National Action Week for Bone and Joint Health

*National Bone & Joint Health Action Week*

October 12th-20th

Maintaining bone and joint health is one of the most important aspects to living a great life

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National Action Week for Bone and Joint Health, a global initiative promoting the care of people with bone and joint disorders, is observed October 12-20. This initiative focuses on improving quality of life and advancing the understanding and treatment of musculoskeletal conditions through research, prevention, and education.

Most Common Bone & Joint Conditions

  • Osteoporosis - This disease essentially causes the thinning of bones which makes them brittle and prone to fractures. Women aged 50 and over are most at risk.
  • Osteoarthritis - Also known as degenerative joint disease. Over time the cartilage in your joints breaks down causing inflammation and pain. Although osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, knees, hips and spine.
  • Rheumatoid Arthritis - An autoimmune disorder occurs when your immune system mistakenly attacks your own body's tissues, causing painful swelling that can eventually result in bone erosion and joint deformity.

According to the Arthritis Foundation, "More than 50 million adults have doctor-diagnosed arthritis. That's 1 in 5 people over the age of 18." One in every five people that you know may have pains due to bone and joint conditions.

 Physical Therapy: Bone & Joint Health

Physical therapy can help reduce pain levels by slowing the progression of these conditions. A licensed Physical Therapist can help by developing specific programs which may include:

  • Strength training to increase bone mineral density in patients with osteoporosis
  • Gait training to reduce risk for falls and prevent fractures
  • Strengthening surrounding muscles to help alleviate joint pressure
  • Stretching of tight muscles to increase range of motion and reduce joint stiffness
  • Home exercises in order to maintain an active lifestyle
  • Pain relieving techniques

Tackling the issue early with a Physical Therapist will significantly slow disease progression to overall help improve function.

*Schedule Updates* Week of 9/25/17

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Vital Step will be open for a half day on Thursday, September 28th, 2017 from 8:00am - 12:00pm and will be closed on Friday, September 29th, 2017. Additional hours will be available in October for any missed appointments. Please check with your physical therapist for these times.

Open Gym Hours for Vital Fit Clients for the week of 9/25/17 are Monday - Wednesday from 10:00 am - 2:00 pm only. 

Thank you for your cooperation!

- Vital Step

Q&A: Shin Splints

What are shin splints?

A shin splint is the term used to describe general lower leg pain. The shin is the tibia, the bigger bone that is located in the inner side of your lower leg. The pain can either be felt on the front part of the tibia (anterior) or more commonly the inside part of the tibia (medial).  

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What causes shin splints?

The cause can be described in a few words: too much too soon. Shin splints most commonly, but not exclusively, occur with athletes who do not GRADUALLY build up their workout plan. For example, runners who abruptly build up their mileage are more at risk for shin splints due to excessive demands on the foot/leg that they are not quite ready for.

Causes include:

  • Excessive pronation: Pronation includes the motions of plantar flexion (foot points down), eversion (foot points out to the side) and external rotation (foot rotates or turns out to the side). While running, pronation normally occurs in order to allow the arch to absorb shock. However, with excessive pronation, the arch collapses and creates more contact between the foot and the ground, increasing the force up the tibia bone of the lower leg. 
  • Flat foot: This follows the same concept with excessive pronation. Flat footed people have weaker muscles in their foot that would usually keep their arch upright. As mentioned, the arch's role is to absorb shock between the foot and the ground. Therefore, without a strong arch, there will be more force going up into the leg.
  • Worn out shoes
  • Tight lower leg muscles
  • Increased dominance of one side over another: If you are right handed, you most likely favor your right leg when you are running. Therefore, your right leg will be receiving more force from the ground than the left leg and will become the leg that gets the shin splints.
  • Muscle strength imbalance between lower leg muscles

How do I know that I do not have a stress fracture?

Symptoms of shin splints and stress fractures can seem similar, however there are common characteristics that distinguish the two conditions:

Shin splints:

  • Felt throughout the tibia, no matter where pressure is placed
  • Worse in the morning because overnight, the muscles and other soft tissue tighten up
  • Worse with excessive dorsiflexion (pointing foot up) and plantarflexion (pointing foot down)

Stress fracture:

  • Felt in a specific spot when pressure is applied to it
  • Better in the morning because overnight, the bone has time to heal without any weight bearing
  • The direction of pain, in regards to the ankle, depends on the location of the stress fracture
  • Pain with weight bearing
  • An X-ray is required to diagnose stress fractures.
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How do I treat shin splints?

Here are some recommendations to manage the pain:

  • RICE: Rest, Ice, Compress, Elevate
  • Stretch the muscles of your lower leg: Below are some stretches you can perform easily at home
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  • Update your current running shoes if they are worn out.

Below are treatments that a physical therapist can provide to treat your shin splints:

  • Manual therapy techniques:
    • Soft tissue mobilization including Graston technique
    • Passive range of motion stretching
    • Joint mobilization of the ankle
  • Individualized program to strengthen intrinsic foot muscles, as well as proper body mechanics for return to sport.

Moral of the story: Remember to GRADUALLY increase your workload when starting a new exercise program or returning to a particular sport.

What is Causing My Headache?

What is a "cervicogenic headache"? 

Headaches can develop through referred pain. Referred pain is pain that is felt in another part of the body other than the actual source of the pain. In the case of headaches, the pain that is thought to be felt in the head may actually be coming from the neck muscles. This type of headache that results from neck pain is known specifically as a cervicogenic headache

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What caused my "neck pain" in the first place?

Here are some common causes of neck pain that can lead to a cervicogenic headache:

  • Poor posture: This includes having a forward neck and rounded shoulders that can excessively stretch and/or tighten the neck muscles
  • Prolonged/sustained positions at work
  • Facet joint dysfunction: The small protrusions from the sides of each vertebrae make up joints within the cervical column and have a proper way of moving. If those small bony connections do not move the right way or get stuck with certain movements, they can pinch certain structures in the neck such as a nerve and cause pain.
  • Arthritis in the cervical spine
  • Whiplash 
  • Strained/weak neck muscles
  • History of trauma to the neck 
  • Scoliosis
  • Sleeping posture

How do I know if I have a cervicogenic headache?

Here are some symptoms you might feel that can be associated with a cervicogenic headache:

  • Pain felt on one side of the head (temples), forehead or around eyes
  • Headaches triggered by neck movement
  • Pressure on certain parts of the neck
  • Stiffness in the neck
  • Limited range of motion
  • Nausea or vomiting in severe cases

These are only some of the most common symptoms. However, it is difficult to diagnose since cervicogenic headaches can be easily mixed up with other types of headaches or migraines. Therefore, it is important to seek professional help from your local direct access physical therapists to accurately assess what may be causing your headache. 

How do I treat my cervicogenic headache?

Visit your direct access physical therapists @ Vital Step PT so they can provide the appropriate treatment that you need for your cervicogenic headache. PT treatment can include:

  • A personalized exercise program that will strengthen, increase range of motion, and relieve pain in the affected neck muscles
  • Manual therapy techniques: Physical therapists are trained in this type of technique where they use their hands to manipulate joints and/or relieve pressure in the soft tissue in your neck in order to correct any joint abnormalities and relieve pain. Manual therapy can include:
    • Suboccipital release
    • Cervical traction
    • Passive range of motion
    • Joint mobilization 
    • Soft tissue mobilization

 

  • Patient education: Physical therapists can educate you on what exactly is is causing your neck pain and how to prevent pain from returning. Patient education and treatment includes:
    • Correcting sitting/standing and sleeping posture
    • Correcting your posture at work including lifting/bending techniques 
    • Personalized home exercise program (HEP): An exercise program a PT can design for you addressing your specific problem so that you can easily perform and continue treatment at home.

Q&A: Plantar Fasciitis

What is plantar fasciitis?

Plantar fasciitis is inflammation of the plantar fascia. The plantar fascia is a strong band of tissue (like a ligament) that stretches from the heel (calcaneus) to the middle of the foot bones (metatarsals). The main functions of the plantar fascia are to support the arch of the foot and absorb shock in your foot.

 

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How can I get plantar fasciitis?

Here are a few factors that can increase your risk of plantar fasciitis:

  • Prolonged use of improper footwear, meaning wearing shoes that do not have good heel cushion and arch support
  • Frequent long distance running
  • Active occupation where you are always on your feet such as a factory worker or restaurant server
  • Active men and women between the ages of 40 and 70
  • Occurs more frequently in women more than men
  • Flat feet meaning you naturally have very little or no arch in your foot
  • Having a very high arch 
  • Tight Achilles tendon, which is the tendon that attaches the calf muscle to your heel
  • Obesity
  • Pregnancy

 

How do I know that I have plantar fasciitis? 

Here are common symptoms of plantar fasciitis:

  • Heel pain
  • Pain with weight bearing, especially in the morning
  • Pain after prolonged sitting/standing
  • Pain after activity
  • Tenderness at the heel (calcaneus)
  • Pain when stretching the big toe
  • Mild swelling
  • Decreased range of motion with dorsiflexion (moving the foot up)

In order to accurately diagnose plantar fasciitis, imaging (x-rays, ultrasound scan, etc) can see if there is thickening or swelling in the plantar fascia. Another way is to visit your local direct-access physical therapist @ Vital Step PT, where they can perform a few diagnostic tests. These diagnostic tests can include assessing how you walk and the range of motion/strength of your foot, palpating or using their hands to feel for any inflammation or tenderness, and the Windlass test. The physical therapist can perform this test by bringing your foot and great toe into extension (moving the foot and big toe up towards the ceiling) to see if that motion causes pain in the heel.

 

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How can I treat plantar fasciitis?

Although fascia tissue takes quite a long time to heal, there are ways to speed up recovery.  If the plantar fasciitis happened just recently (in a few hours to a day), then below are some conservative treatments:

  • Rest: Avoid excessive walking, standing or other activities that would stretch the plantar fascia
  • Choose proper footwear: Avoid walking barefoot on a hard surface initially. Make sure that you wear cushioned heeled shoes with a good arch (sneakers over sandals). This also means avoid old and worn out shoes.
  •  Visiting your local direct access physical therapist @ Vital Step PT for:
    • Personalized and appropriate exercises that will stretch the plantar fascia and strengthen the foot and ankle muscles.
    • Professional stretches for the plantar fascia and the muscles around the ankle.
    • Pain modalities or techniques to relieve pain such as estim, ultrasound and ice massage.
    • Graston technique to break up scar tissue or adhesions that can build up over time.
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Trigger Points and What You Need To Know

What are trigger points?

Trigger points are contracted “knots” found in the muscle that cause pain. At the microscopic level, many sarcomeres or muscle units are contracted into one small area of the muscle.

 

How do you get trigger points?

Trigger points come from stressed or injured muscles. Here are examples of how trigger points can develop:

  • Repetitive overuse or performing the same movements on a daily basis can cause stress within the muscle.
  • Sustained loading such as heaving lifting
  • Poor posture
  • Direct injury to the muscle
  • Prolonged bed rest or sitting

Trigger points can hinder how we move and decrease efficiency of the muscle.

How do I know if I have trigger points?

Trigger points can be discovered via palpation. Palpation is a special technique where physical therapists use their hands to assess the body. Here are common characteristics of trigger points:

  • Hard consistency
  • Referred pain is felt, meaning that the pain is not felt right on the area – instead it is felt close to the area
  • Muscle twitch can be seen when touched

How do you treat trigger points?

One way to treat trigger points is through a trigger point pressure release. This technique simply requires localized pressure onto the problem area until the trigger point is “released” and the muscle softens.

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Another common way that trigger points can be treated is through the Graston technique where a blunt metal object is used to mobilize and break up problem areas in the soft tissue.  Both methods are preferably done by a medical professional who is certified in the Graston technique, such as a physical or massage therapist, so that not only can they accurately assess and treat the trigger points, but also educate you on how to prevent future issues.

Contact your Graston Certified Physical Therapist @ Vital Step for more information on treatment options!

 

 

Preventing Rotator Cuff Injuries

What is a rotator cuff?

The rotator cuff is comprised of 4 muscles: supraspinatus, infraspinatus, teres minor and subscapularis. These muscles originate from your scapula (shoulder blade) and then merge to insert into your humerus (upper arm bone).

 

Why is my rotator cuff important?

The rotator cuff is important in reaching over your head, rotating your arm and overall stabilizing your ball and socket shoulder joint. This means that this group of muscles are very involved our every day activities.

How do I know that I have a rotator cuff Injury?

The following are possible symptoms you can experience when you injure or tear your rotator cuff:

  • Pain
    • When raising your arm
    • Night pain: You might wake up frequently at night from pain when lying on the affected side or from delayed soreness after a long day at work.
  • Muscle weakness
  • Joint stiffness/tenderness
  • Feeling of instability

 

How do I prevent a rotator cuff injury?

Rotator cuff injuries mainly come from repetitive, overhead activities. These are some tips to prevent a rotator cuff injury:

  • Maintain good posture! Stand/sit straight and avoid slouching. Slouching can change the position of the shoulder, causing tightness and poor movement patterns.
  • Watch your lifting technique! Lifting improperly can injure your rotator cuff instantly or overtime due to repetitive stress.
  • Wear protective gear when playing sports!
  • Take frequent breaks! Avoid over-working your arms and prolonged stressful positions. 
  • Exercise! Keep your shoulder flexible and strong with the proper exercises recommended by your physical therapist.

What course of action should I take if I tore my rotator cuff?

Since the rotator cuff is highly involved in our every day activities, it is common to injure those muscles. Injuries can range from a muscle strain to a complete tear. When injuries get as severe as a tear, the question comes into mind of whether physical therapy or surgery is the solution.

In general, if you are feeling those symptoms you can first consult with your local Direct-Access Physical Therapist to see if rehabilitation is the solution. The Physical Therapist will assess your pain and symptoms then prescribe the best course of treatment for your shoulder. The goal is to avoid costly surgery however if necessary your therapist will refer you to your doctor an orthopedic surgeon.

Contact Vital Step Physical Therapy for more information!