Knee Rehab
Knee Rehabilitation is important for daily life! Having a pain free knee joint is important to maintaining daily life tasks, exercise routines, general function and mobility. Rehabilitation can be utilized for arthritic pain, strains, sprains and weakness. Therapist will listen to your complaints and descriptions of pain while palpating the area to feel for arthritic changes and muscular inflammation.
Treatment will then include strenghtening, plyometrics, stretching, taping and manual therapies to assist with the healing process. Manual therapy can consist of dry needling, soft tissue mobilization, and joint mobilization. A combonation of each treatment will be utilized to meet the patient’s goals. As goals are met, a home exercise program and self care instructions are given for long term needs. Strong pain-free knees make work and daily routines effortless! You may contact our clinic directly to schedule an appointment at any time. Direct access allows you to be seen 30 days without a signed prescription from your physican. We do stay in constant contact with your physican during your physical therapy.
Osteoporosis – What You Need to Know
Got Calcium? May is Osteoporosis Month.
Osteoporosis is the thinning and loss of bone density over time.
Osteoporosis occurs when the bone mass decreases when bone resorption is greater than bone formation. As a result, the bone weakens and easily fractures especially in the hip and vertebrae. (Image credit: American Recall Center) #YWCR #osteoporosis #calcium #fractures
Spider Bites
Springtime in Oklahoma!
Time for Spring Cleaning and Yard Work!
Spiders hide in dark quiet areas of our home and lawns. If you are bitten by a spider medical attention could be necessary!
Contact us immediately if bite area becomes red, swollen, spreads or begins to blacken! We can help monitor, treat, and contact your Physician for possible antibiotics! 405-265-2255 (Pictures is a Brown Recluse) #woundcare #YWCR #springtime #spiders
Shoulder Pain
Many American’s suffer with shoulder pain for several different reasons. Shoulder pain can be the result of rotator cuff tear, bursitis, tendonitis, labrum tear, frozen shoulder, osteoarthritis and impingement. Physical therapy is usually the first line of care and the gold standard in treating shoulder pain. Physical therapy can restore active range of motion, reduce inflammation, pain and restore stability and strength.
Rotator cuff tear is either incomplete (partial) or complete tears (full thickness) (McKinnis, 2014). The cause of rotator cuff tear could be from traumatic injury or from progressive tendon tearing during overhead repetitive activities (McKinnis, 2014). The rotator cuff is made up of 4 muscles, subscapularis, supraspinatus, infraspinatus and teres minor. The most common tendon tear is the supraspinatus muscle. Imaging to diagnose a rotator cuff tear is MRI or US.
Shoulder bursitis is usually a gradual onset of pain caused by repetitive activities resulting in inflamed bursa. Shoulder pain is usually worse lying on affected side. The most cost effective and useful imaging modality to diagnose shoulder bursitis is US (McKinnis, 2014). Shoulder tendonitis also known as shoulder impingement is caused by repetitive overhead activities or trauma. Pain is usually gradual and worse with resistance. At initial injury (RICE) rest, ice, compression and elevation is useful in pain relief. Again US is the least expensive imaging modality to use to diagnosis shoulder tendonitis and / or impingement (McKinnis, 2014).
Labrum tear is usually from shoulder trauma injury causing pain with overhead activities, and instability. There are two types of labrum tears SLAP involving the superior labrum and Bankart involving the inferior labrum. Treatment is usually NSAID’s and RICE rest, ice, compression and elevation. If pain persist and shoulder is increasingly unstable surgery may be needed to restore stability. Imaging to diagnosis shoulder labrum tear is MRI (McKinnis, 2014). Frozen shoulder is a gradual increase in pain that cause loss of joint movement and can occur after shoulder injury or lifting something heavy. Physical therapy is the first and best treatment for pain and restoring joint mobility. Imaging for diagnosis is usually plain radiography and MRI (McKinnis,2014).
Osteoarthritis is the most common reason for shoulder pain in glenohumeral joint and acromioclavicular joint. Osteoarthritis of shoulder generally is gradual onset of pain and loss of mobility and responds to NSAID’s and physical therapy to resolve pain and immobility. Imaging to diagnosis shoulder OA is plain radiography which is the least expensive, then MRI followed by CT (McKinnis, 2014). Shoulder pain is extremely common in both men and women of all ages. Surgery is usually the last resort and should be avoided if possible. Physical therapy is the gold standard of care and most effective treatment to restore range of motion, strength, function and resolve pain.
References
McKinnis, L. N. (2014). Fundamentals of musculoskeletal imaging.
Pressure Ulcers
Pressure ulcers, also known as bed sores and decubitus ulcers, are the result of external prolonged pressure causing damage to soft tissue such as skin, fat, muscle and fascia (Godman & Fuller, 2015). Most pressure ulcers begin over bony prominent areas and can occur anywhere bone protrudes. Pressure ulcers occur for several reasons including: external pressure, friction, shearing, tissue softening from moisture, tissue weakening from dehydration, under nourishment and poor circulation (Goodman & Fuller, 2015). Additional patient related influences that can cause pressure ulcers are reduced sensation, poor mobility, incontinence, malnutrition and confusion. Unfortunately, acute care hospital admissions is the most common factor in causing pressure ulcers, because of acute illness and immobility during the hospital stay.
Pressure ulcers are identified and documented in stages I, II, III, IV and unstageable: Stage I is non-blanchable with intact skin, Stage II is non-intact skin with tissue damage to epidermis and/or dermis but superficial, Stage III is non-intact skin with tissue damage to epidermis, dermis, fat and muscle, but not past fascia. Stage IV is non-intact skin with tissue damage to epidermis, dermis, fat, muscle, fascia, bone and / or tendon. Unstageable is non-intact skin with tissue damage that is covered with eschar or necrotic tissue of 50% or more, viewing wound unstageable (Goodman & Fuller, 2015). In addition, pressure ulcers once they are staged should never be backstaged. As the wound heals documentation should be written as healing stage I, II or III and so on (Goodman & Fuller, 2015).
Preventing pressure ulcers from ever happening is difficult and challenging for the patient and caregivers, but is the best line of defense. Prevention guidelines include: patients at risk should undergo a full skin evaluation daily with close attention to bony areas, keep patients skin clean after soiling with gentle washing using gentle soaps and washing to avoid drying or shearing skin, avoid skin drying with adequate moisturizer, avoid skin friction and / or shearing using correct positioning, transferring, turning and use moisturizers, skin barriers and padding, preserve patients activity function and mobility, monitor nutrition to avoid drop in albumin levels and dehydration, reposition all patients at risk every 2 hours or more and use pillows and wedges assist in maintaining positioning and avoid pressure on knees, ankles and heels, use equipment such as trapeze bar, lifts, sliding boards, or sheets to avoid dragging movement, use pressure- redistributing mattresses on all high risk patients, patients who are wheelchair bound are at high risk and should be taught to relieve pressure every 15 to 30 minutes and use pressure- redistributing chair devices such ae Roho cushion (do not use doughnut-type devices) (Goodman & Fuller, 2015).
References
Goodman, C. C., & Fuller, K. S. (2015). Pathology: Implications for the physical therapist.
Lymphedema
The Function of a Physical Therapist Treating Lymphedema
Lymphedema is progressive chronic swelling usually in extremities, but can occur in the chest, stomach and groin regions. Currently there is no cure for lymphedema, but treatment from a physical therapist is extremely helpful to prevent immobilizing side effects and possible dangerous complications (APTA.org, 2009).
Prompt discovery of limb and / breast lymphedema is key to managing and preventing complication (APTA.org, 2009). In our practice we work closely with physicians and patients to treat lymphedema quickly with minimal to no pain. We use manual lymphatic drainage therapy and begin immediate compression for long term management. Other physical therapy terms used to describe lymphedema treatment are decompression therapy, complete decongestive therapy and complex physical therapy (APTA, org,2009). Complex physical therapy for lymphedema is the gold standard of care and includes: manual lymphatic drainage, compression garments, exercise and education about skin and nail care (APTA.org, 2009). In most cases patients who receive lymphedema therapy see an 80% improvement in just one to two weeks.
Evidence based research has proven success in lymphedema treatment and management using patient education, exercise, compression and lymphedema therapy can stop lymphedema from returning (APTA.org, 2009). Early onset of lymphedema improves outcomes and reduces complications. Patients with breast cancer should be aware of the risk factors and warning signs that include:
Risks
- Overweight or increasing weight during and throughout cancer treatment.
- Lymph node removal
- Radiation therapy
- Infection or blood clot in affected extremity.
Warnings
- Pain and fullness in affected limb
- Tightness in affected limb
- Noticeable swelling in affected limb
- Numbness and tingling in affected limb (APTA.org, 2009).
In conclusion, the role of physical therapist treating patients with lymphedema is to help patients identify lymphedema early to prevent lasting side effects and possible dangerous complications. Currently there is no cure for lymphedema. However, treatment from a physical therapist is highly successful in eliminating lymphedema and preventing reoccurrences.
Sincerely, Sherri Boos, PT, DPT
References
Physical Therapist Play Integral Role in Lymyphedema Prevention, Treatment. (2009). Retrieved from APTA.org, 2009
Role of Physical Therapist in the treatment of Lymphedema. (2009). Retrieved from http://APTA.org