Think about the last time you made a big purchase, say $1,000 or more. Did you go out and buy the first thing you saw? Take one recommendation from somebody? Or did you research it, learn some things, compare it to other options, and select something that was right for you? Most people tend to be educated and research large purchases like cars, televisions, or the newest iPhone. So why do we so often neglect to do this with healthcare?
By becoming more educated healthcare consumers we can go from being passive patients who take the first recommendation that comes from a practitioner, to an active consumer who weighs options and makes choices. Here are some questions to talk through with your practitioner the next time a healthcare decision comes up.
WHAT ARE THE BENEFITS OR EXPECTED RESULTS?
When a treatment or procedure is recommended, the patient often assumes that it will make them "better." But what the patient expects and what the healthcare professional expects are often two different things. Engage with your practitioner and candidly share the benefits and results you are expecting and ask for your practitioner to openly share his or her expectations for your results.
WHAT ARE THE RISKS AND DOWNSIDES?
Patients want to hear about the benefits of a treatment, but they often don't ask or care about the risks. To be an educated consumer, you need to. If one treatment has a 3% edge over another, but has a high risk of causing new issues, do you want it? The risks of one treatment versus another need to be compared.
WHAT ARE THE ALTERNATIVES?
Don't feel bad asking about alternative treatments. If you were looking at a new (or used) car you wouldn't go out and just buy it. You'd at least consider all options and probably even test drive them. You should at least look at the other options in healthcare too. Maybe the first recommendation that your practitioner makes is the right one for you, but if you don't consider the alternatives you'll never really know.
WHY THIS TREATMENT OVER THE OTHER ONES?
This is the question where the rubber meets the road. You've learned about all the options, now you can see if your practitioner is balancing the risks and benefits to make the right choice for you. By asking for the rationale and carefully weighing options, you can avoid being one of the people who gets an ineffective treatment.
WHAT'S IT COST?
This last question is becoming more important as patients bear an increasing share of the cost of healthcare. Even if you don't have a high deductible plan or pay hefty co-pays, by being financially responsible today, you'll probably see smaller price increases in your premiums down the road.
A PLUG FOR PHYSICAL THERAPY
With all that is going on in our world right now and with healthcare concerns being in the forefront of all news stories, you can see how these questions can apply to any type of healthcare concern you might have. As an example, in the Physical & Occupational therapy field, an educated consumer would learn that physical therapy is often a viable alternative to surgery with comparable outcomes, much less risk and lower cost. In fact, a large study of 122,723 subjects showed that people with back pain who got physical therapy in the first 14 days lowered their healthcare costs by 60%.
GET INVOLVED & GET EDUCATED
Though it is easy to become a passive patient, we know that the healthiest patients are those that get involved and get educated. Because, as we ALWAYS say, when you take care of your body, it takes care of you!
We’ve all seen the headlines that emphasize the dangers of sedentary behavior, particularly for those who sit at a desk throughout the day. The headlines may grab your attention and scare you, but here are some facts that are worth your consideration.
The biggest danger comes from sitting for long periods of time.
If you need to sit for your job, try to sit for less than 11 hours a day, and make every effort to move every 30 minutes or so.
The more you sit, the more your body needs exercise to compensate for that sitting.
While no amount of exercise can completely make up for sitting for long periods of time, studies show the positive effects of exercise when parts of your day are sedentary.
If you’re concerned about the amount of time you’re sitting at your desk, you might consider using a standing desk to add some variety to your posture during the day. The studies advising standing desks recommend sitting for 30 minutes and standing for 30 minutes each hour. While people who get these desks might commit to such constant change at first, they often end up sitting at their desks when shifting back and forth becomes cumbersome, particularly if you have a desk that requires manual lifting and lowering.
So what are good alternatives?
When you’re simply trying to avoid sedentary behavior and don’t feel that a standing desk would work for you, here are some habits you can adopt during your work day:
Remember that as physical therapists we are trained in understanding and teaching good body mechanics. While many understand the value of our rehabilitation services, our preventive services are equally beneficial.
Most people think of heart rate or blood pressure when they think of vital signs. It is common to use numbers to quantify health and risk of disease. The American Heart Association encourages people to "know their numbers" referring to blood pressure, blood cholesterol, blood glucose, and weight. However, research is now showing the importance of moving properly for health.
Let's take a look at some of the numbers you can use to quantify your movement health:
Walking speed has been called the "sixth vital sign" in medical literature recently. It is easy to measure, and takes into account strength, balance, coordination, confidence, cardiovascular fitness, tolerance to activity, and a whole host of other factors. It has also been shown to be predictive of future hospitalizations, functional decline, and overall mortality. Normal walking speed is considered to be 1.2 to 1.4 meters per second.
Push ups are popular to build strength, but a recent study found that they can show us a lot about your heart too. Researchers found that men who could do 40 or more consecutive push ups were at a 96% lower risk for cardiovascular disease than were men who could do less than 10. The push up test was also more useful in predicting future cardiovascular disease than aerobic capacity measured on a treadmill.
Hand grip strength has been shown to be strongly correlated with health. The stronger your hand grip is, the less likely you are to suffer from cardiovascular disease, respiratory disease, COPD, and all types of cancer. In the study, muscle weakness was defined as grip strength <26 kg for men and <16 kg for women. Grip strength below these numbers was highly correlated with an increase in disease.
Standing From the Floor
If you can't easily get down on the floor and back up your health might be in trouble, according to a study that looked at more than 2,000 people. The study asked people to go from standing to sitting on the floor and back up with as little support as needed. They found that if you need to use more than one hand to get up and down from the floor that you were 2 to 5 times more likely to die in the next 7 years than someone who can do it with just one hand, or even better, no hands at all. Moving well is obviously important to overall health and longer life. These tests can give a snapshot of how you're doing. If you're having trouble with any of them, considering seeing a movement specialist - your physical therapist.
In this week's 2020 MOBILITY INSIGHT with PTP, we are highlighting 9 great tools you can use to protect the joints in your hands, wrists, elbows and shoulders. These tools can be helpful to all adults and most especially to those with arthritis, injuries and other health related issues impacting every day movement. We encourage you to check out this 2 minute video and share it with those you love.
Chances are that you probably haven’t given much thought to how your neck and back are faring in the era of the smart phone, but studies show that you most certainly should. It’s practically a reflex these days to pull out our smart phones when we’re standing in line, sitting at the airport or riding the subway. And while it’s great that we rarely need to venture beyond our pockets for entertainment, our bodies are beginning to retaliate—and mourn the pre-texting days.
So, what exactly are these contemporary conveniences doing to our bodies? A surgeon-led study that was published in Surgical Technology International assessed what impact surgeons’ head and neck posture during surgery—a posture similar to that of smart-phone texters—has on their cervical spines. With each degree that our heads flex forward (as we stare at a screen below eye level), the strain on our spines dramatically increases. When an adult head (that weighs 10 to 12 pounds in the neutral position) tilts forward at 30 degrees, the weight seen by the spine climbs to a staggering 40 pounds, according to the study.
How pervasive of a problem is this? According to the study, the average person spends 14 to 28 hours each week with their heads tilted over a laptop, smart phone or similar device. Over the course of a year, that adds up to 700 to 1400 hours of strain and stress on our spines. As a result, the number of people dealing with headaches, achy necks and shoulders and other associated pain has skyrocketed. Trained to address postural changes and functional declines, physical therapists are well-versed in treating this modern-day phenomenon, widely known as “text neck.”
Over time, this type of poor posture can have a cumulative effect, leading to spine degeneration, pinched nerves and muscle strains. Scheduling an appointment with a physical therapist can help people learn how to interact with their devices without harming their spines. The PT will prescribe an at-home program that includes strategies and exercises that focus on preserving the spine and preventing long-term damage.
Exercise is an important part of taking care of our spines as we age, but what we do when we’re not in motion matters, too. So next time you pick up your smart phone or curl up with your e-reader, do a quick check of your head and neck posture. Your body will thank you for years to come.
Dealing with the pain and limited mobility associated with an injury or illness can be stressful for so many reasons. You might have questions like, “How long will I be sidelined?” and “What do I need to do to get better?” Or maybe you’re worried about how you’ll pick your children up from school, walk to the train for your commute or prepare meals for your family.
These are all perfectly normal concerns. Luckily, there are some ways that you can gain control over the situation and ensure that you return to the activities you care most about—especially if physical therapy is part of your plan.
What you can do before your very first appointment—and during physical therapy—to take control of that injury-related stress? First and foremost, it’s important to come prepared for physical therapy. And no, we're not talking about dressing appropriately and arriving on time (or even better, 15 minutes ahead of your scheduled appointment). That stuff is important, of course, but there’s one thing you can do in the days leading up to your appointment that will set you up for success.
Any guesses? We're talking about starting a list. What kind of list? Well, every time that you feel pain in the affected area or notice an activity that is harder than it was pre-injury, add it to the list! And the more specific you are, the better.
Here’s an example to help drive this point home: Let’s say that you’re recovering from a moderate meniscus tear and you have an appointment with your physical therapist in three days. Take notes on how your knee feels first thing in the morning after you’ve been off your feet. How does your knee react when you stand up from a chair—does it feel unstable? Or do you find that you need to clutch the back of the couch on your way to the bathroom? Sharing each of these details helps your physical therapist understand your limitations beyond the injury printed on your intake form.
Now let’s take that list a step farther and add some details about the activities that you typically participate in on a regular basis. Let’s say that you normally go for a walk several days a week, play on the floor with your kids or go to a yoga class each week. These activities have become an important part of your life so let’s make sure that they’re factored into your list, perhaps in the “what you hope to get out of physical therapy” category.
Painting a clear picture of how active you are—and what types of activities and sports you participate in—can help your physical therapist design an individualized treatment plan and to better help you on your road to recovery.
Have you been to physical therapy lately for an injury? Did you find anything else that helped maximize your time in rehab or that improved communication with your physical therapist?
When it comes to exercise, one size doesn’t fit all. The exercise you choose is influenced by your health, lifestyle, work hours, responsibilities and more. While we’ve all come to understand how important it is to exercise, having a strong sense of what your choices are, is helpful. Here are the basics on the 4 types:
Endurance: Walking, jogging, yard work and dancing, are all considered endurance, or aerobic, exercises. They have a positive impact on your heart, lungs and circulatory system. Not only do they improve your cardiovascular system and reduce your risk of many diseases, they also help you build stamina.
Strength: Strength training makes your muscles stronger and help you stay independent. Strength exercises like lifting weights, using resistance bands, and doing isometric exercises (where muscles are held in place with minimal movement) can make quite a difference in your ability to do things like carry groceries, lift up a child, and other such everyday activities.
Balance: Many lower-body strength exercises that are a part of balance training can make a world of difference in the quality of life for seniors. Exercises like, standing on one foot, doing a heel-to-toe walk, and Tai Chi, strengthen the lower body and help to prevent falls.
Flexibility: Being flexible will naturally give you more freedom in your movement and the benefits are obvious when it comes to everyday activities like getting dressed and driving. Flexibility exercises intentionally stretch your muscles and help your body stay limber. Yoga is a great flexibility exercise along with doing things like calf-stretches and shoulder and upper-arm stretches.
When you think about these exercises and what works best for you, it is helpful to contemplate ways that you can incorporate all 4 types of exercise into your life. Doing just one exercise, such as focusing only on weight-lifting for strength, can help you get stronger, but reduce your flexibility. Walking without stretching can lead to muscle injuries.
While we encourage you to exercise, we also encourage you to mix it up. Remember that physical therapy isn’t just for rehabilitating from an injury. We set up exercise programs regularly for patients who are of all different ages with many different goals. Exercise is a key component to injury prevention and optimal performance.
When you choose, choose wisely and know that we are here to help you, too.
For those who struggle with food, the holidays followed by the beginning of a new year can be overwhelming. The pressure to adopt (and keep) a new year’s diet resolution is heightened. Promotions for dietary programs are everywhere. There is traditionally lots of focus on the prospect of “looking good” – which is far less important than feeling good and being able to move well and live well.
In our first entry for our 2020 Mobility InSight with PTP series, we want to share just a few motivating facts about how a well-balanced diet impacts your mobility. We encourage you to use these facts to strengthen your resolve and make food choices that enhance the quality of your life. We sincerely value our patients and are committed to giving you information that promotes your well-being in a simple and helpful manner.
Here are 3 meaningful MOBILITY reasons to adopt and maintain a well-balanced diet: (In case it is helpful, here is a great link to what is considered a well-balanced diet.)
A well-balanced diet will reduce fluid build-up in your legs and ankles. Swelling in your lower legs and ankles is often caused by hypertension. When your blood pressure is high, your heart works harder. Over time, this extra effort can lead to the heart muscle becoming thicker and less effective. This allows fluid to build up in your lower legs and ankles, which causes them to swell up and often causes movement to become painful and difficult. Eating smart helps your heart and your mobility.
A well-balanced diet has a positive impact on arthritis. Processed (packaged) foods, sugar and sugar alternatives, fried foods, white flour products (like pasta, some breads) are all examples of foods that can cause inflammation. Inflammation, a major cause of arthritis, can be made worse when these foods are part of your daily diet. Reducing your intake of these foods can reduce inflammation and pain and improve your mobility.
A well-balanced diet can reduce the risk of falls and fractures. Though our bones can weaken over time, there is excellent data that shows us that the loss of bone density and strength can be reduced by making healthy food choices. When we don’t have a well balanced mix of calories, protein, fat, carbohydrates, vitamins and minerals (all often out-of-balance in fad diets), we compromise our bones (and our nerves and muscles), often leading to an increased risk of fractures and other related health issues.
To give you a healthy reminder of WHY making great food choices is a gift to you and your mobility, we made you a small poster that you can download HERE. Stay tuned for our next 2020 Mobility InSight with PTP segment.
Until then know that we are rooting for you, your good health. and your mobility!
The holiday season is officially here! Bells are jingling, parties are hopping, and we’re preparing to share our tidings of comfort and joy! With the pace of life picking up, the demand on our bodies picks up too, and with it the challenge of protecting our good health. Understanding how these challenges impact our patients (and many of the people they care about), here are 5 ways you can increase your holiday comfort (and joy!) with a little mobility self-care.
#1: PACE YOURSELF: As much as we want to get everything done and checked-off of our holiday to-do list, there is great value in being patient with yourself and others. When you pace yourself, you reduce the possibility of physical strain and resulting pain. Whenever possible, take care of your holiday preparation activities a little bit each day instead of pushing yourself too hard.
#2: FEET FIRST: The holidays almost always include standing longer and walking more than you may be accustomed to. Without a good pair of supportive shoes, you can experience back pain, muscle spasms and joint problems. Put your feet first and choose shoes that provide good support.
#3: TAKE A DEEP BREATH: When the demand of the holidays gets too intense and the tension gets high, comfort can be replaced by anxiety and physical pain. Taking several deep breaths regularly will relax your body and help to release muscle tightness and tension, allowing comfort to return. This practice is good any time of the year, but is especially important during the holidays.
#4 STAND UP STRAIGHT: Just like good shoes, standing up straight when you are on your feet for long periods of time can really help your comfort. Though many of us remember being told to do this by our parents, very few of us really understand the impact of posture on our mobility.
#5 ASK FOR HELP: Most of us take pride in our independence and self-sufficiency and can sometimes find it difficult to ask for help. There are times, however, when asking for help really is a smart way to take care of yourself. If an item at the store is too high, don’t stretch so far it hurts, ask for help. If an item is too heavy, ask for help. If you can’t seem to finish everything that needs to be done, ask for help. It is okay to be kind to yourself and recognize what you can do healthfully and what you can’t. Besides, the good feelings that others experience when they know they helped another, brings comfort and joy to everyone involved!
Increase your holiday comfort and enjoy this beautiful season!
One of the more common questions we are asked is, “Can physical therapy help me avoid surgery?”
Out of respect for how different each patient’s situation can be, we can’t responsibly say yes or no without knowing something about the patient. There are, however, 4 primary areas that we ask about or observe to help us gauge this question when we start working with a patient. These areas are:
1. The patient’s diagnosis
There are some medical conditions that can be more readily rehabilitated without surgery (when the other factors listed here are ideal). For instance, rotator cuff tears and arthritic knees can often be improved through the many benefits of physical therapy. Other conditions may not be easily corrected without surgery.
2. The doctor’s recommendation
We work closely with our referring physicians when we are treating our patients. When a physician recommends surgery, we will respond honestly to patient questions and encourage them to listen carefully to the physician’s reasoning as to the importance of surgery versus strictly physical therapy. It should be noted that pre-AND-post surgical physical therapy can make a significant difference in the healing process.
3. The patient’s personality
Patient’s who are patient with themselves and interested (and willing) to put forth concentrated effort towards physical therapy (appointments and at home) have a better chance of rehabbing without surgery, just by the virtue of their attitudes and perceptions.
4. The patient’s personal circumstances
In situations where the pain the patient is experiencing is beyond tolerable, avoiding surgery may not be ideal. And, in situations where a patient needs to be able to heal very quickly (due to a job, family or other area of demand in their lives), they may not be able to devote adequate time to rehabbing without surgery.
When surgery is being considered, it is especially important to talk speak candidly to your physician and your physical therapist(s), to explore the answer to this question. Considering each of these areas listed is especially helpful in determining what is best for you or your loved one.