The History of Physical Therapy

National Physical Therapy month is celebrated in October to recognize the impact physical therapy has had on the medical profession and to encourage community awareness on the benefits that physical therapy has on treating chronic or acute pain.   So how did the profession of physical therapy get started?   Little known is how far back in … Continue reading “The History of Physical Therapy”

National Physical Therapy month is celebrated in October to recognize the impact physical therapy has had on the medical profession and to encourage community awareness on the benefits that physical therapy has on treating chronic or acute pain.  

Physical therapists and physicians work together to treat children at a New England poliomyelitis clinic in 1916.

So how did the profession of physical therapy get started?  

Little known is how far back in history the idea of physical therapy goes.   There are documented records as early as 430 BC that Hippocrates recognized the benefits of massage, manual manipulation and water therapy for pain relief.  It wasn’t until much later towards the end of the 19th century with the establishment of orthopedics in medicine, the outbreak of polio  and with women recruited in WWI to restore function to injured soldiers, that modern day physical therapy as we know it was recognized as a profession.    

It is recorded that the Swedish scholar and fitness enthusiast, Per Hendrik Ling, is given credit for being the first to recognize physical therapy as a profession when he established the Royal Central Institute of Gymnastics in 1813 for manipulation and exercise.  He recognized the benefits exercise and manual manipulation had on restoring function and movement in people with disabilities. In 1887 the Swedish National Board of Health & Welfare was the first to register practitioners working in Ling’s institute as physical therapists.   

Other countries were soon to follow as they recognized the benefits of physical therapy.  In 1896, nurses in England formed the Chartered Society of Physiotherapy. In 1913 New Zealand started one of the earliest schools of physical therapy at the University of Otago.  In 1914 a school for “Reconstructive Aides”, a term used for those practicing physical therapy was established in the United States at the Walter Reed Army Hospital in Washington DC.   

As the profession continued to gain recognition, the first physical therapy research in the US was published in March of 1921.  That same year, the American Women’s Physical Therapeutic Association was established by American physical therapist Mary McMillan.  Due to her extensive contributions to the profession, Mary McMillan became known as the “Mother of Physical Therapy”. 

Mary McMillan, circa 1921

The demand for physical therapists became even greater during WWII and the polio epidemic during the 1940’s and 1950’s.   By late 1940’s, the physical therapy association changed its name to what is known today as the American Physical Therapy Association, or APTA. The goal of the APTA is to further advancements in physical therapy practice, research and education.  Current membership is over 100,000.

Reconstruction Aides treat soldiers at           Fort Sam Houstan, Texas, in 1919

The month of October is the time physical therapists across the country celebrate and encourage everyone to raise awareness of physical therapy as a cost-effective and safe alternative to medication and in many cases surgery.  According to the APTA, physical therapy is “a safer way to manage pain.”  

If you, a friend or family member is suffering from chronic or acute pain, recent or unresolved injury, please consult with your local physical therapist who will design a plan specific to your needs and goals. 

Written by : Marilyn Johnson PT, facts and references from : APTA and Wikipedia.

Watch & Learn: Ways to Improve Your Balance at Home!

Dr. Justin LaLonde, DPT and Dr. Monique Lassaga-Bishop, DPT demonstrate ways to improve your balance at home! Your balance is managed by 3 systems: Sensory system – where you feel Visual system – using your eye sight Vestibular system – inner part of ear that manages your equilibrium 3 Exercises to try at home for … Continue reading “Watch & Learn: Ways to Improve Your Balance at Home!”

Dr. Justin LaLonde, DPT and Dr. Monique Lassaga-Bishop, DPT demonstrate ways to improve your balance at home!

Your balance is managed by 3 systems:

  1. Sensory system – where you feel
  2. Visual system – using your eye sight
  3. Vestibular system – inner part of ear that manages your equilibrium

3 Exercises to try at home for balance improvement:

  • Tandem balance – put on foot in front of the other and hold for 30 seconds, then switch and put the other foot in front
  • Single leg balance – lift one foot up off the ground, hold for 30 seconds then switch
  • Move and tap – using a stair or item with height ( a book, box, etc) slowly move one foot forward to tap the stair and bring it back, then switch to the other foot.
video exercises by Dr. Justin LaLonde PT, DPT and Dr. Monique Lassaga-Bishop PT, DPT.

Fall Prevention

Falls are often overlooked as a harmless topic. Falls cause more than 95% of all hip fractures, the most common cause of traumatic brain injuries, and number one cause of harm and resulting death in elderly Americans.  While falls are common, they are preventable. These are some signs that you may need to work on … Continue reading “Fall Prevention”

Falls are often overlooked as a harmless topic. Falls cause more than 95% of all hip fractures, the most common cause of traumatic brain injuries, and number one cause of harm and resulting death in elderly Americans. 

While falls are common, they are preventable. These are some signs that you may need to work on your fall prevention strategies in order to keep yourself safe and sound:

  • You find yourself stumbling over objects or your own feet
  • You tend to shuffle your feet when you walk 
  • You hold onto nearby furniture and tall objects to improve confidence with walking
  • You have fallen at least once in the past 6 months  

Here are 5 ways to reduce your risk of falling and potential harm:

  1. PT to improve balance, strength and activity endurance
  2. Fall proof your home
    • Restrain small pets
    • Removed area rugs and any clutter in walkways 
    • Make sure the area is well lit when walking through it 
    • Install handrails in more difficult walking areas such as stairs and bathrooms 
  3. Wear sensible shoes 
    • Avoiding unsafe shoes such as loose slippers of flips flops can reduce risk of falling
  4. Speak with your Doctor about medications which may be causing dizziness 
  5. Use an assistive device 
    • Sometimes an assistive device such as a cane or walker may be necessary based on balance deficits. A Physical Therapist can assess your limitations and help decide which device could best keep you safe.

Here are some exercises you can practice on your own in order to improve your balance:

Single Leg Balance:

Image result for single leg balance

  • Having something sturdy to hold on to next to you in case you lose your balance, stand on one leg. Try to maintain balance for 30 seconds. To make the exercise more difficult try standing on an unstable surface like a pillow, or try closing your eyes. 

Head Rotations:

Image result for head rotations

  • Stand tall with your feet together. Have a wall or sturdy piece of furniture next to you in case you need to hold on. From here slowly move your head from side to side then up and down while you keep your body still. Do this for 30 seconds and repeat. If you become dizzy, try moving your head more slowly. If you still become dizzy, stop the exercise and speak with your PT about your doctor symptoms. To make the exercises easier, stand with your feet hip width apart. To make the exercise more difficult, try performing with your feet in tandem or on one leg.

Foot Taps:

Image result for foot taps on stairs for balance

  • Stand tall with our feet hip width apart in front of a step of bottom of a staircase. Have a wall or sturdy piece of furniture next to you in case you need to hold on. Do your best not to use your hands while you slowly raise one foot to tap the step in front you, then slowly return it to the floor. Perform 15-20 taps then repeat on the opposite leg. 

If you are unable to do each exercise for 4-5 sec try making it a little easier until you are ready to progress to the next level. If you can do 30 sec each time you try, the exercise is probably too easy for you.

Speak with a Physical Therapist if you feel your balance is becoming unsafe and want a professional recommendation to help you best prevent falls.

Blog researched and written by Dr. Monique Lassaga-Bishop, PT, DPT

 

Balance! Use It or Lose It!

BALANCE AWARENESS MONTH September is Balance Awareness Month! Balance is one of the most important aspects of life that most of us take for granted until we begin to lose it. Take a few moments this month to get familiar with balance! Remember when you were a youngster and fell all the time, and bounced … Continue reading “Balance! Use It or Lose It!”

BALANCE AWARENESS MONTH

September is Balance Awareness Month! Balance is one of the most important aspects of life that most of us take for granted until we begin to lose it. Take a few moments this month to get familiar with balance!

Remember when you were a youngster and fell all the time, and bounced up like nothing happened except for maybe a scrape or small bruise? Well as adults, we tend to fall much less until we reach a certain age. As many as 1 in 4 adults over the age of 65 experience a fall every year.  That’s 25% of human beings!  The risks of falls become greater as we age as well – torn muscles, broken bones, and even head trauma. Balance and steadiness on our feet are concepts we often take for granted when we are younger. However, as we age we can become less stable and with that can come the fear of falling. With aging, muscles begin to atrophy, bones become weaker, and our sense of balance diminishes. But it is possible to train our bodies to become more resilient and prevent falls. 

Balance is the process by which we keep our center of mass over our base of support, whether it is stationary or moving (static vs dynamic), and the ability to make adjustments to stay upright in a given environment. This involves an inherent problem-solving process where our brain and our body interact to provide equilibrium between gravity and ourselves. This process is multidimensional based on the interaction of specifics of the task at hand, constraints imposed by the environment, and individual capabilities. Therefore balance strategies are highly variable between individuals. 

A variety of systems work together to maintain an upright posture: 

  • Musculoskeletal: muscle strength, endurance of muscles, range of motion of specific joints
  • Neuromuscular: the coordination of strength, timing and sequencing of muscular contraction
  • Somatosensory: nerve receptors and the ability to feel and detect changes in surface
  • Visual: provides info about body position and environment
  • Vestibular: our equilibrium system! This serves to stabilize our gaze during head movement and provide info about our head position relative to gravity
  • Cognition: individual awareness, attention, memory, emotion, and judgement all have an effect on postural control and balance

It is the sum of these systems that provides our balance within our environment! Balance impairments begin to occur when pathology or dysfunction is present in one or more of the above systems that alters the relationship between them. Common causes of balance dysfunction include weakness in trunk and legs, tightness in hips and ankles, loss of visual acuity, decreased sensation (especially in the feet and ankles), vestibular disturbances such as vertigo or dizziness, and any change to the nervous system that involves control of our muscles. Many of these balance impairments can be addressed by physical therapy or regular exercise/practice. 

Balance can be broken down into static and dynamic balance. Static is when the body is not moving and dynamic is when the body is in motion. It is important to address both of these in order to keep balance sharp and prevent falls. Here are a few strategies to help keep those systems up to par!

Image result for balance exercises examples

Static Balance Practice: 

  • Standing Feet Together
  • Standing Feet Staggered
  • Standing Feet one in front of the other (tandem stance)
  • Standing on One Leg

* These can all be made harder or easier with closing the eyes, moving the head back and forth, or changing the surface you’re standing on!

Image result for balance exercises examples

Dynamic Balance Practice:

  • Walking
  • Marching in Place
  • Marching while walking forward
  • Walking heel to toe (one foot in front of the other)
  • Turning around in space
  • Walking sideways
  • Walking backwards

Keep in mind everyone will be at different levels of where their balance capacity is. Some things may be easy, some things may be difficult. It really depends on what systems are dominant versus underutilized. Just remember balance is something that CAN BE IMPROVED if practiced. It truly is a USE IT OR LOSE IT kind of deal! 

If balance is a concern for you, come see one of our Physical Therapists at Innovative Physical Therapy. They can help decipher which systems are working well, and which systems may need some work to help improve balance. Life is all about balance, so let us help you stay upright and healthy!

Blog researched and written by Dr. Justin LaLonde PT, DPT

Video: Exercises to Strengthen and Stretches to Relieve IT Band Pain

Dr. Brandon Brym, PT, DPT takes us through some exercise techniques and important stretches that help alleviate pain in the IT Band area and help build the muscles surrounding it. Your IT Band is connective a band of tissue that runs from the top of the hip to past your knee, the muscles connected to … Continue reading “Video: Exercises to Strengthen and Stretches to Relieve IT Band Pain”

Dr. Brandon Brym, PT, DPT takes us through some exercise techniques and important stretches that help alleviate pain in the IT Band area and help build the muscles surrounding it.

Your IT Band is connective a band of tissue that runs from the top of the hip to past your knee, the muscles connected to this are the TFL ( Tensor Fasciae Latae) and the Gluteus Maximus.

Pain attributed to this area from tightness or weakness in your hips or alterations in your foot mechanics.

Stretching and strengthening your TFL muscle and Gluteus Maximus will reduce pain as these muscles connect the IT Band to the hip joint.

Exercise #1 for TFL -Half kneeling position, lung forward till you feel a nice stretch down your leg. For more of an intense stretch raise your opposite arm up and bend slight over to one side. Hold for 30 seconds and repeat 3x daily to help loosen up.

Exercise #2 for both TFL and Gluteus Max – Use foam roller to roll out the TFL and Gluteus Max. Roll out each for a few minutes, putting a little pressure to loosen the muscles up. 

Great to do pre-workout and post workout!

Exercise #3 – Single Leg Stance – a version of the Romanian deadlift. Doing one leg at a time, standing upright with knees slightly bent, slowly lift one leg back, hold for the stretch, then release and switch to the other side. This is not only a great stretch but can be used as an exercise with weights to strengthen your muscles around the IT band as well! 

 

Corrective Stretches for Injury Prevention

Stretching is an essential part of any exercise regimen, it will not only improve your endurance and balance, but will also decrease the risk for injury. If you are participating in any sporting event or physical activity, time should also be set aside for stretching. Two types of stretches are typically conducted: static stretching (stationary) … Continue reading “Corrective Stretches for Injury Prevention”

Stretching is an essential part of any exercise regimen, it will not only improve your endurance and balance, but will also decrease the risk for injury. If you are participating in any sporting event or physical activity, time should also be set aside for stretching. Two types of stretches are typically conducted: static stretching (stationary) or dynamic stretching (mobility). The timing of stretching is important as well as the specificity, in other words your stretching routine should be specific to the demands of your sport. Typically, dynamic stretches should be performed pre-activity and static stretching post-activity. 

 

Dynamic Stretching-

These types of stretches are great for getting your heart rate up, warming up your joints and muscles, and enhancing range of motion and power. Again, these stretches should be specific to the demands of the activity you are about to perform.

Some general movements for most activities can include:

  • Standing hip circles
  • Leg swings
  • Trunk rotations
  • Arm circles
  • Butt kicks
  • Karaoke stretching
  • Lunges

The idea with these stretches is to make sure your muscles are ready to perform, with that said it is best to work into deeper ranges of motions (not into pain) but not holding the position.  Warm-up should be around 15 minutes. 

Static Stretching- 

These types are stretching are best to perform after activities as they can help maintain flexibility, lower recovery time, and decrease soreness. The idea for these stretches is to hold the position for at least 30-45 seconds to allow time for the tissue to adapt to the new range. Static stretching takes consistency, in order to change the properties of the tissue the stretches must be performed on a consistent basis.

Some examples include:

  • Seated or standing toe reaches (hamstrings),
  • Lunge stretch (hip flexors)
  • Knees to chest (hamstrings, glutes, low back)
  • Butterfly (groin), doorway stretch (pectorals)
  • Runner’s stretch (gastric/soleus)
  • Flamingo (quadriceps).

Try 3 sets per stretch in order to get the most out of your stretching. Stretching should not be painful, but some discomfort is normal especially in more restricted areas. Remember to always listen to your body, perform all stretches as tolerated. 

Blog researched and written by: Dr. Brandon Brym, PT, DPT.

Do You Actually Know What and Where Your “IT Band” Is?

Are you experiencing “IT band” pain? What is the cause? The Iliotibial band (ITB) is a broad band of connective tissue that runs along the outside of the thigh, it extends from our lateral hip down to the outside of your knee.  It is a passive stabilizer of the hip and lateral stabilizer for our … Continue reading “Do You Actually Know What and Where Your “IT Band” Is?”

Are you experiencing “IT band” pain? What is the cause?

The Iliotibial band (ITB) is a broad band of connective tissue that runs along the outside of the thigh, it extends from our lateral hip down to the outside of your knee.  It is a passive stabilizer of the hip and lateral stabilizer for our knee. It is also the attachment point for a couple muscles in our hip. Due to faulty mechanics or overuse, the ITB can become stressed and lead to inflammation, irritation and pain. Typically, pain occurs at the knee or hip, but can occur anywhere along its path. An injury to the ITB can cause difficulty with daily activities or setbacks to training. 

Due to the complexity of the cause(s) of pain in the ITB, it is helpful to break down the most common causes into internal and external factors. There is typically more than one factor at play, so a thorough assessment is key to starting a successful recovery:

  • Internal FactorsPoor flexibility in the hip or thigh, weak gluteal musculature, poor running or lifting mechanics.
  • External FactorsImproper footwear, improper orthotics, change in training intensity, change in training surface, or sudden increase in activity level.

Other common conditions associated with ITB pain include:

  • Trochanteric Bursitis This is often the result of increased rubbing of the ITB over the bursa on the outside of our hip. Pain can travel the length of the ITB and even down into the lower leg/calf. Typically caused by overuse or from a traumatic fall landing on the outside of the hip. Rest, stretching, and activity modification are key initial interventions to relieving the symptoms.
  • ITB SyndromeThis is very common in runners. Weakness in the hips and lack of flexibility can lead to increased wearing and rubbing of the ITB over the bony prominences of the leg resulting in pain. Running and lifting mechanics are often poor as well and need to be addressed to prevent further ITB injury. 
  • Knee or Hip PainSometimes the pain can be general, diffuse areas of our hip/knee joints and can be hard to determine exactly where they originate. Typically, the result of overuse with the combination the internal/external factors above. 
  • Lumbar Spine RadiculopathyPain in the ITB could be coming from nerves in our low back, known as lumbar radiculopathy. This is often difficult to tell apart from the other conditions above, it can be accompanied by numbness/tingling or even burning pain.

A couple of useful injury prevention activities include: 

Stretching the muscles around the hips and knee, the ITB does not stretch but the muscle that attach to it do so focus on these areas. Also, listen to your body and gradually increase activity levels giving yourself time to recover and determine your tolerance to new activities. The use of a foam roller to address the areas of tightness can be a helpful adjunct to stretching. Physical therapy your Physical Therapist can perform a thorough examination and determine which factors are contributing to your pain and help develop a comprehensive, individualized exercise program to help you get back to your activities.

Blog researched and written by : Dr. Brandon Brym, PT, DPT.

Video: Craniofacial Exercises for Head, Neck and Jaw Pain

Follow along with Dr. Lindy First, DPT and Dr. Monique Lassaga-Bishop, DPT as they demonstrate easy exercises to relieve craniofacial pain. At Home Exercises: Seated Butterfly- sit upright with feet on ground, tighten stomach, overlap hands and place behind your neck. tuck your chin, make a long neck and retract your head backwards. Squeeze shoulder … Continue reading “Video: Craniofacial Exercises for Head, Neck and Jaw Pain”

Follow along with Dr. Lindy First, DPT and Dr. Monique Lassaga-Bishop, DPT as they demonstrate easy exercises to relieve craniofacial pain.

At Home Exercises:

  1. Seated Butterfly- sit upright with feet on ground, tighten stomach, overlap hands and place behind your neck. tuck your chin, make a long neck and retract your head backwards. Squeeze shoulder blades and pull your elbows back as far as possible. hold for 10-15 seconds, repeat 2x every hour building up to 1 minute over 6 weeks.
  2. Self Masseter Release- locate the bone by your ear, your TMJ and move fingers down 1/2 inch to your masseter muscle, find the belly of that muscle and make small circles on your face for 2 minutes. 2x throughout the day
  3. Self Temporalis Release- locate again your TMJ bone and go up about 1/2 to your temporal muscle. Make small circles on this area for 2 minutes. 2x throughout the day

REDUCE= Muscle Tension & Pain

PROMOTE= Overall Skeletal Health

RESULT = A Healthier You!

Benefits of Yoga

Yo·ga /ˈyōɡə/ noun Definition : a Hindu spiritual and ascetic discipline, a part of which, including breath control, simple meditation, and the adoption of specific bodily postures, is widely practiced for health and relaxation. The Benefits of Yoga Can reduce stress  A study done for the Journal of Affective Disorders showed that people who do … Continue reading “Benefits of Yoga”

Yo·ga
/ˈyōɡə/
noun
  • Can reduce stress 
    • A study done for the Journal of Affective Disorders showed that people who do yoga regularly have a reduced amount of cortisol (the stress hormone). 
  • Relieves Anxiety 
    • It emphasizes the importance of being present in the moment and finding a sense of peace, which could help treat anxiety.
  • Could improve heart health 
    • One study in the Indian Journal of Physiology and Pharmacology  found that participants over 40 years of age who practiced yoga for five years had a lower blood pressure and pulse rate than those who didn’t
    • High blood pressure is one of the major causes of heart problems, such as heart attacks and stroke. Lowering your blood pressure can help reduce the risk of these problems
  • Could promote better sleep quality
    • Reduced cortisone levels and focus on breath may improve sleep 
  • Improves Flexibility and Balance
    • Although some poses and stretches may be difficult for a beginner, with time muscles stretch and flexibility improves. Its not uncommon for aches and pains to disappear when this happens, because tight muscles can cause unneeded stresses on joints. 
  • Increases strength 
    • Being able to maintain positions for extended amounts of time with the proper engaged muscles will improve strength throughout the body.

We have Adaptive Yoga and Pilates/Yoga at our Fitness Gym – Mondays @ 12:30pm and Wednesdays @ 12pm for Adaptive Yoga and Mondays and Wednesdays @ 3pm for Pilates Yoga. Ask your Physical Therapist which Yoga class would be right for you, and come try your first class on us!

Do you Have Chronic Face, Head and Neck Pain?

Craniofacial pain is a term used to describe any chronic facial, neck or head pain.  The most common forms of craniofacial pain are temporal mandibular joint dysfunction, trigeminal neuralgia and chronic headache disorder. Temporomandibular joint disorder (TMD, aka TMJ) is pain or malfunction at the jaw joint. You may be more likely to get TMJ … Continue reading “Do you Have Chronic Face, Head and Neck Pain?”

Craniofacial pain is a term used to describe any chronic facial, neck or head pain.  The most common forms of craniofacial pain are temporal mandibular joint dysfunction, trigeminal neuralgia and chronic headache disorder.

Temporomandibular joint disorder (TMD, aka TMJ) is pain or malfunction at the jaw joint. You may be more likely to get TMJ if you have rheumatoid arthritis, chronic fatigue syndrome, or fibromyalgia. Women are affected more often than men. Most people with TMJ are between the ages of 20 and 40.   TMJ symptoms can include clicking, locking of the jaw, headache, earache, phantom tooth pain and facial muscle fatigue.

Trigeminal neuralgia is an ongoing pain condition that affects certain nerves in your face. Women are more likely than men to get trigeminal neuralgia, and the disorder is more common in people older than 50.  Symptoms can include facial pain, difficulty in chewing, speaking, and brushing teeth.

Chronic headache disorder is a headache (Migraine, tension, or cluster) that occurs repeatedly. Tension-type headaches are the most common form of chronic headache disorder. A tension-type headache is generally described as a diffuse, mild to moderate pain or ache across the forehead, sides or back of your head or neck; a tight band-like feeling around your head; and sensitivity and/or tenderness of the scalp, neck and shoulders.   

Migraines like tension-type headaches are also a very common form of chronic headache disorder. See previous newsletter on migraines for more details regarding symptoms and treatment options.

Cluster headaches are the least common type of chronic headache disorder affecting less than 1 in 1,000 people.  This headache is of shorter duration but very painful, occurring daily for weeks or months at a time, then disappears completely to return without warning months or years later. Symptoms include severe pain in or around one eye that may radiate to your face, head, neck and shoulders; usually one-sided pain;  restlessness; excessive tearing and redness in your eye on the affected side; nose congestion or runniness on the affected side; forehead or facial sweating; pale skin or flushing of the face; and swelling around the eye or drooping of the eyelid on the affected side.

There are many causes of craniofacial pain.  Macro traumas, direct injury, to the face, jaw and neck that are caused by car accidents, sports injuries and accidental falls can result in craniofacial pain.  Micro traumas, indirect injury occurring over time, from stress, poor sitting and standing postures, chronic grinding and/or clenching of the teeth, and sleep disorders (sleep apnea, snoring) can cause the muscles that help to stabilize the head, neck, and/or jaw to be over worked and become fatigued resulting in craniofacial pain.

Airway – Sleep disorders like sleep apnea or or snoring

Bruxism -grinding of the teeth

Craniofacial pain – a result of both airway and bruxism

Whatever the cause or symptoms, craniofacial pain should not be taken lightly.  It can lead to depression, sleep deprivation, overuse of medication, and severely affect your activities of daily living.

If you are experiencing symptoms of craniofacial pain your physical therapist can help you determine the origin of your symptoms and initiate a treatment plan which would include manual therapy techniques to treat soft tissue and joint imbalances, modalities (ultrasound, electrical stimulation, cold laser) to decrease inflammation and exercises to improve your posture and head, neck and jaw alignment. 

For more information on craniofacial pain please contact us at 619.260.0750 today.