Congratulations to the Fairfield Encore Athlete of the Month, Darrell Thomas! Darrell is a senior, multi-sport athlete at Midfield High School in Birmingham, AL. He is a member of the Football and Basketball teams, and has played on their Varsity teams for 2 years. You can find him on the football field wearing jersey #5 and on the court wearing jersey #20. After graduation, Darrell plans to attend ASU and major in Physical Therapy. He is the son of Patricia Thomas.
We can’t stop time. Or can we? The right type and amount of physical activity can help stave off many age-related health problems. Physical therapists, who are movement experts, prescribe physical activity that can help you overcome pain, gain and maintain movement, and preserve your independence—often helping you avoid the need for surgery or long-term use of prescription drugs.
Here are nine things physical therapists want you to know to #AgeWell.
(Download the list in Adobe PDF)
1. Chronic pain doesn’t have to be the boss of you.
Each year 116 million Americans experience chronic pain from arthritis or other conditions, costing billions of dollars in medical treatment, lost work time, and lost wages. Proper exercise, mobility, and pain management techniques can ease pain while moving and at rest, improving your overall quality of life.
2. You can get stronger when you’re older.
Research shows that improvements in strength and physical function are possible in your 60s, 70s, and even 80s and older with an appropriate exercise program. Progressive resistance training, in which muscles are exercised against resistance that gets more difficult as strength improves, has been shown to prevent frailty.
3. You may not need surgery or drugs for low back pain.
Low back pain is often over-treated with surgery and drugs despite a wealth of scientific evidence demonstrating that physical therapy can be an effective alternative—and with much less risk than surgery and long-term use of prescription medications.
4. You can lower your risk of diabetes with exercise.
One in four Americans over the age of 60 has diabetes. Obesity and physical inactivity can put you at risk for this disease. But a regular, appropriate physical activity routine is one of the best ways to prevent—and manage—type 1 and type 2 diabetes.
5. Exercise can help you avoid falls—and keep your independence
About one in three U.S. adults age 65 or older falls each year. More than half of adults over 65 report problems with movement, including walking 1/4 mile, stooping and standing. Group-based exercises led by a physical therapist can improve movement and balance and reduce your risk of falls. It can also reduce your risk of hip fractures (95 percent of which are caused by falls).
6. Your bones want you to exercise.
Osteoporosis or weak bones affects more than half of Americans over the age of 54. Exercises that keep you on your feet, like walking, jogging, or dancing, and exercises using resistance, such as weightlifting, can improve bone strength or reduce bone loss.
7. Your heart wants you to exercise.
Heart disease is the No. 1 cause of death in the US. One of the top ways of preventing it and other cardiovascular diseases? Exercise! Research shows that if you already have heart disease, appropriate exercise can improve your health.
8. Your brain wants you to exercise.
People who are physically active—even later in life—are less likely to develop memory problems or Alzheimer’s disease, a condition which affects more than 40% of people over the age of 85.
9. You don’t “just have to live with” bladder leakage.
More than 13 million women and men in the US have bladder leakage. Don’t spend years relying on pads or rushing to the bathroom. Seek help from a physical therapist.
*This article was taken from the Move Forward PT website and can be found at this link: http://www.moveforwardpt.com/Resources/Detail/9-physical-therapist-tips-to-help-you-agewell
Congratulations to the Ocean Springs Spine and Orthopedic Clinic Patient of the Month, Kathy Slaten! Kathy is a native of Ocean Springs, MS and has been receiving physical therapy at our clinic on her lower back. Before physical therapy, Kathy wasn’t able to live the active lifestyle she was used to, and couldn’t perform household duties such as cooking, laundry, or cleaning. One of Kathy’s friends came along side her and recommended she try physical therapy under our DPT, Valerie Sullivan. Kathy has now been with us for 4 weeks and says her back is stronger, has increased mobility, and says she is almost pain free!
“I was ignorant of what physical therapy could do for me, but I am certainly a believer now and would recommend Encore to anyone! I could not be more impressed!”
– Kathy
Ensure that your body is ready to carry a baby by addressing before pregnancy any pain or problems associated with posture or weakness. Here are some physical therapist tips for helping to prepare your body for pregnancy and to guard against musculoskeletal pain and dysfunction during and after it.
1. Strengthen your pelvic muscles. To strengthen your muscles, use pelvic floor contractions (commonly referred to as Kegels), which involve gently squeezing the sphincter muscles (rather than the buttocks and thighs). These tightening exercises help prevent leakage when a woman sneezes, coughs, etc, and also can help reduce pelvic pain during pregnancy. However, many women do Kegels incorrectly (perhaps because muscles are too tight and need to be relaxed before strengthening). Doing Kegels incorrectly can worsen conditions such as incontinence, pelvic pain, and even low back pain. This is why it is important to consult a women’s health physical therapist before beginning an exercise program. Physical therapists who specialize in women’s health can instruct women in how to perform these exercises safely and correctly. (Encore Rehabilitation has a specialized clinic that treats incontinence and pelvic pain, located in D’Iberville, Mississippi).
2. Prepare for “baby belly” by focusing on your core. Core exercises can help prevent diastasis recti —abdominal muscle separation. As your belly grows, the abdominal muscles that run vertically along either side of the belly button can be forced apart, like a zipper opening. If these abdominal muscles separate from each other too much, the result can be low back pain, pelvic pain, or other injuries as your body tries to compensate for its weaker core. This also can result in the postpregnancy “pooch” many women find undesirable.
Some exercises, such as sit ups, increase the likelihood of developing diastasis recti, incontinence, and back pain during and after pregnancy. It is important, therefore, to work with your physical therapist on the right exercise strategy for establishing a strong core.
3. Take a breath! Learning proper breathing and relaxation techniques from your physical therapist will help prepare your body and mind for a healthy pregnancy. It is important to learn to properly exhale before performing any exercise. With proper technique, your core and pelvic floor muscles will contract automatically, and this will lead to optimal stability and injury protection.
4. Begin a regular fitness routine. Exercise will help reduce the amount of cortisol (stress hormone) in your body and will boost your muscle and cardiovascular strength—strength you’ll need to carry that extra baby weight. Once you become pregnant, consider engaging in relatively low-impact activities, such as swimming, walking on even surfaces, biking, or using an elliptical machine. Runners should be aware that loosening of their ligaments may make them more susceptible to knee and ankle injuries. Also, when the muscles and ligaments that support a woman’s pelvic organs weaken, the repetitive jarring of running can cause these organs to descend. This is known as pelvic organ prolapse. Physical therapists strongly recommend that, to prevent this condition, women wear undergarments that offer pelvic floor support, or compression shorts that support the pelvic floor, both during and after pregnancy.
5. Practice good posture. Poor posture can have a major effect on every part of your body, particularly with regard to pain during pregnancy. A physical therapist can evaluate your posture and suggest muscle-strengthening exercises and lifestyle education (such as not sitting at a desk for long periods, and carrying grocery bags properly). Establishing healthy posture habits—pre-baby—will better prepare your body for the extra weight of pregnancy and lessen your chances of low back and pelvic pain.
While moderate weight gain is a common concern for women during and after pregnancy, there are many other factors to consider in the 4 to 6 weeks after childbirth. You may want to get back into pre-pregnancy shape immediately, but it is important to make a slow return to full activity. Here are some tips on what you can do in the first 6 weeks after delivery to begin getting your body back into pre-pregnancy shape.
1. Get help with tasks. A new mom needs an ally in the weeks following childbirth. During this time, a woman should not lift anything heavier than her baby, in spite of the temptation. Make sure all the heavy nursery equipment is set up by someone else in advance of the baby’s arrival. It’s important now for you to rest and engage in light activities only.
2. Breathe. Believe it or not, something as natural and instinctive as breathing will require focus after childbirth. This is because the growing uterus pushes the diaphragm upward, causing it to lose its ability to descend during inhalation. Since the diaphragm forms the top of the core muscles, it is important to work with a physical therapist, who will prescribe exercises to help restore your diaphragm function to its full capacity.
3. Focus on your core. A woman’s abdominal muscles undergo a great deal of strain during pregnancy. In fact, separation of abdominal muscles, called diastasis recti, is a common occurrence. Also, engaging in inappropriate exercise, such as sit ups, can worsen the problem for some women. A physical therapist can prescribe exercises to help “close the gap” between muscles. Gentle core-strengthening exercises also can be done, paving the way for more-vigorous abdominal exercises 6 or more weeks after delivery.
4. Strengthen abdominal and pelvic floor muscles. Physical therapists recommend that immediately post-partum, women focus on exercising the abdominal muscles and the muscles of the pelvic floor. During pregnancy, these muscles often are stretched and weakened. Strengthening them gives women a strong, stable base from which to work and move. This can alleviate pain later on, and makes much simpler such tasks as carrying the baby, getting in and out of the car, and lifting and reaching.; Women who have had a caesarian section should be watchful of discomfort during abdominal exercise. Pain could indicate that the exercise is being done too soon, incorrectly, or too vigorously.
Fortunately, women can do gentle Kegel (pelvic floor) exercises immediately after childbirth, whether the birth was vaginal or by caesarian section. Kegels can be done during everyday activities such as nursing or feeding the baby. Strengthening the pelvic floor also can improve sexual satisfaction and help prevent incontinence. Physical therapists can recommend several types of Kegel exercises—for endurance, (in which the woman contracts or lifts the pelvic floor muscles and holds them for 5 to 10 seconds) and to produce quick, brisk muscle contractions.
5. Every minute counts. Over time, a woman may begin incorporating fitness into her everyday routines—such simple activities as taking a family walk around the neighborhood or participating in a fitness group with other new moms. Remember to go at your own pace. New moms should sleep whenever they have the opportunity.
Acknowledgement: Marianne Ryan, PT, OCS
Congratulations to the Columbus Patient of the Month, Allen Saxton! Mr. Allen lives in Reform, AL and has been coming to us for physical therapy on his hip since the beginning of the month. With the help of his Physical Therapist, Lee, and his personalized therapy exercises, Mr. Allen has been making great progress and will be back in the swing of things in no time!
Congratulations to Ally Iachino who was chosen as the Patient of the Month at our Ocean Springs Spine and Orthopedic clinic. Ally lives in Ocean Springs, MS and has been coming to us for Physical Therapy after suffering from a high ankle sprain while competing in a national dance competition. Her dream job of dancing professionally at Disney World seemed to be something that she may not be able to do with the show starting in October. However, through the personalized physical therapy program we created for her, she is now a stronger dancer and says she feels very confident to start her dream job. We are proud of you for following your dreams, Ally, and we’re cheering for you the whole way!
People everywhere are experiencing the transformative effect physical therapy can have on their daily lives. In fact, as experts in the way the body moves, physical therapists help people of all ages and abilities reduce pain, improve or restore mobility, and stay active and fit throughout life. But there are some common misconceptions that often discourage people from visiting a physical therapist.
It’s time to debunk 7 common myths about physical therapy:
1. Myth: I need a referral to see a physical therapist.
Fact: A recent survey by the American Physical Therapy Association (APTA) revealed 70% of people think a referral or prescription is required for evaluation by a physical therapist. However, all 50 states and the District of Columbia (DC) allow patients to be evaluated by a physical therapist without a physician’s prior referral. In addition, 49 states and DC allow for some form of treatment or intervention without a physician referral or prescription (Michigan being the exception). On January 1, 2015, patients in Michigan will be able to do so, as well. Some states have restrictions about the treatment a physical therapist can provide without a physician referral. Check out APTA’s direct access summary chart (.pdf) to see the restrictions in your state.
2. Myth: Physical therapy is painful.
Fact: Physical therapists seek to minimize your pain and discomfort—including chronic or long-term pain. They work within your pain threshold to help you heal, and restore movement and function. The survey found that although 71% of people who have never visited a physical therapist think physical therapy is painful, that number significantly decreases among patients who have seen a physical therapist in the past year.
3. Myth: Physical therapy is only for injuries and accidents.
Fact: Physical therapists do a lot more than just stretch or strengthen weak muscles after an injury or surgery. They are skilled at evaluating and diagnosing potential problems before they lead to more serious injuries or disabling conditions—from carpal tunnel syndrome and frozen shoulder, to chronic headaches and lower back pain, to name a few.
4. Myth: Any health care professional can perform physical therapy.
Fact: Although 42% of consumers know that physical therapy can only be performed by a licensed physical therapist, 37% still believe other health care professionals can also administer physical therapy. Many physical therapists also pursue board certification in specific areas such as neurology, orthopedics, sports, or women’s health, for example.
5. Myth: Physical therapy isn’t covered by insurance.
Fact: Most insurance policies cover some form of physical therapy. Beyond insurance coverage, physical therapy has proven to reduce costs by helping people avoid unnecessary imaging scans, surgery, or prescription drugs. Physical therapy can also lower costs by helping patients avoid falls or by addressing conditions before they become chronic.
6. Myth: Surgery is my only option.
Fact: In many cases, physical therapy has been shown to be as effective as surgery in treating a wide range of conditions—from rotator cuff tears and degenerative disk disease, to meniscal tears and some forms of knee osteoarthritis. Those who have recently seen a physical therapist know this to be true, with 79% believing physical therapy can provide an alternative to surgery.
7. Myth: I can do physical therapy myself.
Fact: Your participation is key to a successful treatment plan, but every patient still needs the expert care and guidance of a licensed physical therapist. Your therapist will leverage his or her specialized education, clinical expertise, and the latest available evidence to evaluate your needs and make a diagnosis before creating an individualized plan of care.
Congratulations to the Citronelle Encore Athlete of the Month, Paige Reach! Paige is a senior athlete at Citronelle High School. She has been playing Varsity Softball for the Lady Wildcats for 4 years and wears jersey #5. Paige has obtained quite a few sports awards in the past 4 years – Bryant-Jordan Scholarship nominee, Offensive MVP, Defensive MVP, and team captain for the softball team. She has a 4.43 GPA and plays to attend Alabama Southern Community College where she received a softball scholarship and will major in nursing.
Paige is the daughter of Tommy and Christy Anderson. Good luck in softball this season, Paige! We are proud of you!
Congratulations to the Long Beach Patient of the Month, Mike McCoy! Mike is a fire fighter for Gulf Port and lives in Pass Christian, Mississippi. He has been coming to our Long Beach Clinic for 9 Weeks to have Physical Therapy treatment after his knee and shoulder surgeries.
“Encore is preparing me to get back to full duty as quickly as possible. Long Beach Encore has great group of fun and dedicated ladies that truly care about what they do.”
Keep up the good work, Mike! Thank you for serving the community!
These are some of the frequently asked questions regarding total knee replacement (TKR):
How long does a TKR last?
A common reply to this question is that total joint replacement lasts 15-20 years. A more accurate way to think about longevity is via the annual failure rates. Most current data suggests that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and a 80-85% that it will last 20 years. With improvements in technology, these numbers may improve.
What types of implants are there?
The orthopaedic implant industry has developed a number of innovative technologies in an effort to improve the outcomes of TJA. In recent years, these technologies have been marketed directly to patients, which has increased the awareness as well as confusion on what these different designs mean. The most important message is that while a certain manufacturer may claim that their design is better, almost all of the available registry data (large collections of data from countries that track TJA) show that there is no clear advantage to any of these designs when it comes to improving outcomes. Here are specific implant design terms:
- Gender specific: This refers to a modified implant design that accounts for average anatomic differences between men’s and women’s knees. Most manufacturers have incorporated similar modifications in their newer designs, which allow for more sizing options so that the prosthesis can be more accurately fit to the patient’s native anatomy and recreate the natural function of the knee.
- Rotating platform: This refers to a plastic bearing that independently rotates on a metal tray on which it is seated. More often, the plastic bearing locks into the metal tray – referred to as a “fixed bearing.” Some theoretical advantages to the rotating platform concept when it was initially designed was that it could reduce the wear of the plastic bearing, reduce the rate of loosening of the metal parts, and better replicate how a patient’s knee works (kinematics). Most current data shows that after 5-10 years in use, there does not appear to be any difference between rotating platform and fixed bearing designs in any of these outcomes.
Will my surgeon use a computer, robot, or custom cutting guide in my surgery?
There are many studies attempting to evaluate these emerging technologies and their influence of the success of surgeries. Each of these technologies has a specific goal that has fueled its development (i.e. more accuracy in implant placement, more efficient or faster surgery, etc.). To date, there appears to be both pros and cons to each of these technologies, but more research is required to determine what advantage, if any, these may offer. The best approach is to discuss this topic with your surgeon. You may want to know if they use one of these technologies, why they have chosen to do so, and what their experience has been in using it.
Will I need general anesthesia?
While general anesthesia is a safe option, both hip and knee replacements can be performed under regional anesthesia. Choices for regional anesthesia include spinal anesthesia, epidural anesthesia, or one of a variety of peripheral nerve blocks. Many surgeons and anesthesiologists prefer regional anesthesia because data shows it can reduce complications and improve your recovery experience with less pain, less nausea, less narcotic medicine required, etc.
How long will I stay in the hospital?
You will likely stay in the hospital for 1-3 days depending on your rehabilitation protocol and how fast you progress with physical therapy. This is highly dependent upon your condition before surgery, your age, and medical problems which can hinder your rehabilitation.
When can I walk after surgery?
Most surgeons and hospitals today emphasize getting you out of bed quickly. Most people are walking with the assistance of a walker on the day after surgery, and using a cane or nothing at all by 2-3 weeks.
When can I shower?
Many surgeons use waterproof dressings that allow for showering as early as the day after surgery. If your surgeon uses a standard dressing, you won’t be allowed to shower for 5-7 days, and usually no soaking for 3-4 weeks to allow the incision to fully heal.
Is TKR very painful?
Pain following total knee replacement has come a long way over the last 10-15 years with increased use of regional nerve blocks, spinal blocks, and various other modalities used for pain control. Total hip replacement is generally considered to be less painful than total knee replacement. Early range of motion and rapid rehabilitation protocols are also designed to reduce early stiffness and pain, making the procedure in general much less painful than in years past. You may have relatively mild pain following the procedure, or you may have a more difficult time than others. Everyone is unique and handles and perceives pain differently.
How long does it take to recover?
It can take up to 3 months for you to return to most activities, and likely 6 months to one year to fully recover to maximal strength and endurance following a TKR. This depends on your condition before surgery, additional medical problems, and your expectations.
Will I need physical therapy, and if so, for how long?
Most people who have undergone TKR require outpatient physical therapy following surgery. A skilled therapist can accelerate the rehabilitation as well as make the process more efficient with the use of dedicated machines and therapeutic modalities. Depending on your condition before surgery, physical therapy is beneficial for up to 3 months and rarely longer. The amount of therapy needed depends upon your condition before surgery, motivation, and general health.
When can I drive?
Most surgeons allow patients to drive at 4 to 6 weeks after surgery, and sometimes sooner if the operative leg is the left leg. There is some literature that states that your reaction time will not be back to normal prior to 6 weeks. You should not drive while on narcotics.
When can I return to work?
Returning to work is highly dependent on your general health, activity level and demands of your job. If you have a sedentary job, such as computer work, you can expect to return to work by 6-8 weeks. If you have a more demanding job that requires lifting, walking, or travel, you may need up to 3 months for full recovery
What restrictions will I have after surgery?
Restrictions following TKR are generally few and should be discussed with your surgeon. Following TKR, you will have some difficulty kneeling on the operative knee, which you will become less aware of with time, but will always have a general perception that the knee is artificial and doesn’t really feel like a normal knee. Most patients are able to return to usual activities and work but may have some difficulty performing heavy labor such as construction or farming. Most sporting activities are fine with the exception of running or jumping. Traveling should be not be affected by a joint replacement after the first 4-6 weeks when most surgeons advise against prolonged seated travel or flying due to increased risk of blood clot.
Are there complications to TKR?
- TKR is primarily a pain relieving procedure; however, it may not relieve all pain, and there is a possibility of residual stiffness and swelling.
- Although complications are relatively rare (1-2% of patients), patients may experience a complication in the postoperative period. These include very serious and possibly life threatening complications such as heart attack, stroke, pulmonary embolism and kidney failure.
- Stiffness or loss of motion can also occur.
- Infection (1%) is one of the most debilitating complications and often requires prolonged antibiotics with several additional surgeries to rid the infection.
- A blood clot in the leg is also a relatively common complication requiring some type of blood thinner following surgery to reduce the incidence.
- The implants can also fail over time due to wear or loosening of the components, but this generally occurs many years after surgery.
Should I continue to see my surgeon after I’m healed?
It is important to follow up with your surgeon after your joint replacement. In most cases, joint replacements last for many years. You need to meet with your treating doctor after surgery to ensure that your replacement is continuing to function well. In some cases, the replaced parts can start to wear out or loosen. The frequency of required follow up visits is dependent on many factors including the age of the patient, the demand levels placed on the joint, and the type of replacement. Your physician will consider all these factors and tailor a follow-up schedule to meet your needs. In general seeing your surgeon every 3-5 years is recommended.
Will I need to take antibiotics prior to seeing a dentist or having other invasive procedures?
The American Academy of Orthopedic Surgery (AAOS) and American Dental Association (ADA) have generally recommended short-term antibiotics prior to dental procedures (1 dose 1 hour prior to dental procedure) for patients who have had joint replacements. This recommendation continues for up to 2 years after your joint replacement.
Two or more years after the replacement, continued use of antibiotics prior to dental procedures is based on the discretion of the treating surgeon and the patient. Your surgeon will consider many factors including whether or not you are at increased risk of infection due to immune suppression (i.e. diabetic, transplant patients, and rheumatoid arthritis).
The use of prophylactic antibiotics prior to dental cleanings and other invasive procedures remains controversial. Most orthopaedic surgeons now recommend lifetime suppression. Patients should discuss whether or not they need antibiotics prior to dental or other invasive procedures with their treating orthopedic surgeon.
Will my implant set off metal detectors at airports and courthouses?
Usually patients with joint replacements will set off metal detectors. It is reasonable for you to inform the TSA screening agent at the airport that you have had a joint replacement; however, you will still require screening and will need to follow the directions of the screening agent. Learn more about airport security.
There are millions of individuals with joint replacements, and screening protocols recognize that people who have had joint replacements may set off detectors. You do not need to carry specific documentation to prove that you have a joint replacement. Metal detector screenings follow universal protocols that allow for people with joint replacements to proceed after confirmation that no threat exists.
Article from: http://www.aahks.org/care-for-hips-and-knees/do-i-need-a-joint-replacement/total-knee-replacement/
