Apr
18

Treating Low Back Pain Part 2 – Stabilization Exercises

By: admin Published: April 18, 2012

  By Lauren Shafer PT, DPT

 

 

Treating Low Back Pain is Not One Size Fits All

The second subgroup for treating low back pain is stabilization exercise. I find this to be an interesting category in the way it has evolved and what we are finding through research. It is commonly thought that “core training or stabilization” is the best way to treat low back pain, but this isn’t always the case. The literature over the past several years has prompted popularity in the prescription of stabilization exercise, however, results on its true effectiveness are inconclusive. While strong abdominal and back muscles definitely can help prevent and manage low back pain, it isn’t always the correct intervention for someone with low back pain.

The criteria for this subgroup include:

  • Age < 40
  • Greater general flexibility (straight leg raise >91°)
  • Positive prone instability test (locating a relatively more mobile segment of the lumbar spine that also reproduces symptoms when direct pressure is applied. The test is positive if pain is no longer reproduced while the patient performs a movement eliciting lumbar muscle contraction)
  • Aberrant movement when actively bending forwards and backwards, referred to as an “instability catch”, and the patient may perform “thigh climbing” when coming up.

 Is this the right intervention for me?

A person who meets at least three of the four criteria is 80% likely to report at least a 50% decrease in symptoms when a core stabilization program targeting both deep and superficial trunk muscles is utilized. What I find even more interesting is that when at least three of these factors are negative, the person is 86% likely to FAIL to improve with a stabilization program. If you currently have back pain and just can’t seem to get better no matter how strong you get, this may shed some light as to why! There is also an additional set of factors to identify women with pain who are postpartum and likely to benefit from a stabilization program.

For more information about classifications of low back pain, you can read the article here.

Call or e-mail CoreBalance Therapy to schedule an evaluation with a physical therapist so that we can determine the best approach for you!

928-556-9935

reception@corebalancetherapy.com

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Mar
30

Treating Low Back Pain is Not One Size Fits All

By: admin Published: March 30, 2012

By Lauren Shafer PT, DPT

We have a significantly high incidence of low back pain (LBP) in our society, and it accounts for over 50% of complaints in a physical therapy office. There is a plethora of research investigating the most effective interventions for LBP, however, the evidence remains largely inconclusive on how to best treat it.

One proposed explanation for the lack of consistent evidence is that it is commonly treated as a homogenous condition, meaning, it is assumed all back pain is the same. Leading researchers in physical therapy are finding that all low back pain is not the same, and each person and episode needs to be evaluated and treated differently.

If you’ve been trying one approach to managing your back pain that doesn’t seem to be helping, there may be a reason why.

Currently, the literature suggests four subcategories of LBP, which all require a somewhat different approach to treatment. The four categories are: Manipulation, Stabilization, Specific Exercise and Traction. Thus far, the Manipulation category has been the most extensively researched, so I will begin here.

Manipulation is defined as a high-velocity low-amplitude thrust that is applied to the spine. Current studies show that a person who reports recent onset of symptoms (less than 16 days) and who does not have symptoms radiating past the knee is highly likely (95%) to have at least a 50% reduction in symptoms with manipulation. There is a slightly increased chance of success (97%) if that person also meets two other criteria involving hip mobility and low fear avoidance. When the specific factors are not present, the likelihood of success reduces to 9%.

What’s more, the evidence now suggests that treating an episode of back pain in that early 16 day window reduces the likelihood that a patient goes on to develop chronic lower back pain.  So please call or email us if you have an acute episode of back pain so we can get you on the right track quickly!

I’ll be posting blogs on the other treatment categories over the next few weeks, so please stay tuned!   And remember, no matter how long your back has been bothering you, there’s a lot that our expert physical therapists can do to help.

Call or e-mail CoreBalance to schedule an evaluation with a physical therapist so that we can determine the best approach for you!

928-556-9935

reception@corebalancetherapy.com

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Mar
20

March is Brain Injury Awareness Month

By: admin Published: March 20, 2012

Katie Pierce, PT, DPT

How “Aware” are You about Brain Injury?

Perhaps you have been following recent national news on the impact of concussions on athletes.  Perhaps you too are troubled by the staggering number of veterans returning from the wars in Iraq and Afghanistan with brain injury.  Maybe you have a loved one affected by Traumatic Brain Injury (TBI), Aneurism, or Stroke.  Perhaps you are one of the 3.5 million Americans living with a disability from acquired brain injury.

 

March is the month: Help Raise Awareness of Brain Injury.

Awareness and education lead to injury prevention, as well as improved outcomes for those living with the effects of brain injury.

 

March 20 is “Wear Blue Day” for Brain Injury Awareness

Please, post this flyer at your work place!

 

Some Brain Injury Facts*:

  • Every 21 seconds, someone in the United States sustains a brain injury.
  • In 2010 alone, over 60,000 people were seen in Arizona hospitals for TBI.
  • Falls are the most common cause of TBI. Motor vehicle accidents are second.
  • Higher-risk groups: children birth to four, seniors, youth ages 15-19, military personnel, and Native Americans.
  • The Invisible Injury:  Disabilities from brain injury are often not noticeable to the eye. Additionally, mild Traumatic Brain Injury (mTBI, concussion) does not show up on medical imaging, such as MRI scans.  Because of this, individuals may have their lives changed by brain injury, yet go undiagnosed for years.

 

*Source:  Brain Injury Association of Arizona: www.biaaz.org

 Recovery After Brain Injury: Physical Therapy is Key!

Physical symptoms after brain injury may include:

  • Balance and walking challenges
  • Loss of strength and mobility; partial paralysis
  • Dizziness and nausea
  • Difficulty with fine motor tasks and coordination, especially when tired, stressed, or trying to multi-task

 

A physical therapist skilled in neurological and vestibular rehabilitation can develop a plan of care to address these symptoms and help the person regain maximal functioning and quality of life.

 

If you or a loved one struggle with symptoms after Brain Injury, call the expert physical therapists at CoreBalance Therapy for an evaluation:

(928) 556-9935; or email reception@corebalancetherapy.com.

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Feb
20

“Extreme” Exercise and Pregnancy

By: admin Published: February 20, 2012

by Amy Flory, PT, MPT

My fellow physical therapist and expert rock-climber, Aimee Roseborrough, recently had a brush with fame when she was featured on Good Morning America in a segment about “extreme” exercise during pregnancy.  Considering that the “top-roped” climbing she has been doing in her second pregnancy is generally safer than, say, driving to the climbing location, the only “extreme” part of the whole thing was the hateful commentary by an uneducated audience (and the naïve expectation by the field reporter that he should try climbing for the first time without bringing proper equipment—see Aimee’s blog)

However, the situation does illuminate the fact that there are still many people out there that believe some old wives’ tales about pregnancy and exercises—and, that not everyone posting on internet sites knows much about climbing techniques.

Now, don’t get me wrong; there are times, such as higher-risk pregnancies, when exercise should be very carefully monitored, and sometimes restricted.  And, there are some women, me included, that simply cannot exercise at all during pregnancy.  I could scarcely climb off the couch without vomiting, let alone be in a moving vehicle on the way to climb a big rock.  The startling lack of cooperation on the part of my body shattered any pre-pregnant preconceptions I had about being one of those women who would run miles and miles during their glorious, relatively-pain-free pregnancies.

Prenatal Exercise Guidelines

The American College of Obstetricians and Gynecologists publishes a working list of guidelines on exercise during pregnancy; it is updated at times based on the most recent studies.  Over the past decade, these guidelines have become more broad and general; I’ve summarized them below.

  • For women with normal pregnancies, 30 minutes of moderate exercise daily provides many benefits (this is the same intensity and duration recommended for non-pregnant women).
  • If you’ve been engaged in a certain activity or sport before pregnancy, you probably can continue it during pregnancy (as long as you’re not getting injured, and it’s not a contact sport).
  • You need to avoid lying on your back after the first trimester.

Yoga mama? Maybe not…

Contrary to the serenity suggested by ethereal music and deep breathing in a yoga class, prenatal yoga can actually be very stressful to the maternal joints and ligaments, especially in asymmetrical stances.  If you’re not experiencing low back or hip pain, by all means continue your yoga classes!  However, if you are getting sharp shooting pains in the low back or buttocks, you may need to significantly alter your routine, or discontinue it altogether.

These kinds of pains usually indicate a need for physical therapy intervention.  Talk with your physical therapist about your exercise activities during pregnancy for recommendations on how to keep active without causing lasting injury to your body!

Posted in Pregnancy | Tagged Tags: , , | 1 Comment

Jan
13

Tips for Avoiding Workplace Aches & Pains

By: admin Published: January 13, 2012

By Colleen Gest, PT, DPT

Proper workstation set-up can make all the difference on feeling good at work

Are you experiencing headaches, back or neck pain at work? Long hours in front of computers are becoming more common in today’s workplaces. Prolonged poor postures lead to cumulative stresses on body structures, resulting in headaches and back, neck, shoulder and wrist pain. Proper workstation set-up, good sitting posture, and frequent breaks are all important in avoiding workplace musculoskeletal injuries.

Following are a few tips for keeping your body in top shape at work:

  • Place your computer: Place the computer monitor at or just below eye level, directly in front of you. The keyboard and mouse should be in front of you with the wrists in a relaxed position. Do not rest on the wrist rest unless you are taking a break from keying.
  • Sit Well: Sit with the hips and knees bent at a ninety degree angle with your feet flat on the floor. Sit upright in your chair with the low back and shoulders against the backrest. The natural lumbar curve of the back should be supported by your office chair or a small towel roll. Adjust your armrests so your shoulders can relax while typing.
  • Take Breaks: Take frequent breaks at least twice hourly for stretching, or to stand and change your position.

While these changes help decrease the potential for injuries, stretching and strengthening exercises are essential to counteract the effects of prolonged positioning.

For more information on ergonomics, stretching, or strengthening specific to avoiding workplace musculoskeletal injuries, contact CoreBalance Therapy at 556-9935.

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Jan
11

Recognizing Signs of a Stroke

By: admin Published: January 11, 2012

by Katie Pierce, PT, DPT

Stroke occurs when a blood vessel breaks in the brain or a blood clot blocks an artery, interrupting blood flow to an area of the brain.  When this happens, brain cells begin to die and brain damage occurs.

Stroke is a medical emergency, in which every second counts.  The sooner a person can get medical care, the sooner life-saving medications or other measures can be administered.  Each year in the United States, about 750,000 people sustain a stroke.  Would you know how to recognize the warning signs of stroke in yourself or a loved one if it occurred?

Warning Signs: Think “S.T.R.O.K.E.”

S = Speech, or any problems with language.

T = Tingling or numbness.  Tongue is off-center when stuck out

R = Remember: any problems with memory

O = Off balance, problems with coordination

K = Killer headache

E = Eyes, or any problem with vision.

Stroke is an emergency. Call 9-1-1

After Stroke: How can Physical Therapy Help?

A Physical Therapist can help treat a variety of impairments that may have arisen from a stroke:

  • Decreased strength and endurance
  • Increased muscle tone, or spasticity
  • Balance and coordination challenges
  • Dizziness
  • Walking and mobility difficulties

Your Physical Therapist will perform a thorough evaluation and, with your input, design an appropriate plan of care to help you regain maximal function and quality of life. If you or someone you know has suffered a stroke, call the Physical Therapists at CoreBalance Therapy, LLC.: (928) 556-9935.

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Jan
6

Fall Recovery

By: admin Published: January 6, 2012

Fall recovery training

by Amy Flory, PT, MPT

Often, people don’t realize how much their strength has declined until they’ve fallen and are unable to get up off the floor—even if they weren’t injured in the fall. If this unfortunate person finds themselves, fortunately, referred to physical therapy for balance training, the physical therapist should evaluate why you are not able to get up off the floor.

A couple of simple tests I do with patients are:

  1. While standing, can you “hike” your hip? Hiking your hip involves tightening one side of your waist so your hip bone gets closer to your ribs.  The foot on that side should be lifted off the floor, but the leg remains straight.
  2. Can you move from hands-and-knees to side-sitting and back to hands-and-knees?

In my clinical experience (disclaimer: this isn’t seen—yet—in the research literature!), if you cannot do one or both of the above activities, you probably are not able to get up off the floor easily, and, more importantly, you probably will not do well with certain balance activities.  Therefore, you are more likely to fall in the first place.

I didn’t even know I couldn’t do this anymore!

Perhaps you lost the ability to do these things because you hurt your shoulder years ago and have avoided bearing weight on your hand, or pulling with your arm certain ways.  Perhaps you’ve been sitting watching TV a couple of hours a day and now your back is stiff enough to keep you from being able to hike your hip, or makes you lose your balance while looking over your shoulder.

Your physical therapist at CoreBalance Therapy will look at the obvious factors causing you to lose your balance, but they will also search for the hidden reasons you’ve been falling as well.  It might seem like opening a can of worms, but identifying these problems and addressing them will help your balance therapy be much more successful in the long run!

To begin improving your strength, call to schedule your appointment today: (928)556-9935.

 

Posted in Balance, Fall recovery | Tagged Tags: , , | No Comments

Dec
14

You Have Options for Back Pain

By: admin Published: December 14, 2011

Lumbar Spinal Stenosis and Physical Therapy

by Jay McCallum, PT, DPT, OCS

If you or a loved one is experiencing back and leg pain that is made worse with walking and standing, you do have options other than injections, drugs, surgery, or just living with it.  Physical therapy, and in particular an intensive program of manual therapy and exercise, can make a very real difference.  And given that one of the best predictors of longevity and quality of life is a person’s ability to keep moving and walking, this is a case where physical therapy can literally be a lifesaver.

You have options for back pain

You have options for back pain

Do I have Spinal Stenosis?

Spinal stenosis is a condition that affects primarily patients over the age of 65 and is characterized by back and radiating leg pain that is made worse with standing and walking and is generally better with sitting.  ‘Stenosis’ is the expensive medical term for ‘narrowing,’ and the part of the spine that narrows is the space around the nerves in the back.  The narrowing is usually caused by arthritic changes in the spine including bulging discs and enlarged joints, and the position of standing further narrows the space around the nerves so that pain is generated.  Many more patients experience a similar pattern without the radiating leg pain, reporting primarily back pain that is made worse with standing or walking and relieved by sitting.

How can physical therapy help me?

Medical literature supports the idea that a comprehensive program of physical therapy directed at maximizing spine mobility and hip mobility, and improving a patient’s trunk, hip, and leg strength can significantly decrease a patient’s level of pain and increase their ability to stand and walk.  

Because the diagnosis of spinal stenosis is based on structure – that is, the loss of space around the nerves in the spine – many patients and other medical providers do not tend to think of physical therapy as an option.  After all, there is nothing that can be done in therapy to un-degenerate a disc or decrease the enlargement of an arthritic joint.  However, because patients by and large are less concerned with the look of their CT scan or MRI and much more concerned with the pain they experience with walking, then physical therapy it becomes more clear that physical therapy can help.  The literature does support the idea that a comprehensive program of physical therapy directed at maximizing spine mobility and hip mobility and improving a patient’s trunk, hip, and leg strength can significantly decrease a patient’s level of pain and increase their ability to stand and walk.

Want to know more?

One of the best examples of this research was published in the prestigious journal Spine in 2006. To read this article of Spinal Stenosis, please click here.

Call CoreBalance Therapy today to discuss a treatment program that can help with your back pain:

(928) 556-9935

Reception@CoreBalanceTherapy.com

Posted in Back pain | Tagged | No Comments

Nov
1

Conditions We Evaluate & Treat

By: admin Published: November 1, 2011
  • Back & Neck Pain
  • Pelvic Pain
  • Incontinence
  • Dizziness & Imbalance

Posted in Uncategorized | Tagged | No Comments

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