Physical Therapy Archives - Page 2 of 2 - Chesapeake Bay Aquatic & Physical Therapy

Lower Back Pain Treatment in Maryland

Low back pain can be a debilitating condition, often preventing those afflicted with pain from fully living their life. If you have chronic low back pain, you know just how debilitating it can be. You do not want to do anything, let alone undergo excruciating physical therapy.

Did you know there is an alternative to traditional physical therapy, an alternative that may help alleviate much of that dreaded discomfort?

The Solution: Aquatic Therapy!

Aquatic therapy strengthens muscles, decreases pain, increases flexibility, and more in a virtually pain-free environment. How?

Aquatic Therapy decreases Pain: Aquatic therapy helps alleviate pain, making low back pain treatment much more bearable.
Aquatic Therapy is Low Impact: The buoyancy of the water helps decrease pressure on your joints while also adding support, thus lessening pain.
Aquatic Therapy provides Ease of Movement
Aquatic Therapy is Relaxing: The warm therapy pool decreases spasms and pain, promoting muscle relaxation.
Aquatic Therapy promotes Blood Circulation: The hydrostatic pressure of the water helps to increase blood circulation.
Aquatic Therapy Maximizes every Movement: The added resistance of the water helps maximize every movement.

Chesapeake Bay Aquatic & Physical Therapy: Treating Low Back Pain at our Bowie Aquatic & Physical Therapy Center

At Chesapeake Bay Aquatic & Physical Therapy, our therapists have a wide range of experience treating patients of all ages and backgrounds with a wide variety of disorders, including low back pain. 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.

If you have any questions Low Back Pain Treatment, please contact us by visiting cbayaquapt.com today! And if you are a new patient, please review our New Patient Forms page before your first visit

Fibromyalgia Syndrome: What is it?

In the U.S. alone, between three and six million people (predominately women) have a cluster of symptoms which are typical of what we now call “fibromyalgia syndrome” or FMS.

Approximately 20% of these people are formally diagnosed with FMS. These individuals experience a nightmarish combination of poor quality sleep, fatigue, anxiety, stress, whole body stiffness, and gastrointestinal complaints.

Aquatic Exercise and FMS

In a pool, it is possible to perform the vigorous aerobic exercise without the weight-bearing and joint compression experienced on land.

Additionally, aquatic exercise would seem to be an excellent intervention for FMS patients due to the inherent properties of water itself. These properties include buoyancy, turbulence, viscosity, hydrostatic pressure, temperature, and surface tension.

Aquatic therapy for the fibromyalgia patient can cover the spectrum of therapeutic intervention. Patients who present with specific, treatable, musculoskeletal dysfunctions such as an inability to stabilize the spine, postural imbalance, poor spinal mobility, and weak trunk musculature may be treated 1:1 in the pool by a physical therapist.

This treatment may incorporate task simulation, joint, and soft tissue mobility via specialty techniques. After resolving specific dysfunctions, these patients are most often referred to a group class. Why? They just seem to do better in a group.

Patients with FMS often do battle with the unbelief of the health care system, their coworkers, their spouses. People with fibromyalgia often “look fine” to the world. A group exercise class not only provides a means of routine physical activity, but it also provides a support system and a sounding board.

Group classes should be focused on two things: moderate aerobic activity and stress relief or relaxation. An aquatic exercise class which does not urge its members to elevate their heart rates and work aerobically for at least 20-30 minutes is neglecting the one intervention which is known to be beneficial.

Dry Needling in Maryland

Chesapeake Bay Aquatic & Physical Therapy is now offering Dry Needling for pain management and other impairments in our Severna Park and Laurel offices.

Dry Needling Chesapeake Bay Aquatic & Physical Therapy

Dry Needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular and connective tissues for the management of pain and other impairments. A trigger point is a taut and palpable band in the muscle that causes spot tenderness and pain upon palpation. A trigger point can cause disturbed motor function, restricted range of motion, muscle weakness and inhibition, muscle stiffness, local tenderness, and pain. Dry needling can help to address these dysfunctions and improve function leading to improved activity and participation. Areas of the body where dry needling is currently available are as follows; neck, shoulder, shoulder blade, elbow, forearm, lower back, calf muscle, buttocks, hips, knees, and calves.

Relieving Neck Pain

Neck pain is one of the most common pains that a person will experience throughout his life. There are very few people who will not experience neck pain.

What Causes Neck Pain

There are several causes of neck pain, ranging from simply sleeping in the wrong position to poor posture and stress to more severe conditions such as cervical spine tumors.

For the sake of this post, we will cover the most common neck pain. These are caused by incorrect posture, sleeping in the wrong position, stress and other trauma or injury.

Using Exercise To Eliminate Neck Pain

The treatments and exercises described below are very effective in relieving neck pain. Although the treatments and exercises usually take time to eliminate pain, these treatment are natural and have none of the side effects such medications or having steroid injections can cause. Furthermore, these can be done at home.

5 Ways to Eliminate Neck Pain

Gentle stretching – Many people mistake stiffness for pain. When we address the stiffness, the pain instantly goes away. Gentle stretching is an effective way to relieve stiffness or spasms of the muscles. Start by sitting comfortably on a chair. Put one hand over the head and onto the opposite temple and gently pull the head to the side of the hand. The opposite hand can hold on to the edge of the chair to increase the stretch. Do 30-second-holds on each side for 2-3 times.

The range of motion exercises – Having neck pain limits the movement of the neck. This can sometimes make it difficult to turn or bend your head to the side. Preventing loss of range of motion during the time you have neck pain will greatly contribute to your function. Chin tucks and neck rotations with nods are effective in increasing range of motion. To do chin tucks, simply lie down on your back with a pillow under your head. Now, focus on the back of the neck instead of your chin. Push down on the pillow with the back of your neck, this, in turn, will make you do a chin tuck. Simply put, you are trying to make a double chin. Hold it for 1-2 seconds and then go back to starting position. Do 30-50 times several times a day. For the neck rotations with nods, sit comfortably on a chair and straighten your neck. Look to one side as far as possible without pain. As we say in rehab, “stop where the pain starts.” After determining the start of your pain, a nod by trying to touch the shoulder with your chin and then do the opposite side. Do 30-50 times several times a day.

Strengthening of the muscles of the neck – Strengthening the muscles of the neck helps to prevent future neck pain. To strengthen the muscles of the neck, simply sit down comfortably on a chair. Put one hand on your temple and press. Prevent your head by being pushed by stiffening your neck muscles. Hold for 10 seconds and do 10 times, 2 sets each. Do on the other side. Now do the front and back by putting one hand on your forehead and the back of your head, respectively. Again, hold for 10 seconds and do 10 times, 2 sets each.

Heat vs. cold – As a general rule, ice is used for acute pain, whereas heat is used for chronic pain. Acute pain is from 3-6 months after the injury, and chronic pain is 6 months or more. Use an ice pack or heating pad (both are available at CVS, Walgreens, Target, Wal-Mart, etc.) depending on your type of pain. Put them directly on your neck for 10-15 minutes and relax!

Consult your doctor and/or your physical therapist – If you do not see any improvement in your pain for more than 7 days, consult your doctor for further tests. You can also go to your physical therapist to consult. In the state of Maryland, the physical therapist has direct access, meaning you can go directly to your physical therapist without getting a referral from your primary care doctor.

Rommer graduated as a Physical Therapist at St. Jude College in the Philippines in 2003. He is a passionate PT who is always keeping up with the most current, best evidence-based treatments available. He is passionate about physical therapy and is always striving to improve his craft. His treatment method focuses on his patient’s most pressing issues while providing pain relief and improvement of daily activities. He utilizes manual therapy techniques and exercises in his treatments. Rommer is dedicated to giving his patients the best one-on-one, quality care he can provide. Rommer currently lives in Severna Park, MD is married to another PT and the dad of 2 boys.

Remedies for Lower Back Pain

About 80 percent of adults experience low back pain at some point in their life. It is the most common cause of job-related disability and a leading contributor to missed days at work.

Most low back pain is acute, or short term, and lasts a few days to a few weeks. It tends to resolve on its own with treatment at home and there is no remaining loss of function.

Bed rest should be limited for those experiencing back pain. Individuals should begin stretching exercises and resume normal daily activities as soon as possible, while avoiding movements that make the pain worse. Evidence suggests that bed rest alone may make back pain worse and can lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs.

Below is a list of some common exercises given to those experiencing low back pain:

1) Supine hamstring stretch

Setup

Begin lying on your back with your legs straight, holding the end of a strap that is looped around one foot.

Movement

Use the strap to pull your leg up toward your body until you feel a gentle stretch in the back of your upper leg. Hold this position.

Tip

Make sure to keep your other leg straight on the ground during the stretch.
Hold 2 times for 30 seconds each. Perform 2 times a day, 7 days a week.

2) Supine piriformis stretch

Setup

Begin by lying on your back with both knees bent and feet resting flat on the ground. Cross one leg over the other so your foot is resting on your knee.

Movement

Grab your leg just below the knee and slowly draw it towards your opposite shoulder until you feel a stretch in your buttocks.

Tip

Do not allow your back to twist or bend excessively during the stretch.
Hold 2 times for 30 seconds each. Perform 2 times a day, 7 days a week.

3) Posterior pelvic tilt

Setup

Begin lying on your back with your knees bent and your hands resting on your hip bones.

Movement

Slowly tilt your pelvis backward, monitoring the movement with your hands. Then return to the starting position and repeat.

Tip

Make sure to focus the movement only on your pelvis, and keep the rest of your back still during the exercise.
Hold for 5 seconds. Perform 20 times, 7 days a week.

4) Lower trunk rotations

Setup

Begin lying on your back with your feet flat on the floor and your arms straight out to your sides.

Movement

Lower your knees to one side, return to center, and repeat on the other side.

Tip

Make sure to activate your core muscles and keep both of your shoulders in contact with the ground throughout the exercise.
Hold 10 seconds. Perform 10 to each side, 7 days a week.

5) Bridging

Setup

Begin lying on your back with your arms resting at your sides, your legs bent at the knees and your feet flat on the ground.

Movement

Tighten your abdominals and slowly lift your hips off the floor into a bridge position, keeping your back straight.

Tip

Make sure to keep your trunk stiff throughout the exercise and your arms flat on the floor.
Hold for 5 seconds. Perform 20 times, 7 days a week.

Sources:
Medbridge
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

What do foam rollers do besides hurt a lot?

As an orthopedic physical therapist, I use foam rollers during the treatment of many of my patients. They do often complain that the foam rolling hurts at the time of the treatment, but they also say they feel better after using the foam roller. This makes it possible to convince my patients that they should continue foam rolling even after they are discharged from physical therapy. Foam rolling makes it possible for my patients to independently maintain the gains they made while working with me in PT.

So what good do foam rollers do?

Well, a survey of 685 sports and orthopedic physical therapists identified the top four benefits of foam rolling:¹

1. Decreased pain (after you’re done using them)

Pain and fatigue are often associated with trigger point soft tissue damage. There are many studies that have shown that massage is helpful in alleviating the pain caused by this soft tissue damage. This is because massage increases blood flow at the areas where pressure is applied, which aids in healing of the tissue. Foam rolling is a technique you can use independently to get similar results to a deep tissue massage. And it’s a lot cheaper too. The average foam roller costs about $20.

2. Decreased muscle stiffness

Muscle stiffness can actually be measured by something called mechanomyography. This is a test that monitors the temporospatial summation of electrical activity at the motor unit (a building block of the musculoskeletal system that is composed of one motor neuron and the skeletal muscle fibers which it innervates). Mechanomyography has been used in several foam rolling studies to demonstrate decreased muscle stiffness after foam rolling. However, this effect lasts an average of only 15 minutes.²

3. Increased range of motion

Several studies have explored the change in range of motion (ROM) at a specific joint, after foam rolling was performed to a muscle group adjacent to that joint. One specific study found that hip flexion ROM improved by 23 degrees on average from baseline measures, after foam rolling and statically stretching the hamstring muscle group.³ This was compared to an improvement of only 12 degrees of improved hip flexion ROM after static hamstring stretching alone. The group of subjects who only foam rolled their hamstrings and did not stretch, had an average of only 6 degrees of improved hip flexion ROM. So, if you have tight hamstrings, I recommend making the time for both foam rolling and stretching. You might feel a little more pain than you would like, but you will see results!

4. Improved athletic performance

According to a study on collegiate male athletes, foam rolling performed in conjunction with a dynamic warm-up can lead to objective improvements in speed, power, strength, and agility.⁴ This study showed improvements in 1 rep max bench press and 37 m sprint test after a dynamic warm-up and total body foam rolling, versus just a dynamic warm-up. A dynamic warm-up is a series of movement drills that gradually increase from light to moderate intensity. These may include squats, pushups, jump squats, high knees, etc.

Ok, foam rolling sounds great! How do I use a foam roller?

Research suggests that you should foam roll each muscle group for 30 seconds to 2 minutes daily at a self-selected rhythm.
Foam rollers can be used on many different muscle groups, and it is beneficial to perform total body foam rolling. However, if you have time limitations, it makes sense to foam roll the muscle groups that feel the most stiff or painful to you on that day.
You can use a foam roller either before or after your workout. If foam rolling before your workout, you should use it in conjunction with a dynamic warm-up. If foam rolling after your workout, you should follow your foam rolling with static stretching on similar muscle groups in order to maximize gains in joint range of motion.
Foam rollers apply the greatest amount of pressure at more proximal muscle groups (closest to your center of mass). On average, about 29-50% of your body weight is actually applied to the muscle group you are foam rolling. If you feel too little pressure, you can lift one leg up off the ground to increase the compression at the targeted area.
Here are some examples of how to foam roll specific muscle groups:

Here is a video tutorial for foam rolling different muscle groups:

What kind of foam roller should I get?

There are many different types of foam rollers that you can buy. There are different lengths, densities, and surfaces of foam rollers available on the market. In my experience, foam rollers with higher density tend to last longer, and will give you a longer duration of use. This includes foam rollers labeled as “high density,” and those with a plastic insert in the center of the roller. However, you have to be comfortable with consistently using the foam roller you get. If you have a lower pain tolerance, you should avoid the spiky, deep-tissue massage option, and opt for the lower density foam. I generally recommend the 36-in length foam rollers in order to allow more room for movement without rolling off of the foam.

Want to learn even more? Here is a great summary on the benefits of foam rolling:

Plantar Fasciitis and Physical Therapy

The hallmark sign of plantar fasciitis typically is sharp, severe pain in the foot immediately upon getting out of bed in the morning. Plantar fasciitis is one of the most common sources of foot pain, and more specifically heel pain in the U.S.

This band of connective tissue serves as a major defense component in the over flattening of your foot’s arch. When this part of your body becomes inflamed or sustains small microscopic tears, PAIN and limitations in weight-bearing function can occur.
Who suffers from Plantar Fasciitis?

With 10% of the population in this country experiencing this persistent pain it falls into a cluster of common orthopedic issues affecting a wide spectrum of people. This diagnosis is prevalent in active runners but also affects individuals who may be overweight and exerting excessive force on the lower extremities.
Proper Diagnosis

Undoubtedly you have heard your co-worker, BFF, or next door neighbor tell you all about his or her “Sciatica”, “Rotary cup tear”, or “Plantar Fasciitis”. The important thing to remember when digesting this diagnosis and deciding how to go about treating it is to first acknowledge that the internet (and your cousin’s mailman’s ex-boss) is full of information and misinformation. So as always let’s look at what the CURRENT research and science say……
What are the most effective treatments?

In 2014 JOPST (Journal of Orthopedic & Sports Physical Therapy) published a comprehensive update on clinical practice guidelines for the treatment of plantar fasciitis. This reassessment of the guidelines formally proposed in 2008 rated various treatment’s effectiveness on a letter grading scale with A being the strongest and F being the lowest.

Manual therapy, stretching, taping, foot orthoses, and night splints all received grades of A’s in their effectiveness. Physical agents such as low-level laser therapy, phonophoresis, and ultrasound received C grades. Electrotherapy and dry needling received the lowest grades with ratings of D and F respectively.
How about steroid shots?

If conservative treatments are not effectively reducing pain symptoms after several months, other options may be explored. Typically imaging tests are unnecessary but an X-ray or MRI may be suggested if a compressed nerve or stress fracture is suspected.
Or Antiinflammatories?

Pain relievers like Ibuprofen may reduce some of the inflammatory response in the foot and cortisone/steroid injections may be administered. These options typically will only provide temporary relief. It may be detrimental to have multiple steroid injections as they can actually reduce the integrity of the plantar fascia and weaken it.
Why choose physical therapy for plantar fasciitis?

Despite the strong evidence for conservative treatment of plantar fasciitis, physical therapy is often under-utilized by patients and their physicians. In a study published this past February researchers looked at a database of over 800,000 individual cases of plantar fasciitis and discovered that only 7.1% of these individuals were prescribed physical therapy.

If you suspect you have plantar fasciitis and it is limiting your daily functional activity consult with a physical therapist. He or she can help both with manual treatment and developing a guided and progressive exercise program. With the state of Maryland being a “direct access” state you may be able to see a physical therapist initially without requiring a visit with or script from your physician.

Greg Chrest, DPT, Reisterstown Clinic Director

Greg graduated from Elon University in 2011 with a Doctorate of Physical Therapy after completing his undergraduate degree in 2006 where he majored in exercise sports science with a minor in psychology. He worked as a Personal Trainer in Charleston, South Carolina where he was able to focus on his love of adult fitness along with getting people of all ages interested in exercise and living a healthy lifestyle. His special interest is continuing to cultivate his manual therapy skills along with sports medicine and management of chronic pain. Growing up in Bel Air, Greg is a die-hard Oriole and Raven fan and spends his free time training for triathlons and road races, playing the guitar, and sharing time with his family and friends.

Click here to contact Greg Chrest

Chesapeake Bay Aquatic and Physical Therapy perform injury assessment at no cost to you or your insurance. If you suspect you have plantar fasciitis contact us for an appointment.
REFERENCES

Fraser et al, titled “Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States” (J Orthop Sports Phys Ther 2017;47(2):49–55. doi:10.2519/jospt.2017.6999).

Martin RL, Davenport TE, Reischl SF, et al. Heel pain—plantar fasciitis: revision 2014. J Orthop Sports Phys Ther 2014;44(11): A1-A23.

“Plantar Fasciitis”. Mayo Clinic Staff. https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/diagnosis-treatment/treatment/txc-20268820. November 16, 2016.