Friday, June 25, 2010
Foot and Ankle Course
On Thursday June 17 our entire clinical staff attended the “Effective Examination and Treatment Techniques for Foot and Ankle” course which was offered here in Albany. Dr. Jim Keller presented an outstanding seminar on the biomechanics of the foot and ankle as they relate to potential problems with lower extremity and spinal conditions. The kinetic chain demonstrations and how they influence foot position were quite enlightening and added valuable evaluative and treatment techniques to our current musculo-skeletal and neuromuscular evaluation systems. This was a great team building experience as we were able to compare ideas among our own clinicians as well as those from throughout the country about how to effectively manage foot, ankle and lower extremity dysfunction. It was amazing to feel the difference in foot position by simply strengthening and isolating trunk or other lower extremity muscles. This adds a whole new realm of options in difficult foot and ankle pain which has not responded to traditional methods of care.
Our latest patient success story!
I began the McKenzie Method of physical therapy on May 14th, 2010. My primary physician recommended that I do this to alleviate the back and leg pain I was having from degenerative disc disease. My pain level was at a 10! I learned about centralization techniques to get the pain out of my leg and into my back. After only 8 visits, I had completely centralized and I was pain-free!. This technique will now be part of a new lifestyle for me.
- Patricia F.
- Patricia F.
Thursday, May 27, 2010
Our Latest Patient Success Story!
When I first came to physical therapy I was falling on a regular basis over a period of about six months. This had significantly altered my ability to function and I was very apprehensive. After completing my physical therapy my balance and stability have greatly improved and my scores have increased by 79%. This has resulted in a renewed confidence in my ability to walk and carry on in my daily life.
Ruth R.
Ruth R.
Thursday, April 22, 2010
Tips for exercising safely in the summer
The summer is a great season for getting in shape. Whether by playing a sport, an aerobic exercise routine, or just returning to that familiar running path...this is the time for activity.
Dr. Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, says, "Exercise is the fountain of youth and summer is the perfect time to reconnect with your body."
However, exercising during the warmest season of the year can lead to dehydration, profuse sweating, exhaustion, and even a cardiac event.
Dr. Andersen offers the following tips to those looking to resume or begin a workout routine this summer:
•Talk to your doctor. Consult your physician before beginning or changing your exercise regimen.
•Take your workout indoors. When it is too hot or humid outside, exercise in a cool, air-conditioned space. Extreme temperatures can alter your circulation, increasing the work of your heart and making breathing more difficult.
•Remember to stretch. Even in the summertime, our bodies need to warm up. As you are exercising, take time to work on breathing and posture–improving these will greatly enhance your health.
•Drink plenty of fluids. Throughout your workout routine it is important to drink plenty of water, even before you feel thirsty. If you are prone to lightheadedness (from low blood pressure), are an endurance athlete, or over age 75, you should replenish your "electrolytes" as well–having a little salt can be important for you.
•Try to maintain an even body temperature. After your workout you should not take an extremely hot or cold shower, or a sauna, as these can increase the workload on your heart.
•Be an early bird. If you truly enjoy exercising outdoors, take advantage of the coolest times of day–the early morning and evening hours.
•Wear sunscreen. If you have a sunburn, it will decrease your body’s ability to cool itself off. Always remember to apply sunscreen to your entire body every morning.
•Take it slow. Start your exercise regimen slowly and pace yourself throughout the workout, including plenty of time for breaks and to drink fluids.
•Have fun. Taking time to exercise is taking time for you. Enjoy it–smile, breathe deeply and clear your mind. Exercising to music is mood and energy enhancing, but if you are outside wearing headphones, PAY ATTENTION!
Dr. Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, says, "Exercise is the fountain of youth and summer is the perfect time to reconnect with your body."
However, exercising during the warmest season of the year can lead to dehydration, profuse sweating, exhaustion, and even a cardiac event.
Dr. Andersen offers the following tips to those looking to resume or begin a workout routine this summer:
•Talk to your doctor. Consult your physician before beginning or changing your exercise regimen.
•Take your workout indoors. When it is too hot or humid outside, exercise in a cool, air-conditioned space. Extreme temperatures can alter your circulation, increasing the work of your heart and making breathing more difficult.
•Remember to stretch. Even in the summertime, our bodies need to warm up. As you are exercising, take time to work on breathing and posture–improving these will greatly enhance your health.
•Drink plenty of fluids. Throughout your workout routine it is important to drink plenty of water, even before you feel thirsty. If you are prone to lightheadedness (from low blood pressure), are an endurance athlete, or over age 75, you should replenish your "electrolytes" as well–having a little salt can be important for you.
•Try to maintain an even body temperature. After your workout you should not take an extremely hot or cold shower, or a sauna, as these can increase the workload on your heart.
•Be an early bird. If you truly enjoy exercising outdoors, take advantage of the coolest times of day–the early morning and evening hours.
•Wear sunscreen. If you have a sunburn, it will decrease your body’s ability to cool itself off. Always remember to apply sunscreen to your entire body every morning.
•Take it slow. Start your exercise regimen slowly and pace yourself throughout the workout, including plenty of time for breaks and to drink fluids.
•Have fun. Taking time to exercise is taking time for you. Enjoy it–smile, breathe deeply and clear your mind. Exercising to music is mood and energy enhancing, but if you are outside wearing headphones, PAY ATTENTION!
Thursday, December 10, 2009
The Facts about MRI’s
We have noticed an aggressive trend of increase MRI studies on low back patients over the past year. It is important to note that the false positive rates for lumbar MRI’s are quite high. Several studies or investigations have been conducted looking at groups of people who have never experienced back pain and had MRI’s taken. These asymptomatic individuals presented with disk bulges, protrusions, and extrusions. We see this often in the clinic as many patients come in with MRIs that show pathology on the opposite of involvement and we are quick to point out the importance of these false positive rates.
The McKenzie method or mechanical diagnosis and therapy (MDT) utilizes a phenomenon known as “centralization” which has been shown to be a more accurate indicator as to successful outcome for discogenic problems. Studies by Donelson have reported that referred symptoms to the buttock, thigh or leg in 89% of patients with acute pain, centralized during mechanical assessment. Of this centralization group, 91% have excellent outcomes resulting in complete relief of pain and restoration to function.
Some insurance plans are now requiring an MDT assessment be done prior to MRI studies to avoid the problematic issue of false positives and excessive cost. Of those patients that do centralize, we not only reduce their pain and restore function, but they also learn a valuable tool on how to prevent recurrent episodes.
The McKenzie method or mechanical diagnosis and therapy (MDT) utilizes a phenomenon known as “centralization” which has been shown to be a more accurate indicator as to successful outcome for discogenic problems. Studies by Donelson have reported that referred symptoms to the buttock, thigh or leg in 89% of patients with acute pain, centralized during mechanical assessment. Of this centralization group, 91% have excellent outcomes resulting in complete relief of pain and restoration to function.
Some insurance plans are now requiring an MDT assessment be done prior to MRI studies to avoid the problematic issue of false positives and excessive cost. Of those patients that do centralize, we not only reduce their pain and restore function, but they also learn a valuable tool on how to prevent recurrent episodes.
Monday, December 7, 2009
Back to the basics
This past month, we have seen an increase in the number of patients with pain or parathesia that travels into the lower extremity. Back in 1990, a study was published “The centralization phenomenon: It’s usefulness in evaluating and treating referred pain”. In this study of 87 patients, 87% of all acute, sub- acute and chronic patients exhibited centralization. 81% of the centralizers and even 33% of the non-centralizers had good or excellent outcomes. Of this group, only 4 were surgical patients and were also non-centralizers and did quite well with surgery as well. The conclusion is that centralization is that it occurred commonly and its present or absence was a strong predictor of treatment outcome and present or absence of surgical disk pathology.
Very often our patients in these times are very eager to obtain an MRI study of their spine which will indicate a history of what condition their spine has been in and is not always conclusive to the source of pain. Centralization has proven to be a very valid predictor of treatment and outcomes and should still be considered the gold standard before more invasive procedures are tried. We will be compiling studies which have supported the importance of mechanical diagnosis and therapy and the issue of centralization in hope educational white paper or pamphlet which will help guide decision making for diagnostic decision making among our patients.
Very often our patients in these times are very eager to obtain an MRI study of their spine which will indicate a history of what condition their spine has been in and is not always conclusive to the source of pain. Centralization has proven to be a very valid predictor of treatment and outcomes and should still be considered the gold standard before more invasive procedures are tried. We will be compiling studies which have supported the importance of mechanical diagnosis and therapy and the issue of centralization in hope educational white paper or pamphlet which will help guide decision making for diagnostic decision making among our patients.
Friday, November 6, 2009
Anterior derangements
The anterior derangement which is classified as symmetrical or asymmetrical pain usually across L4/5 with or without buttock and/or thigh pain has a deformity of an accentuated lumbar lordosis. This is a rather rare condition that we see but of course since I started this blog, just about every type of derangement has surfaced.
We had a patient with a long standing recurrent history of back pain (8 years) which was originally described to us by his wife and it took several recurrent episodes before she dragged him in to see us. The most enlightening piece of information was the dramatic lordosis (swayback) and the fact that he could not bend forward nor could he reverse the curve. He was then put through the appropriate testing which in these types of derangements usually reverses rather rapidly allowing for full forward flexion to occur.
This again emphasizes the importance of a good mechanical exam and also the importance of patient generated referrals. Even though this patient had medical care in the past, it was his wife that researched the McKenzie method and made the appropriate referral.
We had a patient with a long standing recurrent history of back pain (8 years) which was originally described to us by his wife and it took several recurrent episodes before she dragged him in to see us. The most enlightening piece of information was the dramatic lordosis (swayback) and the fact that he could not bend forward nor could he reverse the curve. He was then put through the appropriate testing which in these types of derangements usually reverses rather rapidly allowing for full forward flexion to occur.
This again emphasizes the importance of a good mechanical exam and also the importance of patient generated referrals. Even though this patient had medical care in the past, it was his wife that researched the McKenzie method and made the appropriate referral.
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