rotator cuff.  By nature, the shoulder is a weak and unstable joint, it’s important to ensure that it is balanced and strong before undertaking any aggressive exercise program.  If you want to understand more don’t hesitate to come in for an assessment or personal training session at Fix Body Group.  We can prehab or rehab any shoulder injury that you might have or incur in the future.
FIT-Aqualogix

FIT-Aqualogix

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