For Tendon Pain, Think Beyond the Needle

Ever have tendonitis (now more commonly called "tendinopathy")? Another infomormative article from the New York Times on these frustrating injuries, and what research is showing is effective and not so effective in treating them. Click the link below for more.......

http://www.nytimes.com/2011/03/01/health/01brody.html?scp=6&sq=physical%20therapy&st=cse

The Evidence Gap: The Pain May Be Real, but the Scan Is Deceiving

Interesting article in the NY Times regarding diagnostic tests like MRI's, what they can tell us, and how they should be interpreted. You may be surprised to find that they won't necessarily help you get better. Click the link below to read on........

http://www.nytimes.com/2008/12/09/health/09scan.html?pagewanted=1&ref=physicaltherapy

New Guidelines for Fall Prevention in Elderly

Do you know anyone with balance problems or are you concerned about them falling? Seeing a physical therapist can help greatly. Below is a description of new guidelines in fall prevention by the AMerican Geriatric Society and British Geriatric Society.

For the first time in 10 years, the American Geriatrics Society and the British Geriatric Society have updated their guidelines for preventing falls in elderly patients, stating that all interventions should include an exercise component.

Assessments should include the patient’s feet and footwear, fear of falling, and ability to carry out activities of daily living, the guidelines state. Healthcare providers should ask patients if they have fallen recently or if they are unsteady walking. If a patient answers “yes,” the caregiver should diagnose problems such as muscle weakness, poor balance or blood pressure that drops significantly while standing.

If patients have evidence of gait problems or recurrent falls, caregivers should perform the multifactorial interventions described in the guidelines, which include exercises for balance, gait and strength training, such as Tai Chi.

A little bit of exercise makes a big difference - USATODAY.com

For you couch potatoes out there, or for those who think you should be doing maybe just a little bit more exercise......read on below. This article offers some good practical advice for exercise. Plus, as we all know, we can ask our local PT!

A little bit of exercise makes a big difference - USATODAY.com

Early Therapy Can Help Knee Surgery Patients

Beginning physical therapy within 24 hours of knee arthroplasty (knee replacement) surgery can improve pain, range of joint motion and muscle strength as well as cut hospital stays, according to new research in Clinical Rehabilitation.

Physical therapy and public health researchers from Almeria, Malaga and Granada in Spain compared patients who began treatment within 24 hours of surgery with those who began 48 to 72 hours after their operation in a random, controlled clinical trial. Each group had more than 150 patients, ages 50 to 75.

The post-operative treatment began with a series of leg exercises, breathing exercises, and tips on posture. By the second day, walking short distances with walking aids was added. In subsequent days the regimen built up to adapting to daily life activities, such as beginning to climb stairs on the fourth day.

On average, those beginning treatment earlier stayed in hospital two days less than the control group and had five fewer rehabilitation sessions before discharge. An early start also led to less pain, greater range of joint motion both in leg flexion and extension, improved muscle strength and higher scores in tests for gait and balance.

Other benefits of early mobilization after this surgery are fewer complications, such as deep vein thrombosis, pulmonary embolism, chest infection and urinary retention. With hospital-acquired infections, such as MRSA, also a serious concern, a shorter hospital stay also might lower the risk to patients of contracting this type of secondary infection.

More Tests Not Always Needed for Diagnosis

COURTESY OF REUTERS AND FOX NEWS HEALTH

Examining patients and taking a medical history are more useful to hospital doctors in diagnosing patients than high-tech scans, according to a study from Israel.

Tests such as CT scans and ultrasounds add to hospital bills, but doctors said that such tests given right after patients showed up in emergency rooms only helped with diagnosis in roughly one of three cases, the study — published in the Archives of Internal Medicine — said.

There is also research showing that the radiation from multiple CT scans might increase the risk of cancer over the long term. To see whether such scans were really helpful, researchers led by Ami Schattner of Kaplan Medical Center in Rehovot, Israel, followed all the patients who showed up at the emergency room of a teaching hospital and were subsequently admitted.

"Basic clinical skills remain a powerful tool, sufficient for achieving an accurate diagnosis in most cases," Schattner and his colleagues wrote. "Physicians may count more on their clinical faculties when making decisions about patients."

Over about two months, Schattner and his colleagues observed 442 consecutive patients. Each was separately examined by two doctors, a resident and a senior physician, who also asked patients about past health problems.

Both doctors had access to results from all routine tests, including blood and urine analysis, and any extra scans that had been done when the patient first got to the emergency room. The researchers later looked at how accurate the clinicians were in their decisions, compared to the final diagnoses patients were given during or after their hospitalization. They also asked the doctors what factors they relied on most when diagnosing each patient.

Both clinicians made the correct diagnosis between 80 and 85 percent of the time.

Only about one in six patients had extra testing — mostly CT scans, usually of the head — done in the emergency room. The rest just had simple blood, urine or heart tests. But even for the patients who did have extra scans, the doctors said the results helped to make a diagnosis only about one-third of the time.

Instead, patient history alone or history plus a physical exam were most important to a doctor's correct diagnosis in almost 60 percent of cases. When basic tests were included, they were the basis of more than 90 percent of correct diagnoses along with the history and exam.

"The doctoring process is still a personal communication between the patient and the clinician," said Matthew Sibbald, a cardiologist at the University of Toronto who wasn't involved in the study. "As much as we want to... rely on the technology, it's not the technology that helps us make a diagnosis," he told Reuters Health.

Read more: http://www.foxnews.com/health/2011/08/15/more-tests-not-always-needed-for-diagnosis/#ixzz1V7V33j2r

Young Athletes: Burnout, and Avoiding Overuse Injury

Nice article below from the Sun Sentinel, discussing the trend these days in athletes specializing at an early age, and the potential negative side-effects. If you have or know a young athlete, consider checking this out. Have a great weekend!

http://www.sun-sentinel.com/sports/highschool/fl-part-four-year-round-burnout-0803-20110802,0,674573.story

AVOIDING SURGERY FOR LOW BACK PAIN: From the American Academy of Orthopedic Surgeons

Click the link below to read an interesting article that summarizes recent research findings about low back surgery. Note: these conclusions were reached by orthopedic surgeons from the AAOS. It makes many nice points, and the last paragraph sums it up pretty well in our opinion.

Avoiding Surgery for Low Back Pain - AAOS

Study: Overuse, not curveballs, leads to injuries - USATODAY.com

For you baseball players and enthusiasts out there - nice article discussing recent research findings showing that it is overuse in general, and not throwing curveballs, that contribute most to arm problems. Adding to that, making sure that players are conditioning their bodies properly so that they can withstand the demands of the sport is of utmost importance, as is developing the skills necessary for the sport, and keeping pitch counts. Hope you enjoy.....


Study: Overuse, not curveballs, leads to injuries - USATODAY.com

Vertigo May Have Simple Solution

Know anyone with vertigo or dizziness? This is a nice video below explaining a very common cause of vertigo and how it can be treated, many times fairly easily. It is called Benign Paroxysmal Positional Vertigo (BPPV for short). However, dizziness can be caused by many things, including blood pressure problems, reaction to medications, and many other issues, so check with your family doctor first if you're experiencing these symptoms. Seeing a physical therapist trained to treat vertigo and dizziness can help you or someone you know!


Vertigo May Have Simple Solution - WGAL Health News Story - WGAL The Susquehanna Valley

Possible Cure for Age-Related Muscle Loss?

COURTESY OF FOX NEWS

Ever notice – as you grow older – that things just seem to get heavier? Ever watch a person of advanced age struggle to hoist a carry-on bag into the overhead compartment of an aircraft?

As we age, our muscles become weaker. It starts at around age 40 and progresses until 75, when muscle strength pretty much falls off a cliff.

Doctors recommend exercise to counter the loss, but it inevitably progresses. Some people have tried hormone supplements – testosterone, human growth hormone and insulin-like growth factor-1 to hold off Mother Nature. But the long-term safety of those therapies is in question.

Exciting new research released Tuesday by doctors at Columbia University Medical Center may have found a novel new way to prevent age-related muscle weakness. Dr. Andrew Marks has been targeting something called the “ryanodine receptor” in muscle cells.

Without getting too complicated, muscle cells use calcium to contract. Each cell has a little “gas tank” of calcium in it. When the brain sends a signal to the muscle to contract, the ryanodine receptor acts like a fuel pump and releases calcium into the cell, where it’s used to pull muscle fibers together. When the brain tells the muscle to relax, the receptor pumps calcium back into the tank, and the fibers separate.

As we age, the mechanism becomes damaged from stress and allows an unusual amount of calcium to leak out of the cell. Think of it in terms of a rusty old gas tank developing a small leak. Eventually enough calcium (gasoline) leaks out that the muscle (car) can’t function properly.
Basically, the muscle runs out of gas and over time, withers away.

Using a new drug (s107) developed by pharmaceutical startup ARMGO Pharma, Marks treated mice that were 24 months old – the equivalent of 70 in human years. The mice, which were becoming weak and sedentary could spend 50 percent more time on the exercise wheel than before. The drug had slowed the calcium leak in their muscles and improved muscle function.

So – how is this different from exercise or hormone treatments? Dr. Marks says they build muscle mass. But they don’t necessarily improve muscle function the way this drug does.

What if people didn’t wait until old age to begin treatment? What if the drug was used as a preventive beginning at say – age 50? Could age-related muscle loss be prevented altogether?
Marks said that’s very possible.

There’s another aspect of Marks’ research that is very interesting. Age-related muscle weakness occurs by much the same mechanism as muscular dystrophy in children. As people grow old, they literally acquire a form of MD.

Which begs a question. If the drug reverses some of the effects of age-related muscle loss, could it be a possible treatment for Muscular Dystrophy? That’s something Dr. Marks told me he is looking into.
He’d also like to see his therapies used in developing countries where heart failure and other age-related muscle conditions go untreated.

The other big question: When could this be available for human use?
The drug is currently in Phase II trials for treatment of heart failure. Dr. Marks says he hopes to begin Phase II trials among people of advanced age for muscle-weakness/loss within a year.

It should also be pointed out that Dr. Marks is a founder of ARMGO Pharma and stands to become a very rich man if the FDA approves this new drug. That said, he is also a noted and well-respected researcher who has received numerous awards and citations for his ground-breaking research.


Read more: http://www.foxnews.com/health/2011/08/02/possible-cure-for-age-related-muscle-loss/#ixzz1Tudqgk1v

A Good Walking Program!

Thinking about beginning a walking program to help recover from an injury or condition, or just to get in better shape? Here is a good place to start with some good guidelines from the American Academy of Orthopedic Surgeons (AAOS).

We also advocate including mobility and strengthening work into your exercise program, but walking is an excellent place to start for beginners if you're trying to improve your physical condition. And as always, a good physical therapist can help you get started if you're not sure what to do!

COURTESY OF THE AAOS

Exercise Walking

The average person walks between 2,500 and 5,000 steps each day. Although this may seem like a lot, you may want to add more steps to your daily routine with an exercise walking program. Consider the benefits to your physical and mental health:

• A brisk walk increases your intake of oxygen, strengthens your heart to pump more blood, improves circulation, and lowers blood pressure.
• Walking also slows development of arthritis, slows loss of bone mass in osteoporosis, and tones your muscles gently.
• Walking reduces stress, helps you keep a positive outlook, can make you feel (and look) younger, and can help you sleep more deeply and restfully.

If you are recovering from a recent injury or surgery or have a chronic condition, you may want to see your doctor before beginning a walking program. You may be able to withstand the low-stress effort of walking without aggravating your condition. Walking has helped many people find relief from arthritis and back pain.

You can walk alone or with friends, almost anywhere and anytime it is convenient for you. The only equipment you need is a good pair of shoes, which should be comfortable and supportive and not cause blisters or calluses. Choose shoes that support the arch and elevate the heel slightly. There should be stiff material surrounding the heel (the heel counter) that keeps your heel from turning in or out or wobbling. The toe box should be roomy but not too long.

Starting Your Program

When you start your exercise program, warm up by walking as you normally would for 5 minutes, then pick up the pace to whatever speed gets your heart beating faster and your lungs breathing deeper. Keep up the faster pace for about 15 minutes. While you walk:

• Swing your arms
• Keep your head up, back straight, and abdomen flat
• Point your toes straight ahead
• Take long strides, but do not strain

Cool down by walking at your warm-up speed again for 5 more minutes. Do gentle stretching exercises when you are done.

Establish a Routine

Repeat the above routine 3 or 4 days a week with days for rest in between. After 2 weeks, add 5 minutes to the strenuous part of your walk. Keep adding 5 minutes every 2 weeks as you gradually build strength and endurance.

Another way to build fitness with a walking program is to use walking sticks or poles. Using a stick in each hand gives your upper body a better workout and provides your lower body with more stability.

Proper Hydration

During exercise, be sure to keep a water bottle handy to prevent dehydration. Drink 1 pint of water 15 minutes before you start walking, and another pint after you cool down. Have a drink of water every 20 minutes or so while you exercise.

Commit to Physical Activity

When you start an exercise walking program, you are making a commitment to yourself to be more physically active. This should be a lifetime pursuit, as the major health benefits of exercise walking take place over time.

Keep track of your progress as you become more physically fit and increase the intensity of your workouts. You might consider getting a pedometer (available at most sporting goods stores) that clips on your belt and automatically records every step you take. In addition to your exercise walking routine, consider ways you can build more steps into each day, such as taking stairs instead of elevators or parking your car at the far end of parking lots.

AAOS does not review or endorse accuracy or effectiveness of materials, treatments or physicians.