Physical Therapy Care Archives - Page 3 of 3 - Bacci & Glinn Physical Therapy

Direct Access Over Physician Referral

Before aggressive treatment with potentially harmful side effects, here’s why you should consider physical therapy

If you hurt yourself or start noticing any sort of pain, there are many decisions you’ll have to make next. Do you avoid physical activity or movements that might aggravate the pain? Do you put ice or heat on it, or take any medications to reduce your pain level? If the pain doesn’t improve after a certain period of time, do you see a professional for treatment? And if you do decide to see someone, who will it be?

It may be difficult to find the best answers to these questions, especially the last one about who to see first for treatment. As a result, many people will end up scheduling an appointment with their primary care doctor, since it probably seems like the safest and most familiar choice when something is wrong. While primary care doctors are expected to always provide patients with the best possible treatments, it doesn’t guarantee you’ll receive treatment from a physical therapist.

Physical therapists are movement experts that are trained to optimize patients’ quality of life through carefully designed exercise and educational treatment programs. They treat a wide variety of injuries and conditions, but the most common symptom that they address is pain, and research consistently shows that physical therapy is effective for reducing it.

This is why most guidelines recommend that anyone in pain sees a physical therapist as a first-line treatment for their condition. Patients can either go straight to a physical therapist because of direct access—which allows anyone to at least have an initial consultation without a referral in all 50 states—or they can go their primary care doctor or some other medical professional and possibly get referred to therapy. Primary care doctors are strongly encouraged to direct patients with painful conditions involving the muscles and bones to physical therapy, but this does not always occur as it should.

Study highlights a major issue with the referral system for physical therapy

One of the many conditions that can benefit from physical therapy is knee osteoarthritis (OA), which has doubled in prevalence in recent years (at least 15 million Americans currently have it). As with other issues, many patients with knee OA visit their primary care doctor first, which may or may not lead to a physical therapy referral. To evaluate how many patients with knee OA are actually being referred and what other treatments patients receive, a study was conducted. Below are some highlights from its results:

There were 2,297 visits with a primary care doctor, surgeon, or another specialist
There was a significant decline in the number of referrals to physical therapy from orthopedic specialists over three years
The number of primary care doctors that referred patients to physical therapy was low and did not change in any significant way over three years
There was a non-significant increase in narcotics prescriptions and a significant increase in the number of non-steroidal anti-inflammatory drug prescriptions

This study shows that many doctors are not referring patients to physical therapy, and that the trend is actually going in the wrong direction, with an increase in pain medication prescriptions and a decrease in therapy referrals. That’s why the best way for patients in pain to avoid the risk of not getting referred is by taking matters into their own hands and accessing physical therapy directly.

Plantar Fasciitis Treatment in Visalia

IF YOU ARE LOOKING FOR PLANTAR FASCIITIS EXPERT IN VISALIA, WE TREAT A VARIETY OF INTERVENTIONS FOR PESKY HEEL PAIN

If you’ve ever experienced a piercing pain in the bottom of your foot the first thing in the morning, there’s a strong chance plantar fasciitis was to blame. Before you start taking pills, you should consider seeing one of our plantar fasciitis experts in Visalia. As one of the most common causes of heel pain in existence, plantar fasciitis can strike people who exercise too much just as easily as those who wear the wrong pair of shoes. But whatever causes it, most patients would agree that it’s a pesky problem that they’d prefer to eliminate.

The plantar fascia is a thick band of tissue that runs across the bottom of your feet and connects the heel bone to the toes. Its primary purpose is to absorb the majority of the stresses we put on our feet, but it has a limit: too much pressure or strain can damage the tissue and lead to inflammation in that region.

This inflammation results in the most typical symptom of plantar fasciitis: a stabbing pain near the heel that’s usually worse with the first few steps of the day or after standing for a long period of time. Plantar fasciitis is particularly common in long-distance runners, but can stem from repeatedly performing any weight-bearing activities or spending too much time standing every day. People who are overweight, older than 40, and those who have high arches or flat feet are also at an increased risk of developing plantar fasciitis.

As is the case with any other painful condition, trying to push through or ignore plantar fasciitis can go on to cause chronic (long-term) heel pain and may result in pain in other parts of your body if you alter the way you walk. The good news is that most cases of plantar fasciitis with some basic modifications, such as the following:

Limit or completely stop the activity that led to pain in the first place
Ice the bottom of your foot for 20 minutes, 3-4 times a day
Avoid walking around barefoot, which puts more strain on the foot
Purchase a new pair of supportive shoes with good arch support

If your pain doesn’t improve within a few weeks after making these changes, your next step should be to see a physical therapist, who can address the issue with a number of interventions and techniques. In addition to stretching and strengthening exercises, your treatment program is also likely to include manual therapy, in which the therapist uses their hands to perform a variety of movements and mobilizations to the muscles and soft tissue of the heel that will release muscle tension and reduce pain. There is strong evidence that shows manual therapy techniques to be beneficial for plantar fasciitis, including one study published last year, which concludes as follows:

According to reviewed moderate and high-quality randomized-controlled trials (high-quality studies), soft tissue mobilization is an effective modality for treating plantar heel pain (another term for plantar fasciitis)

In light of this information, we encourage you to seek out physical therapy if you’re experiencing any symptoms that suggest plantar fasciitis is present. Taking this step will put you on a path to recovery and a future with less pain.
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Prevent the cycle of ankle sprain recurrence by taking action now

Our ankles serve one of the most important roles of any of the body’s joints by supporting the weight of our entire body. With such a heavy task at hand, the ankles are also one of the most frequently injured regions, and ankle sprains are at the top of that list.

Ankle sprains result from the stretching or tearing of ligaments in the ankle and usually lead to some degree of pain, swelling, and tenderness. They are the most common injury in the athletic population, accounting for approximately 45% of all sports injuries. They are most frequently seen in basketball, football, and soccer, but can occur during any sport or activity when the ankle moves beyond its normal range of motion.

Ankle Sprains Usually Heal Quickly

Fortunately, the pain from ankle sprains will typically subside after 4-6 weeks if the patient follows the RICE protocol (Rest, Ice, Compression, and Elevation) and does not aggravate the injury further. But if the ankle sprain is not properly rehabilitated, it can lead to decreased range of motion of the ankle joint, particularly a loss of dorsiflexion motion (raising the foot upwards). This can lead to not only recurring ankle sprains, but excess stress on the knees, hips, and even the lower back, which may all be forced to overcompensate for the bad ankle in order to allow the body to move normally.

Physical Therapy Can Help in More Ways than One

For patients that do fail to recover properly from an ankle sprain and go on to experience additional sprains or other injuries, physical therapy can help prevent the problem from getting any worse with a targeted treatment program that typically includes:

Stretching exercises 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

Prevention Should Be Part of Your Plan

But taking it a step further, physical therapy can also help individuals prevent a first ankle sprain from occurring altogether with a similar type of program designed specifically to prepare the ankle for increased stress loads. Athletes involved in some of the high-risk sports mentioned particularly stand to benefit from these types of program, which have been supported by research as effective for reducing the risk for ankle sprains. One study published in 2017 evaluated the effectiveness of proprioceptive exercises (which improve ones sense of where their body is in space) for preventing ankle sprains, and concluded:

Proprioceptive training programs were effective in reducing the incidence rates of ankle sprains in the athletic population, including those with and those without a history of ankle sprains

So if you’re concerned with your risk for ankle sprains and would like to reduce it, or if you’ve already suffered from a sprain and would like it to be your last, take action now by connecting with a physical therapist and addressing you risk head-on.

Herniated Disc Treatment in Visalia

If you have neck pain that radiates into your shoulder and/or down your arm, you may have a herniated disc. If so, then of course you’re likely to be looking for a specialist – one that provides herniated disc treatment in Visalia.

Successful Treatments for Cervical and Shoulder Pain – Physical Therapy Offers Relief

A common problem treated in Physical Therapy clinics is cervical pain combined with shoulder pain. The patient may experience radiculopathy into either upper extremity, or pain radiating proximally into the suboccipital region or distally into the spine. As with all effective treatment, addressing the cause of the problem leads to fast, effective relief for our patients.

A primary cause of cervical and shoulder pain is poor posture. Many patients we treat work at a desk or computer terminal for eight or more hours a day, or 2,000 hours per year. With time his or her posture will break down resulting in a forward head, rounded shoulders, and increased thoracic kyphosis. If this process is not addressed, the patient may eventually experience degenerative cervical changes, cervical apophyseal disease, tightening of the anterior cervical musculature, rhomboid and upper trapezius muscle spasms and other permanent postural changes.

Poor Posture Causes Other Problems

Poor postural habits change the angle of the resting scapula on the thoracic cage. This leads to impingement of the rotator cuff muscles (especially the supraspinatus) with shoulder elevation.

Try this yourself:

Sit with good posture. Shoulder blades are pulled back and down. Low back is slightly arched into lordosis. Eyes are looking forward and level. Chin is up. Raise your arms as high as you can. This typically is close to 160 degrees or near vertical.
Now sit with poor posture typical of patients we see in our treatment or exam rooms. Slouch your low back. Round your shoulders forward. Let your chin and eyes drop forward. Now try and raise your arms overhead. Most people will experience a 60 degree decrease in range of motion or more.

Thoracic Outlet Syndrome is the peripheral entrapment of the brachial plexus producing symptoms often mistake for shoulder tendonitis, elbow tendonitis, nerve root pain or musculoskeletal pain of the neck and shoulder.

The Journal of Shoulder and Elbow Surgery (1995:4: 113-117) and JAMA (2004;196: 109-111) reported Thoracic Outlet Syndrome is suspected in cases of a patient history involving upper extremity heaviness or numbness with prolonged postures such as sitting and when laying on the involved side.

Wrist Fracture Exercises After the Bones Have Healed

After a fracture has healed, wrist fracture exercises are an important part of the overall recovery process. We’ve seen some patients lose function because they didn’t receive any physical therapy after their Smith or Colles fracture. Don’t let this happen to you or a loved one.

Here’s more information on wrist fractures:

The wrist is made up of 15 different bones, each of which can get injured if the joint sustains a force that’s significant enough. But some of these bones are more likely to become injured than others, and the term “broken wrist” usually refers to a fracture of the distal part of the radius. These injuries can be serious and possibly even require surgery, but regardless of the treatments used, a course of physical therapy will be essential to ensure a complete recovery.

The radius is located on the thumb side of the wrist and is the larger of the two bones that make up the forearm. Along with the ulna, these bones permit movements of the elbow, hand, and wrist, and the distal radius takes on a great deal of the load that is sent to the wrist. This is one of the main reasons the distal radius are one of the most common injuries in the body. Of all fractures seen in the emergency room, about one-sixth are distal radius fractures. If you’d like to read more about these fracture types in our medical library, click here.

The vast majority of distal radius fractures occur after someone falls and lands with their hands outstretched, which is often called a “fall on an outstretched hand,” or FOOSH injury. Falls in sports like soccer and basketball, as well as biking, skateboarding or rollerblading accidents can all lead to a distal radius fracture if the person lands with enough force. These injuries are usually categorized depending on how the person lands on the wrist, as either a Colles’ fracture or a Smith’s fracture:

Colles’ fracture: these injuries are caused by a fall onto the palm of the hand, which places the wrist in an extended position; the result is a fracture of the distal radius and possibly the ulna
Smith’s fracture: also known as the reverse Colles’ fracture, these injuries occur from falls onto the back of the hand with the wrist in a flexed position

After a Colles’ or Smith’s fracture, the initial treatment for most patients is a reduction, in which the broken bone(s) are situated back into the correct position so that healing can occur. A doctor usually performs the reduction manually, but surgery may be needed if a bone is displaced too far out of position. Reduction is typically followed by a period of immobilization in a cast or brace that must be worn for 4-6 weeks. Regardless of whether or not surgery is performed, a course physical therapy is crucial both during and after the immobilization period to ensure a proper recovery.

Expert Suggestions About Wrist Fracture Exercises After the Break has Healed

While the wrist is still in a cast, a physical therapist can prescribe some gentle exercises the keep the shoulder, elbow, and fingers moving so that these joints don’t lose their flexibility. After the cast is removed, the wrist usually feels stiff and the arm feels weak, so your physical therapist will prescribe some post-injury wrist fracture exercises to address these issues and restore the function of your wrist. This usually includes manual (hands-on) therapy, ice and heat therapy, stretching and stretching exercises, and sport-specific exercises when applicable.

The effectiveness of physical therapy for treating patients with wrist fractures can be seen in the findings of a study published in 2017. Patients who experienced a distal radius fracture were randomly assigned to undergo either a home-exercise program or a supervised physical therapy program, and the results were as follows:

A supervised physical therapy program is effective in the short and medium term, showing a clinically and statistically significant increase in function. This treatment also reduces pain and improves wrist range of motion ROM compared with a home-exercise program.

Colles’ and Smith’s fractures are common injuries that should not be taken lightly, as failing to properly rehabilitate them can lead to long-term issues. This is why all patients should see a physical therapist and complete a comprehensive treatment program to guide them back to full strength.

Laser Therapy in Visalia – A New Approach to Pain Relief

If you’re dealing with a painful condition, laser therapy may provide the relief you’re looking for.

When you think about lasers, physical therapy might not be the first thing that comes to mind. But with recent technological advances, laser therapy is now emerging as a promising new intervention used by some physical therapists to treat a wide array of painful conditions.

The term “laser” is actually an acronym for light amplification by stimulated emission of radiation, and lasers are devices that emit 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) is a non-invasive treatment that makes use of these beams of light for the purpose of reducing pain related to an injury or condition. LLLT utilizes a red infrared light and directs it to areas that are damaged from injury. When this laser is targeted upon a painful region of the body, particular changes take place within the cells in a process called photobiomodulation. When used properly and appropriately, the expected result of this process is less pain.

High-Intensity Laser Therapy is What We Offer for Good Reason

High-intensity laser therapy (HILT) is based on the same concepts as LLLT, but as the name suggests, it uses a higher-powered laser. This higher power and use of a particular wavelength allows the laser to penetrate deeper in the body through bone, soft tissue, and muscle. As a result, HILT can stimulate soft tissues at a deeper level and treat a wider area than LLLT, which could possibly make it even more effective in speeding up the healing process and alleviating pain.

HILT has been approved by the FDA and there are no known side effects when it is used by a properly trained professional like the physical therapists here at Bacci & Glinn Physical Therapy. Because it is a newer treatment, new studies are starting to emerge about its effectiveness. In fact, researchers recently performed a powerful two-part study called a systematic review and meta-analysis to determine how effective HILT was for treating painful disorders. They concluded with the following statement:

The results of this study showed that HILT treatment for back and neck pain significantly improved pain and functional disability compared to controls.

While additional research will help to further define the role of HILT and its potential benefits, this high-quality study supports its use for two of the most common painful conditions out there.

Come Try Our LightForce™ Laser Therapy

We use a specific brand of laser therapy called LightForce™ Laser Therapy. It’s one of the best units available on the market. So, if you’re dealing with neck or back pain—or any other type of pain—and have a condition that isn’t responding to conventional medical treatment, you may want to consider HILT.

The Best Physical Therapy in Visalia – Why We’re On The Cutting Edge

There are many factors to consider when looking for the best physical therapy in Visalia or Hanford. Here are four reasons why we feel our physical therapists are some of the best in the Central Valley.

One way to judge a practice and its clinicians is by their online reputation – we have a great reputation on Google
Another is how long the practice has been in business – we’ve been here for almost 40 year.
A third is their academic credentials – our staff have earned doctoral degrees in physical therapy.

Then There’s Another Way and Here’s a Great Example…

Another way to judge the quality of a practice is to ask if they are up-to-date on the latest clinical research. This means considering new information about physical therapy treatment and how to educate our patients based on the new data, so we can continue to deliver the best care possible.

For this post, we are sharing information from a recent research study that challenges social thoughts on the prevention of lower back pain. Here’s a question that a recent scientist asked:

What if lifting with what has been considered ‘improper form’ isn’t as bad for the back as most people think?

From the first time you’ve ever had to lift anything of substantial weight and been in the presence of someone else with more experience in the field of lifting, you’ve probably been instructed to use “good form” so you don’t “throw out your back,” or something of the sort. By now, there’s actually a good chance that you have provided the same advice to others as well, so that they may also benefit from the ideal lifting posture and save themselves from back pain. But a recently published study has investigated the safety of back posture and found that while most people seem to believe in its importance, the evidence to support it as the best approach to lifting is not that strong.

To review, the “good lifting posture” that most of us are taught and try to practice usually consists of the following:

Bending from the knees instead of the waist
Lifting primarily with the power of the legs
Keeping your back straight and avoiding a “rounded” back
Always facing towards the object you intend to lift
Keeping the shoulders and hips square

There may be some slight variations to this technique, but most lifting guidelines drill the importance of keeping the back straight and lifting with the legs rather than the back to prevent strain. Knowing this, a team of researchers conducted a study to investigate how deeply ingrained these beliefs on lifting posture were in the average person and what the research had to say about it all.

To perform the study, researchers recruited individuals who did not have any episodes of low back pain (LBP) in the past year. This search led to 67 participants being included, 11 of which had experienced LBP at least once in their lives, and the rest of which had no history of it. These participants were then instructed to complete a series of tests and questionnaires that were designed to gain insight into their thought process regarding lifting posture and safety.

Most participants think lifting with a rounded back is dangerous, but it’s not clear if this is accurate

The results showed that most participants displayed an implicit—or automatic—bias towards thinking that bending and lifting with a “round back” were dangerous behaviors. This suggests that these individuals had pre-existing beliefs regarding how a person lifts and that it was likely to have a negative impact on them. Additional analysis found that the beliefs of bad lifting posture being dangerous were also represented explicitly, meaning that participants were aware of this position and held it intentionally, too.

The concept that lifting with a straight back is good and a rounded back is bad comes from prior studies on the topic that eventually became common practice. But when researchers reviewed this evidence, they found that it was not as strong as might be expected. The author of one of the original studies later stated that the differences between a straight back and rounded back postures were only minor, while other studies have found no significant difference between the two lifting techniques. In addition, several other studies have been unable to find a connection between lifting and the development of LBP.

This does not necessarily mean that lifting with either a rounded or straight back is better than the other, but it does suggest that the beliefs most of us have on “proper lifting posture” may not be based a great deal of evidence. Additional studies on the topic will help us to better understand if there is a connection between lifting and LBP, and if the guidelines on how to lift should be changed. In the meantime, if you are experiencing LBP or any other type of pain right now, the best choice you can make is to see a physical therapist first and fast. Doing so will address your issue and get you back to being yourself without pain in no time.

To Recap, to be considered one of the Best Physical Therapy Clinics in Visalia, You Need Stay Up-To-Date

This is why we are always asking questions about how we treat and educate our patients as well as look for new treatments like our laser therapy as an example.

If you are looking for exceptional care in a family-friendly environment, consider seeing one of our physical therapists. We bet you’ll have a great experience and hope you will be our next success story.

Click here for to learn more about how to contact us to set up an appointment.

Hip Replacement Rehabilitation in Visalia

Physical therapy is crucial for getting back on your feet after hip replacement surgery. The good news is Bacci & Glinn Physical Therapy specialize in hip replacement rehabilitation in Visalia and Hanford.

Hip Replacement or Hip Arthroplasty Can Alleviate Severe Pain But…

Hip replacements have consistently grown in popularity to become one of the most frequently performed orthopedic surgeries. Since first being introduced in 1960, the technique and the prosthesis used have been continually improved upon and perfected over time. All along, the goal has been to help patients recover more quickly and with less pain, so they can get back to doing the things they love.

Hip replacement surgery—which can be either partial or complete— is used to treat patients with severe osteoarthritis or a hip fracture after all other conservative (non-surgical) treatments have failed. The procedure removes damaged bone and cartilage from the painful hip and replaces it with a prosthetic, or artificial hip. If successful, the end result will relieve pain, improve joint mobility and restore or improve a patient’s ability to safely perform daily activities like walking, standing, and climbing stairs.

The surgery itself, however, is not the end of the story. In order to have a successful recovery, it’s incredibly important that the patient follows a course of physical therapy following the hip replacement. Physical therapy is a necessary component of the recovery process that will help patients regain their flexibility, build back their strength, and gradually return to everyday activities.

Highlights of hip arthroplasty rehabilitation in Visalia

In most cases, a physical therapist will come to the patient’s bedside on the first or second day after surgery to begin post-operative treatment. This period of time is called the acute phase of recovery, and the therapist will help you with tasks like turning in bed and rising to a sitting position, getting out of bed to stand, and walking with an assistive device like a walker or crutches a short distance. The therapists will also begin some gentle exercises to increase flexibility and strength at this time.

Some time after being discharged from the hospital, patients will begin an outpatient treatment program at a local clinic will begin. During this time, physical therapists will continue to focus on helping patients with walking and stair climbing, balance, full movement of the leg and new hip, and transferring to the bed, chair and car. They will also incorporate specific muscle strengthening to improve the patient’s ability to stand and walk safely and independently.

Sometimes a Good Home Program is All That is Needed

In some cases, our physical therapist may have enough confidence in a patient to prescribe an unsupervised rehabilitation program to be performed at home. While less capable patients may require the specific guidance of a physical therapist at the clinic, a recent study has shown that both supervised and unsupervised treatment programs can lead to similar results after surgery:

The results demonstrated that outcomes in response to rehabilitation after hip total replacement surgery are clinically and statistically similar whether the program was supervised or not. The results suggest that early rehabilitation programs can be effectively delivered unsupervised in the home to low-risk patients discharged home after surgery.

Patients who are scheduled to have a hip replacement surgery are therefore encouraged to confirm that physical therapy is part of their recovery plan, and to participate in it fully in order to experience the best possible outcomes.

When a Home Program Isn’t Enough – Give Us a Call

If the home program isn’t enough to get you back to walking normally or you don’t have good pain relief after the procedure, then total hip replacement physical therapy program may be for you. Contact us for additional information and details. We accept most insurance plans and can usually get you in within a few days.

Fall Prevention Program in Visalia – Reduce Your Fall Risk

Staying active and physical therapy can help reduce your risk for falls

Falls are the leading cause of both fatal and non-fatal injuries in older adults, and as a result, they threaten seniors’ safety and independence in major ways. This is exactly why we offer a fall prevention program in Visalia.

Approximately one-third of Americans aged 65 and over falls each year, which results in more than 2.4 million injuries treated in emergency rooms. Most fractures among older adults are caused by falls, with over 95% of hip fractures resulting from a fall of some sort.

A fall can occur for a number of reasons, but they are often due to a combination of internal and external factors. Poor vision and/or balance in an environment with bad lighting, bad footing or slippery surfaces can be a recipe for a fall, and environmental hazards are responsible for at least one-third of all falls, both in and out of the house.

If a fall does occur, many people unfortunately go on to develop an even greater fear of falling, even if they’re not injured. This can cause them to limit their activities, which leads to reduced mobility and loss of physical fitness. Worst of all, this process can turn into a vicious cycle that actually increases the risk for falling rather than lowering it.

What’s most important to realize is that falling should not be seen as an inevitable part of aging. Making simple changes around your home, as well as improving your balance with some targeted exercises can significantly reduce your risk of falling. Below are some fall-prevention tips to help you stay on your feet and injury-free:

Get physically active on a regular basis, as keeping up with your physical fitness is one of the best ways to keep your body strong and prevent falls
See a physical therapist for a balance training program to be completed in the clinic and at home; these types of programs focus on improving balance and posture, which will reduce your chances of falling
Wear shoes with nonskid soles, consider getting Velcro or spyrolaces if needed
Conduct a walkthrough of your home to identify possible problems that may lead to a fall; once identified, make any necessary changes to remove these risks
Install handrails on both sides of all stairways, avoid clutter and putting any items on the floor, remove throw rugs and make sure your home is well-lit
Get your eyes checked once a year, and get adequate calcium and vitamin D
Take your time, be patient and ask others for help with difficult, risky tasks

Balance training programs created by physical therapists have been shown to be effective for reducing the risk for falls in older adults, and the conclusion of this recent study highlights the potential benefits of any type of exercise in the elderly population:

Adding resistance exercise to aerobic exercise improves factors associated with an increased risk of falls. However, both exercise regimes, combined or aerobic alone, are more effective than no exercise in the reduction of fall risk factors.

So if you are concerned with risk for falling or that of a loved one, seeing a physical therapist is one of the best choices you can make to do something about it. Contact us to find out more about our Fall Prevention Program in Visalia and how we can help reduce your fall risk so you can lead a safer life.