There are many fine physical therapy clinics in the Olympia, Tumwater and Lacey area. How do you chose where to go?
You can choose based on location. A friend of mine told me today she chose to go to physical therapy at a clinic close to her house. What would prompt a close choice versus reputation? Maybe she needed to go 2 or 3 times per week. If someone needs to go to PT 2 or 3 times a week for a month or so, then going close to your house would be very convenient, HOWEVER, ask yourself the question: does your condition warrant 2 or 3 times per week?
Recently a former patient returned for a new session of physical therapy. She is a fairly frail 80 something year old, and was sent for BOTH headaches AND shoulder pain by her physician. Her prescription from the physician was directed to be 2 to 3 times per week for 4 to 6 weeks. She may have thought she needed to come that often, but…….when I evaluated her headache AND shoulder pain, I determined that both problems were mainly caused by the same anatomical structure.
I gave her an exercise program based on this one problem, and added customized and specific exercises for the shoulders and neck. As of Friday (January 30) 100% better in the headache and 75% better in the shoulders. She came for 6 visits at 1 x per week.
So the bottom line is, unless you actually NEED to have therapy 2 or 3 times per week consider going somewhere that uses less visits more effectively and you may save yourself some time and money.
The therapists at Comstock Physical Therapy, Joyce Mills, Lori Waterman and Linnea Comstock have extensively studied the body to make our exercise programs very effective and efficient. Give us a call if you would rather go to PT once per week instead of three times a week!
A flyer came in the mail last week from Capitol Medical Center that included an article about radiation treatment for plantarfasciitis.
(Plantarfasciitis is a very painful condition in the bottom of the arch of the foot when the plantarfascia, pictured below, becomes inflamed , causing a lot of pain with walking and standing and significant pain on the bottom of the feet after sleeping or sitting followed by getting up)
You can see the link to an advertisement for this on Comstock Physical Therapy’s link page.http://comstockpt.com/links-resources-directory/
I was SHOCKED and SURPRISED that radiation treatment is used for a diagnosis/condition that can be treated safely and effectively with no side effects. Many other treatments are available which treat plantarfasciitis without side effects. I researched information about the level of radiation used for treatment of plantarfasciitis, and found that typically .5 Gy to 1 Gy dosage of radiation is given one time to someone with the heel pain. (at the bottom of this article, please see the links that you can use to look up this information, 1 Gy = 1 Sv in Xray measurements) . I also found out that this is higher than the maximum level of radiation considered safe for diagnostic x-rays and CT Scans.
What treatments does science tell us work? The summary linked below mentions shock wave treatment and physical therapy treatments being very good at treating this condition.
Here is another very complete rundown of the science about what works to treat plantarfasciitis:
Many treatments that help relieve plantarfasciitis are mentioned including stretching, rolling your arch over a can and massaging the bottom of the foot. Physical therapy specifically helps by using the therapist’s hand to move the stiff joints on each other as well as massage the plantarfascia, and giving strengthening exercises to the feet, legs and hips the take stress of the plantarfascia using the muscles to support the legs instead.
Self treatments to help relieve plantarfascia also include these:
Calf and arch stretch using a towel. Consider keeping the towel near the bedside and performing before going to sleep and before taking first steps in the morning. Pull back on foot for 30 seconds 3 times with 30 seconds of rest in between.
Roll plantar fascia with can or ball. Consider keeping at the bedside and performing before going to sleep and before taking first steps in the morning. Roll plantar fascia for 1 minute 3 times with 30 seconds of reset in between.
Manual plantar fascia stretch with cross-friction massage. Stretch and massage before taking first steps for 1 minute 3 times with 30 seconds of rest in between.
If you do consider radiation treatment for plantarfasciitis, please ask about side effects, for your own benefit.
This link documents the dosage used in one treatment protocol for plantarfasciitis: http://www.ncbi.nlm.nih.gov/pubmed/23443608
This link documents the level of radiation considered safe: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996147/
The video demonstrated below, by an orthopedic surgeon, shows the mechanics of why shoulder impingement happens with the tendons.
See the small space between the ball acromium? That is where the impingement happens. Making sure the supraspinatus tendon, which pushes the ball down as the arm bone is lifted by the deltoid, is working well is a big part of the picture of shoulder healthy function. BUT….if you raise the shoulder blade UP by STRENGTHENING the muscles which lift it up, (such as serratus anterior) and STRETCH muscles which PULL it down (such as latissimus dorsi) you can gain more space, which puts less pressure and pinch on the supraspinatus tendon.
http://comstockpt.com/2011/11/22/neck-pain-stretches-out-olympia-wa/ This link will show you some latissimus stretches, and if you refer to Part 1 in this series of blog posts, with the man leaning against the wall you can see how to strengthen the serratus anterior
More about how the shoulder blade works with the shoulder and how bad shoulder girdle strength can cause shoulder impingement. The image and movie clip below show shoulder blade elevation, with the actress in the video showing LESS elevation and upward rotation on the left than the right.
The space between the ball (humeral head) and the shelf above (acromium) which sits on the shoulder blade is where impingement of one or two of the rotator cuff tendons happens (supraspinatus or infrapinatus).
Here is an image of a normal shoulder and one with impingement:
If the shoulder blade is hanging low (like the one on the left in the video) the space for the tendon is a lot smaller. So doing shoulder blade strengthening exercises to elevate the shoulder blades will help with shoulder blade pain itself.
Have you been to PT for shoulder pain? Have you been given shoulder blade strengthening exercises plus actual shoulder exercises?
Here is a picture of an actual shoulder (ball and socket) exercise:
Here a picture of a shoulder blade (scapula) exercise:
If I were a patient, I'd be thinking, "those therapists sure are giving me a lot of exercises." The truth is, the shoulder blade has to elevate and rotate up for your arm to reach all the way up overhead.In fact, if the shoulder blade does NOT raise up, the rotator cuff muscles will get pinched when the arm raises up.
So, in fact to really get better from shoulder pain a person needs BOTH shoulder and shoulder blade exercises.