Core Ex + Manual Therapy for CLBP

Manual Therapy And Core-Strengthening Exercises Can Effectively Alleviate Chronic Low Back Pain

Low back pain is jarringly common. About one-half of all working Americans will experience symptoms at least once every year, and roughly 31 million are affected by it at any given point in time. So if you consider yourself part of this group, you have plenty of company.

Dealing with low back pain can be troublesome and place a strain on everyday life. Typical movements like bending over to pick something off the ground or twisting your torso when looking to the side might suddenly give you pause and make you less mobile in the process. This is one of the main reasons that low back pain is also one of the leading causes for missed work due to disability.

Fortunately, most cases of low back pain will resolve on their own over a short period of time

Ninety-percent of people with back pain will experience complete resolution, but for about 10% of patients, pain will persist beyond three months, in which case it’s called “chronic” low back pain. When the condition becomes chronic, it often leads to greater disability and has an even stronger impact on one’s quality of life due to the frequency and severity of the pain. In addition, although only a small percentage of patients experience chronic low back pain, it accounts for 80% of the indirect costs because treating it is often more difficult.

Physical therapy, however, is an extremely effective treatment option for low back pain at any stage of its development. When treating chronic low back pain, physical therapists use many of the same principles that are used to treat acute low back pain—which is pain lasting for less than three months—but they place an even greater focus on education about the psychological aspects of pain, which are significant in these cases. Some of the interventions therapists use most frequently for chronic low back pain include manual (hands-on) therapy, stretching exercises, strengthening exercises for the back and core muscles, and education on the nature of chronic pain and how to break out of negative thinking patterns.

Study supports the value of manual therapy and core-strengthening exercises

The benefits of physical therapy for chronic low back pain were highlighted in a recently published study called a randomized-controlled trial, which is considered the gold standard for individual studies. For the study, 148 patients with chronic low back pain were randomly assigned to either cognitive functional therapy or a therapy program focused on core exercises and manual therapy. Cognitive functional therapy is an intervention led by physical therapists that integrates strategies from psychology and neuroscience into a comprehensive treatment regimen. Both interventions lasted for eight weeks, and patients were evaluated periodically for up to one year.

Results showed that one year later, both groups experienced improvements in disability and there was no difference in pain intensity between the two interventions. Therefore, this highlights how core-strengthening exercises and manual therapy are effective for patients with chronic low back pain in the long term.

If you’re dealing with chronic low back pain, we can help. Contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or to schedule an appointment today.

Cervicogenic Headache Treatment in Visalia

Some Headaches Are Caused By Neck Issues, But Physical Therapy Can Help

If you are searching for someone that can alleviate your headache pain, there’s a good chance we can help.  Cervicogenic headache treatment in Visalia is provided at our physical therapy center…quite successfully.  Below is some educational information about this type of headache pain.

There are Over 100 Different Kinds of Headaches – We Treat One of the Common Types

More than 100 types of headaches have been categorized by healthcare experts, but they all share in common an ability to cause serious impairment when they strike. Cervicogenic headaches are caused by a dysfunction of the neck and are one of the most common types of headaches, but various physical therapy techniques can effectively address them.

Headaches can generally be classified into two groups: primary and secondary. A primary headache simply means the headache itself is the disorder, while secondary headaches result from an injury or disorder in another area of the body. Cervicogenic headaches are one of the most prevalent secondary headaches, as they account for about 15–20% of headaches overall.

Since cervicogenic headaches occur due to a dysfunction of the neck, they are considered a form of referred pain in which the source of the pain is within the cervical—or neck—region of the spine, but the sensation of pain is felt in the head as a headache. This is because there are nerves in the upper spine that have connections with certain nerves in the head, and damage or dysfunction in one area leads to symptoms in the other.

Cervicogenic headaches frequently occur after trauma to the neck, such as after whiplash from a car accident. Poor posture and regularly straining the neck can also be contributing factors. Symptoms can occur rapidly or develop gradually, and the most common sign of a cervicogenic headache is pain on one side of the face or head, which can get worse after sudden movements of the neck, coughing, sneezing, or taking a deep breath. Other symptoms include stiff neck, pain attacks lasting for hours or days, and pain that stays in one location.

Study shows how two hands-on therapy techniques are effective for cervicogenic headaches

Physical therapy is among the most effective treatments for cervicogenic headaches, and a typical treatment program will likely consist of postural reeducation, strengthening and stretching exercises, and manual therapy. Manual therapy involves various techniques administered by the hands of the treating physical therapist, including manipulation and mobilization, which are two of the most frequently used types of manual therapy for cervicogenic headaches.

The consensus among physical therapists is that manipulation and mobilization have similar effectiveness for cervicogenic headaches, but research directly comparing these two methods is lacking. Therefore, a study was conducted in which 45 patients with cervicogenic headache were randomly assigned to undergo a single session of either manipulation or mobilization by a physical therapist. All patients were assessed for neck pain and disability, headache severity, and several other outcome measures before and after treatment.

Positive Outcomes for Both Seeking Headache Pain Relief

Results showed that both groups improved over time for all outcomes measured, and there were no significant differences between groups at each of the follow-up periods. In addition, no patients reported any adverse events during the trial. These results suggest that both manipulation and mobilization are similarly effective for patients with cervicogenic headaches, although it’s important to note that spinal manipulation is generally associated with greater risks.

If you’re at all familiar with headaches, then you know what they can do to your life when they strike. While there are still many unknowns when it comes to managing headaches, physical therapy remains an effective option that individually caters treatment based on the specific type of headache that is present.

So if you regularly deal with headaches, and are looking for cervicogenic headache treatment in Visalia or Hanford, we can help.

Contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or to schedule an appointment today.

Opioid Prescription Rates – This is Why You Should Try PT First

Prescription Rates For Opioids Are Decreasing While Rates For Non-opioids Prescriptions Are Increasing

Try as we might, it’s nearly impossible to avoid pain altogether. Whether it’s twisted ankle or a sore neck, we all experience pain at one point or another, which is why pain is by far the most common reason people seek out health care. But treating pain—especially long-lasting, or chronic pain—is rarely easy or straightforward. Treatment often requires a multifaceted approach due to the numerous variables that contribute to a patient’s perception of pain and response to treatment.

The use of opioids to treat pain has long been controversial. Some patients, such as those with terminal illnesses and those who are on end-of-life care, may require opioids due to the extreme amount of pain they are in. Opioids may also be appropriate for a limited period for certain short-lived (acute) painful conditions; however, it’s not clear if they are also effective for patients with chronic pain. But this has not stopped medical professionals from prescribing these drugs for all types of conditions.

Starting in the late ‘80s and early ‘90s, opioids were prescribed on a major scale to individuals dealing with both acute and chronic pain. Over the years, prescribing these drugs has become a standard practice that many doctors assumed was safe and effective, even though there has always been a lack of high-quality research on the benefits and harms of opioids. As a result, opioids have been overprescribed for far too long, and at least 400,000 people have died of an opioid overdose between 1999 and 2017.

The CDC Recommended Prescribing Changes for Pain Meds

The epidemic has brought light to the situation and raised questions about prescribing these drugs to patients in pain, and professional organizations like the CDC have therefore provided guidelines on when and how to give prescriptions, and what else can be done to address this problem. One of the central messages that has been stressed by healthcare leaders in various positions is that physical therapy should be utilized as a first-line treatment and an alternative to opioids for managing pain. Here are some examples:

  • In August 2016, the U.S. Surgeon General at the time, Vivek Murthy, MD sent a letter to 2.3 million medical professionals to address the opioid epidemic provide a call to action to end it. The letter was combined with an infographic to assist these professionals in the prescription of opioids, and one of the central recommendations made was to consider non-opioid therapies first, with physical therapy being listed as an important alternative.
  • A task force made up of experts in various medical fields was created to establish guidelines for managing pain and the role of opioids in the process. One of the key guidelines was that restorative therapies like physical therapy should be a central component of patient care. It points out that these therapies play a significant role in managing acute and chronic pain, and that positive patient outcomes are more likely when they are used.
  • In 2016, the Centers for Disease Control and Prevention (CDC) provided a set of evidence-based recommendations for opioid prescriptions, stating that opioids should only be prescribed when the expected benefits outweigh the risks, and nonopioid pain treatment should be prescribed instead of, or in addition to opioids. Physical therapy is mentioned among the nonopioid and nonpharmacologic therapies recommended because evidence shows that it can alleviate chronic pain.

What are the Non-opioid Prescriptions Doing to Consumers?

The CDC’s 2016 recommendations for opioid prescriptions prompted researchers to investigate whether prescription patterns changed since their release, and a study on their findings was published in 2022. Researchers found that patterns did in fact change significantly from 2012 to 2018. In 2012, the prevalence of opioid prescriptions was approximately equal to that of non-opioid medication prescriptions, but by 2018, there were about 50% more prescriptions for nonopioids than opioids. This suggests that many healthcare professionals have been following the CDC’s guidelines by prescribing opioids cautiously. However, the increases in non-opioid prescribing were much higher than expected, and the decreases in opioid prescribing were not completely offset by these increases.

Further research is therefore necessary to determine if the use of nonpharmacologic treatments like physical therapy also increased during this period, but these findings are good news nonetheless, as they show that opioid are not being prescribed nearly as frequently as they once were, which is saving many patients from future issues with dependence and addiction.

Before Any Drugs, You Should See One of Our Physical Therapists First

There is a place for medication. However, often medications don’t work, can be abused, or have terrible side effects.  Given that physical therapy is as effective for most muscle and joint pain diagnoses, it only makes sense that you contact us first at one of our two locations, to see if we can help…and permanently end your pain.

Celebrating National Physical Therapy Month

In Honor of National Physical Therapy Month, Learn How Physical Therapy Can Save You Time And Money While Avoiding Unnecessary Tests And Interventions

Every October, physical therapists around the country come together to celebrate National Physical Therapy Month. The purpose of this annual campaign is to highlight the many ways that physical therapists can provide numerous benefits to individuals of all ages with an individualized approach to neuro-musculoskeletal conditions & treatment. In honor of the month, we’d like to discuss a few of the key reasons why seeing a physical therapist first for numerous types of pain is likely to be the best treatment decision you can make.

Quick Access = Quick Relief

For anyone that experiences pain or gets injured, quick relief is often the number one priority. There are many treatment options available to address painful conditions, and it may be difficult to decide what’s best for you. But regardless of your diagnosis or its severity, one universal truth applies: trying physical therapy first is a smart move that will usually help you avoid other unnecessary tests, drugs, injections, and surgery in the future.

Physical therapy is not a cure-all that will immediately fix any physical problem, but it does have vast range of applications and is appropriate for most painful conditions. Every physical therapy treatment program is individually tailored with each patient’s abilities and goals in mind, and by carefully guiding patients through exercises and movement-based techniques, significant improvements are very likely to occur.

Physical Therapy vs. Surgery, Injections, and Opioids

Other popular treatments for pain include surgery, injections, and prescription medications like opioids, but research continuously shows that physical therapy is a wise option that will save patients money and time while leading to similar—if not superior—outcomes.

For example, one study found that physical therapy was just as effective as surgery for patients with various tendon disorders, while another found only minimal differences after five years between patients treated with surgery versus physical therapy for ACL tears. Physical therapy can also help patients avoid taking prescription drugs like opioids, which are a significant problem in the country today due to alarmingly high rates of addiction, overdose, and death. One study found that patients who underwent physical therapy had a lower chance of being prescribed opioids the next year, while another found that those who saw a physical therapist early were 33% less likely to use narcotics like opioids and 50% less likely to receive non-surgical invasive procedures than patients who did not.

Seeing a Physical Therapist First Saves You Money

Seeing a physical therapist early is also associated with better odds to experience a positive outcome with lower overall healthcare costs. This is exemplified in other research that found early physical therapy to be associated with an average savings of $2,172 on healthcare costs over one year compared to late physical therapy, as well as a lower risk for patients being prescribed opioids, having a spinal injection, or undergoing an imaging test.

Physical Therapy in Hospitals Associated with Higher Costs

Avoiding the hospital for elective reasons like surgery will further lower costs for patients, as receiving physical therapy in a hospital is typically lower than receiving it at a clinic. One study compared these costs, and results showed that the average prices were 41% higher for therapeutic exercises and 64% higher for manual (hands-on) therapy in a hospital than a community setting. A 15-minute session of manual therapy, for example, was about $58 in a hospital versus $35 in a clinic.

In addition, you can often see a physical therapist much sooner than some other healthcare professionals. While it could take several days, weeks, or longer to get an appointment with certain healthcare professionals, many physical therapy practices can schedule you as soon as the next day. This yields further dividends, since the sooner you see a physical therapist, the better your outcome will be.

So if you’re currently dealing with any type of painful condition, we strongly recommend seeing us before consulting with your primary care doctor. We can quickly identify the source of your problem and get you started on a tailor-made treatment program right away that factors in your needs, abilities, and goals.

Contact Our Hanford or Visalia Office for More Information  – Click Here for Details

Resistance Training for Older Adults

Physical Therapist-Led Fitness Programs With Resistance Training
Can Increase Longevity And Improve Quality Of Life

As we age, our bodies experience a series of changes that often make everyday activities more difficult. Decreased flexibility, a decline in posture, and pain within one or more joints are just a few of the many changes that frequently occur throughout the aging process. These types of changes can lead to decreased mobility and less physical activity, which can in turn diminish one’s quality of life and potentially lead to psychological issues like depression and anxiety.

Although age-related changes are completely normal, it doesn’t mean they are unavoidable. Healthy aging in a way that preserves your mobility, physical function, and quality of life is possible, and its leading ingredient is simple: regular exercise and physical activity.

Keeping Active is Essential to Overall Health at All Stages of life

You’ve probably heard the phrase “No matter how slow you go, you’re still lapping people on the couch!”  In other words, it’s really important to be active as we age; it’s particularly valuable once a person enters their 60s and 70s because it can extend and enhance life. That’s why we strongly encourage all older adults to find ways to become more physically active every day, whether that’s by taking a daily walk—or two—doing yard work, cleaning, or other household chores, or even practicing a sport recreational activity. But beyond this, at Bacci & Glinn Physical Therapy we can also provide personalized exercise and fitness programs for any individual interested in becoming more active.

A Goal-Oriented, Personalized Physical Therapy Program is Important

All physical therapy exercise programs are individualized for each patient’s needs, abilities, and goals, and most include a variety of balance, stretching, and strengthening exercises to improve one’s overall fitness level. Strengthening, or resistance exercises, help to build strength and increase stability—which can reduce the risk for certain injuries—but this type of training may provide other benefits that transcend beyond strength as well.

Scientists Look for Additional Benefits of Resistance Training

To investigate these purported benefits, a systematic review and meta-analysis was conducted. This type of study involved researchers reviewing studies on resistance training for adults aged 60 years and older that were identified in a comprehensive search of five major medical databases. A thorough review and analysis of 21 studies revealed that resistance training led to a variety of both physical and mental benefits. In particular, resistance training significantly improved physical functioning, mental health, bodily pain, general health, social functioning, depression, upper- and lower-limb muscle strength, and handgrip muscle strength.

The Right Choice – A Physical Therapist-Led Exercise Program

These findings underscore the extreme value of resistance training for older adults and show that its benefits are widespread in both physical and mental arenas. Given the innumerable health risks associated with aging if physical activity is neglected, we strongly encourage you to consider a fitness program custom designed for your specific needs (and taking into account your physical impairments) to improve your health and reduce your injury risk.

If you’re interested in learning more or would like to schedule an appointment, contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford).

The Best Treatment for Ankle Sprains?

For A Sprained Ankle, Consider Seeing Us First-Here’s Why

If you play sports, there’s a strong chance you will sprain your ankle at some point. Ankle sprains account for up to 45% of all sports injuries, and approximately 25,000 people sprain their ankle every day in the U.S. In addition, about 10% of visits to the emergency department (ED) are for ankle sprains, which leads to direct medical costs of $2 billion. Most sprains (41%) occur in basketball, followed by football and soccer, which is mainly because each of these sports involve lots of jumping and cutting movements, which significantly increase the risk for sprains.

Ankle sprains involve the ligaments of the ankle joint, which are flexible bands of tissue that connect one bone to another. Ligaments are elastic and can be stretched to a certain length and then return to their original position, but they have a limit. When any of the ligaments in the ankle is stretched beyond its maximum range of motion, it becomes damaged, which is called a sprain. Most ankle sprains involve pain, swelling, tenderness, stiffness, and some degree of instability, depending on the severity of the sprain.

What You Do Right After a Sprain Can Impact Your Future

If you do sprain your ankle, the prognosis is usually quite good, and most people can get back to sports or training within about 4–6 weeks; however, what you do immediately after the sprain will likely influence your eventual outcome. Some individuals will go to an urgent care center or the emergency room/department (ED), especially if the injury seems serious. While this might seem like a logical decision, it can have negative repercussions that many patients don’t expect. When a patient goes to an urgent care center or the ED for an ankle injury, an X-ray may be ordered to determine the extent of the injury and if any bones have been fractured. But X-rays aren’t necessary for many ankle injuries and undergoing an X-ray can lead to longer wait times, higher healthcare costs, and unnecessary radiation to patients.

Consider Seeing a Physical Therapist Right After an Ankle Sprain

An alternative approach is to instead visit a physical therapist after the ankle injury. Physical therapists are cautious about ordering tests like X-rays and will only do so if they believe it to be necessary. To determine if an X-ray should be ordered, here at Bacci & Glinn Physical Therapy, we utilize the Ottawa Ankle Rules, which are a set of guidelines developed in 1992 to reduce the use of imaging tests like X-rays for ankle and foot injuries. A recent study found that if the Ottawa Ankle Rules were used universally, it would eliminate one-third of all X-rays performed for ankle and foot injuries.

Once we’ve taken a look at the ankle sprain, our physical therapists will get you started the appropriate treatment program for your ankle injury. Although each program differs depending on the type and severity of the injury, most will include the following components:

  • Mobility & pain relieving techniques to restore ankle movement
  • Strengthening exercises to help patients regain strength and prevent long-term ankle disability
  • Balance training to improve stability and help patients to learn to deal with any potential hazards
  • Functional training, which consists of performing activities patients might have difficulty with like walking, running, or jumping

If you’ve recently injured your ankle, physical therapy may be the best option for you.

Contact Bacci & Glinn Physical at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or to schedule an appointment today.

Dangers of Sport Specialization

With School Starting Up Again, It’s Crucial To Understand The Risks Of Single-Sport Specialization In Young Athletes

After a long summer, schools are back in session, which means children of all ages are eager to hit the ground running both in and out of the classroom. For student-athletes, this means involvement in a sport—or sports—of their choosing, which is a major commitment for some.

About 72% of school-age children—nearly 29 million—participate in at least one organized sport, which is associated with a bounty of physical and mental benefits. But a sizable portion of these young athletes choose to participate only in one sport, which can lead to almost non-stop obligations for practices, competitions, camps, and other forms of training throughout the entire year. This is called single-sport specialization, which is believed to help young athletes excel in their sport and make it to the next level of competition; however, specialization also comes with numerous risks, and it does not appear to be the best approach for young athletes.

Spelling Out the Potential Risks of Single-Sport Specialization

Single-sport specialization is a relatively recent trend in which children have been shifting away multi-sport participation to focus on the one sport they are most interested in pursuing. Parents and coaches may sway young athletes in this direction, usually because they assume that it will improve their chances of being successful at collegiate and possibly professional levels. But research has consistently shown that specialization appears to have the opposite effect on most young athletes.

Single-Sport Athletes Account for About 50% of Overuse Injuries

According to one study, sport specialization is strongly associated with overuse injuries, which occur when too much activity combines with insufficient rest and recovery. In fact, children who specialize in a single sport account for about 50% of overuse injuries seen by pediatric orthopedic specialists. Another study of 1,200 young athletes found that specialization was the strongest predictor of injury, with athletes who specialized in one sport being 70-93% more likely to experience an injury than children who played multiple sports.

Burnout is a Real Concern for Single-Sport Athletes

Children who specialize early are also at an elevated risk for burnout from stress, pressure, and diminished motivation. This may cause athletes to quit sports altogether at a young age, which could have long-term implications like lower rates of physical activity later in life. Finally, exclusively focusing on one sport early in life can prevent young athletes from working out other parts of their body, which may lead to reduced motor skill development and other developmental complications.

Young athletes should therefore be encouraged to participate in a variety of sports during their early years so that they can sharpen a variety of motor skills and identify the sports that they enjoy most. In our next blog, we’ll talk about the benefits of multi-sport participation and offer some tips to avoid overuse injuries and burnout.

If you’re concerned with your child’s risk for sport specialization, Bacci & Glinn Physical Therapy can help.

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or schedule an appointment today.

Benefits of Multi-Sport Participation

Playing Multiple Sports Is More Advantageous To Young Athletes In The Long Run

In our last blog, we discussed how single-sport specialization is a trend that’s becoming increasingly more common in youth sports, even if it may not be in the best interests of these young athletes. As we noted, children who specialize in one sport are up to 93% more likely to suffer from an injury than those who play multiple sports, and they are also at an increased risk for burnout from fatigue and not giving taking adequate time for recovery.

For these reasons, most experts recommend that young athletes should diversify their pursuits and try to engage in multiple sports throughout most of their childhood. Research has shown that doing so is healthier for athletes and more likely to lead to long-term success. For example, early participation in multiple sports is associated with:

  • Better overall motor and athletic development
  • Longer athletic careers
  • Increased ability to transfer sports skills
  • Higher levels of motivation and confidence in sports
  • Better decision-making, pattern recognition, and increased creativity

It may also come as a surprise and conflict with popular assumptions, but most athletes who play at the collegiate level have histories in multiple sports rather than just one. A study of nearly 300 NCAA Division I male and female athletes found that 88% participated in an average of 2-3 sports as children, and 70% did not specialize in a single sport until after 12 years of age.

If College Scholarship is the Goal – Think About Multi-Sport Participation

It’s also important for parents and coaches to recognize that only about 2% of high school athletes receive scholarships to play at the collegiate level. This should serve as a gentle reminder that the odds of achieving elite-level success are extremely slim, which means single-sport specialization could be for naught in many cases. Therefore, most young athletes should be encouraged to participate in several sports and activities throughout their childhood. For those that do decide to specialize in one sport, here are a few tips to avoid overuse injuries and burnout:

  • Weekly participation (in hours) should not exceed the athlete’s age
  • Athletes should take one or two days to rest each week, as well as one or more longer breaks (up to one month) throughout the year
  • Athletes who engage in more than 16 hours of intense training per week should be monitored for signs of burnout and overtraining
  • Encourage children to communicate clearly about any pain or discomfort

If you’re concerned with your child’s risk for sport specialization, Bacci & Glinn Physical Therapy can help.

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or schedule an appointment today.

Physical Therapy or Surgery for Musculoskeletal Injuries

Exercise Therapy Is A Safe Intervention With A Low Risk For Adverse Events

Physical activity and exercise are regarded as integral components of physical therapy for most musculoskeletal disorders (eg, knee osteoarthritis, shoulder, neck, back pain, ankle sprains, etc.), as well as for losing weight and for treating various other conditions, such as depression, heart disease, and high blood pressure. These interventions are generally extremely safe, with reported adverse events—or side effects—expected to be less frequent and less severe than those associated with pharmaceutical or surgical interventions.

Nonetheless, it’s important to report on the severity, type, and frequency of adverse events that do occur from exercise interventions so that patients are aware of the potential risks involved and how these risks compare with other interventions. Therefore, a powerful study called a systematic review and meta-analysis was conducted to evaluate the relative risk of serious and non-serious adverse events from exercise therapy.

Researchers analyze 180 reviews that include 778 primary studies

Before discussing the details of the study, it’s important to state some key definitions:

  • Physical activity: as any bodily movement produced by skeletal muscles that results in energy expenditure
  • Exercise: a subset of physical activity that is planned, structured, and repetitive, and has a final or intermediate objective of improving or maintaining physical fitness
  • Exercise therapy: a regimen or plan of physical activities designed and prescribed for specific therapeutic goals
  • Adverse event: an undesirable or harmful outcome that occurs during or after the use of an intervention; can be serious (ie, leads to death, hospitalization, or serious risk of health deterioration) or non-serious (all other reported events)

Using these definitions, researchers performed a search of the Cochrane Library for Cochrane systematic reviews that investigated the effectiveness of exercise therapy for any condition. Exercise therapy had to be the main intervention of the study and each exercise session had to include active exercise therapy for at least 50% of the total time. The exercise also could not be combined with any pharmacological, surgical, or electrotherapeutic intervention.

Analysis of Top Quality Research (i.e. Cochrane Reviews) Shows Exercise Therapy Continues to be a Great Choice

This led to 180 Cochrane reviews being included, and 773 primary studies were identified from these reviews, with 378 reporting serious adverse events and 375 studies reporting non-serious adverse events. The main finding from these studies was that there was no increase in the risk of a serious adverse event from exercise therapy compared to a non-exercise intervention; however, there was an increase of 19% in the risk of a non-serious adverse event. This means that for every 6 people who participated in an exercise intervention, one additional non-serious adverse event occurred in the exercise group. The most common non-serious adverse events reported were pain, fatigue, bursitis, low back pain, and edema (swelling).

NOTE: this study examined exercise therapy prescribed by a number of different healthcare providers…not just physical therapists.  Adverse events with our patients happen far less than 1 in 7 of our patients.  Nevertheless, we wrote this post to let you know that non-serious adverse events in response to exercise therapy can happen, albeit, they are very rare at our practice.

Physical Therapist Directed Exercise Therapy is the Clear Winner for Natural/Conservative Care of Most Musculoskeletal Injuries

These results show that while there was an increase in the relative risk of non-serious adverse events associated with exercise therapy (provided by anyone), it was small. Therefore, exercise therapy can be regarded as a relatively safe intervention. Thus, physical therapists and other healthcare providers that prescribe exercise therapy are appropriately including it as an essential component of treatment for patients with various conditions.

If you’re dealing with pain of any sort, Bacci & Glinn Physical Therapy can help.

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or schedule an appointment today.

Patellar Dislocation Treatment in Visalia

If you’ve experienced a patellar (kneecap) dislocation and are looking for patellar dislocation treatment in Visalia or Hanford, we can help. Another way people often find us is by searching for patellar dislocation expert in Visalia or a patellar dislocation specialist in Visalia.  Quick note, if you are looking for care in Hanford, we also have an office there.

Surgery And Nonsurgical Treatments Lead To Similar Outcomes For Patients With Knee Pain

As a specialist in the conservative treatment of kneecap dislocations, the information below is worth reading.

The knee is the largest and one of the most complex joints in the body. It is a hinge joint that’s responsible for bearing weight and allowing the leg to extend and bend back and forth with minimal side-to-side motion. It primarily joins the thighbone (femur) to the shinbone (tibia), but also includes the kneecap (patella) and other lower leg bone (fibula). The patella is a small, upside down triangle-shaped bone that sits in the front of the knee within the quadriceps muscle, and it’s lined with the thickest layer of cartilage in the body because of the massive forces it takes on.

These structures provide the knee with strength and durability, but the knee also has limits that can be exceeded under certain circumstances. Due to the frequent use of the joint, the knee is among the most common locations for pain and injury, with knee pain being the leading cause of disability in older adults.

Dislocations of the patella account for 2–3% of all knee injuries, which typically occur on the lateral side—outside of the knee—and leads to ruptures of the medial patellofemoral ligament in about 90% of all cases. These injuries are most common in sports, particularly basketball, soccer, and football.

It is unclear whether patellar dislocations should be treated with conservative (nonsurgical) interventions like physical therapy or if surgery is needed when there are other associated injuries. In addition, the literature comparing conservative to surgical treatment for first-time patellar dislocations is scarce.

However, this study that we outlined below is one of the first of its kind and points to the value of seeing a physical therapist first.

20 Patients Undergo Either Surgery or Conservative Treatment for Kneecap Dislocation

Therefore, a study was conducted to investigate the outcomes of conservative versus surgical treatment for first-time patellar dislocations. Researchers recruited patients aged 15 to 40 years with a patellar dislocation in one knee, which led to 20 individuals being included. Twelve of these patients underwent surgery, which was limited to diagnostic arthroscopy followed by a soft-tissue repair of damaged structures, while 8 patients underwent conservative treatment. Patients in both groups were also treated with a brace that allowed for limited flexion and extension of the knee, along with partial weight bearing for 3 weeks, followed by full weight bearing.

Why Conservative Physical Therapy Care is Your Best First Choice – from the Patellar Instability Treatment Experts in Visalia and Hanford

Results showed that 25% of patients overall (5/20) sustained a redislocation, while the remaining 75% remained stable after 24 months. By group, 37.5% of patients (3/8) in the conservative group and 16.7% (2/12) in the surgical group experienced a redislocation; however, more patients (45.5%) experienced episodes of instability in the surgical group compared to the conservative group (37.5%). In addition, overall outcomes were not significantly different between the two groups, with a similar number of patients reporting “fair” and “good” final outcomes in both groups.

The Study Concludes You Should Strongly Consider Physical Therapy Care if You’re Looking for Patellar Dislocation Treatment in Visalia

Based on these findings, it appears that surgical and conservative treatment for patellar dislocations leads to similar results. Patients with a patellar dislocation should therefore attempt conservative treatment first, such as physical therapy, before considering surgery.  Moreover, physical therapy treatment for kneecap dislocation is less likely to cause patellar instability in the future too!

If you’re dealing with knee pain that may be related to a patellar dislocation, Bacci & Glinn Physical Therapy can help.  We provide, natural, conservative care for rehabilitation after kneecap (AKA patella) dislocations at our offices in Hanford and Visalia.

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or schedule an appointment today.

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