ACL Rehabilitation in Visalia

 

After ACL Surgery, A Comprehensive Rehabilitation Program Is Essential To Return To Activity And Reduce The Risk For Re-injury

Tears of the anterior cruciate ligament (ACL) get lots of attention in sports, primarily because they are very common and often put athletes on the sidelines for extended periods. Discussions about ACL tears often focus on the severity of the damage to the knee and the timetable for when an athlete will get back on the field or court after surgery.

One topic that may get overlooked, though, is the athlete’s risk for re-injury after returning to play, which is quite high in certain populations—especially young athletes.

Here’s Why Visalia Residents Looking for ACL Knee Rehab Should Contact Us for More Information:

In order to completely recover from ACL surgery and avoid additional injury, both the athlete or weekend warrior must undergo a comprehensive rehab program, which we can provide.

The ACL is one of the four main ligaments within the knee that connects the tibia (shinbone) to the femur (thighbone). It runs diagonally in the middle of the knee and prevents the tibia from sliding forward on the femur, and it also provides a great deal of stability for the knee that keeps it from rotating out of position.

ACL injuries are called sprains. In mild (grade I) sprains, the ligament only stretches and is slightly damaged, while grade II sprains are partial tears and grade III sprains are complete tears.

ACL Injuries Are Often a Serious Problem

ACL tears are devastating injuries that typically lead to:

  • Significant pain,
  • Knee instability,
  • Swelling,
  • Tenderness, and
  • Muscle weakness.

Any athlete or active individual can suffer an ACL tear, but the chances are highest in those who participate in high-demand sports with lots of cutting motions, like basketball, soccer, football, and volleyball. In fact, about 1 of every 60 athletes will tear his or her ACL at some point in their career, and this figure is only expected to rise as the intensity of sports continues to increase.

Classifications of ACL Ligament Sprains

Grade I and II ACL sprains can usually be managed with rest and physical therapy alone.

For complete ACL tears (grade III), physical therapy may be an option, but a surgical procedure called ACL reconstruction is often recommended for athletes who want to continue playing sports at a competitive level.

This procedure removes the torn ligament and replaces it with another band of tissue from the leg (usually a tendon).

ACL Surgery is a Start but Full Recovery is More Likely with a Good Post-Surgical Knee Rehab Program in Our Visalia or Hanford Office

ACL reconstruction is usually successful, and many athletes can return to their sport afterwards; however, one notable risk is tearing the newly reconstructed ligament or the ACL of the other knee. Many factors may contribute to this risk, but high-intensity sports with lots of pivoting and cutting have particularly been linked to re-injury of both the reconstructed ACL and the ACL of the opposite knee.

Completing a personalized ACL knee rehab & physical therapy program will minimize re-injury risk

For ACL reconstruction to be successful, a patient must allow enough time for the new ligament to become part of the knee—a process called graft incorporation—and restore the normal muscle strength of the knee to ensure it is properly protected. Physical therapy is therefore necessary during this time to help patients get back to their pre-injury levels and not return to sports until they have completely recovered. A typical ACL rehabilitation program will consist of the following:

  • Strengthening exercises to build back up the weakened muscles of the leg
  • Stretching exercises to increase flexibility and regain normal mobility that may have been lost during the injury and surgery
  • Plyometrics, or jump training, which is crucial for patients recovering from ACL tears
  • Recommendations on how to modify activities to minimize the risk for future injuries
  • Exercises to improve neuromuscular control, which is the body’s ability to stay in a strong and stable position regardless of what movement it’s making

The rehab process after ACL surgery is a long one, as Joe Burrow can attest to. The second-year quarterback for the Cincinnati Bengals tore his ACL in the middle of his first NFL season and has spent the better part of the past year undergoing an intensive rehab program. But the quarterback is now healthy and back on the field, and only time will tell how his knee holds up in the long term.

Rehab your knee with Bacci & Glinn Physical Therapy

If you’ve torn your ACL and are scheduled to undergo surgery, we can help you through every step of your rehab afterwards.

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

Visit our contact page by clicking here for details.

Note: People looking for this content often do these searches too:

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  • Note, we also have an additional office that does ACL rehab in Hanford.

Balance Training in Visalia

 

Looking for a clinic that specializes in balance training in Visalia?  We can help. Read below for more information about our expert clinical services.

Our Physical Therapists Can Help Older Adults Improve Balance To Reduce Their Risk For Falling

As our bodies age, they go through numerous physical and mental changes that can often make life more difficult. One of the most common issues that begins to develop in older age is impaired balance, which can turn basic everyday tasks like walking up the stairs into major challenges that precipitates fear of movement and avoidance of activities.

Having good balance means always being able to control and maintain your body’s position, and it’s necessary for normal physical functioning inside and outside of your home.

A balance disorder, on the other hand, indicates that an individual has trouble maintaining a stable and upright position when:

  • Standing,
  • Walking,
  • Or even sitting.

Older adults are at a much higher risk for having balance disorders than any other age group, as about 75% of Americans aged 70 years and older have “abnormal balance.”

This means that one or more aspects of the person’s balance is out of sync, which can often cause complications.

The risk for balance disorders increases as individuals enter their 70s and 80s due to various age-related changes and other factors, like:

  • Increased muscle weakness,
  • Joint stiffness,
  • Visual Impairments,
  • Inner ear problems,
  • Spending too much time sitting, and
  • The side effects of certain medications.

The greater likelihood of a balance disorder also ties directly into an increased risk for falling, as more than one-third of adults aged 65 years and older suffer from a fall each year. Experiencing a fall and a subsequent injury like a hip fracture can further impair your abilities and infringe on your independence.

Improving Your Balance will Reduce Your Fall Risk

Why do we provide balance training in Visalia and also in our Hanford office?

It’s essential for older adults to take measures that will improve their balance and as a result, reduce their risk for falling. Our physical therapists are great resources for this population because they can prescribe feasible tips to help you achieve a more active lifestyle—a necessary first step—and design personalized programs to mitigate your fall risk.

These fall prevention programs focus primarily on improving balance while also working to increase strength, flexibility, and proprioception (sensing your body’s location in space), which all contribute to fall risk. Specific exercises like the heel-to-toe walk, sit-to-stand exercise, and heel raise are frequently incorporated into these types of programs and can be performed at home as well.

Research Supports Our Balance Training

The benefits of fall-prevention programs have been highlighted in a recent systematic review, a robust type of study that reviewed all the available medical literature on the effectiveness of various programs to prevent falls in older adults. Results showed that programs involving light to moderate exercise training may reduce risk factors related to falls and the incidence of falls in this population.

Researchers also found that the most effective exercise programs were those that accounted for each patient’s specific needs with a personalized approach and recommended that balance training and strengthening exercises should be necessary interventions in any worthwhile fall-prevention program.

Call Bacci & Glinn Physical Therapy Today for Balance Training in Visalia or Hanford

So if you or a loved one has impaired balance and you’d like to take action now, contact Bacci & Glinn Physical Therapy at
559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more about our services or to schedule an appointment today.

Vestibular Therapy in Visalia or Hanford

 

Looking for vestibular therapy in Visalia or Hanford?  Let us explain more about how we can help.

Vestibular Therapy Can Correct Most Balance Problems And Help Re-stabilize Your Life

The vestibular system is the sensory system that provides the brain with the most important information regarding the body’s sense of balance and spatial orientation, which allows it to smoothly coordinate your movements.

This system detects motion of the head—mainly through the inner ear, as well as the eyes, muscles, and joints—and based on this information it generates reflexes that are crucial for completing most daily activities. Some of these tasks include stabilizing our gaze and maintaining the posture of our head and body as you move.

When the vestibular system functions properly, most people are unaware of its existence and don’t think twice when performing physical tasks like walking on uneven surfaces or arising from bed in the middle of the night.

However, when the vestibular system becomes damaged in any way, it leads to a variety of symptoms, most notably dizziness, vertigo, and impaired balance.

There are several causes of dizziness and vertigo, each of which can affect balance in different ways. A condition called benign paroxysmal positional vertigo (BPPV) is one of the more common contributors. BPPV is a disorder of the inner ear that involves tiny calcium crystals, or rocks, which normally help to regulate balance.

Infection or inflammation can cause these rocks to detach and travel to other parts of the inner ear, where they trick the brain into perceiving motion even when the person is at rest. This results in brief periods of dizziness and disorientation that usually occur when lying down, turning over, or looking up.

Targeting the Vestibular System with Specific Exercises

Vestibular therapy is a service we offer to help patients with BPPV and other disorders that cause:

  • vertigo,
  • dizziness, and
  • balance problems.

Each vestibular therapy program is unique depending on which condition is present, but the goal is always to help patients restore their balance and navigate their surroundings more easily.

In each case we start by evaluating all areas of the body associated with balance to determine what condition is present and the degree of impairment. From there, we typically prescribe gaze stabilization exercises, which are designed to keep vision steady while making rapid side-to-side head turns and focusing on an object. This is intended to help the brain adapt to new signaling from the vestibular system.

What We Often Include When Performing Vestibular Therapy in Our Visalia or Hanford Offices

We also frequently prescribe balance retraining exercises, which involve shifting one’s body weight in various directions while standing to improve how information is sent to the brain, and a home-exercise program to help build on the gains made within our clinic

The effectiveness of physical therapy interventions for older patients with vertigo, dizziness, and balance disorders was evaluated in a recent systematic review, which is a robust review of all available medical literature on the topic. This review identified 22 relevant studies and concluded with the following statement after completing its analysis of these studies:

Vestibular rehabilitation in any variation seems to be effective in treating for older adults with vertigo, dizziness, and balance disorders

Come see us to get started on your vestibular therapy program

Therefore, if you’re dealing with a balance issue of any sort, regardless of your age, we strongly recommend coming in for a visit. Our physical therapists can help get to the root of your problem and start you on your way to a more stable life in which impaired balance is no longer a hindrance.

Call Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more about our services or to schedule an appointment today.

HILT and LLLT for Tennis Elbow

Two Types of Laser Therapy Effective For Common Elbow Condition

Lateral epicondylitis is an overuse injury that involves the lateral epicondyle, which is the bony bump on the outside of the elbow. As an overuse injury, it results from repetitive strain and eventual weakening of the muscles in the elbow, which eventually leads to microscopic tears in the tendon that attaches the lateral epicondyle. Individuals with jobs that include lots of gripping or extending the wrist—like plumbers, painters, and contractors—as well as athletes who play tennis and other racquet sports have an increased risk for developing lateral epicondylitis due to the movements used in these professions and sports. For this reason, it is often referred to as tennis elbow.

Various Treatments are Available for Tennis Elbow

Some of the most common treatments for tennis elbow include:

  • Pain-relieving
  • Medications,
  • Injections,
  • Orthotics, Taping,
  • Exercise and
  • Manual therapy.

A Newer Treatment, Deep Tissue Laser Therapy, is Promising

Laser therapy is a noninvasive intervention that’s emerging as another treatment option for various musculoskeletal conditions, including tennis elbow. A laser—an acronym for light amplification by stimulated emission of radiation—is a device that emits light through a process called optical amplification. These lasers are created artificially, and they produce a monochromatic (one color) light of a single wavelength in a very tight, narrow beam.

Low-level laser therapy (LLLT) makes use of these beams of light with the intention of reducing injury-related pain. LLLT utilizes a red infrared light and directs it to areas that are damaged from injury. When this laser targets a painful region of the body, particular changes take place within the cells in a process called photobiomodulation that alleviates pain. High-intensity laser therapy (HILT) utilizes the same principles as LLLT, but with a higher-powered laser, which can penetrate deeper in the body through bone, soft tissue, and muscle. As a result, HILT can stimulate joints at a deeper level and treat a wider area than LLLT, which could potentially be more effective for speeding up the healing process and reducing pain levels.

Both types of laser therapy lead to short-term improvements

Both LLLT and HILT were evaluated in a recent study on patients with tennis elbow. For the study, a sample of 60 patients diagnosed with tennis elbow were randomly assigned to receive laser therapy with either HILT or LLLT. HILT was applied to the painful area of the lateral epicondyle in two phases over three weeks, with the first three sessions (phase I) intended to provide pain-relieving effects and the following six sessions (phase II) intended to provide biostimulatory effects. LLLT was administered to the most painful areas of the elbow with three sessions per week over three weeks. All patients were also instructed to wear strapped bandages, which applied moderate pressure to the forearm muscles through gel pads for additional pain relief.

All patients were evaluated before and after the three-week laser therapy programs for various outcome measures, including hand grip strength, pain levels, quality of life, and physical function. After completing treatment, patients’ scores in both groups improved significantly in all outcome measures assessed.

Better Results for High Intensity Laser Treatment

When results were compared, it was found that the HILT group reported greater improvements in handgrip strength, upper limb function, and quality of life, but the differences were not considered statistically significant. These findings suggest that both LLLT and HILT may be effective for tennis elbow in the short term, with HILT providing slightly greater overall benefits; however, additional research is needed to confirm these results with larger sample sizes and longer follow-ups.

If you’re dealing with tennis elbow or any other painful musculoskeletal condition, you may be a candidate for laser therapy, which we offer at Bacci & Glinn Physical Therapy as a supplemental intervention to a comprehensive physical therapy program.

Contact us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Deep Tissue Laser Therapy for Tennis Elbow

Laser Therapy May Provide Benefits For Your Painful Condition

TLDR;  if you want to try deep tissue laser therapy in Visalia or Hanford for tennis below or other tendinitis diagnosis, give us a call.

In our last blog, we explained that lateral epicondylitis—or tennis elbow—is a painful musculoskeletal condition that occurs most commonly in athletes and other individuals who frequently perform movements that involve lots of gripping or extending the wrist.

We also pointed out that high-intensity laser therapy (HILT) is an emerging treatment option available for sports-related injuries like tennis elbow in which a high-powered laser is applied to painful areas of the body to produce changes within the cells in a process called photobiomodulation. Results from the study featured in that blog found that HILT was more effective than low-level laser therapy (LLLT) for tennis elbow, and other research has also reached similar conclusions.

A Second Study Concludes Deep Tissue Laser Therapy is a Valuable Treatment

Another study focused exclusively on the use of HILT for tennis elbow. In this study, 65 patients with tennis elbow were randomly assigned to either undergo HILT or wear a compression bandage. In the HILT group, a high-intensity laser was applied for 75 seconds to the most painful areas in a circular motion to produce a pain-relieving effect for the first four sessions. In the following six sessions, the laser was applied for 12.5 minutes to the painful areas in a linear motion to elicit a biostimulatory effect. These 10 HILT sessions took place over two weeks. Patients in the other group were instructed to wear a bandage that applied moderate pressure to the elbow for six weeks.

All patients were assessed before and after treatment with various outcome measures. These included an evaluation of hand grip strength, the visual analog scale (VAS) for pain and function levels, the Disabilities of the Arm, Shoulder, and Hand (DASH) score for upper extremity physical functional activity, and the Short-Form 36 (SF-36) survey for quality of life.

Significant Improvements with Deep Tissue Laser Therapy

After completing treatment, patients in both groups reported significant improvements in all outcome measures evaluated. Patients who underwent HILT, however, experienced greater improvements in resting VAS scores and the physical component of the SF-36 survey. These findings suggest that while both interventions were beneficial, HILT may have been slightly more effective than compression bandaging for relieving pain and improving quality of life in patients with tennis elbow. Additional research is now needed to further explore the efficacy of this intervention in the long term.

Deep Tissue Laser Therapy is Available in Our Visalia 0r Hanford Offices

Bacci & Glinn Physical Therapy proudly offers laser therapy as a supplemental intervention to physical therapy for tennis elbow and many other painful conditions.

So if you’re currently dealing with lingering pain, contact us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more about laser therapy or to schedule an appointment.

Exercise Program to Correct Posture for Musculoskelatal Pain

Exercises Intended To Correct Posture Can Effectively Address Painful Conditions

In our last blog, we explained what posture is and reviewed some of negative consequences of practicing poor posture, with a particular focus on forward head posture and rounded shoulders. We also pointed out that many modern habits—like sitting at a desk and using a computer or smartphone—are big contributors to poor posture because these activities encourage improper alignment of the spine and other body parts.

Technology Often Doesn’t Promote Good Posture

If you use a computer for work or tend to spend lots of time on your phone, it might be easy to see why this is the case. Working on a computer requires being in a seated position for extended periods every day, and it’s difficult to maintain proper posture for all—or even most—of this time. Instead, many individuals tend to change their posture frequently throughout the day by slouching, leaning too far back, or crossing their legs to stay comfortable.

Repeated Positions Lead to Bad Habits

The longer the body is out of postural alignment, the easier it becomes to continue these habits, and the greater the risk grows for pain and deformity. Over time, poor postural habits can negatively affect the bones, muscles, and joints supporting the spine and lead to imbalances that limit movement and make normal exercise difficult. Poor posture will also prevent these supporting structures from functioning properly and can go on to cause appearance issues, musculoskeletal pain, and physical restrictions.

Investigating posture-correcting exercises for pain

This highlights the importance of practicing good posture to maintain the proper arrangement, balance, and function of the body’s structures, and shows why taking steps to correct posture are key to optimal overall health. With this in mind, a study was conducted to evaluate the effectiveness of an exercise program designed to correct posture on patients with musculoskeletal pain.

Patients with various types of musculoskeletal pain were screened for inclusion, and 88 of those screened were included in the study. Each of these patients completed an exercise program, which consisted of three 20-minute sessions per week for eight weeks. The first week of the program included stretching exercises intended to improve flexibility of the calves, spine, shoulders, and other regions of the body. The remaining seven weeks included a variety of additional exercises and activities designed to correct posture, such as a lower muscle strengthening exercise, an abdominal muscle strengthening exercise, and head and neck stretching exercise. These patients were assessed before and immediately after the exercise program for pain levels in the neck, shoulders, middle back, lower back, and pelvis by using a 10-point scale.

Physical Therapist Guided Exercise Again is Helpful

Results indicated that the average pain scores were lower after the exercise program in all regions of the body assessed. Of these, the values for shoulder pain, middle back pain, and lower back pain were statistically significant, meaning that these improvements were important enough to support the effectiveness of this intervention. Based on these findings, it appears an exercise program that focuses on correcting posture can alleviate pain in patients with various types of musculoskeletal pain. Physical therapists are movement experts and professionals at identifying postural faults and addressing them with appropriate, individualized exercise programs.

We Can Help You Correct Posture Problems

Therefore, if you’re currently suffering from pain of any sort that may be related to your posture, we strongly encourage you to come in and see us for an evaluation. Contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to schedule an appointment today.

Stabilization Exercises and Manual Therapy for Posture

Hands-On Therapy Plus Targeted Exercises Improves Posture And Reduces Pain

Posture is the position and orientation that each part of your body is in, both when you’re moving and while at rest. Good posture means your muscles and bones are in a state of balance that protects these structures from injury and deformity, and it is primarily characterized by a straight spine that maintains the natural curves of the body. Poor posture, on the other hand, is the improper alignment of various body parts, which can result in increased strain and less efficient balance of the body over its base of support. Any sustained position that places the body in a state of misalignment can contribute to poor posture, such as slouching with the shoulders hunched forward, keeping your head held too high, or looking down too frequently.

Head Forward Posture Needs to be Addressed

One of the most common postural faults is called forward head posture, which can be found in about 66–90% of the population. Forward head posture is a state in which the head is slanted in front of the shoulders by an inch or more instead of directly over the shoulders, where it should be positioned. Other names for forward head posture include “text neck” and “nerd neck” because common culprits include spending too much time bending toward a computer screen and craning the neck downward to look at a smartphone.

Don’t Work Your Postural Muscles so Hard

Forward head posture forces the muscles of the neck to work harder to hold up the head, and the further forward it’s positioned, the harder these muscles have to work. Over time, overworking these muscles can lead to muscle imbalances as the body tries to adapt while figuring out other ways to hold the head up straight. Excessive forward head posture may also lead to reduced flexibility of the neck—particularly when rotating and flexing the neck—and can have a negative impact on balance.

Rounded Shoulders – Another Easy Fix

Another related postural issue is rounded shoulders—or “mom posture”—which is when the resting position of the shoulders is too far forward from the body’s ideal alignment. As with forward head posture, rounded shoulders often result from extended periods of slouching with the shoulders positioned too far forward and downwards. When combined with forward head posture, it can lead to further strain and cause shoulder pain and dysfunction.

Strengthening exercises and hands-on therapy could be a solution for posture issues

These types of postural faults can effectively be addressed through exercises that increase muscle strength and stability, as well as manual (or hands-on) therapy techniques that improve range of motion and alleviate pain; however, research on the combination of these interventions for improving posture is limited. Therefore, a study was conducted to evaluate the effectiveness of a physical therapist-led treatment program that combined stabilization exercises with manual therapy for patients with forward head and rounded shoulder postures.

Research Supports Specific Exercises…Again

After being screened for inclusion, 60 patients were randomly assigned to 1 of 3 groups: Group 1 performed stabilization exercises and received manual therapy, Group 2 performed stabilization exercises only, and Group 3 performed home exercises only. Each of these programs lasted for six weeks. A physical therapist guided patients through the stabilization exercises, which were performed three times per week for the six weeks and were designed to increase the strength and flexibility of the neck muscles. Manual therapy was performed by a manual therapist and focused on increasing the range of motion of the neck muscles through a series of manipulations. Group 3 served as the control group and performed a basic home exercise program three times per week that was intended to improve posture during daily activities. All patients were assessed before these interventions, immediately afterwards, and then one month later with several outcome measures related to pain and function.

Manual Therapy by a Physical Therapist is Even Better

Results showed that pain and function significantly improved in Groups 1 and 2 after completing the treatment program, and these improvements were maintained at the one-month follow-up. When compared to one another, it was found that patients in Group 1 experienced greater benefits in pain and function than Group 2. This suggests that the addition of manual therapy added to the positive effects from the stabilization exercises, which was likely the result of improved range of motion and reduced swelling and inflammation that resulted from manual therapy.

Exercise & Hands-on Care by a Physical Therapist Help

Additional research is needed to confirm these findings, but it appears that a physical therapist-led program that combines manual therapy and neck stabilization exercises is beneficial for patients with forward head and rounded shoulders posture.

Call Us Now for Help with Your Posture

So if you’re dealing with any neck or shoulder pain and feel that your posture is not quite ideal, Bacci & Glinn Physical Therapy can help. Contact us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to schedule an appointment today.

Surgery vs. Physical Therapy for Shoulder Pain

Surgery And Physical Therapy Lead To Very Similar Outcomes
For Older Patients With A Rotator Cuff Tear

The shoulder is one of the most common sites for pain in the body, ranking only behind the back and knee in overall prevalence. Shoulder pain becomes even more common later in life, with many older adults complaining of restricted shoulder mobility that interferes with their ability to complete overhead tasks as they age.

Tears of the rotator cuff—a group of four muscles and tendons that wrap around the shoulder—are particularly common in this population, with about 30% of adults over the age of 60 experiencing this injury. Rotator cuff tears are associated with significant disability, and many patients therefore turn to surgery to alleviate pain and help them regain physical function. However, it’s unclear whether surgery leads to better outcomes than a nonsurgical approach such as physical therapy.

Physical therapy versus two surgical procedures

With this in mind, researchers performed a study to compare patients with a rotator cuff tear who had physical therapy to those who underwent one of two types of surgery. All 150 patients included were older than 55 years and had a confirmed, full-thickness tear of a rotator cuff tendon called the supraspinatus. Patients were then randomly assigned to one of three treatment groups: 1) physical therapy, 2) acromioplasty and physical therapy, or 3) rotator cuff repair, acromioplasty, and physical therapy.

Patients in the physical therapy treatment group were guided by a physical therapist through a standardized exercise training program that was to be completed at home. The first six weeks of the program aimed to increase the range of motion of the shoulder and then progressed to focus on muscle stability and function until the 12-week mark. Patients then increased the intensity of their strength training further for up to six months and participated in 10 in-person sessions with the physical therapist as a supplement to the at-home program.

The acromioplasty and physical therapy group underwent a procedure in which the acromion—a bony protrusion of the shoulder blade—is made smoother with surgical instruments. Afterwards, patients completed the same physical therapy program as the first group. The third group underwent a repair of the torn rotator cuff, plus the acromioplasty procedure, and then finally completed the physical therapy program. All patients were assessed before the interventions and then at regular intervals over five years for various outcome measures.

Patients should take into account these findings when considering surgery

After five years, there were no significant differences between patients in either of the three treatment groups, and surgically repairing the supraspinatus did not lead to any notable improvements, as researchers had expected. Therefore, according to these findings, it does not appear that surgery is any more effective for treating rotator cuff tears than physical therapy.

Seeing One of Our Physical Therapists is the Best First Choice

So if you’re dealing with shoulder pain and surgery is suggested as a possible avenue forward, we strongly recommend considering these findings and the limitations of a surgical approach when making your decision.

And for a hands-on, evidence-based, and personalized physical therapy treatment program for your shoulder pain, contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to schedule an appointment today.

Why a Shoulder MRI Often Isn’t That Useful

MRIs Of Both Painful And Non-Painful Shoulders Are Similar,
Which Questions The Usefulness Of These Tests

Shoulder pain is the third most common musculoskeletal condition, as up to 67% of individuals will experience it at least once in their lifetime. When pain in the shoulder occurs, the traditional approach is to identify its source through diagnostic testing and then treat the injury appropriately. MRI scans are frequently used during this process because they provide highly detailed images of shoulder structures, but more recently, some experts have questioned whether these tests are helpful or even necessary.

The primary reason is that abnormal findings from MRIs do not always correlate with pain, and some patients with no signs of pain display so-called “abnormal” MRI results. This has led researchers to take a closer look at MRIs of individuals both with and without shoulder pain to help determine the reliability of these tests when making a diagnosis or treatment decisions.

Comparing both shoulders in patients with pain in one shoulder

One study took a unique approach by comparing MRI scans of both shoulders in patients with shoulder pain in only one shoulder. For the study, 123 individuals with chronic shoulder pain for an average of three years were recruited and accepted to participate. The average age of participants was 39.4 years, with 15 individuals being aged 60 years or older. All patients underwent an MRI of both shoulders, and two healthcare professionals—a radiologist and a shoulder surgeon—interpreted the findings from these scans independently.

Results showed there was a high prevalence of structural abnormalities in both shoulders of these patients. For example, the radiologist identified complications with the rotator cuff and one of the major shoulder joints in both shoulders for about 90% of patients, while the surgeon found these issues in about 75% of patients. In addition, no significant differences were detected in the prevalence of abnormal MRI findings between the painful and non-painful shoulder, except for one type of injury.

The source of your pain may be something else

These findings suggest that MRI results may not always indicate the source of pain in many patients with shoulder pain, since abnormal findings were also found to be very common in shoulders with no symptoms. Therefore, despite the frequent use of MRI for shoulder pain, it may not be the most effective way to diagnose these injuries. Of particular concern is that focusing exclusively on MRI findings can lead to costly and risky interventions like surgery being performed unnecessarily, even if the pain is not related to these findings.

Try conservative, natural care first

Physical therapists, on the other hand, treat most cases of shoulder pain from the first visit and rarely order MRIs unless it’s deemed completely necessary. This saves patients time and money, which allows them to start their path towards improvement immediately rather than being held back by MRI findings that may not truly reveal the reason behind their shoulder pain. So if you’re dealing with shoulder pain, we strongly recommend seeing a physical therapist at Bacci & Glinn Physical Therapy before having an MRI.

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

Orthotics Prescribed By A Physical Therapist May Be A Simple Strategy For Foot Pain

The way that your feet connect with the ground has a major impact on how you walk or run and if you’ll experience pain when doing so. The feet are the foundation when walking or running, and if they strike the ground incorrectly during these activities, it can start a chain reaction that leads to problems elsewhere in the body. To address potential problems like foot and ankle pain, orthotics may be recommended to alter the way your foot contacts the ground and correct any imbalances that might be interfering with your stride.

Foot orthotics are molded pieces of rubber, leather, plastic, or synthetic materials that can be inserted into many types of shoes and then worn normally. They are available in various lengths, sizes, and styles, and range from over-the-counter to fully customizable, giving individuals a wide range of options to choose from. The main purpose of orthotics is to support and stabilize the feet by correcting any imbalances in each foot and more evenly distributing one’s bodyweight.

Orthotics Can Benefit Many that are in Pain

Orthotics are usually prescribed for people who are already suffering from foot and/or leg pain, but they may also be recommended to prevent problems from occurring down the line. Two of the more common conditions addressed with orthotics are plantar fasciitis and Achilles tendinitis:

  • Plantar fasciitis occurs when the plantar fascia ligament—which connects the back of the heel to the front of the toes—becomes inflamed or irritated, leading to a stabbing or jabbing pain over the arch and under the heel of the foot
  • Achilles tendinitis is inflammation of the Achilles tendon, which connects the calf muscles to the back of the heel and allows you to stand on your toes when walking, running, or jumping; this leads to pain, stiffness, and/or swelling at the back of the heel or directly above it

For some patients, orthotics can help to address issues with foot shape—like flat feet or high arches—that may be responsible for plantar fasciitis and other foot-related issues. Orthotics may also be recommended for conditions like shin splints, knee pain, back pain, bunions, hammertoe, and calluses, as well as for individuals who are older, overweight, or have diabetes.

Expert advice on orthotics from our physical therapists
If you’re thinking about giving orthotics a try, the physical therapists at Bacci & Glinn Physical Therapy can help you navigate this process. One of the biggest challenges patients face is choosing the right type of orthotic for their foot type, since there is an abundance of options to choose from. But our physical therapists can evaluate your foot type, gait, and whether you’re dealing with any foot or heel pain, and then recommend the best type of orthotic, which are usually categorized into the following three groups:

  • Heel cups
    • The smallest and simplest type of orthotic
    • Can be easily inserted into most types of shoes
    • Made of gel, silicone, or plastic
    • Can alleviate pain from plantar fasciitis, Achilles tendinitis, and other conditions by absorbing shock and reducing tension on painful structures
  • Orthotic insoles
    • Provide arch support and cushioning for some or all of the foot
    • Ideal for correcting foot shape issues like flat feet or high arches, which may be contributing to heel pain
    • Available in full length, 2/3 length, or 1/2 length sizes
    • Can be customized or purchased over the counter
    • Worn during the day
  • Night splints
    • Treat heel pain related to plantar fasciitis throughout the night
    • Hold the foot and toes back so the calf muscles, Achilles tendon, and plantar fascia are kept slightly stretched
    • Simple and effective way to alleviate heel pain that strikes in the morning with the first steps of the day
    • Available in a boot style cast, sleep supports, and sock style supports

For additional guidance on selecting the right foot orthotic, contact:

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

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