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.
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
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 reviewof 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.
A 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
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.
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.
TPM® Technology. Vital ET®, a patented technology that decreases redness and swelling while fortifying resistance to inflammation caused by environmental stressors.
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
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!
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!
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.
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 inAmesbury called Our Neighbors Table.
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!”
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!
For those of you who don’t know, we are offering another specialized service at OrthoWell PT. It is called Trigger Point Dry Needling. Our new PT, Katie Moulison,DPT, is certified in dry needling and she has been performing this technique for 2 years as well the past several months in our clinic. I have created a comprehensive web page devoted to trigger point dry needling. CLICK HERE. It is another one of those techniques that not everyone knows about. It is a technique that can have a profound effect on the chronic pain associated with trigger points and myo-fascial restrictions.
Here is a video that we made in-house about trigger point dry needling. It includes an explanation of trigger points as well as a demonstration of the actual trigger point dry needling technique. It will give you a much better understanding of the technique and may even encourage you to come in for a FREE session to try it out. Just give us a buzz and we will get you in the schedule. The video will be available on our trigger point dry needling web page as well as a comprehensive Q&A section. Don’t forget to share with your friends!!
For those of you who haven’t been in to see us recently, we have been using a demo class IV laser device from Litecure since the beginning of June and have been getting some amazing results. We were so impressed with the results that we “bit the bullet” and purchased our own laser. A very worthwhile investment for OrthoWell and for the health of all of our patients.
I have added a page on our website that provides a comprehensive explanation and videos of the benefits and effects that a class IV deep tissue therapy device provides. In a nutshell, the laser uses photon energy to stimulate chemical reactions at the cellular level. Research has demonstrated an increase in metabolism, a decrease in inflammation, a decrease in pain, and an acceleration of healing at the treatment site. In other words, the application of laser in combination with our manual therapy and exercise techniques is getting our patient better even FASTER! It has also been extremely beneficial to conditions that have NOT been responsive to our traditional physical therapy interventions.
If you are interested in trying laser or if you feel that your symptoms have plateaued, then laser may be the answer that you are looking for.
We want you to experience the benefits of deep tissue laser therapy so we are announcing a special offer. Call us now to schedule a FREE laser treatment. We will introduce you to laser therapy and provide a laser treatment FREE of charge. Let us know what works for you!
First of all, you need to understand the difference between aerobic and anaerobic exercise. Aerobic exercise requires oxygen, is low powered and lasts for greater than 15-20 minutes. Anaerobic exercise, like Cross Fit, does not require oxygen, is high powered and each exercise lasts less than 2 minutes.
The Positives: Recent studies have shown that anaerobic exercise is a vastly superior protocol for fat burning than it’s less intense aerobic counterpart. There is evidence that shows that anaerobic exercise is evenly matched to aerobic exercise with regard to cardiovascular benefits. Check out the evidence in an article in the Journal of Strength and Conditioning. More evidencethat comparable calorie burning effects can be achieved in half the time with anaerobic exercise.
The Negatives: Potential for INJURY! The article in the Journal of Strength and Conditioning also states that 16% of the participants dropped out due to “injury or overuse”. In addition, in 2011, the U.S. military, in conjunction with the American College of Sorts Medicine, advised soldiers to avoid CrossFit, citing “disproportionate musculo-skeletal injury risk.” You can read it HERE. In 2009, the US Military was encouraging training programs such as CrossFit. You can read it HERE. So what happened?
CrossFit goes out of its way to warn people that if they can’t maintain proper technique, they should back off. After all, the CrossFit mantra is “Mechanics, Consistency, Intensity”. Backing off , however, is a hard sell for many participants because workouts are viewed as a competition. The 2009 US Military study states that “Properly trained coaches are fundamentally important in both establishing an effective training program and developing proper movement mechanics in athletes.” It sounds like something, or someone, went wrong between 2009 and 2011.
So I guess the biggest question that you should ask (before joining a local Cross Fit gym) is WHO is running the classes and HOW they are trained. Make sure they at least have Level I or Level II Cross Fit training. A power lifting background is very helpful as power lifters are obsessive about proper form. Make sure you observe a class or two to witness how or if the instructor is scrutinizing and ensuring proper form. The proof is in the puddin’.
We reviewed an ARTICLEin Precision Nutrition about the effects of chronic inflammation and how to combat it with exercise. Researchers are using the term “cold inflammation” to describe chronic inflammation because it doesn’t have the typical hallmarks of acute inflammation such as fever, heat, or swelling. Cold inflammation is an inflammatory process caused by every day exposure things such as pollution, nutritional deficits, and chronic stress (what’s that?). An uninterrupted cycle of cold inflammation has been linked to obesity, diabetes, and heart disease.
This article presents a study published in the Medical Science of Sports and Exercise Journal. The study looked at two groups of healthy, yet obese, post menopausal women. The control group was given patient education and sedentary activity. The other group was given a moderate general resistance training routine to be done 3 times a week for 12 weeks. The results included a reduction of specific inflammation cells between 18% – 33% and an increase in an anti-inflammation markers by 20%!
By working with a health care professional or personal trainer to develop a safe resistance program, you can significantly improve your health and reduce your risk of disease.
Throwing a baseball is the fastest known human movement. The speed of the throw from a professional baseball pitcher can be upwards of 7000 degrees per second. Now that’s fast! In addition to that, the shoulder is the most mobile joint in the human body. So what does this mean?
For those of you that “feel a need for speed”, you need to beware of the risks. In anarticle from the Journal of Sports Medicine, twenty-three professional pitchers were followed over three seasons. Those pitchers who were throwing at the highest maximum velocity suffered the highest incidence of elbow injuries. So how does that effect you? It is vitally important for the throwing athlete to understand the stresses that repetitive throwing places on young as well as mature joints. In the words of baseball trainer phenom Eric Cressey, “injuries occur when you ignore the things that need to be addressed, plain and simple.” In one of my previous blog posts, I talk about how it has been scientifically proven that strength training enhances athletic performance. Shoulders and elbows become problematic not only because of muscular weakness, but also from poor flexibility, poor tissue quality ie scar tissue and, of course, faulty mechanics.
For example, consider the dreaded inverted or upside down “W” exhibited by the Yankees’ Joba Chamberlain or the National’s Stephen Strasburg.
Just because a joint is flexible does NOT mean that it is stable. Consider the six phases of throwing and all the potential areas of instability when throwing at maximum velocity. Our objective should be to achieve dynamic stability during ALL phases. Yes, if you are stiff we are going to stretch you and if you are loose we are going to stabilize you…but what about the gray areas? Every major league pitcher suffers from a loss of shoulder internal rotation for at least 3 days after an outing. This is a situation when you do NOT stretch. The resulting loss of motion is due to the micro-trauma of eccentric load during deceleration and needs time to heal. It has been shown that the posterior aspect (the back part) of the shoulder joint capsule actually thins out after repetitive throwing. So let me ask you, should we ever stretch the posterior aspect of the shoulder joint? Or should treatment focus more on the scar tissue that results in the decelerators?
So what are the most common upper extremity baseball throwing injuries? These injuries include the problems associated with overuse or improper training such as:
• Impingement syndrome
• Rotator cuff tendonitis
• Biceps tendonitis
• Medial elbow pain from flexor-pronator tendonitis
These overuse injuries can lead to more serious conditions such as:
• Rotator cuff tears
• Labral tears
• Ulnar collateral ligament (UCL) tears
We have many manual tests that we can perform in the clinic to differentiate and determine what structures may be involved in YOUR specific case. In the case of impingement syndrome, I have previously posted a BLOG articleon the different types of impingement syndrome as well as a VIDEO demonstrating the tests that we use to differentiate rotator cuff versus labral dysfunction. It should be noted that a condition called scapular dyskinesis can lead to impingement syndrome. This condition is characterized by an imbalance of scapular motion relative to shoulder motion. It is the result of weakness in the muscles that stabilize the scapula during the throwing motion. I have also listed some of the best, evidence-based exercises in a previous postfor specific shoulder and scapular retraining.
It is very important for your therapist to differentiate between what we call active restraint or passive restraint structures. Active restraint structures are those things that contract and relax like your muscles and tendons. Passive restraint structures are things like ligaments ie UCL, cartilage ie labrum and meniscus, and discs ie intervertebral discs. I would like to highlight the UCL of the elbow as one example of this. For many pitchers, the first sign of impending trouble with the UCL is pain or stiffness in the flexors of the forearm. The flexors and pronators of the forearm are the active restraints and the UCL is the primary passive restraint to the extreme valgus forces that occur at the elbow during terminal cocking phase and early acceleration. Did you know that when the UCL is tested in isolation during cadaver studies that it only takes 32 newton/meters of force to rupture it? Guess how much valgus stress is on the inside part of the elbow during terminal cocking phase….64 newton/meters!! It has been shown that the UCL takes on 35 newton/meters of that force. Yikes!! So why doesn’t it rupture? It doesn’t rupture because the rest of that stress is controlled by the active restraints…your muscles in the forearm. You can probably guess what happens when you ignore your forearm muscles?
As mentioned earlier, imbalances in flexibility, tissue quality, biomechanics, or weakness can lead to stress on both active and passive restraints during the throwing motion. Invariably, the process of repetitive throwing leads to the development of scar tissue. There is a constant state of break-down and build-up that occurs during sport specific activity. I have blogged on problems with scar tissue and the debate on whether pain arises from tendonitis or not. I have also explained the benefits of the Graston Technique as a way to ensure that scar tissue does NOT inhibit your ability to throw.
Now, what blog post is complete without a little twist. After listing the most common injuries that we see in the throwing athlete, I would like to share a list of conditions that have been confirmed via MRI in athletes that have NO pain:
* 79% of overhead throwing athletes have labral tears
* 34% of athletes have rotator cuff tears
* 82% of athletes have disc herniations
Does this mean that you may ALREADY have a tear and that you are currently asymptomatic like the athletes in the previous studies? Yes, you may. Does this mean that your future hall of fame career is over? No, it doesn’t. Some practitioners are of the opinion that you may very well need a labral lesion to throw hard in the first place. The biggest challenge with this is ensuring that the throwing athlete develops all the things that we have talked about in this post:
It is ALL these reasons that make it vitally important to be as educated as you can about your shoulder mechanics and to be aware of the important role that training and physical therapy play in keeping you healthy. It is our role as your physical therapist and performance specialist to guide you with you in this process. Here is an example of an effective warm up program for baseball players by the former trainer for the Boston Red Sox, Mike Reinold,PT. CLICK HERE.
Understanding throwing biomechanics in combination with a thorough knowledge of the anatomy and function of the shoulder and elbow is imperative to properly diagnose and treat the throwing athlete. Your prognosis for a healthy return to competition after arthroscopic surgery or ligament reconstruction has dramatically improved especially when you are in the right hands during recovery. My job as a physical therapist is not only to effectively rehabilitate your body after surgery but, more importantly, to help PREVENT the need for surgery in the first place. Of course, this is a two way street. I can only be your coach if you are a willing and motivated player.