Human Performance and Rehabilitation Centers, Inc.

Physical Therapy at the gym: HPRC Physical Therapy opens satellite inside MÜV Fitness

Imagine the convenience of an experienced physical therapist on site in the gym where you work out. Suddenly, you’ve got the potential to expand your body’s movement and function and to protect it against injury. You don’t have to imagine it in Columbia, where HPRC Physical Therapy has launched a new partnership with MÜV Fitness.

HPRC physical therapists experienced in sports medicine are accepting new patients at our recently open satellite location at MÜV Fitness on Forest Drive. HPRC Physical Therapy took this step in order to bring physical therapy services directly to active adults.

According to WebMD, adults can sustain a workout injury no matter how in shape they are, and the most common injuries include shoulder and knee strain, tendonitis, sprain, dislocation and shin splints. Working with a physical therapist can help ensure you’re exercising not just for general health, but for joint and musculoskeletal health as well. In fact, nothing is more important to keep you in the gym or on the trail long term. Guarding against injury is an important investment that will ultimately save you time, pain and money.

Do you need to see a doctor before visiting an HPRC physical therapist at MÜV? Absolutely not. Thanks to direct access (available to varying degrees in all 50 states), individuals can see an HPRC physical therapist at MÜV Fitness without having to get a doctor referral. So if you experience pain while working out, if you want a physical therapist to help you prepare for an athletic event or if you have existing aches and pains, you can access an onsite physical therapist at MÜV without hesitation. These services are available to both members and non-members of the gym.

The benefits of physical therapy don’t stop with the last session. You will take with you new knowledge on how to stretch properly, warm up, cool down and move your body correctly in any fitness setting.

Founded in Columbus, Georgia in 1955, HPRC has been providing physical therapy services to the Columbia community since 1988.

To make an appointment, please fill out the screening form at HPRC.net/forestdrive or call (803) 939-2213.

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Child’s Play: What you need to know about pediatric physical therapy

Lots of issues bring children to a pediatric physical therapist, from developmental delays to “head tilt” (torticollis) to a diagnosis of Cerebral Palsy or Down Syndrome. Pediatric physical therapists play a part in enabling children to live full lives by helping them build strength and balance. Here’s what parents and caregivers should look for in a productive pediatric physical therapy experience. [Read more]

The basic principles of physical therapy are applied consistently to people of all ages, but treating kids requires a special approach. To an adult, a PT might say, “give me 3 sets of 10 reps of this leg strengthening exercise,” but to a child, that doesn’t sound like much fun. Trained pediatric physical therapists know how to create an evidence-based plan of care that is both effective and engaging to a young person.

We begin by carefully evaluating our patients’ neuromuscular function, and we ask parents about how their child is getting along in his or her daily environments. Depending on the patient’s age, mobility and condition, we design a treatment plan that could include neuro-, ortho- aquatic or hippo therapy and other best practices.

On site, we use equipment and activities that look like fun, but that are actually proven strategies for achieving treatment goals. We might use therapy balls, platform swings, adaptive bikes, a jungle gym or a Wii. We might play basketball or kickball. We might place a child in front of a mirror and play tic-tac-toe with a dry erase marker as they balance on one foot. Each activity is an intervention proven to help pediatric strength, mobility and balance.

Sometimes children are scared and it’s hard to keep their attention. In such cases, we might invite a parent to act as lead therapist while we provide direction. Parents play a primary role in their child’s ongoing development, so this helps educate them as well.

In fact, a home therapy program is crucial to success. A good pediatric physical therapist will ask about a child’s living situation and daily routine and will adapt a treatment plan accordingly. A comprehensive plan of care will help pediatric patients improve their long term motor development, confidence and independence.

Think F.A.S.T! Warning Signs of a Stroke

Plain and simple, a stroke is an emergency. It’s important to recognize warning signs and know when to call for help. Surviving a stroke and minimizing its debilitating effects depends on how fast a patient receives treatment.

In recent decades, our society has become more aware of the warning signs of a heart attack, and this knowledge has saved lives. But we also need to know how to spot signs of a stroke, which we should think of as a “brain attack.”

Stroke is the No. 4 leading cause of death in the United States and a leading cause of severe long-term disability. The Centers for Disease Control and Prevention has labeled the majority of the southeastern U.S. states the Stroke Belt because of our higher rates of stroke incidence and mortality. Contributing factors include the region’s higher rates of uncontrolled blood pressure, smoking, diabetes, obesity, high fat diets and poor activity levels. Strokes affect African Americans at a higher rate than Caucasian.

If you or a loved one is having a stroke, acting F.A.S.T. is key. According to the American Stroke Association, patients who take a thrombolytic or clot-busting drug within the first three hours of their first symptom can reduce long-term disability from ischemic stroke, which accounts for about 87% of stroke cases.

To recognize the signs, think F.A.S.T.

F.A.S.T. stands for:

  • Face drooping. Sudden numbness or weakness of the face, especially on one side of the body, is a key sign that something is wrong.
  • Arm weakness. Sudden numbness or weakness of the arm or leg, especially on one side of the body, is also a sign.
  • Speech difficulty. Sudden confusion with speaking or understanding.
  • Time to call 9-1-1. Acting quickly has the potential to save lives and ensure a better recovery.

Symptoms can also include sudden trouble seeing or blurred vision in one or both eyes; trouble walking, dizziness or a loss of balance or coordination, or a sudden severe headache with no known cause. Any one of these can signal that is stroke is happening.

It’s important to try to document a patient’s last known well time so that first responders can pinpoint exactly when the stroke occurred. This critical piece of information will influence how the patient is treated and can greatly improve long-term outcomes.

Links

http://www.cdc.gov/dhdsp/maps/national_maps/stroke_all.htm

http://www.strokeassociation.org/STROKEORG/?gclid=CIj5l46M8c0CFQcMaQod5hUA3w

https://www.goredforwomen.org/about-heart-disease/symptoms_of_heart_disease_in_women/symptoms-of-a-stroke/

 

Good News: Bladder Leakage Improved by Strengthening Pelvic Floor

For many women, basic acts like sneezing, coughing and even laughing can trigger bladder leakage. It’s an embarrassing nuisance, but the good news is that physical therapy is an effective tool for eliminating and improving this condition.

About half of all women say they have experienced urine leakage at some point in their lives, and for some, it’s a daily event. The culprit is often weak muscles in the pelvic floor, or pelvic floor dysfunction (PFD). Certain acts like coughing, laughing bending or high impact exercise push on the bladder, but the pelvic muscles are not strong enough to push back and prevent leakage. This is called stress incontinence. Women of all ages experience this type of incontinence. We’re not talking about mental stress, but physical stress to the pelvic floor. That’s why women who have experienced pregnancy and delivery, or who may be carrying extra weight are at greater risk for experiencing this kind of bladder leakage. Athletes that engage in heavy impact exercise, running and jumping are also at risk. Older women may experience bladder leakage due to reduction in hormone levels and age-related muscular changes, but aging itself is not a cause of stress incontinence.

So, how can physical therapy help? The short version is we strengthen the pelvic floor muscles, a group of muscles that attach from the pubic bone in the front of the body to the tailbone behind. These muscles, resembling a hammock, are intricate and incredibly important, and it’s easy to take them for granted. Most of us have thought about toning our deltoids, glutes and quads, but have we considered strengthening our pelvic floor? We should.

A physical therapist who specializes in PFD will develop a targeted plan that will strengthen the pelvic floor and reduce and even eliminate bladder leakage. Such a plan goes beyond telling a woman to “just do Kegels,” the pelvic exercises developed by Dr. Arnold Kegel in 1948. Kegels are helpful, but they are not one size, fits all, since every woman is unique. Moreover, not all women understand how to perform this exercise correctly. About 51% cannot do a Kegel correctly with verbal instructions alone.

Kegels are just part of our approach. Physical therapists deliver a comprehensive program for strengthening the pelvic floor, followed up with customized at home exercises tailored to each patient’s therapy goals.

The National Association for Continence (NAFC) website reports it takes an average of seven years – seven! – before a woman will discuss bladder problems with her physician. Don’t wait. Physical therapy is a non-invasive, highly effective tool in resolving this issue.

Dry Needling: Let’s Get to the Point

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Therapy that includes the word “needle” is an attention-grabber, but for a growing number of patients, dry needling is a game changer for managing pain and increasing mobility.

We’ve seen great results using dry needling in a variety of patients, including a chronic migraine sufferer in her 50s who was able to stop taking the prescription drugs she’d relied on for years after just a few sessions. In another case, dry needling helped a high school soccer player hindered by severe hip and glute strain regain his performance and play without pain. We’ve also used the intervention in a breast cancer survivor in her 40s who was eager to regain arm movement after a double mastectomy and reconstructive surgery. Dry needling was an individual component of a complex therapy regimen, but a very important one. It helped our patient regain the ability to raise her arms above her shoulders and meet her goal of competing in a local charity dance event.

Because of its success rate and its ability to treat numerus pain-related conditions, dry needling has quickly become a popular therapy intervention across the country. Availability depends on state laws. HPRC was the first physical therapy provider in the region to offer dry needling several years ago, and we continue to be a leader in the field. Several of our PTs have become certified in this technique, completing 50 hours of additional training. Used in concert with manual therapies, this safe and effective practice is being used routinely across the U.S. to treat a range of common and unusual conditions.

How does dry needling work? What’s happening in terms of the body’s neuromuscular function is complex, but the short version is that small filament needles are carefully inserted into trigger points, areas we commonly refer to as “knots” in the muscle. They’re located below the skin’s surface within the muscle and connective tissue. Dry needling differs from acupuncture in that it’s based on medical principles supported by research, as opposed to an Eastern form of medicine that focuses on the body’s energy. Dry needling elicits a muscle twitch response that can be temporarily uncomfortable, but this is far outweighed by the benefits normally seen.

Before we begin dry needling, we locate trigger points through careful assessment and palpation. Trigger points occur when an overstressed muscle tries to heal itself, creating a ball of angry tissue that can trigger pain in other parts of the body. By inserting a needle into a trigger point, we force it to let go of that tension, effectively “resetting” the muscle and nerves and restoring their function. One of the most hopeful aspects of dry needling is that the targeted pain isn’t likely to return; there’s a good chance we’ve eliminated it long-term.

How to protect your child from an overuse injury

Bryce Gaunt, PT, SCS
Director of Physical Therapy
HRPC St. Francis Rehabilitation Center – Main Campus

Over the last 20 years, a growing number of children have become involved in youth sports. Keeping kids active is a positive trend, but in today’s hyper-competitive environment, it’s important to protect young athletes from overuse injuries.

An overuse injury results from excessive physical activity without adequate rest and recovery, and it occurs when the body’s workload is consistently greater than its level of fitness. Children who train and or compete intensely over time are more at risk for overuse injuries. This is especially true for the growing number of young athletes who play one sport year-round, what we call sports specialization.

We tend to think of kids as having unlimited flexibility and endurance, but they’re actually at higher risk for overuse injury because their bodies are still growing and developing and they’re doing so at constantly changing rates. Kids’ muscles, bones, joints and coordination are not yet mature, and they can’t handle the same kinds of trianing that a healthy adult might.

Consider the following:

• Overuse injuries account for half of all athletic injuries in children and teens.
• Young people are at nearly double the risk of injury when they participate in more hours of sports practice per week than their number of years in age, or where the ratio of organized sports to free play time is in excess of 2:1.
• Young people are more than eight times more likely to be injured if they train more than 16 hours per week.

There are many things we can do to safeguard against overuse injuries. Keep the following in mind:

• Appropriate training can decrease the likelihood of injury as much as 50%.
• Recovery is essential. Adequate rest and proper nutrition are key to helping a young body recover.
• Kids should participate in a wide variety of sports. This provides different stresses to the body, and improves athletic development through a wide range of movements.
• Training intensity should vary over the course of a year and include periods of high and low intensity.
• Proper stretching is key. Children tend to have excessively tight muscles due to their growing bones. A regular stretching regime can reduce injury risk.

Remember, the goal is to make sure that any kind of training is appropriate for a child’s fitness level and stage of growth and development. The workload must fit the body’s capacity to do the work.

Plantar Fasciitis:

Question:
My heel is very painful and my doctor told me I have plantar fasciitis, what does this mean and how can I treat it?

Answer:
The plantar fascia is a tight band of connective tissue that runs along the bottom of your foot attaching your heel to the ball of your foot. Plantar fasciitis is an injury or inflammation to this area, which typically results in heel pain. Patients with plantar fasciitis often report sharp stabbing heel pain which is worst with the first few steps in the morning or after prolonged sitting. The pain may also be more severe after you have been on your feet for a long time.

A physical therapist can evaluate your foot and develop a treatment plan to address your specific needs. The therapist will assess your range of motion, flexibility, strength, walking pattern, and balance. A treatment program of stretching, strengthening, modalities and manual therapy will likely help to relieve your pain and get you back to your desired activities.

Typically frequent stretching of the calf and/or foot is needed to help relieve pain and tension in the plantar fascia. A normal walking pattern is essential to avoid over-stressing other tissues throughout the body. Your doctor or physical therapist will likely recommend you wear supportive shoes as much as possible and may prescribe shoe inserts. Your physical therapist may need to help mobilize your soft tissue, and may use a variety of tools to accomplish this. Massage or tool assisted soft tissue mobilization to the bottom of your foot may be uncomfortable during the treatment, but you should feel better afterwards. You may need to temporarily decrease aggravating activities such as running while you heal. Taping techniques may be necessary to support your painful foot and supportive shoes are essential. Overall, while working with your physical therapist, you should experience a gradual decrease in the intensity and frequency of your pain.

The Things We Take for Granted

Dr. Oz brought women’s health into the limelight in April 2014 with an episode about Pelvic Floor Dysfunction (PFD). His segment introduced a very well-known pelvic floor physical therapist, Amy Stein MPT, from Manhattan. If you viewed or missed his segment you might be asking, “I need a physical therapist for my what?” Don’t fret, let me explain. The pelvic floor is a group of muscles, nerves, and soft tissue that attach from the pubic bone in the front of your body to the tailbone behind, similar to a hammock.

Physical therapists are well known and effective in treating all types of muscle problems. We treat muscle strain, spasm, weakness, and tightness. We treat muscles after injury and especially after surgery to regain their best function. Are you still asking, “Do I need a pelvic floor physical therapist?” The answer may very well be yes. The Massachusetts General Hospital website states one in three women will develop a pelvic disorder in her lifetime.

Physical therapists are teaming with doctors to effectively and conservatively treat many types of pelvic floor disorders.

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The muscles of the pelvic floor serve the important function of supporting the organs in the pelvis, and assist in stabilizing and supporting the spine. They also play a role in sexual function and pleasure, indeed important muscles! It is these muscles that help keep us dry or continent and must relax in order for us to empty the bladder or rectum, and stretch to deliver a baby. We take for granted that these muscles will function throughout our lifetime, but sometimes they just need help.

In May 2014, Moore Magazine had an article highlighting all the treatment options for one type of PFD, stress incontinence. A physical stress from above the bladder pushes down on the organs in the pelvis and the muscles just do not have enough oomph to push back. This is a muscle problem. The pelvic organs are not well supported due to muscle weakness. Does your bladder leak with sneezing, coughing, laughing or lifting things? Think again about that physical therapist.

In 1948 Dr. Arnold Kegel developed exercises for women to reduce bladder leakage, assist in vaginal laxity, and support mild pelvic organ prolapse. Pelvic floor muscles can be strengthened just like any other muscle with properly prescribed Kegel exercises. But, one size does not fit all! So, if you were ever told to practice Kegel exercises, you were on the beginning of the right path…possibly. I hear many women state, “Oh, I tried Kegel exercise and they didn’t work for me.” Unfortunately, up to 51% of women are not able to perform Kegel exercises through verbal instruction alone (Bump et all 1991). Properly prescribed, instructed (squeeze and lift) and practiced (repetitions determined by your ability to produce and hold a contraction) Kegel exercises do work. You don’t have to squeeze your thighs or hold your breath or clench your buttocks, but you do need to learn to isolate the hammock of muscles in your pelvic floor. You can learn to exercise these muscles with your regular gym workout, and no one will know the difference, except you. You will be more comfortable, dry and less anxious about finding a bathroom. Take a look at www.totalcontrolprogram.com or www.nafc.org for more info.

Kegel exercises are NOT all we do. Not all women or men need or should even try to do Kegel exercises. For various reasons, pelvic floor muscles can also become short and tight, and lose their ability to relax. Symptoms of tight muscles might be pelvic and low back pain, constipation, finding it hard to empty the bladder or bowel, or experiencing pain with intercourse. Physical therapy can help with that too. Manual techniques to soften and lengthen muscle tissue and reverse Kegel exercises help to restore function and reduce pain.

The muscles of the pelvic floor are especially vulnerable in women due to pregnancy and delivery, but are important in men’s health as well. Dysfunction has multiple causes and affects all ages. The National Association for Continence (NAFC) website reports it takes an average of 7 years before a woman will discuss her bladder problems with her physician. Ignorance is not bliss. Your doctor can guide your treatment. The GOOD news is pelvic floor dysfunction is treatable, and a physical therapist that specializes in the pelvic floor can offer conservative options.

In September 2014, The American College of Physicians released guidelines for non-surgical solutions for uncomplicated stress incontinence. These guidelines include pelvic floor muscle exercises, bladder training and weight loss as effective options, and recommended conservative options as a first choice of treatment.

A pelvic floor physical therapist specializes in understanding and treating the multiple problems of the pelvic floor muscles. We can help you find your muscles in your pelvis and learn to control them. We can help that got-to-go feeling with a bladder training program. A pelvic therapist will complete a comprehensive pelvic floor muscle exam, digitally examine the pelvic floor muscles, evaluate posture and examine the joints of the low back and pelvis and prescribe appropriate treatment options.

There is HELP and HOPE for your pelvic health problems! You will be grateful for those hidden muscles once they are no longer hiding from you!

The HPRC Brand, Competence, Service, Culture

HPRC celebrates its 60th anniversary in 2015! The company has not only witnessed change but has endured and survived change. Medicare did not exist when HPRC was founded. About the only thing that hasn’t changed in our 60 years is our brand. In fact, we believe the reason we have survived for so long and through so many changes in the healthcare landscape is because of our brand. The HPRC brand is about EXCELLENCE – excellence in the level of care we provide, excellence in the delivery of that care, and excellence in our culture and how we treat each other and present ourselves to those we serve.

The founder of our company, George M. McCluskey Jr., PT is singularly responsible for establishing HPRC’s brand of excellence. He founded our company with one idea in mind – to improve life, one patient at a time. One of his favorite quotes is from St. Francis of Assissi: “If you work with your hands you are a laborer. If you work with your hands and your head you are a craftsman. If you work with your hands, your head, and your heart you are an artist.” He encouraged all of us to be artists.

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Mr. McCluskey, or “Coach” as we called him, challenged and inspired us to grow professionally and advance our knowledge. He taught us to then use our success to make a difference in the lives of others. He taught us about relationships – the importance of treating everyone with respect and dignity regardless of their situation. He had very high expectations of all of us, and gave us the means to accomplish anything we dared. He eliminated our fear of failure and replaced it with a spirit that wasn’t afraid to dream. And we loved him for it.

At HPRC, as we plan for our future, we plan together. Whatever the climate may be, we know we can count on each other. We know who we are, what we do, and why we are here. We are about excellence – excellence in our competence, our service, and our culture. An African proverb says if you want to go fast, go alone; if you want to go far, go together. We vow to keep alive the lessons we learned from our founder, and advance our brand of excellence.

Brian S. McCluskey, Ph.D.
Chairman and CEO
HPRC, Inc.

Knee Osteoarthritis

I was diagnosed with osteoarthritis in my knee. What caused this and how can physical therapy help me?

Knee osteoarthritis is a very common condition causing pain, stiffness, and limited mobility. It occurs when the cartilage or padding in a joint deteriorates and wears away. Arthritis is a degenerative condition and joint damage progresses or worsens over time. Arthritic joints can be quite painful, stiff, and sometimes swollen. Many people with osteoarthritis report that their knee is the most stiff in the morning.

There are a variety of factors which increase your risk of developing knee osteoarthritis. Arthritis is much more common in older adults. There is also a genetic component to developing arthritis, so you are more likely to develop arthritis if others in your family have it. People who are overweight are more susceptible to developing osteoarthritis and the joint damage can progress more quickly in heavy individuals. Also, if you have injured your knee in the past you are more likely to develop knee osteoarthritis as you age.

If you have the misfortune of developing painful knee arthritis, a physical therapist can evaluate you and develop an appropriate treatment program. Your physical therapist should assess your strength, range of motion, balance, and the alignment of your body while you move. People with arthritis often benefit from strengthening, stretching, and instruction on how to move correctly to minimize further joint wear and tear. As your strength, flexibility, and alignment improve, you should find that it is easier for you to walk, move around, and participate in your desired activities.