How PT Can Help the Aging Population Minimize Their Risk For Falling

By: Alyssa Tallo, PT, DPT

 

Each year, approximately one-third of people over the age of 65 will fall at least once, and the likelihood of another fall increases with age. Falls can create debilitating injuries such as hip fractures or head trauma, and they can also lead to emotional harm including depression. Injuries related to a fall often create reduced activity due to the fear of falling again.

 

Although the incidence of falls increases with age, there are also other factors that contribute to potential falls. These risks include: the improper use of an assistive device, lack of an assistive device (such as a cane), multiple medications, unsecure throw rugs, or cluttered areas that make it more difficult to navigate the space. Limitations in strength, balance, vision, and sensation can also significantly contribute to fall risks.

 

Physical therapists can help reduce the risk for falling by performing a thorough examination that identifies individual risk factors. Once these factors are assessed, the physical therapist can create a safe personalized exercise program. Physical therapists focus on education, strength, balance, and safety, and can assist in referrals to other necessary care providers if warranted. Physical therapists are the primary experts on the evaluation and treatment of movement to help restore quality of life.

 

For more information on risk for falls, please contact us at info@sptny.com.

 

Helpful Strategies to Prevent Pain in Your Garden

By: Justin Seward, SPT 

 

With warmer weather appearing, many of us will soon be outside mulching, digging, weeding, and planting. These activities are often repetitive and tiring on our bodies; therefore, it is important to maintain proper posture and to use approaches that allow completion of these tasks without pain. Here are a few strategies.

 

Plant Location

 

  • Ground level: Try to do ground level work on your hands and knees to minimize pressure placed on your spine. Periodically swapping your working hand with the one you’re putting weight through may reduce pressure on wrists/shoulders.
  • Raise your garden: For gardeners who cannot make it to ground level, consider a vertical garden design to reduce the need for bending. Lots of inexpensive ideas exist, get creative!

 

Lifting

 

  • Lift closer to your body: Objects further away prevent us from using our larger, stronger muscles. Using a closer approach with good form allows us to use these muscles.
  • Bend at your knees – not your back: A rounded spine with lifting causes increased pressure on the discs in our backs. Keep your back flat and squat down to lift target object by bending your knees and hips.
  • Tighten your abdominals: Grenier and McGill1 found that an abdominal bracing technique allows for greater stabilization of the lower back. To brace your abdominals, push out your belly; to ensure you’re bracing correctly before lifting, use your hands: the sides and front of your abdomen should be more firm.

 

Tools

 

  • Keep your tools sharpened: Dull tools may cause us to use more repetitive motion creating more stress the joints in our hands and wrists. It’s a worthy investment to reduce effort. Local hardware stores often offer sharpening services at a reasonable price.
  • Use body-friendly tools: Tools designed for a neutral wrist/hand position may allow for improved strength and less repetitive stress on your joints. They may also reduce the amount of force required from your shoulders to garden.

 

Hopefully these tips will help both novice and experienced gardeners this spring. If you do suffer from pain with gardening this spring, don’t hesitate to seek the expertise of a physical therapist.

 

 

Reference: Grenier SG, Mcgill SM. Quantification of lumbar stability by using 2 different abdominal activation strategies. Arch Phys Med Rehabil. 2007;88(1):54-62.

 

Sports PT is proud to invest in teaching and mentoring students of physical therapy throughout New York State. To learn more about the student experience, visit: http://www.sptny.com/Students/overview.aspx.

 

Proper Positioning of the Shoulder Sling

By: Nicole Nolan, PT, DPT

 

Patients will occasionally need to wear a shoulder sling after rotator cuff repair surgery, shoulder arthroscopy, shoulders dislocation or instability, or a shoulder, elbow or wrist fracture. However, it is imperative to the healing process that the shoulder sling be positioned properly on the body. The sling should also be put on and taken off in the correct manner.

 

The images below show how the sling should be positioned on your body:

 

 

 

 

 

 

 

 

 

 

 

 

How to put on a sling:

 

1.  Gently rest your affected arm on a table or counter. Using your uninjured arm, place the sling on your involved arm. Be careful to keep it as relaxed as possible.  The sling should fit snugly and comfortably around your elbow. It should also come to the very end of your arm without cutting off your wrist or hand.

 

2.  Reach for the neck strap and place it behind your head. Fasten the straps if they are not already fastened and pull the loop tight enough so that your hand and wrist are above elbow level. This prevents blood and fluid from pooling in your hand and wrist. Your hand should be placed slightly higher than your navel.

 

3.  Stand up and reach for the back strap by leaning towards your uninvolved side. Reach behind your back with your uninvolved arm to grab the strap. Fasten this strap near your involved hand so that it is snug. You should still be able to place 2-3 fingers comfortably between the strap and your body.

 

4.  In some instances you may need to wear an abduction pillow (which moves your shoulder away from your body) with your sling. This allows your muscles and tendons to heal in an optimal position and avoid excessive tension on healing tissues. The pillow should be kept underneath your breast line, and should be worn at all times unless otherwise stated by your doctor.

 

How to take off sling:

 

1. Gently rest your involved arm on a table or counter and loosen the straps.

 

2. Pull the pocket end off your elbow and slide the sling off your elbow and wrist

 

References: Effect of shoulder abduction ankle on biomechanical properties of the repaired rotator cuff tendons with 3 types of double row technique.  Mihata T, Fukuhara T, Jun BJ, Watanabe C, Kinoshita M.  Am J Sports Med. 2011 Mar; 39 (3): 551-6 doi:10

 

The Effects of Bad Posture on Headaches and Jaw Pain

By: Trevor Johnson, SPT

 

When a headache strikes, it’s easy to reach for the aspirin and focus on making the pain disappear. But taking a few minutes to understand some common causes of a headache might help you avoid feeling discomfort in the first place.

 

Headaches (HA) are common in 47% of the population, with 15-20% being caused by postural dysfunction in the neck (cervicogenic); and 44% of people with cervicogenic HAs have jaw pain.1 Forward head posture (FHP) is an epidemic that is common in about 66-90% of today’s population and is a contributing factor to both HAs and jaw pain, also known as Temporomandibular joint (TMJ) pain.2 The simplest definition of FHP is when the head position is ahead of the shoulders, changing the center of gravity, and placing increased tension on the neck and associated structures of the head (see picture below).3

 

FHP results in upper cervical (neck) extension to maintain a level line of vision, thereby shortening the posterior cervical muscles.3, 4 This increased tension may result in repeated pain stimulus into the trigeminal nerve nucleus (face and jaw nerve), thereby lowering the pain threshold and resulting in increased incidence of headaches (see image below).4 Additionally, FHP changes the position of the jaw, thus increasing the amount the muscles must work to open and close the mouth, causing pain.5

 

Common Causes of FHP are associated with:1

 

  • Injury and/or muscle guarding
  • Disease and nutritional state
  • Muscle tension and/or muscle weakness
  • Stress
  • Genetics
  • Improper shoes
  • Occupation that involves sitting for long periods of time
  • Bad habits that precipitate into long-term problems

 

A physical therapist can help you reduce symptoms associated with headaches and Temporomandibular dysfunction (TMD) by teaching you how to: 6

 

  • Improve neck mobility
  • Improve strength
  • Improve posture
  • Modify your home or work environment

 

For more information on how physical therapists can help improve forward head posture that may be related to headache or jaw pain visit:

 

Physical Therapist’s Guide to Headaches

 

See related Sports PT blog titled “Physical Therapy Can Help Chronic Jaw Pain

 

References:

1 Asher, A. (2007) Causes of Poor Posture. Retrieved on 27 March 2014 from http://backandneck.about.com/od/medication/tp/poorposture.htm.

2 Chiropractors’ Association of Australia. (2012) Retrieved 25 March 2014 from http://whatsyourposture.com.au/posture-health/posture-problems/forward-head-posture/.

3 Fernandez-De-Las-Penas, C, Perez-De-Heredia, M, Molero-Sanchez, A, & Miangolarra-Page, JC. (2007). Performance of the Craniocervical Flexion Test, Forward Head Posture, and Headache Clinical Parameters in Patients With Chronic Tension-Type Headache: A Pilot Study. Journal of Orthopaedic & Sports Physical Therapy, 37(2), 33-39. doi: 10.2519/jospt.2007.2401

4 Fernandez-de-las-Penas C, Alonso-Blanco C, Cuadrado ML, Gerwin RD, Pareja JA. Trigger points in the suboccipital muscles and forward head posture in tension-type headache. Headache. 2006;46:454-460.

5 Furto, E. (2014) Physical Therapists Guide to Temporomandibular Disorder. American Physical Therapy Association. Retrieved on 27 March 2014 from http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=0cb55ce4-d260-4887-ad29-d8cb18e0b91e#.UzTEP2dOXIU

6 Furto, ES. (2014) Physical Therapists Guide to Headaches. American Physical Therapy Association. Retrieved on 27 March 2014 from http://www.moveforwardpt.com/resources/detail.aspx?cid=fd8a18c8-1893-4dd3-9f00-b6e49cad5005#.UzTDyWdOXIU

 

Sports PT is proud to invest in teaching and mentoring students of physical therapy throughout New York State. To learn more about the student experience, visit: http://www.sptny.com/Students/overview.aspx