Category Archives: Physical Therapy

AlterG Anti-Gravity Treadmill

Posted October 10, 2017 by FIT Physical Therapy

As a licensed physical therapist and CEO and founder of Fit Physical Therapy, one of the things I try to do to make sure we are practicing cutting-edge physical therapy in our clinics is to look at what the top universities and professional sports teams across the country are using to rehab their injured players.

I have had the opportunity to visit some high-end training facilities and always make a point of checking out the equipment and techniques the trainers and therapists are using on their athletes.

Because there is huge money involved in athletic performance, it stands to reason that when a key athlete goes down, the owners, trainers and therapists working with these athletes will use the very best therapy and rehab equipment at their disposal to help get their injured athletes healthy and back in action as soon as possible.

One piece of equipment that is found in nearly every major college and professional sports team training room is the AlterG Anti-Gravity Treadmill. Many big-time athletes have used this treadmill to speed their recovery and healing.

I was so impressed with this treadmill that I purchased the first AlterG in Southern Utah for our St. George clinic. It has been so successful we hope to add one to our Mesquite clinic soon.

The technology for the AlterG Treadmill was originally developed at NASA as part of an effort to help astronauts maintain fitness during prolonged space flight. AlterG combined this technology with an advanced pressure regulation system and a treadmill to produce the first anti-gravity treadmill. AlterG is the first company to use a pressurized enclosure to provide a counter force to the person’s body weight, reducing their effective weight on the treadmill surface.

The AlterG treadmill looks a little intimidating at first but is actually surprisingly simple to set up and use. The first step is to get into a funny-looking fitted pair of neoprene shorts that has an upper skirt which zippers into a plastic casing, forming an airtight environment. As you stand on the treadmill, it calibrates the machine to your exact weight.

The machine’s plastic casing around the treadmill fills with air and uses its unweighting technology to create a reduced pressure environment from 0 to 80 percent unloading of your body. This means that if you you weigh 200 pounds, you could feel as light as 40 pounds on the treadmill. You then walk or run in the unweighted environment.

The AlterG can be utilized by both athletes and the general population and can assist in rehabilitation post-injury or post-surgery. It is perfect for individuals who suffer from a lower extremity injury, like an ACL reconstruction, hip, foot or ankle injury.

Whether someone is post-operative or trying to prevent surgery, the AlterG can be used to reduce the impact on joints to provide both strength and aerobic conditioning. Even stroke patients can benefit as the treadmill can help retrain their legs and brain with supported movements.

Noninjured athletes have also found ways to utilize the AlterG before and after endurance events. Runners might consider an AlterG run to log a few miles without the impact before a marathon or conversely as a tool for recovery after a long race.

But for runners facing months of injury rehabilitation without logging any miles, the AlterG provides a way to move again – stimulating both the muscles and the mind toward recovery.

For more information about the amazing AlterG Treadmill go to the AlterG website or visit our St. George clinic for a free demonstration.

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Is your “Physical Therapist” really doing “Physical Therapy”?

Posted September 25, 2017 by FIT Physical Therapy

Recently an acquaintance asked if I had heard about the new physical therapy clinic that had just opened up. I replied that I had not and was curious to find out a little more about a new colleague in town. Turns out, the “Doctor” at this clinic is not a physical therapist, nor is his “Kinesiologist” assistant. But in some of their advertising and promotions they stated that they provide “physical therapy” services. Unfortunately the misuse or inappropriate advertisement of physical therapy services is a growing problem.

It’s too bad that there are a few health care providers who feel the need to operate using vague or general titles or they encroach upon other professional titles and designations such as the new “physical therapy” clinic in town.
The following is a good explanation of this issue from The American Physical Therapy Association.

“People who are not licensed physical therapists have held themselves out to the public as providing “physical therapy” or “physiotherapy,” or use the initials “PT” to describe their services. This characterization is misleading to the public, illegal in some states, and a disservice to individuals who are in need of physical therapy and who think they are receiving it, but in reality are not.

When the public receives treatment such as physical therapy, people deserve to know what treatment they are receiving and that the person performing the treatment is a licensed physical therapist (PT) who has the requisite education and training to provide the treatment.

Massage therapists, chiropractors, personal trainers, or health care practitioners may share some of the same treatment modalities or techniques that also are used by physical therapists; however, an intervention should only be described or advertised as physical therapy or physiotherapy when provided or supervised by a licensed physical therapist.

Physical therapy is not a generic term. It describes the care and services provided by or under the direction of a licensed physical therapist. Other health care providers have attempted to classify physical agents, mechanical modalities, and/or electrotherapy as “physical therapy” or “physiotherapy.” The use of these modalities can be described as the practice of physical therapy only when a licensed physical therapist provides the modalities. Some professions may use some of the same physical agents and modalities as physical therapists, but only physical therapists and physical therapist assistants under the direction and supervision of physical therapists practice “physical therapy.”

What makes the terms physical therapy and physiotherapy exclusive to the physical therapy profession is the distinct education of physical therapists, the special body of knowledge of the physical therapy profession, the regulatory standards and requirements for licensure as a physical therapist, and the unique perspective, specific skills, practice standards, and specialized care that are provided by licensed physical therapists.

The patient/client management elements of examination, evaluation, diagnosis, and prognosis should be represented and reimbursed as physical therapy only when they are performed by a physical therapist. Physical therapists are the only professionals who provide physical therapy examinations, evaluations, diagnoses, prognoses, and interventions based on the physical therapist’s examination and evaluative process. Intervention should be represented and reimbursed as physical therapy only when performed by a physical therapist or under the direction and supervision of a physical therapist.

The rationale behind term protection generally relates to the protection afforded to consumers and patients. Specifically, state regulatory bodies are often concerned that an individual or entity that is not properly qualified to provide physical therapy services may, for example, advertise or represent that physical therapy services are being provided, when in fact there is no physical therapist involved in the provision of services. A consumer also may mistakenly believe that someone using the initials “PT” is a licensed physical therapist, when in fact they are not.

In addition to consumer protection issues, term protection also seeks to address concerns relative to third party payers. For example, third party payers who bundle physical therapy benefits with those of other health care professionals may, depending on the time a service is provided, offer a “physical therapy” benefit that is in fact exhausted before the patient ever sees a licensed physical therapist. Additionally, allowing nonphysical therapists to use terms such as “physical therapy” may result in a payer reimbursing for a service that it believes to be physical therapy when in fact there is no physical therapist involved in the provision of services.
The protection of the terms physical therapy and physiotherapy is not referring to protection against the use of various physical agents, modalities, or procedures by others, but rather is against the inappropriate labeling of those modalities and procedures as physical therapy”.
Darren Marchant, PT,MSPT,OCS
CEO
FIT Physical Therapy

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DDD

Posted August 28, 2017 by FIT Physical Therapy

It’s estimated that as many as 75% of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery—and conservative care such as physical therapy usually gets better results than surgery. Degenerative disk disease (DDD) is one cause of back and neck pain. Usually the result of the natural aging process, degenerative disk disease (DDD) is a type of osteoarthritis of the spine.

Your spine is made up of 33 vertebrae that are stacked on top of one another. Between each of these vertebrae is a rubbery piece of cartilage called an “intervertebral disk. Imagine the disk as a tire, with gelatin filling the hole in the tire. The tire is called the “annulus,” and the gelatin is called the “nucleus.” When we’re young—under 30 years of age—the disk is made mostly of gelatin. As we age, and sometimes with injury or excessive wear and tear, we start to lose some of that gelatin, and the volume of the disk decreases, resulting in less space between the vertebrae. The disk becomes flatter and less flexible, leaving less space between each set of vertebrae. Sometimes bone spurs form in response to this degeneration of the disk, making the spine stiff. When the rough surfaces of the vertebral joints rub together, pain and inflammation may result. Nerves may become irritated or compressed.

Disk degeneration might occur throughout several regions of the spine, or it might be limited to one disk. When it’s part of the natural aging process, the degeneration does not always lead to pain. For some people, however, it can cause a great deal of pain and disability.You are more likely to develop DDD if you smoke, are overweight, do physical work or don’t get very much exercise.

You might have mild to intense neck and back pain—or no pain at all. A degenerative disk in the neck can cause pain in the arm, shoulder or neck. A degenerative disk in the low back might cause pain in the back, buttocks or legs. The pain is often made worse by sitting, bending, and reaching. It may be worse first thing in the morning and after staying in any one position for a long time. In severe cases, when DDD results in pressure on the nerves, it can lead to numbness, tingling, and even weakness in the arms or legs.

If you have muscle weakness and loss of sensation or very severe pain, special diagnostic tests, such as x-rays, or MRI’s may be needed. Physical therapists work closely with physicians and other health care providers to make certain that an accurate diagnosis is made and the appropriate treatment is provided.
Research shows that in all but the most extreme cases (usually involving muscle weakness or high levels of pain), conservative care, such as physical therapy, has better results than surgery.
After the evaluation, if your therapist suspects you have DDD and there are no major medical problems, treatment can begin right away.

Darren Marchant, PT,MSPT,OCS
CEO
FIT Physical Therapy

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Runners Knee

Posted July 28, 2017 by FIT Physical Therapy

 

If you are a runner, an athlete, or just fairly active and have developed pain around the front of your knee you may be suffering from Runner’s knee, or what the medical world calls Patellofemoral pain syndrome (PFPS).

Patellofemoral pain syndrome refers to pain at the front of the knee, in and around the kneecap. (The kneecap, or patella, is the triangle-shaped bone at the front of the knee joint. The pain usually is accompanied by tenderness along the edges of the patella.

PFPS often occurs in people who are physically active or who have suddenly increased their level of activity, especially when that activity involves repeated knee motion such as running, stair climbing, squatting, or repeated carrying of heavy loads. If you are older, you might have age-related changes that cause the cartilage on the under-surface of the patella to wear out. The result is pain and difficulty completing even the simplest daily tasks without pain.

Usually, patellofemoral pain is worse when you walk up or down hills or stairs and on uneven surfaces. This pain tends to increase with activity and improve with rest. You also may feel pain after sitting for long periods of time with the knee bent or occasionally hear or feel a “cracking” or “popping” when you bend or straighten your knee.

Current research indicates that PFPS is an “overuse syndrome,” which means that it may result from repetitive or excessive use of the knee. Other contributing causes may include:

  • Weakness, tightness, or stiffness in the muscles around the knee
  • An abnormality in the way the lower leg lines up with the hip, knee, and foot
These conditions can interfere with the ability of the patella to glide smoothly on the femur (the bone that connects the knee to the thigh) during movement. The friction between the under-surface of the patella and the femur causes the pain and irritation commonly seen in PFPS.

If you suspect you have PFPS a visit to your medical doctor and/or physical therapist is advised.
In physical therapy we use certain tests and measures to help diagnosis PFPS. In addition, we observe the alignment of your feet, analyze your walking and running patterns, and test the strength of your hip and thigh muscles to find out whether there is a weakness or imbalance that might be contributing to your pain.
Finally, we check the flexibility of the muscles in your leg, paying close attention to those that attach at the knee. Generally, x-rays are not needed to diagnose PFPS.

No two patients are exactly alike so the key to appropriate treatment is a customized evaluation and treatment program. Some of the treatments that help this condition are:

  • Strengthening exercises targeted at the hip (specifically the abductor and rotator muscles of the buttock and thigh), the knee (specifically the quadriceps femoris muscle, which is located on the front of your thigh and straightens your knee), and the ankle.
  • Stretching exercises for the muscles of the hip, knee, and ankle
  • Taping of the patella to reduce pain and retrain muscles to work efficiently
  • Exercises for improving your performance of activities that have become difficult for you

If the alignment and position of your foot and arch appear to be contributing to your knee pain you may benefit by getting a special shoe insert called an orthosis. The orthosis can decrease the stress to your knee caused by excessive rotation or impact during walking and running.

PFPS is much easier to treat if it is caught early. Early diagnosis and treatment by a physical therapist may help stop the underlying problem before it gets worse. Your physical therapist also can help you adjust your daily activities and teach you exercises to do at home to strengthen your muscles and bones and help prevent PFPS from recurring.

Darren Marchant, PT,MSPT,OCS
CEO
FIT Physical Therapy

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Mom Struggles

Posted June 1, 2017 by FIT Physical Therapy

A friend posted on Facebook a few weeks ago about “#momstruggles.” She was referring to her attempt to jump on the trampoline with her kids. Many women responded in agreement that they weren’t as young as they used to be and their bladder control isn’t what it used to be.

Most women who have given birth consider urinary leakage normal. Urinary incontinence is common, with as many as 13 million Americans being incontinent. Roughly 25 percent of young women, 50 percent of middle-age women and 75 percent of older women experience incontinence. It affects their ability to play with kids and grandkids, run, play tennis and even laugh.

There are multiple types of urinary incontinence. Stress urinary incontinence means there is involuntary leakage with physical exertion. It can have multiple contributing factors.

Regardless of the cause, the symptoms make women feel embarrassed and powerless as though they are beginning to lose control of their bodies. The real truth is that although urinary incontinence is common, it is not normal. There are many options to help treat this condition and get women active again.

Kegel exercises are relatively well-known, and some women even do them consistently. Other women have tried them but haven’t noticed any changes in the frequency or severity of their urinary leakage. It’s easy to give up hope when the only thing you know doesn’t seem to work.

Even with instruction most women are performing these exercises incorrectly. One tip is to make sure that the abdominal muscles and gluteal muscles are not being tightened at the same time. When these muscles tighten, they often overpower the pelvic floor muscles since they are smaller and usually weaker.

Some individuals are reluctant to bring this issue up in discussion with their physicians, but doctors recognize that the first line treatment for stress urinary incontinence is a pelvic floor exercise program. They may prescribe a home program or refer patients to physical therapy. This can be a surprise to many people.

Physical therapists who do pelvic floor physical therapy often get additional specialized training. When a patient is seen for pelvic floor physical therapy, they can expect the therapist to do a full evaluation of overall strength, flexibility, pain and movement. The therapist will collect information about symptomatic bladder, bowel or other pelvic floor problems.

To get a complete understanding of contributing factors an internal examination is performed to assess the condition, coordination and strength of the pelvic floor muscles and surrounding tissues. It is sometimes possible to treat symptoms without doing an internal examination if that is the patient’s preference. Maintaining a patient’s comfort throughout each session is a priority.

An individualized treatment program is then developed, usually including instruction on pelvic floor muscle training, breathing or relaxation techniques, dietary modifications, bladder retraining and a home program.

Most patients begin to see progress quickly after implementing some of the changes into their lifestyles. Progress continues to be made well after a patient is discharged from physical therapy. Moms can jump on the trampoline with their kids. Women can run, play tennis, sneeze and laugh without worrying. Patients are always grateful to have control of their bodies and their active lives back.

Tricia Burbank, DPT
FIT Physical Therapy

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Stretching

Posted May 4, 2017 by FIT Physical Therapy

If you want to see good movement, watch kids play. Recently I took my kids to the park to play around on the large playground there. Their motion was free and easy as they climbed stairs, slid down slides and swung like monkeys from the bars.  I was impressed, and must admit, a bit jealous, at the ease in which their young bodies moved around.  How and why did we lose this ability to move so easily?  The easy answer is because we age, and stiffness and loss of mobility is a natural consequence of this aging process. True that. But could it also be, at least in part because we sit on our rear ends for several hours a day, don’t exercise much, and think stretching is a dirty word!

Many of us have no problem with lifting weights, walking or running to improve our fitness. But stretching? Well that’s often the forgotten and neglected red headed step child of fitness. We neglect stretching and flexibility exercises to our own detriment. In fact, I can think of nothing as important than proper stretching to improve our movement and prevent and reduce injury, decrease pain, improve strength and increase performance in all aspects of our lives.

Most of us have several areas in our bodies that are tight and lacking full motion.  The key is to identify those areas and address them through appropriate stretches.  Because we tend to do things alike, there are common tight areas in our bodies. These areas include, our upper backs/ chest muscles, hips and hamstrings and our calves.

There are a few things to keep in mind when stretching. First, always warm up before stretching. Just as an motorized engine need to warm up properly before driving, so too do our bodies need to warm up before stretching.  Just start moving to warm up.

Dynamic stretching is the type of stretching that involves moving our bodies freely and is best done right before exercise as a warm up, or right after exercise as a cool down.

Static stretching is where you place a muscle on stretch and hold it for a period of time, usually 30 seconds. Why 30 seconds? Well, studies show that 30 seconds is better than 15 or 20 seconds, and just as effective as a minute in achieving an effective stretch. You should breath and relax slowly into the stretch. While stretching may not be comfortable, it should not be painful. If it is, do not push it as that may indicate an underlying problem that should be addressed by a trained professional.

Remember the saying, motion is lotion. Stretching can and should be done on a near daily basis. While we may never move quite as easily kids on a playground, frequent stretching will help increase our ability to move better, prevent injury and do more of those things we love to do.

Darren Marchant, PT,MSPT,OCS
CEO
FIT Physical Therapy

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Parkinson’s Disease

Posted April 7, 2017 by FIT Physical Therapy

What do Michael J. Fox, Muhammad Ali, Pope John Paul II and Johnny Cash all have in common? If you answered Parkinson’s Disease, you are correct.

Parkinson’s disease (PD) is the second most common degenerative brain disorder, after Alzheimer’s disease. PD is more common in men than in women. People of all ethnic groups can develop PD, but it is less common among African-American and Asian populations. Most often, symptoms begin when people are around 60 years of age.

Parkinson’s disease is related to a loss of nerve cells in your brain that produce a chemical called dopamine. Dopamine is an important factor in controlling movement.

The exact cause of PD is not yet known. Family history, aging, or exposure to certain environmental toxins may contribute to the onset of PD. It is a chronic degenerative disease, which means that it gets worse over time; however, people usually do not die from PD.

Symptoms typically include stiffness (rigidity), shaking (tremor), slowness with movement, and balance problems. Because of these symptoms, people with PD are at risk of falling and breaking their bones. Treatment includes a combination of medication and physical therapy – and, in some cases, surgery.

The symptoms of PD can be very mild at first. A common early symptom is a tremor in one hand, most often when you are at rest. It might look like you are rolling a pill between your thumb and forefinger. Tremors also can occur in your legs or jaw when you are at rest. Since the tremors are most apparent during rest, they usually go away when moving and typically don’t interfere substantially with daily function.

There is no specific “test” like an x-ray or head scan that can be used to identify PD, so it can be difficult to diagnose. A diagnosis is usually made based on your medical history and a neurological examination. If your health care provider suspects that you have symptoms of PD, you may be referred to a neurologist for further examination.

The severity and type of symptoms of PD can vary widely. Some people have the disease for 20 to 30 years and have a slower progression and decline in mobility over a long period of time. For others, the disease progresses more quickly, and they may experience difficulty with mobility within 5 to 10 years.

To date, there is no known way to prevent PD. Studies have shown improved walking, balance, strength, flexibility, and fitness in people with PD who participated in an exercise program. However, these studies also indicated that people with PD gradually lost the gains they had made when their supervised exercise program ended. It’s important to work with your physical therapist to help develop good long-term exercise habits.

Your physical therapist will help you stay as active and as independent as possible. You will be taught special exercises and techniques to combat the symptoms of PD. Your treatment program should be customized to your needs and adjusted from time to time based on the progression of the PD and the effectiveness of your medication.

Darren Marchant, PT,MSPT,OCS
CEO
FIT Physical Therapy

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Cardiovascular Exercise

Posted March 15, 2017 by FIT Physical Therapy

When people think of exercise, they most commonly think of cardio exercise. Walking, Running, Biking, Swimming are all types of cardiovascular exercise.  This heart healthy exercise is critical for your health because the more active you are, the better your heart works. You’re less likely to get many of the diseases that can effect the duration and quality of your life, including coronary artery disease, high blood pressure, type II diabetes and some cancers.

Cardio exercise helps in weight loss, boosts energy levels, decreases aches and pains, improves mood, aids in digestion and improves sleep. It’s too bad we can’t just take a pill that works as good! Unfortunately, that pill just does not exist. Cardio exercise takes effort and time and there are no short cuts.  Think of the cardio exercise you do as an investment in your health. This exercise, done consistently over time helps you build a strong portfolio of health.

Our bodies were made to move. And we all know that to keep our muscles in shape we need move them. Our heart is a muscle and pumps blood throughout our body.  Our lungs move in sync with the heart to supply oxygen, which fuels our muscles which power movement. Cardio exercise makes them all stronger, and a stronger heart, muscles and lungs make for a more efficient and healthy body.

So how much exercise should you do? The American College of Sports Medicine is the authoritative voice in exercise science and provides the guidelines followed by medical and health care providers. They recommend the following guidelines for cardio exercise.

Adults should get at least 150 minutes of moderate intensity exercise per week. These minutes can be met through 30-60 minutes of moderate-intensity exercise five days per week or 20-60 minutes of vigorous intensity exercise three days per week. They also note that one continuous session and multiple shorter sessions of at least 10 minutes are both acceptable to accumulate desired amount of daily exercise.

Exercise intensity is an interesting discussion. One you can keep it fairly simple, or delve into some pretty complicated stuff. For this piece we’ll keep it simple… Exercise hard enough to sweat!  My guess is that most of us probably don’t exercise hard enough. Casually walking your dog or playing 18 holes of golf in a cart is not cardio exercise!

If you are new to cardio exercise, start easy and gradually progress your time, frequency and duration of exercise on a regular basis. Be patient with yourself and don’t compare yourself to others. Listen to your body and if you are having pain and it does not go away with rest or modification, then don’t quit. Instead, seek the help of an orthopedic trained physical therapists. As movement experts we are often able to identify the underlying problems and help get you back on track.

Although exercise is usually beneficial for everyone, you should always consult your doctor or health care provider before beginning a cardio program, especially if you are just starting or have a history of medical issues.

Darren Marchant, PT,MSPT,OCS
CEO
FIT Physical Therapy

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Weekend Warriors: Five Ways to Battle Injury

Posted February 5, 2017 by FIT Physical Therapy

You used to have game. Now you are a little older, maybe a little slower and those clothes of yesteryear don’t fit so well any longer.  Buy hey, you’re busy, have a job, don’t exercise or run around like you used to. But the weekend comes, you see the court, the course, the ball, whatever, and the glory days are back. Five minutes into the action, you are starting to have visions of grandeur, and then suddenly you hear a pop, feel a sharp pain and know in an instant you are done. Hence the fall of the mighty weekend warrior.  Unfortunately, this happens all the time.

The Centers for Disease Control and Prevention (CDC) estimates nearly nine million Americans pack a full week’s worth of exercise into just two days. These occasional athletes, also known as Weekend Warriors, account for the largest population encountering nonprofessional sport-related injuries, which add up to healthcare costs exceeding more than $18 billion per year.

The most common injuries Weekend Warriors face include rotator cuff injuries, Achilles tendonitis, golf or tennis elbow, acute knee pain and ankle sprains.

Weekend Warriors and recreational athletes suffer from injuries at a rate that far surpasses their everything-in-moderation fitness counterparts. Age and physical condition play significant roles in these injuries, as tissue loses its elasticity and are not conditioned properly for rigorous activity. But injuries can be minimized with a dose of common sense prevention.

Here are some tips and suggestions to help you avoid becoming the next weekend warrior we see in our clinic.

1. See a Physical Therapist:  There is no one more knowledgeable and well equipped to help you understand your musculo-skeletal system than a physical therapist. A physical therapist will assess strengths and weaknesses from which a comprehensive fitness plan can be tailored to best fit your individual’s needs and goals.

2.      Always Warm Up Before Physical Activity, and Cool Down Before Finishing. Warmed muscles are ready for activity and are less susceptible to injury. Warm up and cool down should become part of every workout.

3.      Light Stretching. Often, weekend warriors skip stretching altogether, and sometimes overstretch. Routine light stretching helps warm muscles up and increases range of motion.

4.      Commit to Fitness Throughout the Week. To eliminate muscle shock, introduce physical activity throughout the week that includes cardiovascular activity, stretching and weightlifting for balanced strength and conditioning.

5.      Rest and Listen to Your Body. Consecutive days of training translate into increased injuries. While many athletes think the more they train, the better they’ll play, the truth is, a tired body is more susceptible to muscle strain and other injuries. Consistent pains and strains over time can be a sign of underlying tissue injure and if left unchecked can turn into more serious injury.

Darren Marchant, PT,MSPT,OCS
CEO
FIT Physical Therapy

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Carpal Tunnel

Posted November 4, 2016 by FIT Physical Therapy

What the heck is the Carpal Tunnel? It’s not something you drive your car through, but a narrow tunnel on the palm side of our wrists, about the width of your thumb. It’s an important part of our anatomy because it protects the nerve and tendon that helps bend our fingers. Pressure on the nerve can cause pain and weakness in your wrist and hand and numbness or tingling in some of your fingers. This pressure is caused by crowding or irritation of the median nerve in the carpal tunnel and can lead to a painful and debilitating injury called Carpal Tunnel Syndrome or CTS.

CTS is a common condition affecting 1 out of 20 Americans.  CTS is common in professions where repetitive and stressful demands are placed on a workers hands. Extreme wrist positions, as well as a lot of finger use, especially with a lot of force or vibration (such as holding the steering wheel when driving heavy machinery), can all contribute to CTS. Some leisure activities can also create CTS, such as long-term keyboard use, sewing, sports such as racquetball and handball, and playing string instruments such as the violin.

Other contributing factors to CTS may be injuries to the wrist such as strains, fractures and dislocations, fluid retention, such as at pregnancy, diabetes and long-term steroid use.

CTS usually starts gradually, with symptoms such as burning, tingling, “pins and needles,” or numbness in the palm of the hand and fingers. Often the symptoms are more noticeable during the night, and individuals often report being wakened with symptoms. Many people feel the need to “shake out” their hands to try to relieve the symptoms.

As the condition progresses, the symptoms are noticed during the daytime and are often worse when holding items such as a heavy book or a hairbrush.  Weakness of the hand and more constant numbness may occur if the pressure on the nerve continues. You may find that you drop objects unexpectedly or have a weakness in your grip.

Your health care provider usually diagnoses CTS with a clinical examination. Occasionally a specialized test called an electromyogram or EMG may be ordered. If your evaluation confirms early-stage CTS, conservative care will be recommended as a first step.

Physical therapy treatments can be effective in reducing your symptoms and getting you back to performing normal activities. We often find success in physical therapy using manual therapy techniques, (massage, joint mobilizations, Soft tissue Instrumentation) as well as gentle nerve gliding and stretching of the wrist, forearm, shoulder and neck.
Wrist splints to be worn at night are also commonly recommended as they help keep the wrist in a straight alignment while you sleep, thus reducing compressive forces on the nerve.

If your CTS is more severe, or if your symptoms persist, a visit to an orthopedic specialist is advised for a surgical consultation. If necessary, surgery will be performed to release the band of tissue that is causing pressure on the median nerve. Surgery has proven to be a very effective way to treat CTS that does not respond to conservative measures. Physical therapy treatment is important after surgery to help restore strength to the wrist and to learn to modify habits that may have led to symptoms in the first place.

Darren Marchant, PT,MSPT,OCS
CEO
FIT Physical Therapy

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