Healing, Nutrition, and Physical Therapy

Posted on September 30, 2013 by mayaphysicaltherapyadmin

If you have suffered an injury of any kind, your main objective is to recover as soon as possible. The ideal goal is to return to the shape you were in prior to your injury. Physical therapy can set you on the right path with various effective treatment modalities and exercises to do at home, but there is one thing that you can do for yourself to speed up and boost recovery: eating properly! Proper nutrition is one aspect of healing that is often taken for granted. Shifting your diet to focus primarily on nutrient intake can make a world of difference on the healing process, but a balanced diet is important to everyone in the general population.

It is always best to obtain nutrients from their natural form, which may entail eating the entire (with skin) fruit, vegetable, or grain. Nature meant for to them to be consumed this way so that it can be best absorbed and used by the body. The pill form of a nutrient, via nutritional supplementation, is beneficial but not as effective as consuming the nutrient from its natural source. It is understandable, however, for the supplementation route to be used in certain occasions when the natural form may present some inconvenience for a particular patient. The most important factor is to ensure that you, the patient, are getting enough of the vitamins and minerals needed and to eliminate any type of nutrient deficiency completely.

Almost every injury involves some degree of damage to the tissues. The healing process can only take place if the necessary components are there to rebuild the damaged tissue, strengthen it once more, and reduce inflammation. Nutrients are divided into macro nutrient and micro nutrients. Macro nutrients are required in large amounts and include carbohydrates, fats, and proteins. Micro nutrients are required in very small amounts, but are necessary to the functioning of the body. If too much is consumed, it may be harmful. Micro nutrients include many vitamins and minerals.

Protein

Protein is a very important macro nutrient to consume while healing. Proteins and amino acids are the building blocks of tissues, so they are absolutely necessary after injury. Proteins are needed to repair and rebuild damaged tissues. The table below shows appropriate amounts of daily protein intake.

46 g/day for females, 56 g/day for males
0.8 g/ kg/ BW/ day
*The upper limit is the highest amount of a nutrient that can be consumed without seeing negative effects.
The upper limit for protein is 2 g/kg/BW/day.

Fat
Fat should compose 20-35% of diet, but saturated fats should be less than 10% of the diet. They provide energy for important processes that take place in the body when healing, such as proliferation and maturation.

Carbohydrates

Carbohydrates serve as the body’s main energy source. They must be consumed at a relatively large rate because, without it, the body cannot sustain the metabolic rate necessary for the regeneration of cells to occur. See the chart below.

Males & females- 130 g/day
45-65% of diet
Sugar should be less than 25% of the diet

Vitamins

Below is a simple list of the best sources, functions, and proper dosage of important vitamins and minerals. This list is an excellent reference for knowing how much you should be consuming on a regular basis to keep your body functioning to the best of its ability.

A- 500 mcg/ day
Best source: palmitic acid, yellow animal fat, carotenoids
Main function is for eyesight; deficiency could lead to blindness.

D-300 mcg/ day
Best source: sun and cod liver
Main function is bone health and cartilage remodeling

E- 15 mg/ day
Best source: vegetable oils, seed oils, & wheat germ
Acts as an antioxidant

K- Males need 120 mcg and females need 90 mcg
Best source: plants with skin
Used for blood clotting

B1- thiamine- 1 mg/ day
Best source: whole grains
Thiamine is needed for glucose metabolism and energy production
Deficiency leads to lack of energy

B2- riboflavin- 10 mg/ day
Best source: dark green leafy vegetables
Necessary for energy production

B3- niacin- 10 mg/ day
Best source: chicken and mushrooms
Mainly for energy production as well
General weakness and fatigue if deficient
Lowers LDL (“bad”) cholesterol and raises (“good” HDL)

B5- pantophenic acid- 5 mg/ day
Best source: whole grains, eggs, avocado, legumes
Necessary for energy production
Fatty acid and carbohydrates oxidation

B6- piradoxyl- 1.1 mg/ day
Best source: whole grains, eggs, avocado, legumes, meat and whole grains
Needed for protein synthesis

B9- 300 mcg/ day, 520 mcg/ day if pregnant
Best source: green leafy vegetables, not obtained from meat
Needed for protein synthesis

B12- 7-12 mcg/ day
Best source: meat
Deficiency can cause anemia
Needed for protein synthesis

Iron- (See chart below for appropriate doses)
Best source: red meat, iron-fortified foods
Important for hemoglobin formation and oxygen transport to damaged tissues

Hydration must also be especially monitored. It is absolutely central to the healing process. It enables optimal healing by allowing repair processes and for transport to occur across gradients in the cells. Proper consumption is between 8-12 cups of water a day. It varies based on body weight and caloric intake. Juice and soda are not good sources of hydration. Water is the best fluid to combat dehydration.

In closing, nutrition is underutilized as a complementary aid to the recovery process. In addition to physical therapy, nutrition will speed up the road to recovery. Just remember:

Add more fruits and vegetables to your daily diet to obtain the daily dosage of vitamins needed.

Take nutritional supplements.

Eliminate fried foods, fatty foods, and sugary foods.

Eat lean protein and whole grains.

Drink lots of water.

By making more informed food choices, you could make a worthwhile contribution to improving your situation drastically.

Author
Rebecca Lawrence Exercise Physiologist (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

Bone Health in Women

Posted on September 17, 2013 by mayaphysicaltherapyadmin

After menopause, women experience many emotional and physiological changes. The hormone estradiol, the main form of estrogen, drops significantly and no longer has a protective effect on the bone. Caspase-3 is an enzyme that is notoriously known as the “executioner caspase”. It acts by activating the cell death of osteoblasts, which are responsible for the growth and development of bones. Estradiol stops caspase-3 from performing its function. In so doing, it allows bone growth to continue, while simultaneously limiting bone loss. Postmenopausal women run the risk of obtaining serious fractures due to the deterioration of bones commonly known as osteoporosis. The strength of a bone can be measured by determining the bone mineral density, or BMD. The higher the BMD, the stronger the bone is and vice versa. Though the level of estradiol is the body plays an important role, there are many other factors that affect bone health. Many of these factors are directly influenced by the lifestyle choices of each individual. Below are factors that increase your overall risk of suffering from decreased bone health and osteoporosis:

Advanced age

Family history of bone fracture due to osteoporosis

Being female

Being underweight

Not having an active lifestyle

Smoking (increases bone toxicity)

Drinking alcohol in excess (increases bone toxicity)

Calcium and vitamin D have long been hailed as the supplements that make the most important contribution to bone health. Where osteoporosis is concerned, the best treatment is prevention. Bone mass is difficult to replace once lost, so it is vital to maintain a healthy calcium intake throughout one’s life span. While milk is the most popular source of calcium, it is not the most effective. The body absorbs only 32% of calcium from milk. The animal protein and vitamin A content in milk actually increases the rate of calcium excretion from the body via the urinary tract. Sulfur based amino acids in animal protein increase the acidity of the blood. To neutralize the pH, calcium is extracted from the bones. Interestingly, many green vegetables have high calcium content and a calcium absorption rate of 50% in the body. While milk is still a source for calcium, it may be wise to consider viewing green leafy vegetables as a more efficient source of this important nutrient. It is vital to begin this nutrient intake from a young age and maintain intake through out one’s life in order to peak bone mass and then maintain it. The table below shows the amount of calcium that should be consumed per day based on age.

As for vitamin D, there are two options to getting the adequate daily amount: vitamin D supplementation or exposing your skin to sunlight (specifically UVB rays) for 15 minutes every day.

It is vital that you take care of your body from a young age. Optimal calcium intake is ideal, but so is a well-balanced diet. There should be a focus on fruits, vegetables, & lean protein intake, as well as adequate hydration. Foods high in sugar, like soda, juice, candy, and cakes, should be extremely limited in the diet. Ensure proper nutrition and eliminate bad habits. At least one third of women over 50 will experience a fracture due to osteoporosis, which may lead to a fast downward spiral in many cases. This is why it is important to embrace lifestyle changes that will contribute positively to bone health.

It is beneficial in so many ways to exercise, but particularly in building and maintain bone mass. Weight bearing exercises are exercises that require your body to work against gravity. Cycling and swimming do not increase bone mass because they are not weight bearing, even thought they elicit other health benefits. Examples of weight bearing include walking, strength training, climbing stairs, and even dancing. If you participate in resistance training, it is important to learn and practice proper form to reduce the risk of injury. Weight-bearing exercises should be done 2-3 times a week to maximize gains.

If you have any of the risk factors for osteoporosis, ask your doctor to conduct a bone density test. If you have been diagnosed with this disorder, it is not too late to improve your condition. It will be in your interest to seek a professional because you may put yourself at risk by taking it into your own hands and hurt yourself. It is also possible that you may choose an exercise that does not improve your condition. A physical therapist can guide you along the right path by:

Rehearsing balance exercises with you to prevent falling

Introducing various weight bearing exercises

Initiating proper techniques for resistance training to regain bone mineral density

Provide an at-home exercise program to maximize improvement

Establish a healthy workout routine that can be integrated into daily life

It is especially important to see a physical therapist is you have complications such as advanced osteoporosis, limited range of motion, or have been inactive for a long period of time. This guarantees that you are receiving the best possible care and most knowledgeable advice.

Author
Rebecca Lawrence Exercise Physiologist (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

Manual Therapy

Posted on August 19, 2013 by mayaphysicaltherapyadmin

When patients come to a physical therapy facility, they often expect to receive hot packs, cold packs, ultra sound and instructions to safely exercise. These modalities and exercises usually help to restore muscle imbalance. Manual Therapy also plays a vital role in rehabilitation program. Different manual therapy techniques include soft tissue mobilization, strain-counterstrain and high velocity, amplitude thrusting.

Soft Tissue Mobilization

It is very important to know the function of the muscle as well as its attachment around the joints. The root cause of muscle tension is the lack of movement at the joint. It can be decreased by attaining motion at the joint. But in most cases spasm continue to be present. In such cases soft tissue mobilization is employed. The primary goal of this manual therapy technique is to break up myofascial adhesions (fibrous muscle tissue) such as scar tissue, to move tissue fluids and also to relax muscle tension. The technique is employed on the musculature around the joint, and includes rhythmic stretching as well as deep pressure. The therapist will concentrate on the area with which has greater tissue restriction through layer by layer assessment.

Strain-Counterstrain

Strain-counterstrain manual therapy technique concentrates on correcting irregular neuromuscular reflexes that trigger structural and postural problems which in turn resulting in painful tender points. Physical therapist locates the position in which the patient is comfortable and the tender point diminishes. The therapist introduces asmptomatic strain through mild stretching while the patient in held in the position of comfort for about 90 seconds. This will allow the body to retune its muscles to a normal level of muscle tension.

High Velocity, Low Amplitude Thrusting

The primary goal of this manual therapy technique is to bring back the gliding motion of the joints which in turn will facilitate them to open and close. It is the most aggressive technique when compared to other manual therapy techniques. When this technique is employed correctly it increases mobility at the joint.

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

Adhesive Capsulitis /Frozen shoulder

Posted on July 30, 2013 by mayaphysicaltherapyadmin

The incidence of adhesive capsulitis in the general population is about 2% to 5%.It occurs more in women when compared to men and also people who are above the age of 45.People who gets adhesive capsuilitis in shoulder has a 20-30% probability of getting it in other shoulder.

How does it occur?

It occurs due to scar tissue which makes the shoulder stiff. It may result in loss of motion as well as pain with movement. Actual cause of frozen shoulder is a debatable matter. However, it is believed that it might be caused due to the inflammation of the lining of the joint (synovitis) or autoimmune reactions. Other causes may include reaction after an injury or surgery, painful conditions such as arthritis, tendinitis, bursitis and rotator cuff tear which has caused you to stop moving your shoulder and, any other cause that prevent you from moving your shoulder for a reasonable amount of time such as a sling or surgery.

Symptoms may include pain that worsens over a period of time and loss of movement.

Pre- Freezing Stage

You have already had the symptoms for 1-3 months. You may feel pain with active range of motion as well as passive range of motion. You may feel pain in the shoulder at rest and the pain becomes sharp when you move it. You might have mild reduction in motion and you tend to protect it by moving it less. Reduction of motion is experienced in following movements: external rotation, flexion, internal rotation and abduction. You may experience pain at day as well as night.

Freezing

You had the symptoms for 3-9 month and the pain is increasing day by day. You may have some range of motion but is limited due to pain and stiffness.

Frozen

You have had the symptoms for 9-14 months. At the beginning of the stage, you may experience decreased range of motion coupled with substantial amount of pain. At the end of the stage you may feel less pain however, pain is felt only while moving shoulder (as far as you can move it)

Thawing

The symptoms have persisted for 12-15 month and there is a significant amount of decrease in pain (particularly at night)). You may feel at ease while doing daily activities involving over head motions even though you have limited range of motion at shoulder.

How physical therapy plays a vital role?

At the initial stages, physical therapy focuses on maintaining range of motion at the shoulder joint which in turn will decrease the pain. Physical Therapist will give you a blend of manual therapy as well as stretching exercise. Use of heat and ice by the therapist will help the muscles to relax. A home exercise program (HEP) is designed by the therapist to prevent loss of motion.

As the therapy progress your physical therapist may include strengthening exercise to the previous regime. At the final stages, therapy may include exercises which will help the patients to get back to their normal activities.

Maya physical therapy which serves Davie, cooper city, Pembroke Pines, Hollywood and surrounding areas has the best and experienced physical therapist which will help you to recover from any conditions related to shoulder.

References

Physical Therapist’s Guide to Frozen Shoulder (Adhesive Capsulitis) . (n.d.). Retrieved July 29, 2013, from Move Forward P.T: http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=00661806-1fa0-4fc0-ba17-ea32751d7412

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

Labral Tear

Posted on July 30, 2013 by mayaphysicaltherapyadmin

Instability of the shoulder joint causes labral tear. Labral refers to the ring of cartilage that surrounds the margin of glenoid cavity which is called the glenoid labrum. An injury to the glenoid labrum can cause pain as well make it harder for you to move your arm. Tear is caused by fall or repetitive movements or any sports that requires you to raise your arm above your head. In many cases physical therapy can provide a solution.

Anatomy

The shoulder joint has three bones: Scapula (shoulder blade), clavicle(collar bone) and the humerus(upper arm bone).The head of the upper arm bone rests in the shallow socket(glenoid cavity) of the shoulder blade .The head of the upper arm bone is much bigger than the socket and the labrum which is ring of cartilage that surround glenoid cavity provides stability to the joint. The labrum deepens the socket by 50% and hence the head of the humerus fits better.

What are the different types of tear?

Traumatic labral tear- It happens due to a single event that causes tear such as shoulder dislocation or heavy lifting. Weight lifters, gymnasts, and construction workers are more likely to have this kind of tear.

Non traumatic labral tears- It occurs due to the instability of the shoulder joint as well as weakness of shoulder muscles. When the shoulder muscles are weak, it puts more stress on the labrum and causes tear.

What are the symptoms?

People who have labral tear often experience pain at the top of the shoulder especially while doing overhead activities. Popping, catching and/or clunking with shoulder movements as the torn labrum has loose ends. People often experience weakness of shoulder, usually one side.

How physical therapy can help?

Your physician may prescribe anti-inflammatory medication and rest until the final diagnosis is made. Physical therapy is effective when the symptoms are minor. Physical therapist will educate you about the movements and activities that need to be avoided. They may include strengthening exercises such as external rotation and internal rotation to provide support for the joint and to reduce stress on the labrum. Your physical therapist may include stretching exercises such as door way stretch or cross body stretch to increase the function of the muscles that surround the shoulder. They may also employ manual therapy to improve movement at the joint as well as decrease pain.

What if my case is severe?

If the conservative measures are insufficient your doctor may recommend you an arthroscopic surgery. After the surgery you may have to keep the shoulder in sling for about 3-4 weeks. A proper rehabilitation program is needed so that you can return back to your daily activities as soon as possible.

Reference

Physical Therapist’s Guide to Labral Tear. (n.d.). Retrieved July 29, 2013, from Move forward P.T: http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=99c2e561-5a77-450c-867a-2e2edaaa9b7c

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

Hip Fracture and Physical therapy

Posted on July 19, 2013 by mayaphysicaltherapyadmin

Pelvic fracture occurs when one or more bones of the pelvis crack or break. It is also called hip fracture. In the United States, hip fracture isrelatively rare with an incidence rate of 0.3% to 6% of all fractures.

What are the two types of fractures?

Low impact pelvic fracture-It occurs in two age groups: Adolescents and elderly. The former age group usually experiences fracture of the tip of one of the pelvic bones. This type of injury occurs in adolescents who are involved in sports such as hockey, skiing, football or jogging. It can also occur after minor falls in people who have osteoporosis. In elderly most often injury occurs at the thicker part of the pelvic bones. This type of fracture is called pelvic ring fractures and is result of falling on to one side of hip. Usually, this kind of fracture occurs due to balance problems, unintended obstacles, general frailty, vision problems or medications side effects.

High Impact Pelvic fracture-These fractures may occur due to major accidents, or fall from high place. This type of fracture can be life threatening and needs emergency room care and extensive physical therapy care.

How physical therapists’ can help?

Recovery from a pelvic fracture often involves surgery and prolonged bed rest. Most often bed rest is recommended for weeks or even months and the patients tendto lose muscle mass, strength, flexibility, endurance and balance. The main goal of physical therapy is to reduce pain level, improve hip, spine and leg motion, improve strength and flexibility as well as speed recovery.

24-48 Hours

The use of crutches is recommended by your physical therapist in order to avoid weight bearing on fractured hip. Your physical therapist will teach you how to use crutches so that you can move around without putting weight on the injured hip. Patients with severe pelvic fracture may have to use wheel chairs.

Reducing Pain

Your physical therapist may use modalities such as electrical stimulation, ice, heat, and ultrasound to reduce pain. Physical therapist’s initial goal is to attain patient’s normal range of motion at hip and knee joints thorough passive range of motion exercises. Manual therapy may include soft tissue mobilization as well as “trigger point release”.

Improving strength and Balance

Individualized exercise program is designed in order to regain strength. Exercises which target muscles of hip and core are given by the physical therapist. Exercise protocols would include free weight training, treadmills and/or stationary bicycles. Improving balance is very important as muscles of hip play a vital role in balance as well as steadiness in walking. Over time stretching exercises are also added to the treatment to loosen up the tight muscles.

Help to prevent future problems

Your physical therapist may recommend a home exercise program (HEP), so that you can prevent future problems. Physical therapist may also educate you about fall prevention strategies. At Maya physical therapy our therapists are trained and experienced in choosing the right treatment for you, so that you can get back to your pre-injury state as soon as possible.

Reference

Physical Therapist’s Guide to Pelvic Fracture (Hip Fracture) . (n.d.). Retrieved July 17, 2013, from Move Forward PT: http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=1388924b-8118-4182-b8e9-247463af00bf

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

Parkinson disease and the importance of movement

Posted on July 19, 2013 by mayaphysicaltherapyadmin

After Alzheimer’s disease, Parkinson disease is ranked the second among the degenerative brain disorder diseases. It is most prevalent in men when compared to women. Symptoms are usually seen when people are at 60s’.Most common symptoms are slowness with movement, balance problems, stiffness and shaking. Usually the treatment includes a combination of physical therapy and medication.

What is it?

It is related to loss of nerve cell in your brain which produces dopamine. Dopamine is a crucial factor in controlling movement. The precise cause of the disease is not known. However aging, exposure to certain environmental toxins and family history may contribute to it. It is a chorionic disease and the severity and nature of symptoms are different from one person to other.

What are the signs and symptoms?

Most common symptom is tremor in one hand. It can also occur in jaw or leg. It is more visible when you are rest and goes way when you are moving. As it progress, you may develop the flowing symptoms such as shuffling when you walk,arms swinging less when you walk and your handwriting may also get affected by the disease. You may also feel stiffness or rigidity in your muscles which causes pain in neck, shoulders and trunk. Postural instability caused by PD will result in poor balance and risk of falling. As the symptoms advance your movement becomes slower which makes daily activities more challenging. You may develop stoop posture and might find difficult to speak loudly. Other symptoms may include depression, lack of motivation, inability to concentrate on a particular task for long period of time, fatigue and light headedness.

What is the treatment for it?

Physical therapy in combination with medication has proven to be more effective than any other interventions. Physical therapist will do a thorough examination which includes testing your flexibility, strength, balance and coordination. Your physical therapist will work with you to battle the symptoms of PD and will help you to stay active and independent. Depending up on the type and severity, your physical therapist may focus on following objectives

To improve patient’s overall fitness level as well as flexibility and strength

Work on patient’s strategy of getting in and out of bed

Teach techniques so that the patient can turn over in bed at ease

Teach patents how to maneuver efficiently so that they can avoid falls

Improve fluidity and coordination in walking

Educate patient how to climb and descend stairs without falling

Improve aptitude to perform hand movements

Educating patients family about patient’s condition

Improve trunk rotation

Prescription medications which are used to treat Parkinson disease will have an immediate effect and typically movements are easier shortly after taking PD medications. To get bet result your physical therapist will schedule the treatment based on the effects of medication. Physical therapist may recommend cane or a walker as some patients benefit from it. In addition, physical therapist can also make suggestions on changes to home environment so that you can manure effectively and prevent injuries.

Reference

Physical Therapist’s Guide to Parkinson Disease. (n.d.). Retrieved July 17, 2013, from Move Forward : http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=98297eb9-eaa1-452e-9489-b46eedf27e80

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

ACL reconstruction and Rehabilitation

Posted on July 19, 2013 by mayaphysicaltherapyadmin

The knee joint is a hinge joint formed by bones-femur tibia and patella and is held together by ligaments. There are four ligaments and they are: MCL (medial collateral),(LCL) lateral collateral,(ACL)
anterior cruciate and (PCL) posterior cruciate ligament.All these ligaments provide stability to the joint. The weight bearing surface of the knee is covered by articular cartilage. The medial meniscus and lateral meniscus between the cartilage surface of femur and tibia and they act as shock absorbers.

Most often anterior cruciate ligament (ACL) of the knee is injured. It is estimated that about 200,000 injuries occur annually and about 100,000 ACL reconstruction surgeries are performed. The incidence of ACL injuries is higher in people who participate in sports such as basketball, skiing, foot ball and soccer.

How does it occur?

About 70 percent occurs with non-contact mechanism and about 70 percent occurs due to direct contact with an object or a player.

Does Physical Therapy help?

Proper rehabilitation and progressive physical therapy may help to restore the patients to pre- injury state. A physical therapist may also educate the patient how to avoid future injuries. Patients can avoid surgery however it may cause secondary injury to knee due to recurring instability episodes.

Who can avoid surgery?

• Patients who have partial tear and do not have any instability symptoms
• Patients who have complete tear and do not show any knee instability symptoms during low demanding sports, who are willing to give up high demanding sports.
• Patients who do light manual work and who have a sedentary life style
• Mostly children who have their growth plate still open

Is Physical Therapy advised before and after Surgery?

Physical therapy plays a crucial role in successful ACL surgery. Usually patients are sent to a physical therapist. The main goal of the therapy session is to attain the full range of motion. Patients who have stiff, swollen knee during surgery may have problems regaining motion post surgery. It takes 3 or more weeks to gain full range of motion after the initial injury. Braces are recommended during this time so that the injury may heal before the surgery.

After the surgery, precautions are taken to keep the wound dry and clean. Initially, physical therapy sessions emphasis on straightening knee and resorting quadriceps control. Ice is used to reduce swelling and pain. Physician determines if crutches and post operative braces should be used. The primary goal of physical therapy is to attain full range of motion as well as strengtheningquadriceps and hamstring muscles while keeping swelling and pain under control.

Once the patient attains full range of motion and strength, physical therapy session may concentrate on endurance and functional training. Exercises which improve neuromuscular control are also included in regime to increase patient’s sense of balance and control. The rehabilitation program after surgery may take up to 6 months depending on the circumstance.

Reference

ACL Injury: Does It Require Surgery? (n.d.). Retrieved July 17, 2013, from American Academy of Orthopedic Surgeons: http://orthoinfo.aaos.org/topic.cfm?topic=a00297

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

Physical Therapy &Vestibular Rehabilitation

Posted on July 15, 2013 by mayaphysicaltherapyadmin

What is vestibular rehabilitation?

It is exercise based program designed to promote central nervous system compensation for inner ear deficits. Benign paroxysmal positional vertigo and the unilateral or bilateral vestibular hypo function associated with Ménière’s disease, labyrinthitis, and vestibular neuritis can be treated using VRT. Studies indicate that individuals with long term inner ear disorders are benefited from VRT who have already undergone through other medical treatments which had little success.

Importance of VRT

Brain relies on vestibular organs to obtain accurate information about equilibrium and motion. When vestibular organs are damaged, brain can no longer rely on it which results in dizziness, vertigo, balance problems and other symptoms. Many people recover from these symptoms in few weeks as the brain adapt to it. This is process is called vestibular compensation. In the cases where the vestibular compensation is unsuccessful people tend to rely on the input from eyes and muscles and joint to avoid the symptoms such as dizziness and nausea. The patients may develop new pattern of body movements to compensate with situation.

Goal of VRT

The only goal of VRT is to retrain the brain to recognize and process signals from vestibular system in coordination with vision and proprioception

How physical therapist can help?

An experienced Physical therapist will do a thorough evaluation of medical history. It also includes observing and measuring postures, balance and gait as well as compensation strategies. In addition, eye-head co ordination tests are done. The patient is asked to fill the questionnaire to measure the frequency and severity of symptoms. Using the results physical therapist design specific head, body and eye exercise which can be done in therapy setting as well as home.Thus brain is retrained to recognize and process signals from vestibular system in coordination with vision and proprioception. This often involves desensitizing the balance system to movements that provoke symptoms. Increasing home based activities and exercise will help the patient t to strengthen muscles. Sometimes exercise and activities may increase the symptoms as the brain is trying to adapt to new movement patterns. Balance improves over time in most of the cases if the exercises are done correctly. It is most effective way when compared to all other treatments.

When people suffer from events such as cold or flu, minor surgery or anything that interrupts the vestibular system, the symptoms may come back as the brain “forgets”. This process is called decompensation. People can recover from this process by immediately going back to the home exercise program which was initially prescribed by the physical therapist. If the symptoms persist, you need to seek medical help as it indicates additional vestibular damage.

References

Vestibular Rehabilitation Therapy (VRT). (n.d.). Retrieved June 19, 2013, from Vestibular disorders Association: http://vestibular.org/understanding-vestibular-disorder/treatment/treatment-detail-page

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

Inversion Therapy

Posted on July 12, 2013 by mayaphysicaltherapyadmin

What is it?

Most of the people suffer from neck and back pain. Some of the factors that might contribute to it are poor posture, muscle spasm, weak abdominal muscles and back muscles. Root cause might point towards that one force we battle every day and the force is called gravity. Inversion therapy can provide solution for your back and neck problem.

What is the science behind it?

Inversion therapy puts you in a position where the gravity works for you; by keeping you in line with the downward force. This will help to elongate your spine and as a result the space between the vertebrae increases. This will take off the pressure from the Intevertebral disc, nerve roots and ligaments. Spasm of the muscles of the neck, shoulder and back, headaches and other problems are caused by stress and tension. This will decrease the blood supply to the muscles and hence muscles receive less oxygen. Eventually, this will result in the accumulation of waste chemicals in the muscles. Inversion therapy will increase the lymph flow and will help to flush out the waste chemicals in to the blood stream. It also increases the blood supply to the muscles.As soon as the waste chemicals are removed from the blood the stiffness and pain in muscles is receded

Is there any evidence that suggests the effectiveness?

A study done by a physical therapist L.J Nosse found out that an inversion as little as 25 degree for few minutes can relax the muscles and relieve pain. He used an electromyogram (EMG), and instrument to record muscle activity to detect the activity of the muscle.The results indicated that muscle pain decreased 35% within 10 seconds after attaining inverted position. A study done by New Castle University indicated that about 70% of patients who suffered from back pain were able to cancel their back surgery after few session of inversion therapy.

Can I do it by myself?

Even though the answer is yes, it is always recommended to seek professional guidance before you do it by yourself. This is because a professional guidance from a physician or a physical therapist cannot substitute for any other information you get from websites or other sources. A physician or physical therapist makes sure that you don’t have any contraindications before you use the equipment. Physical therapist will increase the angle of inversion as the treatment progress. Some times patients are not fully inverted as it may cause farther injuries to their back .It is always recommended to complete few sessions with your physical therapist before you do it by yourself.
Inversion therapy is an alternate way to treat you back and neck problems.At Maya physical therapy, our experienced physical therapist will guide you through inversion therapy. If you are skeptical about the benefits of Inversion therapy, you can give it a try and experience the immense benefit of it.

References

Are Inversion Table Effective. (n.d.). Retrieved July 10, 2013, from The Healthy Back Institute: http://www.losethebackpain.com/blog/2010/04/27/do-inversion-tables-work/
Inversion Table Benefits. (n.d.). Retrieved July 10, 2013, from The comfort store: http://sitincomfort.com/inthinthbein.html

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619

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