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Low back pain has become one of the largest causes of pain and disability in the United States. Billions of dollars are spent on trying to care for and remedy this issue. People are advised by friends, coworkers, and physicians to seek out certain types of treatment such as physical therapy, chiropractic care, medicines, diets, or other newfound treatment approaches.  So what to do? If your back is hurting which track do you pursue? While pain can be a very complex problem there have been ways that consistently show how someone can at least better manage their pain if not altogether get rid of it. The Journal of Pain Research has proposed factors to consider when deciding how to address your pain.
Another area can be more of an environmental factor such as work satisfaction, perceptions or demands at your job or even the attitudes of your employer. These can cause a higher risk or predictability of pain.  Some people also say, “I have a ‘high’ or ‘low’ tolerance for pain.” These pain-related beliefs and attitudes can have a real effect on someone’s ability to recover from a painful condition. Often time someone’s expectations, beliefs, or perception of their condition can have a direct effect on their ability to overcome the condition. Our attitude as physical therapists is to educate each individual on their specific condition, so they understand what will positively and negatively influence their symptoms. Also, we promote that the person have an ACTIVE involvement in trying to manage their care. Many studies have shown that individuals who actively participate in managing their condition do better than those who passively receive care.  You may be faced with many recommended options to help take care of your back pain. We would recommend that you first understand that there can be many causes of your back pain and especially many things influencing the level of your perception of pain. We feel a conservative approach such as physical therapy often helps people to manage or alleviate their symptoms. If physical therapy doesn’t work for you, there are other options that you can pursue as well. Give us a call to sign up for a free consultation if you'd like one of our physical therapists to sit down and talk with you about your low back pain, and discuss what PT can do for you.  By: Steve Bartz, PT
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It's been a cold week! Often times the freezing temps lock us up indoors and we become less active. Staying active during the colder months not only helps you stay physically healthy (think cardiovascular benefits, lowers blood pressure, helps with weight management, lowers risk of developing osteoporosis, strengthens bones and muscles and lowers risk of falls), but regular exercise also has many psychological benefits, including:
1. Stairs: Go up one flight of stairs 2x.  2. Rows: Bend at the hips with a slight bend in your knees. With weights in hand (use light weights or soup cans/water bottles), slowly lift weights straight up and squeeze your shoulder blades together as you lift. Repeat for 15 reps.  3. Skaters: Find some space to jump side-to side, focusing on pushing laterally and stabilizing yourself as you land (make sure you have good shoes and a non-slippery surface for this one!) Repeat 10x each direction. *Modification: if this is too high-intensity, take it down a notch with side steps - step right, gather feet, then raise you left up and down. Step left, gather feet, then do a right knee raise. Repeat 10x.  4. Squat + Shoulder Press: Complete a squat (send hips back, watch for knee to stay over toes). At the top drive light weights (or soup cans, water bottles) overhead aiming to get your elbows near your ears. Repeat for 10 reps.  5. High Plank Hold: Pushing through your shoulder, hold a plank position - aim for 30 seconds (if this is easy, bump it up to 1 minute!) Make sure you are not sagging your hips - to avoid this, squeeze your abs. Complete one 30-60 second plank per round. (Or combine multiple planks to add up to 30 second if this is difficult!)  Like this workout, or have other exercises you like to do in your house? Leave a comment below, we love to hear from you!  By: Lisa Pfotenhauer, Cert. Exercise Physiologist Sources:
Kredlow, A., Capozzoli, M., Hearon, B., Calkins, A., Otto, M. (2015, January 18). The effects of physical activity on sleep: a meta-analytic review. J Behav Med. Slentz, C., Houmard, J., Kraus, W. (2019, December). Exercise, abdominal obesity, skeletal muscle, and metabolic risk: evidence for a dose response. Obesity (Silver Spring, Md.) https://doi.org/10.1038/oby.2009.385 Booth, F. W., Roberts, C. K., & Laye, M. J. (2012). Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology. https://doi.org/10.1002/cphy.c110025 Sharma, A., Madaan, V., and Petty, F. (2006). Exercise for Mental Health. Prim Care Companion J Clin Psychiatry. https://www.ncbi.nlm.nih.gov We are happy to announce that we have begun to perform telehealth evaluation and treatment sessions. For those individuals who are not able to come into our physical therapy clinic because of concerns of COVID-19, we are able to set up an easy remote link with you via your phone or computer.  You do not have to have computer expertise to do this. If you can check your emails or a phone text, all you have to do is click on a link. We can walk you through the process and it only takes a couple of seconds. If you’re continuing to have pain and have been unable or not wishing to go to physical therapy because of the current health climate, please give us a call and we will schedule you a telehealth visit! 616-662-0990  By: Steve Bartz, PT This year we are bringing physical therapy to your home!  We are now delivering the same great one-on-one care that patients receive at the clinic to your home! Our goal is to provide people who are having difficulty getting to our clinic access to physical therapy. In some cases the patient will be seen entirely at home, while in other cases it can be used as a bridge to get them mobile enough to come into the clinic. In either case, the goal is always the same, to make sure that our patients are getting high quality one-on-one care from a licensed physical therapist and helping them reach their goals and return to their favorite activities.  By: Brian Colvin, PT  Did you know that you can come to physical therapy without a referral from your doctor? Just a few years ago the law changed in Michigan from requiring a doctor’s referral for all physical therapy, to being able to begin physical therapy without a referral from your doctor, and continue for 21 days or 10 visits (whichever comes first). One question we often get about direct access is “Do I need a referral for my insurance?" In MOST cases, no. Insurances that allow direct access (21 consecutive days of PT) include Medicare, Aetna, Blue Cross Blue Shield of Michigan, Priority Health, PH-Medicare, United Health Care, and more. Some insurances that DO require a referral for all physical therapy visits (including the first 21 days) include Blue Care Network, Medicare Plus Blue, and ASR. If yours is not listed here, call and ask us, and we can check for you. If your insurance is one that does require a referral and you are not able to obtain one, you can always come at our self-pay rate.  Why is direct access helpful to you? Michigan has some of the most limiting laws for direct access (given that it’s only for 21 days/10 visits, compared to most states that have unlimited direct access), but it is still very helpful. You may choose to use direct access to PT because: • Getting into the doctor might take days or weeks and your pain is a problem now • You want to save money on the office copay • It’s an injury you’ve had before and know the musculoskeletal and movement experts can help you (that’s us!)  • Some injuries and conditions may get worse over time, and you want to get it looked at right away • It allows YOU to take control of your health and take steps toward finding out what could be causing your pain, and how to treat it If you have any questions about direct access, give us a call and we can help answer them: 616-662-0990. We want to make physical therapy readily available to you, with a goal of helping you recover fully and be independent!  By: Lisa Pfotenhauer The holiday season seems to be one of the busiest times of the year. Although it is filled with lots of great things – like Christmas, time with family and friends, and fresh start to a new year, it can become a stressful time as well! Physical and psychological stress, as well as lack of sleep, can take a toll on you and make you more susceptible to injury and sickness. Here are four tips aimed to keep the holiday stress in check this year so you can focus on what’s important!  1. Plan ahead – cooking, shopping, etc. If it’s stressful for you to go to the mall on weekends when it’s crowded, try to stay organized and plan your schedule to go on a weekday. Do your Christmas grocery shopping before the week of Christmas. Little steps like these can help you feel prepared!  2. Don’t overdo it – don’t set unrealistic expectations for yourself (hosting, decorating, overcommitting to Christmas parties, etc). If decorating brings you joy, that’s wonderful, but don’t feel pressured to partake in every part of the season. Remember what is important to you and celebrate that in your own way!  3. Exercise – try to move 20 minutes each day – maybe for you that means mall walking or doing some exercises or yoga at home. 20 minutes is only 1% of your day - try to make time for this and see how it relieves stress in the other 99% of your day, including improving your quality of sleep.  4. Take time to be reflect and be thankful – write down a few things every day that make you feel grateful. Sometimes a thankful mindset makes all the difference!  If you are dealing with a new injury or chronic pain, give us a call and see if we can help. Some injuries and conditions heal on their own, and some need expert guidance, hands on treatment, and a program you can follow. Let us know if we can help and have a blessed holiday season!  By: Lisa Pfotenhauer, ACSM Cert. Exercise Physiologist Sources:
J Strength Cond Res. 2016 Jan (1):20-5. Effect of Physical and Academic Stress on Illness and Injury in Division 1 College Football Players (Mann, Bryant, Johnstone, Ivey, Sayers, 201) How stress affects your health. American Psychological Association. https://www.apa.org/helpcenter/stress (2019) Vuori I, Urponen H, Hasan J, Partinen M. Epidemiology of exercise effects on sleep. Acta Physiologica Scandinavica. Supplementum. 1988 ;574:3-7. Winters in Michigan can be long, beautiful at times, cold, and sometimes very snowy and icy!  Every year around 1 million Americans are injured from a fall due to slipping on ice or snow. There is potential for this type of incident during the winter whether you’re healthy or already injured or frail. We see lots of people during the winter months from falls in driveways, sidewalks, or parking lots. These types of falls can cause a range of injuries, like muscle sprains, wrist, hip, and shin fractures, back and knee injuries, and more. We want to give you a few tips for when you do have to go out in poor conditions, to prevent falls:
We hope these tips help you! Remember, if conditions are poor and you do not feel comfortable going on in the snow and ice, put your safety first and stay in or ask a friend to help you safely get where you need to be.
When will I get better? How long will this take? Why does it hurt so much, and it’s not better yet?  We hear these questions all the time in physical therapy. After surgery or an injury, your body is trying to heal itself through regular and predictable stages. Unfortunately, we cannot rush through the stages by just trying harder. You certainly can slow down the recovery by doing too much or too little during each stage. For example, during the early phase of an injury or after surgery, your body goes through an inflammatory phase which is a natural reaction to the injury. By simply exercising “harder”, you can further aggravate this inflammatory process. By doing nothing and just lying around for weeks on end, your body will also stiffen up, ultimately causing loss of range of motion to be able to perform your activities.  There is a balance between how hard and how easy to exercise during your recovery time. We are typically trying to gradually make gains with range of motion and then strength as you work through your rehabilitation. You will have ups and downs, plateaus, and feelings of frustration when things don’t progress smoothly or at a regular rate. Remember, this is not unusual. We do expect our patients to make regular progress on a weekly or biweekly basis. Patience is the key!  Also, ask yourself if you are doing everything as instructed by your therapist. If you are negligent in performing your home exercise program, you cannot expect to see the same results as if you were faithful in performing the exercises. Probably the biggest obstacle in a person’s recovery is their lack of adherence to their home program. So be faithful about doing your exercises, doing them properly and regularly!
Fall is here! And so is the rain and the colder temperatures! It is easy to curl up inside and be inactive during the colder months (which is a lot of the year here in Michigan), but you will feel much better – healthier, stronger, and happier – if you stay active this fall.  Here are five good exercises with which to start. You can do all of these from the comfort of your home! Warm up your muscles first with 30 seconds of jumping jacks or 2 sets of stairs, and if you experience pain with any particular exercise, do not continue with that exercise. 1.) 2 sets of 10 Sit-to-stands in a chair (or couch if you want to make it more challenging)  2.) 2 sets of 10 Push-ups – if you can’t perform 15 full push-ups, try them from your knees or against a stationary countertop/table. The lower the surface, the more challenging!  3.) 2 sets of 10 Glute-bridges – to make it harder, do 10 single leg bridges on both sides  4.) 10 Bird-dogs on each side (lifting opposite arm and leg  5.) 30 second High-plank hold (from your hands)  Cool down with one minute of deep breathing lying down. Try to do a workout like this one 2-3x per week to build strength and stability. When adding in new exercises, aim for exercises that work large muscle groups, and if you have any questions about exercises you're trying, or experience any pain, feel free to call us to schedule a free consultation: 616-662-0990.
Five years ago, when someone sprained their ankle, what did everyone tell them to do? RICE! Rest, ice, compression, and elevation!  Some of the ideas behind the old acronym for acute injuries remain the same, but RICE was often taken too far. Individuals hindered their recovery by resting the injured body part too long. Because of this, RICE has been replaced by a new acronym, POLICE:  P: Protect the injured joint, ligament, or muscle – this means resting the area for a few days, and then after that, when you do start moving the area, continuing to protect it (for an ankle sprain, this might look like using crutches).  OL: Optimal Loading – while still in the protection phase but after a few days of rest, you should start gently moving the joint, first passively, then actively, and finally with exercises. In the past, injuries often lead to lots of muscle atrophy and stiffness; this optimal loading focuses on beginning to move and strengthen the muscle at the appropriate time rather than getting stuck in the “rest” phase as the muscle continues to weaken and the joint stiffens up.  I: Ice can help temporarily decrease the swelling around your injury. The inflammation is one of the contributors to the pain you feel around your injury, so icing for 20 minute increments can help manage your pain.  C: Compression can also help with swelling. Think: ACE bandage, compression sock, etc. E: Elevation: Placing the injured body part up is another means of reducing swelling and inflammation. If your ankle is injured, try lying down and placing your ankle/leg on a stack of pillows. The main difference is that “rest” has been replaced with “protection” and “optimal loading”. Protecting the injured area and getting a few days of rest is important, but it is also essential to begin moving the area and progressively loading it as your body heals, for optimal recovery. If you’ve just experienced a strain or sprain, whether mild or severe, and have questions on how to handle it, feel free to call and ask for one of our experienced physical therapists! They will be able to give you guidance to help you recover as quickly (and fully) as possible: 616-662-0990.  By: Lisa Pfotenhauer, C-EP |
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