165 Lilly Rd NE, Suite B, Olympia • 360.455-8014

Thurston County

Do I need an MRI?

Have you ever wondered if you should have an MRI? Did your health care provider tell you that you did not need one and you wondered why not?

I had a patient from Lacey with a shoulder bursitis ask me that question…and I told her "no" I didn't think she needed an MRI. She had come to me with horrible shoulder pain; on her first visit we simply treated her bad pain after performing a few safety tests to make sure these procedures were safe. On her first visit she could only lift her arm 3 inches, had to be driven to PT and had to have help getting dressed.

After a 3 or 4 visits, she had a lot less pain. She could drive herself, get dressed and lift her arm overhead. She still had pain rotating her lower arm out to the side and had some tingling and numbness. I evaluated her and told her I thought she had had a bursitis and possibly an infraspinatus (one of the 4 rotator cuff muscles) strain but not tear. She wanted to know if she should have an MRI, and I told her I did not think so….she wanted to know why not.

I walked her through the process of understanding how a physical therapist sees if a muscle is torn. I took a large theraband, and showed her how a torn or cut muscle cannot bring the two ends of the joint together if it is not attached in the middle. A physical therapist knows what directions a specific muscle moves the joint. Seeing a joint move the in direction of the muscle tells the physical therapist that the muscles is not torn; if it was torn the joint would not move. Once she had that explanation she understood why she did not need an MRI.

If you want to know why you don't need an MRI, take the time to ask your provider why not…so you can understand the process.

Bunion Surgery Rehabilitation needs Foot Strengthening

Have you ever had bunion surgery?  It can be a long rehabilitation process. Often people shift the weight onto the second toe when walking after bunion surgery, instead of putting full weight down onto the big toe right before pushing off.  The patient has been walking this way for a very long time, and now shifting the way one walks is pretty hard.

Part of the problem is that people who have bunion surgery developed a bunion partly due to having too much pronation (flat feet). If you have flat feet, your arch will get too stretched out and you will push off your second toe instead of your first toe. Even after the bunion surgery you might continue to push off your second toe–and that will be aggravating. What exercise can you do to strengthen your foot to reduce flat foot and prepare for a bunion surgery?

While you are sitting you can raise you feet up like are coming up on your tip toes. That will start to strengthen the arch, and give your big toe better range of motion.

You will also need scar tissue mobilization to help the big toe be able to bend down and up as you walk.

Good luck with your bunion surgery!

Skateboarder’s Ankle Sprain Gets Better!

 

Ligaments Lateral View, ankle of skateboarder

At Comstock Physical Therapy we treat all kinds of folks, younger, older, and in between. We treat athletes from club teams, recreational athletes and folks with other,  more unique kinds of injuries.  

This young man received an ankle sprain when falling off his skateboard and  had a lot of pain walking an appreciable distance when he first came to physical therapy.  He had difficulty even fully squatting to tie his shoes, or pick something up from the ground.  He was not able to skateboard, which is his long term goal.  

After he started physical therapy, it was found that he had pain with squatting due to pinching and painful feeling where he actually sprained his ankle, on the outside and front of the ankle.  The ligament is called the anterior talofibular ligament.  

The ligament swelled and got pinched.  After moving the specific joints to improve his ability to squat, and giving him strengthening exercises, he began to get better.   His exercises inclued balance exercises on a dynadisc, theraband exercises for strengthening and range of motion exercises to improve his mobility both with his foot up in the air (open chain exercises) and with his foot in the ground and him in the sitting position (closed chain with partial weight bearing).  

After about 4 weeks we put him on an IJOY machine which challenges patients in side to side motions and kind of moves like a skateboard.  Here is a picture of how he did:

 

 

After another week he got quite a bit better and actuallty did a 180 flip on the IJOY

 

 

This week I've asked him to skateboard on a dry, flat surface and he has been cut down to 1x/week.  Hopefully he'll be done sone and back to the sport he loves:

skateboarding!

Are you looking for good physical therapy in Olympia?

What makes  good physical therapy?  Have  you had a good experience?  Did your problem get resolved?  We help you by putting you on an exercise path that is specifically designed to correct your issue.  Precision exercises customized to you for your exact problem.  Physical Therapy in Olympia is getting better all the time!

Comstock
Physical Therapy

165 Lilly Rd. NE, Suite B
Olympia, Washington 98506

360.455.8014

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Help support local business in Olympia!Olympia's Downtown for the Holidays is almost here! Starting Thanksgiving weekend, you can enjoy holiday lights in town, free hot cocoa, discount books, over a mile of garland, snow, Nutcracker selfie sets and more!
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