Can Exercise Totally Cure Low Back Pain?

More than 80% of us experience low back pain at some point in our lives. In most cases, the pain goes away on it’s own or with a little “help” from the internet, yet recurrence rates of low back pain range between 24% and 80% within the first year.

A literature review by Steffens and colleagues summarizes the benefits of exercise and education for low back pain. The types of interventions included in the studies were patient education, core stabilization exercises emphasizing exercises for the back and abdominal muscles, stretching and spinal range of motion exercises as well as general aerobic conditioning exercises.

The reduction in recurrence rates of low back pain was impressive at 25% to 40% in the short-term.

The effects in the long term were more uncertain. Several studies showed no decline in recurrence rates after one year.

So what does this mean?

More than likely, the participants felt better and they stopped doing their exercises. Sound familiar?

In order to prevent recurrence of pain or injury in the future, it is crucial to continue with an exercise program that includes core stabilization training, flexibility and spinal range of motion exercises and general aerobic conditioning.

Don’t delay. Get a refresher from us ASAP or refer a friend or family member who is in pain.

Check out the link below or send it to a friend.

CLICK HERE

 

 

 

 

Do You Really Need To Stretch Your Hamstrings?

Fall has arrived. Amazing colors once again. Should you stretch your hamstrings before hiking thru the fall colors? Read on to see if you should…or if you shouldn’t….

fall-colors

I want to share with you what my staff and I have learned to maximize your health and wellness and to keep you up-to-date on the happenings at OrthoWell. So read on and let’s keep you on track.

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Do you really need to stretch your hamstrings??

So what if I told you that there is actually very little research that substantiates any long lasting effects of stretching? What if I also told you that you may not even have to stretch your hamstrings to get a release of the stiffness? Would that make you stop stretching or does stretching actually make you FEEL good?

I have been practicing PT for 26 years and I can honestly say that my patients have had some pretty amazing results with the soft tissue work that we do in combination with stretching exercises. Just look at our Success Story page. If you are reading this right now, you may actually be one on them. There are some things that get our patients better that may not have a lot of research-substantiated evidence.

In a 2010 article by Wepppler and Magnusson, they point out that there is only a transient mechanical increase in length of tissue after stretching. In other words, the muscle stretch recoils after the stretch is removed. How long the stretch lasts depends on the magnitude and the duration of the stretch. So then, how hard should you stretch and why do we only hold our stretches for 30-60 seconds?

We have used the evidence gathered from the study of tissue deformation or biorheology to determine that the optimum amount of time to acquire the most dramatic “viscoelastic” elongation of tissue is between 30-60 seconds. Yes, there is a much more gradual elongation after that time but who has the time to wait…right? There was a study in 2004 by Guissard and Duchateau that showed partial maintenance of tissue elaongaton 30 days after the program when patents were performing 20 minutes of stretching 5 days per week. So yes, you reap what you sow when it comes to the time spent stretching.

The Sensory Theory of stretching means that we achieve an increase in length while stretching due to a “stretch analgesia” effect in which “it doesn’t hurt as much” so you FEEL as though you can stretch further into the range. So what is wrong with that? If you stand all day and your hamstrings are working overtime to keep you upright and stable, what happens to the tissue? It becomes “stiffer”. This may be due to scar tissue, waste products, and trigger points that form due to this constant state of contraction. Intuitively, it makes sense to perform massage and stretching to counteract these effects. However, is this the cure for the stiffness? Gary Cook, a world renowned PT, who has revolutionized the way that we that we think of functional training would say unequivocally NO!

Gary Cook claims that the “stiffness” we feel is reflexive. It is due to the stabilizing effect that our muscles need to perform on a daily basis in order to control faulty movement patterns and faulty postures. Some parts of our bodies are stabile and other parts are very mobile. For example, your lumbar spine tends to be mobile or “sloppy” as Gray Cook would say. Many people are unaware of how to engage their core or how to perform proper body mechanics to prevent stress to the lumbar spine. Our hamstrings can be the first line of defense when it comes to stabilizing the spine.

If you are unaware of how you stand, you could be placing your pelvis in an anteriorly rotated position. When your pelvis rotates forward, it places a “pinch’ or a stress on your lumbar spine. Your hamstrings will consequently contract in order to correct your alignment and “pull” your pelvis posteriorly. What happens when you squat or roll out of bed? If you are not engaging the proper core and hip muscles then your hamstrings continue to fire in order to stabilize your spine. There you have it. The viscous cycle for constant hamstring stiffness.

So how do you become more stabile? First of all, you need to become reacquainted with your core. Just doing planks may not be enough. You need to be evaluated to determine any faulty movement patterns. If you don’t correct the faulty patterns, then you are reinforcing bad habits and putting yourself at risk for injury. Gray Cook has developed Functional Movement Screens to determine exactly where your deficiencies are. In addition to this, we have put together a version of the Selective Functional Movement Screen in our clinic. Based on the results of our screen, there are many types of corrective exercises that can be instructed to get you back on track.

In conclusion, you need to realize that “stiffness” anywhere in your body could be multifaceted.- especially with your hamstrings. Does this mean that you should never stretch or massage your hamstrings? NO. Stretching can certainly make you FEEL better but you need to realize that stretching alone may not be the cure. In the words of Gray Cook

“If the body doesn’t stabilize correctly, it will figure out another way to get stability: it’s called stiffness.”

So what you THINK is causing your stiffness may NOT be the reason. We all need to think outside the box. You are guaranteed that when you come to see us at OrthoWell PT

All the Best!

Chris

 

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Drinking the Cross Fit Kool-Aid!

Harry feels better now than ever before…

I enjoy CrossFit because it consistently gives me a good workout.  The workout ideology of CrossFit prides itself on never falling into a routine.  This means every workout is something new that will not only work you out in a new way, but also help you to identify some new skill that you could improve upon. When working out with good form and responsible weight/volume, the benefits of Crossfit also translate to your functional daily activities.  After a year of Crossfit I can truly say I have witnessed these benefits during my day to day activities.

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MOUNTAIN RUNNING CHAMPION..

Matt Veiga

 As many of you have heard in the clinic I do a lot of mountain racing. This past weekend I had the luck to have a repeat win at one of the hardest races in the circuit. Check out my interview on levelrenner.com to get a little glimpse into the head of the Female winner Leslie and myself about how the race went down and up in this case.

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 Prevent Your Pain from EVER coming back

 Click the link to read about

this new option at OrthoWell 

Wellness Membership Program

 Our wellness maintenance program is for those of you who want  consistency of care after being discharged from physical therapy in order to prevent any reccurence of pain. We have three different plans the we offer that you can read about by clicking the link above.

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 SUCCESS STARTS HERE!

Marc Smor

5/31/16

 “I would like to thank Chris, Katie and crew for the outstanding care I received after my Achilles surgery.  Their knowledge, experience and attention to detail allowed me to expedite my recovery.  Thank you.”

                                                               – Marc S.

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FREE INJURY SCREENING

Dont forget to take advantage of our Try Before You Buy program.

 We offer a FREE, no obligation injury screening for YOU, a FAMILY MEMER or a FRIEND. Just  click the link below or send it to someone who may need our help. 

 CLICK HERE

 

 

 

Would you like to feel happy and vibrant EVERY day? Here’s how.

Spring has sprung, but it sure didnt feel like it last week. So how do you feel when it is sunny and warm versus cold and damp? There may be a physiological reason why you feel down or painful on cold and damp days. Check out the posts below to see why.

I want to share with you what my staff and I have learned to maximize your health and wellness and to keep you up-to-date on the happenings at OrthoWell. So read on and let’s keep you on track.


 

HOW TO FEEL HAPPY & VIBRANT

EVERY DAY

 No, I havent found the fountain of youth or am advocating that everyone apply for a medical marijuana card. lol. But…there are a few things that could make your body work more efficiently on good weather days as well as bad ones. Knowledge is power so I want to share a few things with you. 

So WHY do you feel stiffer or more painful on rainy days??

 A recent systematic review of the relationship between joint pain and weather found no consensus on the issue. However, several researchers have found evidence that a decrease in the barometric pressure associated with a storm front can increase the pressure inside your joints thereby potentially increasing your stiffness or pain. 

 VITAMIN D

 study published in the Archive of Internal Medicine in 2009 showed that Vitamin D  levels have “plummeted” among ALL U.S. ages, races, and ethnic groups over the past two decades. Because there are such small amounts of Vitamin D in food, the only 2 ways to get adequate amounts is thru direct sun exposure or via supplements.Over the past 10 years, several researchers have found an association between extremely low vitamin D levels and chronic, general pain that doesn’t respond to treatment. Check it out HERE. So start taking your Vitamin D! Click here for a great source of Vitamin D. 

EXERCISE-The Happy Drug

 Did you ever notice how some people are addicted to exercise? There are good reasons for that (some bad if you push through pain…..) Exercise releases endorphins which are your body’s natural painkillers and “feel good” hormones. Read more HERE.

Turmeric-The Spice of Life

You may know turmeric as that yellow spice that is used in indian curry dishes. The active ingredient in turmeric that has been extensively researched and provides more health benefits than there is room on this page is curcumin. One of the main reasons people take curcumin is for its potent natural anti-inflammatory properties. It is important to take curcumin with a pepper based supplement to maximize the effects such as Pure’s Curcumin with Bioperine. You can read more about turmeric HERE

 So what should you take for supplements??

 If you want even more information, then you could read my post on  which vitamins and supplements are best for you. CLICK HERE. 


GET RID OF SURGICAL SCARS

AND

GET A FREE FACIAL FOR TRYING 

 Dear OrthoWell patients, 

 My name is Andrea Linn and I am currently a patient at OrthoWell PT. I just had an ACL reconstruction.

I was born in Europe- Hungary. I went to school there to be a cosmetologist. In the USA, I have worked for many prestigious beauty brands but my most favorite is Le Metier de Beaute. I want to share with my secret for getting rid of surgical scars-quickly. 
 
Does it take long for your surgery scar to heal? Do you need extra nourishment for your body skin? Would you like to erase signs of aging from your body?
 
I have a recommendation for you: Le Metier de Beaute’s fantastic Vital ET Recovery Boost.
 
Redefine Age
Replenish, repair and protect your entire body with Vital ET Recovery Boost – Body. This highly effective form of Vitamin E protects you against free radicals. Free radicals are known to damage collagen, create dryness and lead to the development of fine lines and wrinkles. This deeply reparative serum will drive super antioxidants and vitamins directly into your skin, leaving you with it glowing and age-resistant.
 
Key Ingredients:
TPM® Technology. Vital ET®, a patented technology that decreases redness and swelling while fortifying resistance to inflammation caused by environmental stressors.
 
Usage:
Apply to clean skin in the morning and/or evening. Gently massage Vital ET Recovery Boost – Body over entire body. Pair with SPF protection when going out in the sun.
 
6.35 fl. oz. / 180 mL  $125.00
 
Small samples will be available at the front desk. Please try them.
:
Le Métier de Beauté is one of today’s most technologically advanced skincare brands using a unique TPM technology. TPM increases the therapeutic benefits while reducing redness- inflammation – irritation.
Le Métier de Beauté (which translates to “the craft of beauty”) is known for its award-winning Peau Vierge Anti-Aging Complexe. The line also features stunning makeup and has collaborated with couture and ready-to-wear designers Georgina Chapman and Keren Craig of Marchesa on a fashion-inspired color collection.
 
Le Metier de Beaute features incredible anti-aging skincare and make up — everything that your face and body needs. 
 
Patients of Orthowell Physical Therapy are invited to a complimentary anti aging mini facial in Newburyport or Beverly.
 
Please contact Andrea to schedule your appointment.
 
If you have any questions don’t hesitate to contact Andrea

Prevent Your Pain from EVER coming back

Click the link to read about

this new option at OrthoWell 

Wellness Maintenance Program

 Our wellness maintenance program is for those of you who want  consistency of care after being discharged from physical therapy in order to prevent any reccurence of pain. We have three different plans the we offer that you can read about by clicking the link above.


SUCCESS STARTS HERE!

4/27/16

The winter of 2015 had me shoveling so much snow on our alpaca farm.  Spring into summer convinced me my sore shoulder wasn’t just going away.  I quit “using” my arm as it hurt to even raise it.  I procrastinated so long that I thought for sure I would have to have surgery.  I was in such pain that I finally saw a surgeon.  He strongly suggested I try PT and said he’d heard good things about OrthoWell.  Talk about life changing!  After 5-6 weeks of working with Chris and his team, I have to say that I’m calling this just short of a miracle!  Everything was explained to me and shown to me in a clear and concise manner.  I am looking forward to having my life back this summer, if that sounds dramatic, well, it is! 

                                                                                                             – Olivia Sanderson


WALL OF FAME

Here is the update on our Wall of Fame in Beverly. We are proud of our patients and the success that they have had.  If you have previously provided us with a testimonial, we would love to take your picture with your therapist and hang it with your testimonial for display it in our clinic!  Seeing is believing! 

All the Best,

Chris

 

 

 

 

 

Make A Core Investment This Holiday Season

Wow! The holidays are upon us once again. I hope that you are feeling awesome. If not, then WHY? The purpose of this newsletter is to share as much as I can in order to get you feeling as awesome as possible.

I want to share with you what my staff and I have learned to improve your experience at OrthoWell and to remind you how awesome you CAN feel. Read on and let’s get you back on track.

HOW TO MAKE A CORE INVESTMENT
To get the best return on your investment, you want to make sure that when you go to the gym you are doing the exercises that will be most effective.
We often find that people haven’t been doing the most effective core stability exercises, or they have been doing them with incorrect form. Check out this video blog post about how to properly engage your core.

 


HAPPY HOLIDAYS!

Are you looking for a way to help those in need this holiday season?

Here’s how we can do it if we work together.

As a way of serving our community, OrthoWell Physical Therapy will be donating $10 for each new patient that comes through our doors through the end of 2015 to either of two awesome organizations in Beverly called Beverly Bootstraps or in Amesbury called Our Neighbors Table.

You can check out the videos on our Beverly Facebook page or our NBPT Facebook page. So come on in for a physical therapy evaluation or spread the word about our holiday initiative.

Let’s do this together!


Help us Celebrate Our 1 Year Anniversary 
in Newburyport
 
Wow! This past year just flew by. We have had a great start in Newburyport thanks to ALL of you. As a thank you we would like to extend a special discount on the purchase of one of our maintenance packages.
You can try get one of the following: Laser, Dry Needling or our Wellness Maintenance packages at a 15% Discount thru the end of this year!
You can also purchase these packages for a loved one if you want!  Tis’ the season.   Just let us know by calling 978-522-4199!  And THANK YOU once again for your patronage!

TEAMWORK GETS YOU BETTER…FASTER
I have been coordinating services with local chiropractors, acupuncturists and massage therapists and getting amazing results!
My goal is to improve the way that we collaborate and the way that we coordinate services with each of our patients. I have seen incredible results when we ALL work  together. Why wait to start PT or chiropractic if we can get you better…faster as a team. This means better communication and better results.
Please let me know if you are using another practitioner that you think would be a great addition to our TEAM approach.

Our Commitment to YOU
by Mark Johnson,PT at OrthoWell
 
 I have been treating patients for 1.5 years following completing my Doctorate of Physical Therapy degree from the University of New England.  I have been here at OrthoWell for almost 6 months and I cannot believe how much I have grown as a physical therapist in an environment committed to education and evidenced based practice.

Over the past several months I have been noticing a trend of increased number of patients complaining of neck pain which has sparked my interest to participate in continuing education focused on neck pain in order to get the best results for my patients.  I recently completed a 16 hour course focused on cervical (neck) pathology at the Institute of Manual Therapy where I was able to refine my skills and apply new knowledge to all of my patient with neck pain.

 

So if you or someone you know is suffering from neck pain because life can certainly be a “pain in the neck”, then come on in. You are always guaranteed the most up-to-date, comprehensive and holistic physical therapy at OrthoWell.

SUCCESS STARTS HERE!
Check out what a recent Beverly patient said about his care here at OrthoWell:

“OrthoWell PT has given me my life back, no doubt! After 3 months of knee pain with every step I took, I feared for my job as a nurse and my normally active lifestyle was severely curtailed. Surgery was an option, but without guarantee for improvement.

After just one session of PT and 1 laser treatment i was able to walk without limping. After 1 month of therapy and new orthotics, I am closing in on 100% return of function and I am thrilled with the progress.

The holistic approach used by Chris and his team is unique compared to other PT experiences I have had. I highly recommend OrthoWell PT as the best option out there!”

Doris Bailey-Jones


WALL OF FAME
We are starting a Wall of Fame at each of our clinics. We are proud of our patients and the success that they have had.  If you have previously provided us with a testimonial, we would love to take your picture with your therapist and hang it with your testimonial for display it in our clinic!  Seeing is believing!
Give us a call and we’ll schedule a time to take your photo so you can be one of the first patient success stories on our Wall of Fame!

Sincerely,
Chris

Chris Dukarski
OrthoWell Physical Therapy
(978) 522-4199
info@orthowellpt.com

Are Toe Crunches just as important as Stomach Crunches??

Intrinsic Marbles

 

I have struggled over the years as to the importance of including toe flexor strengthening as part of a program for plantar fasciitis. Many researches agree that the potential causes of plantar fasciitis are just too numerous and multi-factorial. The evidence in the literature has not been conclusive and I have let many of my patient’s comments that “this is silly” when picking up marbles dictate my decision-making. I have slowly but surely, and I believe wrongly, eliminated this important exercise from my treatment approach. I have recently read several articles that have rekindled my enthusiasm for toe flexor strengthening. So why the change in heart??

I am always looking for ways to get our patients better…faster. I have written a book on plantar fasciitis called the Plantar Fasciitis Treatment Manual and it identifies ankle muscle weakness as a result of plantar fasciitis but not include the presence of toe flexor weakness. That is my oversight and I will correct that in the book. Yes, the literature does identify weakness of the ankle muscles and the toes flexor muscles with the plantar fasciits population, yet the research does NOT confirm any causative factor of this weakness on the development of plantar fasciitis.(1,3,4) It is the chicken or the egg conundrum. Unfortunately, there are theoretical assertions that the “flexor digitorum brevis muscle (the muscle directly underneath the plantar fascia) plays an important role in distributing pressure away from the plantar fascia” that are simply not supported by research. (2) Does this mean that we should not perform strengthening exercises? Let me provide some more evidence.

As we get older, we get weaker. We all lose muscle mass, we lose muscle fibers and, as a consequence, we see decreases in strength between the ages of 30 and 80 within a range of 20-40%.(5) Several articles have also shown that “older people” exhibit 24-40% less strength in the muscles of the foot and ankle(5,6,7,8). As a consequence of foot and ankle weakness, older adults are more susceptible to loss of balance, the development of foot and toe deformities and can be susceptible to overuse syndromes such as plantar fasciitis. (5,6,7,8) The biggest question that has not been answered when it comes to strengthening exercises for older adults is WHICH exercises are the most effective?

As a result, we have to rely on some common sense. If the muscles in our ankles and feet get weaker as we get older (proven!), then we should strengthen them to avoid plantar fasciitis. Right? Not necessarily. There is not a direct correlation between weakness and the development of plantar fasciitis but, then again, many people don’t believe that there is a direct correlation between human activity and climate change. My point is why should we wait to change our approach until it is conclusive – whether it be climate change or your plantar fasciitis?

 

  1. http://www.ncbi.nlm.nih.gov/pubmed/12968860
  2. http://running.competitor.com/2014/06/photos/new-techniques-treating-plantar-fasciitis_96398
  3. http://www.jospt.org/doi/pdfplus/10.2519/jospt.2003.33.8.468
  4. http://www.ncbi.nlm.nih.gov/pubmed/1672577
  5. https://www.karger.com/Article/FullText/368357
  6. http://biomedgerontology.oxfordjournals.org/content/61/8/866.full
  7. http://www.jfootankleres.com/content/7/1/32
  8. http://www.jfootankleres.com/content/7/1/28

Do Pain Creams Really Work?

Pain Cream

Do pain creams really work??

There are a lot “pain creams” on the market that tout their effectiveness. Do they really work? Do they just take your mind off of the pain temporarily?

A topical counterirritant is a cream that essentially takes your mind off of the pain. Creams such as BenGay and IcyHot simply activate nerve ending in your skin that “fool” your brain temporarily. These products do not cross the skin barrier to get to the root of the problem. What if I told you that we recommend a product at OrthoWell that is:

*Safe

*Natural

*95% absorbed thru the skin

*Fast acting

*Research proven

We use a cream from two different companies that contains esterified fatty acids. One of the companies is EFAC at Hope Science and the other one is 1-TDC at Elite Science The inventor of the EFAC-brand formula researched the effects of esterified fatty acids and came up with a combination that beats the effects of chondroitin and glucosamine…hands down! You can read the results and more about the evidence behind EFAC HERE.The proprietary formula for esterified fatty acids is the same in both products but the 1-TDC product uses a paraben-free cream. So how does it work?

It has been shown that EFAC reduces joint and muscular discomfort within 30 minutes of topical application and within 14 days of oral consumption. The effects of the esterified fatty acids include:

*Pain reduction

*Tissue regeneration

*Improved function and range of motion

*Reduction of inflammation

*Lubrication of your joints and tissues.

Read what Robin said about it:

“After only 3 days I noticed a huge improvement in my feet. I also applied the EFAC to my knuckles and thumb joint, when arthritis is bad! Pain gone after application! I want to take a bath in this cream!” Robin Graves. January 31, 2017.

The esterified fatty acids are carried in the membranes of our white blood cells. Because white blood cells are the first responders after injury or in the presence of inflammation, the fatty acids are delivered directly to the affected site and play a role in mediating the inflammatory process. You can read more about the pharmacology HERE. These products have shown dramatic effects in the treatment of gum disease and positive results have been demonstrated in humans as well as animals. Don’t forget about your dog!

Both companies offer a cream as well as capsules. The cream contains a 7% concentration of the esterified fatty acids where as the capsules contain a 70% concentration. You can maximize your benefits by taking the supplement orally as well as topically. There are no side effects and no maximum allowable dosage. You can essentially take as much as you want. However, the manufactures suggest 3-6 capsules per day. We recommend that you apply the cream at least twice daily or as needed depending on your pain level. In some cases, we suggest piercing the capsules and applying the contents of the capsule on smaller areas for maximum effect. There is a small amount of menthol in the cream for the topical analgesic effect. Research has been done that compared the effects of the cream with versus without the menthol and the results were the SAME

You can purchase these products online or in our office. Let us know if you want to give them a try! You wont be disappointed.