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Keeping Your Spine Healthy as We Age | Physical Therapy

Keeping Your Spine Healthy as We Age

Our bodies go through many changes as we age, and this does not exclude our spine. Studies have found that as you age, instances of low back pain in older adults increases. Studies have found that 1 in 3 individuals over the age of 65 report spinal pain. But what is this pain from? There are many normal changes that occur in the spine with age including postural changes of increased thoracic kyphosis and decreased lumbar lordosis. This change in posture alone effects the way your body is supported. Some other changes that occur with age is a decrease in muscle strength, decrease in joint range of motion, decreased sensation and reflexes, and flattening of the spinal discs. These changes have the potential to cause stress on your body leading to pain in your neck or back.

Many people with lower back or neck pain obtain imaging to see what could be causing their irritation, however we have to remember that these changes are a normal part of aging, and studies have shown that there are high rates of false positives and false negatives with imaging studies. It is also important to remember that 60% of individuals who have no pain at all also have these abnormal findings. So to sum up, imaging does not always play a role in diagnosis, everyone responds differently to these changes. The best option would be to obtain conservative treatment before imaging if appropriate

What is conservative treatment you ask? It’s Physical Therapy! Your therapist is trained in evaluating your posture, movement, and strength that all play a role in your day to day activities. They are also trained in screening you for any red flags that may warrant referral back to your doctor. Once evaluated, your therapist is able to create a program for you including posture training, muscle stabilization, endurance, strengthening, and manual techniques that will help you improve those day to day activities that you have been limited in, which could be anything from walking, sleeping, sitting, picking things up off the floor, turning your head while driving, and much more!

Each session will be different for each person based on their needs. This includes (but definitely not limited to) range of motion to help improve or centralize your symptoms, strengthening exercises and functional training like transfers and steps, balance, endurance, joint movement, or outcome measures to track your progress. All of these things in combination with your motivation will help to improve overall postural control to support your spine and functional strength to address activity limitations. Your therapist will classify you based on treatment needs, symptoms, movement control, and functional optimization to allow for the most successful plan of care.

So, in the end, Choose Physical Therapy First!

What is the Difference Between PTs, PTAs, and PT Techs

In an outpatient setting like Chesapeake Bay Aquatic & Physical Therapy, there are two primary types of clinical staff: PTs, PTAs, as well as PT Techs. There is also a whole team of Front Desk staff who work a very different type of magic than what I, a clinical staff member, can do. The Front Desk staff are usually the people you talk to first.

The clinical staff consists of Physical Therapists (PTs) and Physical Therapist Assistants (PTAs), who treat patients. Physical Therapist Technicians (“Techs” or “Aides”) assist both the PTs and PTAs to help a clinic run smoothly and help patients with exercises with which they are already familiar. PTs and PTAs are both licensed healthcare providers. This means they are required to attend and graduate from specific educational programs, and to pass a national and state Board of Physical Therapy Exam at the conclusion of this education. PT Techs often have experience in related fields, or are students preparing to become PTs or PTAs.

While both PTs and PTAs are Board-certified clinicians, the education programs for these two professions are different. PT educational programs emphasize learning how to diagnose physical problems so that they can create an appropriate Plan of Care to help solve these problems. This means PTs are also able to evaluate how well the Plan of Care is working. This is why you generally have the same clinician for your Evaluations and your Re-Evaluations (“Evals” and Re-Evals”).

PTA programs emphasize learning various treatment options for solving the problems and attaining the goals outlined in PT’s Plan of Care, but do not teach students to diagnose physical problems or assess how much progress a patient has made. PTAs can perform many of the same treatments as PTs, but do not diagnose problems or add treatment options not already included in the PT’s Plan of Care.

Hopefully you enjoy the time you spend with everyone you work with, but these important distinctions can help you direct your questions (and you should have questions!) to the appropriate staff member throughout your sessions.

Sonya PTA

Dry Needling: What is the Hype All About

Dry needling is growing in popularity across the county. Now-a-days most of us know someone who boasts about the miracle of dry needling for their shoulder, low back, headache pain, etc. This is especially true in the fitness community-it’s all the rave! But what exactly is dry needling and is it for everyone?

Dry needling is named such because the needle does not contain any medication. People often mistakenly think that because it does not contain medication that it cannot possibly be all that beneficial. One research study found dry needling to be just as effective, and in some cases last longer, than trigger point injections that contain the medication Lidocaine. During the procedure, a very thin needle is inserted into a muscle knot. Muscle knots are a constant source of pain and restrict the motion of a given body part. By eliminating the muscle knot with dry needling, the overall effect is that of significant pain reduction, range of motion improvements, and improvements in muscle activation.

Is dry needling for everyone and who performs this procedure? A certified physical therapist is qualified to perform this procedure. Each person is screened beforehand to determine if they are a candidate for dry needling. Dry needling can be use for all body regions including low back, neck, shoulder, knee, and headache pain just to name a few. It is an uncomfortable procedure followed by some muscle soreness over the next 1-2 days. However, most patients feel temporary discomfort is worth it for longer lasting pain relief. Dry needling can also definitely be used with chronic pain conditions, including fibromyalgia, to slowly reduce a person’s overall pain levels. More chronic conditions typically require more dry needling treatment sessions compared to someone who just hurt themselves.

So if you feel like your progress has plateaued or want to get out of pain faster, then I definitely recommend you give dry needling a try! We have several physical therapists who perform dry needling. Any additional questions or to learn more feel free to email me at laurenarihood@cbayaquapt.com.

Is the One Stop Healthcare Shop OK In The Time of Covid?

For the last few decades the healthcare industry has been consolidating into large corporations. The landscape, once filled with: solo practitioners; primary practice partnerships; small groups of specialized physicians banning together out of friendship or a common goal; physical therapy practices where everybody really did know your name, has now been replaced by Health Care’s version of Exxon Mobile or Google.

Where once you could call your primary physician or physical therapist with a problem and talk directly to your care taker, you now must sit through a phone menu as long as the Harry Potter book series. From pleasant little homes turned into office spaces or first floor access into your practitioner’s waiting room, you now walk into an airport waiting room, with at least three very well meaning volunteers getting their 10,000 steps per day escorting you to the correct “Pod”. There you are greeted by a revolving door of customer representatives who are much more familiar with exactly how many minutes your insurance will allow you to speak to the doctor then the name of your children or the ability to express their good wishes for your wonderful dog “murphy” who underwent ACL reconstruction last month.

The reasons for the beginnings of these “mega-plexes” of healthcare were legitimate in the beginning. A way to fight back against overbearing insurance companies who had continued to decrease reimbursement against a group of care takers that independently had no leverage to fight them. You won’t have to travel downtown, to the hospital to see the doctor, they told you, or have to drive to multiple places because all the specialists are in the same building.

Sky rocketing malpractice insurance also played a part of the exodus of solo practitioners into the cover of these large corporations. The physicians and caretakers close to retirement couldn’t pass up the safety of being an employee to round out a great career. No more Human Resource headaches, no more worrying about who called out sick and no more worry about paying rent and utilities.

Healthcare in a world of fewer options

Now we find ourselves where the hospital systems no longer worry about the convenience of your care. It’s all about market share. For the solo practitioners remaining, it’s join or be trampled. It’s been getting more and more difficult to survive for the small groups or solo physicians, Physical Therapists, Chiropractors to survive in this environment.

However, has COVID-19’s awful emergence leveled the playing field?

Do you as the patient want to go to a big hospital or huge healthcare setting where many patients are present? Many sick patients? Possibly ones with Covid 19?

Do you as the patient want to go to a huge group or conglomerate practice that knows nothing about you? Knows nothing about your particular needs? Your possible co-morbidities?

Do you as the patient want to have to walk through many halls, surrounded by many other patients, staff, and family members?

Do you want to take only what the crowded office can give you for an appointment?

It seems to me the small/family friendly health care practices might be a much more comfortable and safer way to go? Where the front desk coordinator who knows you very well is aware that you don’t like traffic and would like to come in mid-day and accommodates you. Where you can walk right in to the office from the parking lot into a caring place where all staff is doing their best to keep you safe? And make you better!

The Virus makes us better?

Maybe it’s time to go back a bit to the way things were? Maybe this virus was a wakeup call? To slow down and spread things out a little? Maybe this virus can in the end put you into a better health care environment?
This awful pandemic will end and we all will go back to some sort of “normalcy” eventually. Maybe then you will want to make an investment in your health. Go somewhere where “everybody does know your name”.

Chesapeake Bay Aquatic & Physical Therapy has 5 clinics throughout Maryland where we focus on one on one care. We are following all Covid-19 guidelines at all times to make sure our patients are in the safest environment possible. We as a family strive to take care of each and every patient as “one of our family” which is what our patients are. Please visit our Web-site at www.cbayaquapt.com to find out more about us.

About the Author:

Ron Herbst, MPT, MTC has been a practicing physical therapist for almost 25 years. As the former head of John Hopkins outpatient department he was intimately involved with public care policy on many issues in the city and community of Baltimore, Md. Ron has been the owner and manager of many practices throughout his career.

The Speed You Walk Means More Than You Think

Our body’s most basic functions are measured through vital signs….. Can you name them? Quick. Ready….go!…. (Body Temperature, Pulse Rate, Respiration Rate, and Blood Pressure)……. These are strong indicators of how your body….the machine that you own and operate each day…. is performing. In 1996 the American Pain Society instituted a campaign to make Pain the 5th vital sign and at that time this movement was widely supported by medical communities and more importantly by historically strong catalysts of change in this country…..pharmaceutical companies. The purpose of this post is to let you know about the 6th vital sign…. Gait Speed. i.e. How fast you walk.

In 2009, a study was published in the Journal of Geriatric Physical Therapy shed light on this and referred to it as “a general indicator that can predict future events and reflect various underlying physiological processes.”

When you start to go down the rabbit hole with this metric you can begin to predict things like risk of falls, hospitalization rates, and discharge statuses from skilled nursing facilities.

So how is this measured?

With a test. No different than slapping a blood pressure cuff on your arm or that dude at Starbucks gunning your forehead temp.

A 20 meter (65.6 feet) straight path is utilized for the test. The true test is only 10 meters, but the full test includes a 5 meter “ramp up” and 5 meter “deceleration” zone. You, the patient, are cued to walk at a comfortable speed and the timer starts when you first lower extremity enters and exits the 10 meter zone.

It is crucial to analyze and interpret the physiological things that keep your motor running. Your heart. Your lungs. But on another level is us…Physical Therapists are trained and further driven on caring about HOW you function. Not only getting from point A to point B but HOW you get there. Can you get out of a chair without using your hands? Can you go up and down your stairs without pulling yourself with the railing and putting both feet on each step? Can you maneuver around your home without grabbing onto walls and furniture? PTs can get you walking faster in your 70s, 80s, and 90s……

If you would like to get tested or have any questions, feel free to contact us at Chesapeake Bay Aquatic & Physical Therapy 410-315 9080.

How To Stay Sufficiently Hydrated While Wearing Masks

What am I talking about? How are we all staying sufficiently hydrated while wearing masks all day? The struggle is real. Facemasks should be doffed and donned (that’s “removed” and “put on,” respectively) with clean, just-washed hands. Frequently removing and replacing facemasks to sip your favorite venti iced beverages can increase chances of spreading illness-causing pathogens. I am very curious to hear how you all are managing to consume your recommended daily fluids, but here are three tactics that I have been utilizing these past few weeks.

Hydrate when home. After my first day back at work, I drank half a gallon of water immediately when I got home. My stomach couldn’t handle this however, and it promptly “returned” the water. Taking smaller sips throughout the time I am home has been more successful. Filling a large container (or several glasses) with water and setting it somewhere obvious like a kitchen counter has helped me keep hydration at the forefront of my mind, and I have avoided the consequences of “over-chugging.”

Be deliberate about “hydration breaks.” I have made it a point to take advantage of times when I am not close to a lot of people. Generally this is when I take a break to use the restroom. I wash my hands, remove my mask, and drink several large gulps (8-10 oz) before donning a clean mask. If I start to feel a little dehydrated, I take an intentional “hydration break” where I step away to drink water and replace my mask with clean hands.

Be smart about supplements. Adding fruit or electrolyte supplements to water can help keep chemicals in the blood at appropriate levels. Obviously, please consult your primary doctor before changing anything about your diet. This has helped ME to manage the symptoms of dehydration, but it may not be the best choice for you.

So what has helped you maintain optimal hydration levels if you are wearing a face mask for part of the day? Leave a comment and let me know!

What Does Three Sets of Ten Mean?

Every day, you, my beloved patients ask me – How many of these do you want me to do? while they are performing therapeutic exercises for increasing strength. For this discussion, it doesn’t matter what the exact exercise is, but my response rarely deviates far from “three sets of ten.”

But what does this mean?

I can almost hear your inner dialogue bubbling to the surface. “What is a set? And why on earth would this greedy clinician want three of them?”

I may be greedy, but it’s only because I want to see strength improvements in the patients I’m treating and this technique, called Progressive Resisted Exercise, has been time-tested for success.

A repetition or rep is one time performing an exercise. Imagine one squat. One bicep curl. That is a rep. Doing several reps consecutively without rest breaks between them is called a “set.” A set generally consists of 5-15 reps. Imagine doing ten squats without taking a break, that is a set. You know you have reached the end of your set when you can’t do any more (though often you will hear me request one more because I know you can do it!).

A short rest sets between permits the muscles to recuperate and get ready to do more reps, but the muscles will be tired the second time around. This is important. Tired muscles have to work harder to complete the same task. The third time around, your muscles will have to work even harder, and this makes them that much stronger.

So when I ask you to do another set, it’s because I love you and I know you can do it, even if your muscles are tired. They are supposed to be tired. That’s why we do three sets of ten.

Relieve Those Pounding Headaches with Physical Therapy

What do you do when you wake up and have a headache or you are working on a report and suddenly start to get a headache? The common response is to take some form of pain medication and this may relieve headache pain in the short-term. If you regularly get headaches or migraines, pain relieving medications will not offer you the long-term relief that physical therapy will provide.

Majority of headaches are cervicogenic headaches, which means that in some form they are related to the neck. Slouch posture, anxiety, and other reasons can contribute to strain, and injury to the cervical/neck muscles and joints. The neck pain can refer up into the back or side of the head, and may even go till the forehead, (depending on the part of the neck involved).

Approximately 70-80% of people across the U.S. deal with random or recurrent tension headaches. Acute (temporary or constant) and chronic headaches can be cured with physical therapy at any of our 5 locations. Request your appointment today!

What can a physical therapist do to help me with my headache?

If you have headaches, contact our office today. At Chesapeake Bay Aquatic & Physical Therapy we are committed to providing you with the best treatments for your headaches.

At your first appointment, one of our highly trained physical therapists will conduct a thorough physical evaluation including asking questions about your health history and symptoms. The evaluation will determine what type of headache you have and the origin of the pain/headache. The therapist, along with your input, will formulate a treatment plan and develop functional goals.

What are the different types of headaches?

The three main types of headaches include:

- Musculoskeletal Headache

A musculoskeletal headache is experienced when there is increased tension in the neck. This is usually a result of physical imbalances or weaknesses, although emotional stress/state can also be a causative factor. Injury to the neck (whiplash) is a common source of musculoskeletal headaches. With neck injuries the muscles and connective tissues in the neck can be strained and sometimes torn. This can cause pain in the head and shoulder, either one sided or both sides, depending on the area of injury.

- Tension headaches

These types of headaches can occur due to repetitive motions, quick movements, or poor posture in the neck. This type of headaches is caused by a strain on the delicate membrane that covers the brain called “dura mater”. The pain is presented in small muscles at the base of the skull that go into spasm when the dura mater becomes tense, shooting pain signals to the brain, and triggering the headache.

- Cervicogenic headaches

This type of headache is related to neck pain and usually involves the top three cervical spinal levels. These headaches can be caused by certain disorders like arthritis, or at times due to a concussion. Work-related stress can also cause a cervicogenic headache. Those people who have professions that require you to look down or slouch, are the most likely to develop this type of headaches. This may include hairdressers, IT professionals, teachers etc.

How can I relieve my headaches and book an appointment?

At Chesapeake Bay Aquatic & Physical Therapy, our individualized treatment plans for headaches focus on relieving pain, educating patients about proper posture, strengthening muscles in the neck and upper back as well as using various manual therapy techniques. The personalized treatment plan will help make your everyday life much more comfortable and manageable – minus the headaches! To schedule an appointment or speak with a therapist, contact us today in anyone of our 5 locations close to you. If you are uncomfortable coming into the clinic for treatment, we also offer TELEHEALTH visits at all 5 locations!

What Is Cupping

What is cupping? Is that with the glass and the fire?, or some variation of this, is probably the first question we get asked by our patients when we discuss introducing cupping to their physical therapy.

“Cupping” is a term that is used in several professions. When most people think of cupping they usually do picture glass cups that have had the air inside them heated so that they create a vacuum when applied to the skin. This technique has its origins in ancient Eastern medicine and is still used by many practitioners in that field today. As a PT and a PTA, we don’t use glass cups and fire, instead we use a soft silicone cup and create the vacuum by compressing the air out of the cup before applying it to the skin. In our scope of practice, cupping is a form of manual therapy for trigger point and myofascial release and we use a combination of soft tissue mobilization, stretching, and negative pressure to lift, separate, and stretch underlying soft tissues.

What do you do with it?

Dynamic techniques involve moving the cup over the area of musculoskeletal tension or restriction in a gliding motion. Static cupping involves placing a cup directly over a trigger point or adhesion and left in place for a short time. This technique may be used in combination with “active release” movements performed by the patient when tolerated to increase effectiveness. When we introduce you to cupping for the first time, we’ll start by placing the cup on a non-painful body part and letting you see how it feels.

How is this going to help me?

Benefits of cupping include decreasing pain caused by soft tissue restrictions, improving scar tissue mobility and adhesions, and improved blood flow to treated areas. While other manual trigger point and myofascial release techniques such as foam rolling involve a compressive force being placed over the muscle tissue, cupping provides a decompressive force, which may be more effective for patients who are not responding to more traditional techniques.

Will it hurt? Will I have big circles all over my body?

Like other trigger point techniques, cupping does involve treating areas of the body which patients may note are tender or painful to the touch, so cupping may be initially uncomfortable, which is why we show you on a non-painful spot the first time. It is important to give your therapist feedback when using this technique so that they may adjust the cup position, amount of suction, cup size, or technique being used if needed. Patients may note discoloration in the treated area after cupping ranging from light red/pink to a darker purple. The greater the suction created with the cup, the more restricted the tissue, and the longer cupping is performed – whether dynamic or static – the more blood is drawn to the surface, which causes more discoloration. This will usually fade within a few days to a week, however because of this effect people with bleeding disorders or who are on anticoagulant medications are not appropriate candidates for cupping therapy. Treated areas may present with some mild soreness, however post treatment discomfort is usually temporary. Again, it is important to provide your therapist with feedback during your treatment as well as your response afterwards to ensure that cupping is an appropriate intervention for you.

Overall, cupping is an effective addition that can be used to improve your outcomes during physical therapy with other manual techniques and exercise. For more information, reach out to Mark or Kelly at our Severna Park location 410-315-9080.

Gardening and Back Pain: The Importance of Proper Body Mechanics

Gardening can be a great hobby. It adds value and curb appeal to your home, but most importantly, it is relaxing. However, back pain often gets in the way making gardening can excruciating!

This could very well be because you are using improper body mechanics.

Improving your Body Mechanics while Gardening

Shoveling: Shoveling dirt (or snow) can put a tremendous amount of strain on your back. To minimize the stress and excess muscle tension shoveling puts on your back, you must use your body as leverage. Be sure to move your entire body, not just your arms and back.

Weeding: Instead of constantly bending over, try sitting on a stool. You will be amazed at how this simple solution can really minimize your back pain.

Heavy Lifting: Gardening sometimes requires some heavy lifting. To avoid injury, make sure you bend from the hips and knees, rather than the waist.

Wheel-Barrowing: Just like heavy lifting, be sure to lift with the knees, not the back. This will save you from any unneeded back strain.

Mowing the Lawn: The easiest way to help avoid back pain is to invest in a self-propelled or riding lawn mower. However, some of us are not lucky enough to be able to afford this luxury. To avoid back strain, be sure to position yourself in a comfortable position. Make sure you are not bending over. After an hour of mowing the lawn, this could prove to be pretty painful.

Treating Back Pain using Physical & Aquatic Therapy

Chesapeake Bay Aquatic & Physical Therapy offers physical and aquatic therapy to treat a full range of outpatient physical therapy needs, including back injuries, back pain, and much more. Our therapists have a wide range of experience treating professional and recreational athletes as well as individuals who have suffered injuries at work or in accidents involving personal injury.

If you have any questions about Body Mechanics or Aquatic Therapy, please Contact Chesapeake Bay Aquatic & Physical Therapy by visiting cbayaquapt.com today!

Thank you for choosing Chesapeake Bay Aquatic & Physical Therapy!

We are privately owned and operated and have been proud to serve the communities of Bowie, Laurel and Severna Park, Maryland for nearly 10 years. Our company’s goal is to provide the highest quality rehabilitation services in our region. We keep our patient volume low in order to spend more time with each patient at every visit.