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
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
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, 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.
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
Warnings
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
Inactivity of the body, but electrical activity of the brain continues in a predictable pattern of brain waves – from slow wave sleep to brain states that mimic wakefulness in 90 minute cycles.
Light sleep
REM
Refreshes memory / dreaming occurs
Stable sleep /diff to wake
Deep sleep, growth hormone released
Sleep restores learning, memory, temperament and regulates hormones.
Average adult needs 7 to 7 1/2 hours each night.
Lack of sleep is defined as frequent daytime sleepiness as a result of sleep deprivation daily for at least 3 months.
Lack of sleep can be unintentional or intentional.
34% of US questioned stated less than 7hrs sleep nightly.
25% of US adults report lack of sleep 15 out of 30 days.
50-70 million US adults have sleep or wakefulness disorder.
Poor sleep is a public health concern!
Common causes of sleep disorders:
Health effects of insufficient sleep:
Inadequate sleep is associated with behavior
Sleep intervention techniques:
Melatonin
Magnesium
Theanine
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Newest natural sleep aid
#6 RediNite
Sherri Boos, PT, DPT
References
Clark, D., Lein, D., & Morris, D. (2017, July 17). Integrating Sleep Health in Physical Therapy Clinical Practice.
Sleep Disorders & Problems – National Sleep Foundation. (n.d.). Retrieved from https://sleepfoundation.org/sleep-disorders-problems
Women’s health is much more than just treating lady parts or pelvic floor complications. Physical therapist address women’s health conditions from infancy through geriatric years focusing on specific women’s health needs.
Clarifying Women’s Health:
I have provided women’s health care for years and find many people including women are confused about women’s health care. The definition of women’s health is providing specific care during the entire life cycle for women’s issues including: incontinence, pelvic dysfunction, osteoporosis, breast cancer, lymphedema, fibromyalgia and other diseases that differ for women than men (Wojciechowski, 2009).
Kristie C. is a patient of mine and is an avid female runner that I admire and appreciate. Kristie has ran 9 marathons all over the world including Ethiopia in 2015. She suffered a right knee injury requiring meniscal repair with osteoarthritis debridement. As a result of her injury and lack of post-op rehabilitation she gained 60 lbs and began suffering additional complications of depression, anxiety and chronic pain. As a women’s health therapist I was able to treat Kristie’s knee, but also considered her complete lifestyle and surpass traditional knee rehabilitation to meet her goals of resuming running. Meeting Kristie’s running goals resolved her depression, anxiety, weight gain and chronic pain. Returning women or any patient to their previous lifestyle or passion, like running marathons is a true blessing.
Another example of women’s health is a patient of mine that was diagnosed with breast cancer resulting in several lymph node removal with lumpectomy. As a result of lymph node removal she suffered with lymphedema in her arm making her job as a hairstylist and being a grandmother difficult. Treating her lymphedema, shoulder range of motion and shoulder strength allowed her to return to full function using her arm as a hairstylist and playing with her grandson again.
Many times women’s health focuses on women during menopause, for things like urinary incontinence and constipation or in younger women with diagnoses of pelvic pain and / or sexual dysfunction (Wojciechowski, 2009). However, pelvic floor diagnoses are not the only conditions women are affected with more than men. Women also are more often diagnosed with rotator cuff tears, shoulder impingement, shoulder adhesive capsulitis, carpel tunnel, osteoarthritis, rheumatoid arthritis, fibromyalgia and lupus (Wojciechowski, 2009). All injuries and diseases affect women differently than men and physical therapist should be aware of the differences even if they don’t treat gynecological and obstetric care (Wojciechowski, 2009). Not only do women recover and heal differently than men they also have heart disease signs and symptoms differently (Wojciechowski, 2009). For example, women usually complain of difficulty breathing, nausea and vomiting, fatigue, back pain, shoulder pain and jaw pain (Medline, 2014).
In conclusion, treating the pelvic floor is a huge part of women’s health physical therapy for condition such as post-surgical complication after c-section, episiotomy, hysterectomy, sexual dysfunction, bowel and bladder disorders. In addition, women’s health physical therapy is treating all women’s health conditions throughout their life cycle for their specific needs and differences.
Respectfully,
Sherri Boos, PT, DPT
References
Wojciechowski, M. (2009). Women’s Health: It’s More Than You May Realize. PT in Motion 7. Retrieved from http://www.apta.org/PTinMotion/2009/11/Feature/WomensHealth
Women’s Heart Disease: Heart Disease Risk Factors. (2014). Retrieved from https://medlineplus.gov/…/winter14/articles/winter14pg26-27.html
Total knee arthroplasty aka total knee replacement is a surgical procedure that has proven success relieving pain for people who suffer with knee difficulties from an injury, degenerative disorder and inflammation (Klein, 2006). In the United states alone over 300,000 total knee procedures are performed and these numbers increase as younger people need a total knee replacement (Klein, 2006). A total knee replacement procedure is a difficult surgery to recover from and should be taken very seriously. The complication are: severe pain, bruising, swelling, blood clot, temporary and permanent paralysis, infection, numbness and even death.
There are several things that help a person’s total knee outcome a success: good physical health and strength, weight, flexibility, education about the procedure and expected loss of function and nutrition to improve healing. Pre-habilitation is program that our facility offers to encourages your success after this procedure. Pre-habilitation is usually just a few visits to educate you about the produce, nutrition, possible loss of function, strengthen specific muscles and stretch tight muscles and joints.
Klein, L. J. (2006, October 18). Total Knee Replacement (CBM 2003-2). Retrieved from https://www.nlm.nih.gov/archive/20061214/pubs/cbm/tkr.html#110
Sepsis is a dangerous illness overpowering your immune reaction to infection (Sepsis Fact Sheet – National Institute of General Medical Sciences, 2017). Your body reacts to the infection using your immune system to produce chemicals to fight off infection. This causes an extensive amount of inflammation throughout the body. As a result of this response secondary complications can happen and tissue damage including internal organs can die. Over 15 million individuals acquire sepsis yearly in the United States and 250,000 die annually (Get Ahead of Sepsis – Know the Risks. Spot the Signs. Act Fast, 2017).
Early identification, quick care and avoiding infection is vital. Anyone can get sepsis and most all infection can cause sepsis (Sepsis Fact Sheet – National Institute of General Medical Sciences, 2017).
Signs and symptoms of sepsis include:
* Delirium and / or incomprehension
* Difficulty breathing
* Fast heart rate
* Fever, chills
* All over body pain and aches
* Moist and sweaty skin
(Get Ahead of Sepsis – Know the Risks. Spot the Signs. Act Fast, 2017.)
Patients and family should be proactive to avoid infections, know the signs of sepsis and act fast if sepsis is suspected (Get Ahead of Sepsis – Know the Risks. Spot the Signs. Act Fast, 2017).
References
Get Ahead of Sepsis – Know the Risks. Spot the Signs. Act Fast. | Features | CDC. (n.d.). Retrieved from https://www.cdc.gov/features/get-ahead-sepsis/index.html
Sepsis Fact Sheet – National Institute of General Medical Sciences. (n.d.). Retrieved from https://www.nigms.nih.gov/Education/Pages/factsheet_sepsis.aspx