What is Proprioceptive Neuromuscular Facilitation?

By Courtney Roth, SPT

 

Proprioceptive neuromuscular facilitation (PNF) is a specific manual technique used by physical therapists to help improve a patient’s functional status. Traditionally, PNF was used to treat patients with neurological conditions such as stroke, multiple sclerosis, and Parkinson’s disease. However, research also supports its use for patients with orthopedic conditions such as back, neck and shoulder pain or muscle imbalances.1-7 PNF is a unique treatment approach because it uses diagonal patterns that incorporate multiple planes of movements, making the task more functional and effective in achieving patient goals.

 

 

 

The philosophy of PNF is based on five concepts8

 

  1. The human body moves as a unit, so PNF involves treating the whole person, not just the area of injury. Physical therapists can help identify whether someone has muscle imbalances or compensations in other areas of the body that may be contributing to their symptoms.
  2. PNF aims to tap into a patient’s underlying potential, by requiring active patient participation in order to mobilize strength, coordination, and range of motion reserves.
  3. A positive therapeutic environment is a critical component of PNF. Tasks that the patient is successful in performing without provoking symptoms are performed first, and then progress is built on those successes. Treatment avoids any movements that are painful for the patient.
  4. PNF aims to help patients achieve their highest level of function.
  5. In order to ensure progress made in the clinic carries over to a patient’s daily life, PNF implements principles of motor learning by using repetition and variability in multiple contexts to achieve retention of motor skill.

 

 

Adding PNF techniques to the treatment plan of many orthopedic conditions can help better integrate the nervous and musculoskeletal systems in order to move easier, more efficiently, and without pain.

 

 

 

References:

  1. Olkzac A, Wlodzislaw K, Domaniecki J. The PNF method in the treatment of intervertebral disc disease. The PNF method in the treatment of intervertebral disc disease. 2008;8(3):241-252.
  2. Rezasoltani A, Khaleghifar M, Tavakoli A, Ahmadi A, Minoonejad H. The Effect of a Proprioceptive Neuromuscular Facilitation Program to Increase Neck Muscle Strength in Patients with Chronic Non-specific Neck Pain. World Journal of Sport Sciences. 2010;3(1):59-63
  3. Maicki T, Bilski J, Szczygieł E, Trąbka R. PNF and manual therapy treatment results of patients with cervical spine osteoarthritis. Journal of Back and Musculoskeletal Rehabilitation. 2017;30(5):1095-1101. doi:10.3233/bmr-169718.
  4. Lee J-H, Park S-J, Na S-S. The Effect of Proprioceptive Neuromuscular Facilitation Therapy on Pain and Function. Journal of Physical Therapy Science. 2013;25(6):713-716. doi:10.1589/jpts.25.713
  5. Park K, Seo K. The Effects on the Pain Index and Lumbar Flexibility of Obese Patients with Low Back Pain after PNF Scapular and PNF Pelvic Patterns. Journal of Physical Therapy Science. 2014;26(10):1571-1574. doi:10.1589/jpts.26.1571.
  6. Jain AS, Anandh S, Pawar A. Effectiveness of Proprioceptive Neuromuscular Facilitation as an Adjunct to Eccentric Exercises in Subacromial Impingement. Indian Journal of Physiotherapy and Occupational Therapy – An International Journal. 2017;11(2):141. doi:10.5958/0973-5674.2017.00051.x.
  7. Voight M, Hoogenboom B, Cook G. The chop and lift reconsidered: integrating neuromuscular principles into orthopedic and sports rehabilitation. North American Journal Of Sports Physical Therapy: NAJSPT [serial online]. August 2008;3(3):151-159.
  8. Adler SS, Beckers D, Buck M. PNF in Practice: an Illustrated Guide. Berlin: Springer; 2014.

 

5 Ways to Decrease Risk of Tennis Elbow in Recreational Tennis Players

By: Rachel Raycraft, SPT

 

 

 

  • Improve Technique

 

  • Racquet head (lower string tension and smaller racquet heads)

 

  • Grip size on the racquet-not too big or too small

 

  • Loosen your grip on the racquet while swinging

 

  • Strengthen your core muscles

 

 

 

 

What is it? Tennis Elbow is caused by very small tears in a muscle in your forearm generally from repeated stress (ex. playing tennis). It can make gripping activities painful and it might be uncomfortable to turn the palm of your hand up and down.

 

 

The tennis serve is the most important stroke in the game because it is your chance to score a point without having to hit the ball a second time. Your tennis serve begins with your feet, the power comes from your legs, hips and core muscles, then you swing your arm. If you use your body to perform the twisting motion it will put less stress on your elbow and shoulder.

 

 

Some basic exercises to do to improve your tennis serve are heel raises, squats, standing on one leg and kicking the other leg out to the front, side and back, Russian twists on an exercise ball, shoulder rows with an exercise band, bicep curls and small tosses against the wall with a ball. These exercises are good to do twice a day.

 

 

If pain continues, contact your local physical therapist for more guidance. Depending on your insurance company you can see a physical therapist without a physician’s referral for 10 visits or 30 days, whichever comes first.

 

 

Sport Specialization vs. Sport Diversification Among Young Athletes: Which is Better?

By Curtis Monin, SPT

 

 

It seems that within the past 10 years, professional sports stars have become increasingly more recognizable and followed than ever before. The Project Play study has shown that 56.6% of all American children are involved in some sort of organized sport activity. With a steady rise of children playing sports, the competition for becoming the best and making it into professional leagues has never been a more challenging task. This increased competition and desire for success has made the majority of children shift their focus from playing multiple sports that they enjoy, to just focusing on one sport, or having sport specialization. This blog will go into the differences of sport specialization and sport diversification among youth athletes and why the latter may be the better option for your children!

 

 

 

What is Sport Specialization?

 

Sports specialization is defined as “intense, year-round training in a single sport with the exclusion of other sports.” This belief follows the idea that if a child devotes a full time commitment into one sport, they will develop and increase their skill levels of that specific sport at a much quicker rate than someone who doesn’t. Having a higher skill level and knowledge of a certain singular sport, increases the child’s chances of performing better than their peers, thus having a larger likelihood of becoming a successful athlete later in life. This is exactly why this school of thought has become so attractive to young athletes and soccer moms alike, however, just about with anything in life, it also has its downfalls. In order to develop their skills to an elite level, children who specialize in one sport for the means of success often have a very high training volume year round which includes rigorous amounts of repetition. This large amount of training can affect children differently than adults simply because the youngsters are still growing. The bodies of developing children are constantly changing, so a certain movement one month may have totally different stresses on the body than the next month. In young athletes, growth cartilage is present at the growth plate as well as the musculotendinous insertion. Growth cartilage is known to be vulnerable to the stress of repeated microtraumas. Injuries like Osgood Schlatter’s Disease of the knee and “Little Leaguers Elbow” are just a few examples of overused injuries within youth athletes that can bring on significant discomfort. Another problem of specialization for younger children early in their development can be the potential mental fatigue a child can face. This can be due to the constant high demands for improvement, success or simply being too active. With this mental fatigue, a child may feel burned out and lose motivation to continue on with performing their sport. Now on to sport diversification!

 

 

 

What is Sport Diversification?

 

Sport Diversification is the school of thought that a child should be involved in as many different sports as they would like throughout their younger years. In early development of their athletic prowess, children exposed to multiple sports allow them to have a higher drive for the gratification of the games themselves rather than a pure focus on training. There is a belief that children who have diversity with the sports they participate in can have a potential physical and cognitive crossover effect between activities. It’s that different sports require different movement patterns, which can allow for children to challenge their minds and brains to numerous unique stimuli that one specific sport simply cannot offer. For example, the power developed from skating in hockey may be applied to increasing the force behind a kick of a soccer ball. Additionally, having high eye tracking abilities from tennis may transfer into following the ball in baseball. Lastly, when children participate in numerous different sports, it allows them to have multiple options to fall back on if they were to ever lose interest in one of the sports, thus improving their chances of continuing to play sports into adolescence.

 

 

 

It may seem tempting for both the young athletes and their parents alike to push the idea of sports specialization in order to achieve greatness, however it is shown that sports diversification as much more long term benefits and fewer negatives. Young athletes should highly consider sports diversification if they would like to participate in sports and have lower chances of injury, lower chances of losing overall interest, and have higher chances of developing multiple, last skills that specializing in one sport can’t contribute.

 

 

 

 

 

 

Sources:

 

-The Aspen Institute, Project Play, 2016

-Difiori, J., Benjamin, H., Brenner, J., Gregory, A., Jayanthi, N., Landry, G., & Luke, A (2014). Overuse injuries and burnout in youth sports: A position statement from the American Medical Society for Sports Medicine. Clinical Journal of Sports Medicine. 24(1):3-20.

-Jayanthi N, Pinkham C, Dugas L, Patrick B, LaBella C. Sports Specialization in Young Athletes: Evidence-Based Recommendations. Sports Health. 2013;5(3):251-257. doi:10.1177/1941738112464626.

-
Oliver, JL, Lloyd, RS, and Meyers, RW. Training elite child athletes: Promoting welfare and well-being. Strength and Conditioning Journal 33(4): 73-79, 2011.

-Childhood Sports Participation and Adolescent Sport Profile

François Gallant, Jennifer L. O’Loughlin, Jennifer Brunet, Catherine M. Sabiston, Mathieu Bélanger

Pediatrics Nov 2017, e20171449; DOI: 10.1542/peds.2017-1449

What to Expect on Your First Visit to Sports PT

By Julie Wolfley, PT, DPT, OCS

 

 

Welcome to Sports PT! Thank you so much for choosing us!

 

 

What can you expect?

 

In one phrase, its our mission …which is, “To be the premier provider of quality physical therapy services in a positive, professional, and compassionate environment.”  That’s our culture, with every patient, every time. Lets explain what you can expect to experience.

 

 

First call:

 

When you make the first call, you will be warmly greeted by one of Patient Services Coordinators (PSC’s) who will help schedule your initial evaluation appointment to your convenience. We will obtain information about your injury, as well as insurance information so our experts can verify insurance benefits. We want to support you in every way, so you can focus on your care.

 

 

First Visit:

 

On your first visit, you will be welcomed by one or our PSC’s and your paperwork will be thoroughly reviewed. Many patients prefer to fill out paperwork from home which is available on our website under “PATIENT FORMS.”  If patients choose to complete this at our office, it typically takes about 10-15 minutes to fill out. The PSC will go over your insurance coverage with you and any other questions you may have.

 

Your Physical Therapist (PT) will be delighted to meet you, and you will be welcomed into an evaluation room. This is where your PT will seek to learn more about your injury and to determine a diagnosis and treatment plan. The evaluation is thorough, with a combination of discussion and hands on evaluation. Comfortable clothing is recommended, and clothing that can allow access to the injured area is recommended. Your PT will ask questions for about 10-15 minutes regarding symptoms, goals and medical history. After this discussion, your PT will perform a physical evaluation to determine what needs to be addressed in PT. Often, there are areas of tightness and weakness that a PT will assess. The objective of PT will be help restore your normal activities and achieve your goals! If for some reason your injury or condition requires a different health care provider, a referral to the person will be facilitated that day.

 

 

Education:

 

We are committed to patient education which includes:  injury, prognosis, and treatment plan. Our PT’s will use medical resources such as posters, models, computer videos, and demonstration to help understand your injury and WHY/HOW PT can help. The PT will make a recommendation as to how many times a week you will attend PT and what the main focus of your treatments will be. Most patients attend PT 2-3 days per week, depending on the condition. Sometimes more, sometimes less.

 

 

TREATMENT:

 

In most cases, you will be given 1-3 exercises on Day 1 with photos and clear instructions for home. Many times, the PT will perform some type of hands-on skilled care to help restore motion or help reduce pain.You will have the same PT the majority of your visits, to maximize your consistency of care.

 

 

 

Day 1 is complete! Whats next?

 

After the evaluation, treatment, and hands on care, your PT and PSC will coordinate appointment with you. The average first visit is a little over an hour. After your visit, the PT will write up your initial evaluation note. If an MD referred you, that evaluation will be sent to him or her.

 

This begins your Physical Therapy journey with us! Thank you again for choosing Sports PT of NY. We are committed to clinical excellence and outstanding customer service in a fun environment.

 

 

Total vs Reverse Shoulder Arthroplasty: Which Allows for Better Return to Sports and Work?

By: Cameron Diedrickson, SPTA

 

 

 

         When the reverse total shoulder arthroplasty was introduced in the United States in 2004, it caused a spike in shoulder arthroplasties. 10,000 RTSA’s were performed in 2007 which was five times as many as were performed in 2004.  As of 2011, RTSA’s accounted for 42% of all shoulder arthroplasties. The indications for both RTSA and total shoulder arthroplasty (TSA) are different, but if given the option, which would enhance your ability to return to sport or work?

 

            71 RTSA and 115 TSA recipients were asked how able they were to participate in sports following the procedure. Swimming and golf were among the most common sports that were reported. TSA patients had a 27% easier time participating in shoulder dominant sports over RTSA patients. The survey also found that RTSA recipients reported a higher inability to perform shoulder specific sports (20%) over TSA patients (4%).  Does this trend hold true for work as well?

 

            When asked about work, housework and gardening were the most common types. Taking that into consideration, 21% of TSA patients reported an easier time with those activities. Gardening was a 65% difference in score and housework came in at 34% difference. The scores for work and sport were relatively consistent between the two groups. Overall, recipients of a TSA have more ability to work and partake in sports following their procedure. With proper rehabilitation though, it is very possible for everyone to return to the activities they enjoy participating in.

 

 

 

 

References:

 

 

Familiari, F., Rojas, J., Nedim Doral, M., Huri, G., & McFarland, E. G. (2018). Reverse total shoulder arthroplasty. EFORT Open Reviews, 3(2), 58–69. http://doi.org/10.1302/2058-5241.3.170044

 

 Jennifer Kurowicki, MD Samuel Rosas, MD Tsun Yee Law, MD Jonathan C. Levy, MD . Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty. Am J Orthop.

May 23, 2018

A Man’s Changing Body

Pulled from the article “A Man’s Changing Body” from www.canyonranch.com

 

 

As a man, you’ve seen your body change with the years. Maybe you’ve put on a few (or more) pounds, or perhaps you’ve started to notice that your hairline isn’t quite where it used to be. Understanding all of the unique ways in which a man’s body ages can open up new ways to lead a healthier, vital life—in every decade.

 

Here are some changes to be aware of as you continue on your path to wellness:

 

Fat: Men often gain weight steadily starting at around age 30 and continuing until roughly age 55. Throughout life, a man’s excess weight tends to be carried as belly fat, which increases his risk of heart disease and other conditions. One simple way to gauge whether you’re carrying too much is to measure your waist circumference. If yours comes in over 40 inches, it’s wise to work toward a healthier goal. The good news is that, as a man, any weight you lose will usually come off your belly first.

 

Muscle: As your male hormones begin to decline around middle age, you’ll naturally lose muscle mass. Although your body will respond less dramatically to strength training as you get older, it’s important to keep it up over the years because it can slow muscle and bone loss, and actually boost testosterone levels. If you’re new to strength training, learn more by reading Getting Started, Getting Stronger. Aim for two strength-training sessions every week with at least a day of rest for those muscles in between (you can do alternative exercise, like cardio activity, on those days, or strength train other muscles). Do several reps of eight to 10 different movements to target each major muscle group.

 

Heart: Heart disease is relatively rare in men in their thirties and forties, but risk factors can creep up quickly with age. For example, more than half of men have hypertension by the time they are age 50 to 64. Even a healthy person’s blood vessels and arteries become slightly less supple with time, which can contribute to high blood pressure. It’s never too early (or too late) to adopt a preventive lifestyle, which includes regular screening. Healthy men should get their blood pressure checked every year and their cholesterol checked at least every five years; you may need to be screened more often depending on your risk factors. Once you’ve turned 45, ask your doctor if you should start a daily aspirin to help prevent a heart attack.

 

Prostate: This small organ tends to get larger as you get older. As it presses on your urethra or bladder, you may find yourself urinating more often—or feeling like you need to go but can’t. You can learn more about how to manage urination concerns by reading Common Urination Problems in Men. Prostate cancer also becomes more common with age, but the same healthy lifestyle that protects your heart also lowers your risk of this disease. As for screening, it’s important to get a manual prostate exam annually starting at age 40; there’s debate over the usefulness of the prostate-specific antigen (PSA) test, so it’s best to discuss it with your doctor.

 

Skin: As you get older your skin gets thinner, which brings changes like slower wound healing and greater sensitivity to the cold. So, it makes sense to take good care of it now—even if you never paid much attention to it in the past. Skip the tanning beds, wear UVA and UVB-blocking sunscreen, use a moisturizer and treat any cuts or scrapes you get. Crusty, rough patches, known as solar keratosis, become more common after age 45. Since this is considered a precancerous condition, talk to your doctor about whether a skin cancer screening may be a good idea for you. If you see any change in your skin, see your dermatologist.

 

Hair: About half of men have male pattern baldness. While some men with a genetic predisposition may begin to lose their hair before leaving the college years, most who experience thinning notice it by their mid-thirties or later. Often, you’ll start to lose hair on the top of your head—the famous “bald spot.” Though less hair isn’t a health concern, of course, it’s important to know that you may be at slightly increased risk of heart disease and prostate cancer if you started to lose your hair early on. All that means is that you have even more incentive to the preventive lifestyle that all men—and women—should pursue.

 

Headaches and Neck Pain? – How Your Physical Therapist Can Help!

 

 

What is a cervicogenic headache?

 

A cervicogenic headache is just another name for a headache that originates from somewhere in the neck (aka cervical spine). This is called “referred pain,” which means that you perceive the pain in a region of your body that is different from where the source of the problem actually exists. This occurs because some of the nerves that supply the neck also supply structures in the head.  If you are experiencing a headache along with neck pain, then the issue might actually be with you neck.

 

The neck is made up of vertebrae that form joints which allow for movement in your neck. During certain movements of your neck, the joints, muscles, ligaments, and nerves could be getting stretched, compressed, or irritated, beyond their normal tolerance and cause pain that is interpreted as a headache. A head/neck injury in the recent past, such as a whiplash injury or concussion, could also refer pain that is perceived as a headache.

 

 

Common Symptoms 1,2,3

 

If you are experiencing a cervicogenic headache, you may experience one or more of the following symptoms:

 

  • Usually one-sided neck pain and a headache that wraps around from the base of the neck, up the back of the head and into the front of the head
  • Headache that is not constant
  • Headache that is brought on or aggravated by certain neck movements or spending a lot of time in the same position (such as driving, sitting at a computer)
  • Tenderness at the base of the head or upper neck when pressing on it firmly
  • Arm discomfort in the arm that is on the same side as the head/neck pain
  • May also be associated with light-headedness, dizziness, nausea, ringing in the ears, decreased ability to concentrate

 

 

Possible Causes: 2,3

 

  • Muscle imbalances, weakness, tightness
  • Poor posture associated with repetitive or prolonged positions at work/home, sleeping, etc.
  • Previous neck or head trauma
  • Stress

 

 

What You Can Expect From Your PT: 1

 

  • An evaluation that will examine the range of motion, strength, and posture of your neck and other surrounding body regions
  • Hands-on techniques such as stretching, pressing, and positioning to help move your neck to assess mobility
  • Exercises focusing on improving the activation, strength, and endurance of muscles surrounding and supporting the neck
  • Patient education about your condition, what your PT can do to help, and things you as the patient can do at home to help improve

 

 

 

It is important to remember that every individual’s body is different and everyone perceives pain differently, so if you think that you might be having cervicogenic headaches, but aren’t sure, schedule an appointment with your physical therapist to be evaluated!

 

 

 

**If you experience any of the following symptoms, it is important to call 911 for immediate medical attention, since they may be a RED FLAG for a more serious condition: 2

 

  • Headaches that are progressively getting worse over time
  • Sudden onset of severe headache
  • Headaches associated with high fever, stiff neck, or rash
  • Onset of headache after a head injury
  • Problems with vision or severe dizziness

 

 

References:

  1. Childs JD, Cleland JA, Elliott JM, Teyhen DS. Neck pain clinical guidelines. J Orthop Sports Phys Ther. 2008; 9(38): A1-34.
  2. Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011; 6(3): 254-266.
  3. Headache (Cervicogenic). http://www.physioadvisor.com.au/9273650/cervicogenic-headache-neck-headache-physioadvi.htm. Accessed: March 8, 2016.

Hydration Facts: Drink Up!

By: Emma Cadwallader, SPT

 

With the warm weather finally making an appearance in Upstate NY, it’s more important than ever to make sure you are drinking enough water & staying hydrated! 

 

 

 

Did you know…

Water makes up around 60% of our body weight!! It’s important for vital bodily function like circulation, regulation of body temperature, and lubrication of joints. Without an adequate amount of water each day you can experience some early signs of dehydration such as feeling tired, muscle cramping, headaches, and dizziness.

 

 

How much is enough?

Research shows women should drink at least 2.21L of water a day, with men needing at least 3L. Good ways to keep track of your water intake throughout the day are keeping a cup that you know the size of or a water bottle with markings on the side for ounces or milliliters. Some people even have multiple water bottles and keep one at work and at home so they don’t have to remember to bring it back and forth every day!

 

 

Can I drink too much water?

Yes, water intoxication can result from excessive intake of water. There is a balance within our bodies called homeostasis, and too much water can disrupt the electrolyte balance and decrease the amount of sodium in our bodies. Symptoms of water intoxication are confusion, nausea, and vomiting. Water intoxication is a very serious problem and requires treatment by a medical professional and can lead to coma and even death in very severe cases.

 

 

So water is important, but why exactly?

Some noticeable and research supported benefits of drinking water are:

  • Increased energy
  • Helps rid the body of toxins
  • Helps with digestion
  • Assists with weight loss 
  • Combats headaches naturally

 

 

Drink up!

 

 

 

RD ASMS. Water intoxication – when you drink too much water. Medical News Today. https://www.medicalnewstoday.com/articles/318619.php. Published July 31, 2017. Accessed May 10, 2018.

 

Laskey J. The Health Benefits of Water. Everyday Health. https://www.everydayhealth.com/water-health/water-body-health.aspx. Published February 16, 2015. Accessed May 10, 2018.

 

McIntosh J. Benefits of drinking water: Recommended intake, uses, and facts. Medical News Today. https://www.medicalnewstoday.com/articles/290814.php. Published February 15, 2018. Accessed May 10, 2018.

 

Staff health enews. 3 liters of water daily: Look 10 years younger? | health enews health enews. health enews. http://www.ahchealthenews.com/2013/11/11/3-liters-of-water-daily-look-10-years-younger/. Published November 11, 2013. Accessed May 10, 2018.

 

 

Physical Therapy Provides a Natural and Effective Alternative to Pain during Pregnancy

By Dr. Alanna Pokorski, PT DPT

 

 

 

Six million pregnancies occur in the United States per year. Of these pregnancies, 80% of women will report experiencing low back pain during the pregnancy, of which one-third will rate their pain as severe to completely debilitating. Physical therapy is an excellent natural alternative to help women manage their low back pain while pregnant, allowing them to focus on the arrival of the new addition to their family.

 

 

During pregnancy, the joints within the low back become very loose, and may become misaligned, creating pain. Furthermore, it is typical for a woman to gain 30 to 50 pounds during her pregnancy, which will create increased compression forces within joints and create imbalances. All of these bodily changes can further lead to poor force placement within the low back, leading to lower back pain.

 

 

Physical therapy is a safe, natural, and cost-effective alternative for the management of low back pain during pregnancy. PT has been shown to decrease sick leave for pregnant women. It is safe for women without a high-risk pregnancy to be active and exercise throughout the nine months leading up to their baby’s birth. Some proven exercises that can be performed during physical therapy are pelvic tilts, sit-to-stands, bridging, and rowing. In addition to these exercises, a physical therapist educates on posture, appropriate hip alignment with hands-on techniques. A trained physical therapist will also take into consideration positions that labor may occur.

 

 

For more information on how PT can help during pregnancy, contact us at info@sptny.com,

 

 

 

 References 

 

  • Depledge J., McNair P., Williams M. Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts. Physical Therapy. Dec 2005; 85; 1290-1300.
  • Foti T., Davids J., Bagley A. A biomechanical analysis of gait during pregnancy. Journal of Bone & Joint Surgery. May 2000; 82; 625-633.
  • Hall, J., Cleland J., Palmer J. The effects of manual physical therapy and therapeutic exercise on peripartum posterior pelvic pain: Two Case Reports. The Journal of Manual and Manipulative Therapy. 2005; 13; 94-102.
  • Irion, J. Bed rest and physical activity in pregnancy are not mutually exclusive says physical therapist. Alexandria, April 24, 2007.
  • Sawyer, L, Montgomery S. Types of Back Pain in Pregnancy. Spine Health. Jan 2000; p 1-4.
  • Noren L., Ostgaard S., Nielson T.F., Ostgaard H.C. Reduction of sick Leave for lumbar back and posterior pelvic pain in pregnancy. Spine. 1997; 22 (18): 2157-2160

 

Why Physical Therapy is the Better Option for Pain Relief The Opioid Epidemic

By Brandon Duca, Student of Exercise Science

 

 

Quote by the CDC: “There is high-quality evidence that exercise therapy (a prominent modality in physical therapy) for hip or knee osteoarthritis reduces pain and improves function immediately after treatment and that the improvements are sustained for at least 2-6 months. Previous guidelines have strongly recommended aerobic, aquatic, and/or resistance exercises for patients with osteoarthritis of the knee or hip. Exercise therapy also can help reduce pain and improve function in low back pain and can improve global well-being and physical function in fibromyalgia.” [6]

 

 

Opioid Epidemic In America

 

The opioid epidemic in America is real.  For the first time, traffic fatalities have been surpassed by opioid related deaths. [1]. According to the American Society of Addiction Medicine, prescription opioid fatalities amounted to over 20,000 deaths in 2015, higher than heroin related deaths that amounted to only about 13,000 fatalities, [4].  In addition, opioid related deaths and injuries (classified as unintentional injury deaths by the CDC) was the leading cause of injury related death for the age bracket of 25-64 years old [5]. 

 

 

Reasons Why Opioids May Not Be Warranted For Short Term Pain Relief

 

Although the Center of Disease Control does acknowledge opioid medicine to be effective at relieving short term symptomatic pain, studies by the CDC suggest that risk of addiction may make opioid usage a problematic source for short-term pain relief. According to CDC, patients who use opioids within 7 days following surgery had a greater risk of usage after one year [2].  This data suggests that even short-term opioid usage may be linked to long-term opioid dependence.  In addition, short-term pain relief from opioid medicine does not equate to beneficial long-term outcomes.  Studies done by the CDC report finding no evidence that opioids continue to have a benefit in reducing pain after one year, compared to a placebo intervention where no opioids were prescribed [2]. 

 

 

How Physical Therapy Can Be An Effective Alternative For Pain Relief

 

Unlike prescription medicine, where the intention is to only mask symptoms of pain, Physical Therapy serves as an outlet to fix pain symptoms at the source by addressing functional impairments and muscle imbalances through quality efforts. Physical therapy not only serves to mitigate the physical symptoms of pain, but it also serves to address the emotional aspects of pain by providing verbal encouragement and patient education. According to the APTA, physical therapy has been shown to increase function, range of motion, and pain symptoms even by just an education session with a therapist [6]. In addition, extensive studies by the CDC and APTA show evidence that nonpharmalogical and non-opioid pharmologic treatments present benefits without the harm associated with opioid therapy [2,3]. It offers benefits of increased functionality physical health and fitness that opioid therapy cannot offer.

 

 

What is the Take Home Message?

 

Prescription opioid medicine may be an attractive source for pain relief due to its simplicity of usage, however its risk for physical harm and dependence advocates Physical Therapy to be a safer and more effective option for pain relief both in the short term and long term. It achieves this goal by addressing both the physical and emotional symptoms of pain at the source of injury, rather than using drugs that only cover up the physical pain in the short term.

 

 

 

 

(1)     https://newgradphysicaltherapy.com/opioid-epidemic-physical-therapy/  (opioid vs car crash statistic)

 

 

(2)    https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm  (cdc article on why opioid use for long term)

 

(3)    https://www.moveforwardpt.com/DidYouKnow/Detail.aspx?cid=cd15e2c9-922e-4b95-bfdb-97247f894f41  (apta website)

 

(4) https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

 

(5) https://www.cdc.gov/injury/wisqars/LeadingCauses.html

 

[6] https://www.moveforwardpt.com/DidYouKnow/Detail.aspx?cid=cd52bad5-f4a3-4f1f-a387-9cd4a3bc1842