About.com

Physical Therapy Community Mourns the Death of Robin McKenzie

Tue, 14 May 2013 05:29:51 +0000

The physical therapy community is mourning the passing of a great physiotherapist. Robin McKenzie, founder of the McKenzie Method of Mechanical Diagnosis and Therapy, died peacefully yesterday at age 82.

Robin was the founder of the McKenzie Method, a system of evaluation and treatment of the spine and extremities that involves repeated end range motions and positions to help classify a patient into treatment categories. This classification system helps to guide patients in treating their problem. The hallmark of the McKenzie Method is active patient involvement and teaching the patient to engage in self-care exercises and positions.

Robin was often quoted as saying, "My patients taught me all know." He believed that each patient held the answer to their own problem, and each patient's problem could be sorted out by listening and by applying specific motions and positions to the body.

For over 50 years, the McKenzie Method has been used to help patient move better, feel better, and gain experiential knowledge of their musculoskeletal conditions. If you have a movement dysfunction, perhaps a McKenzie trained therapist is the right clinician for you. You can find one at the McKenzie Method website. There you can also read Robin's obituary and post a tribute in honor of this great therapist.

Rest in peace, Mac.

Physical Therapy First

Sun, 05 May 2013 20:41:01 +0000

Last week I wrote a blog post about a new law in Indiana that would allow direct access to physical therapy for patients in that state. Indiana is now the 50th state in the US that allows some form of direct access to our services.

Now, I think it's time for the American Physical Therapy Association (APTA) to get the word out.

So often, patients call me with musculoskeletal problems and ask to make an appointment with me. They often ask if they should call their physician so a prescription can be faxed on over. I tell them that they are able to access my services directly. (In my state, there is limited direct access. A patient who self-refers to physical therapy can be seen for 10 visits of 30 days, and then he or she must see their physician to continue PT if necessary.)

Last week I had a previous patient who came in for an evaluation for a minor calf strain. I asked him if he went to his family doctor first before coming to therapy. "Why?" he answered. "My doctor would poke my calf once and then send me to you anyway." My patient knew that I would take the time to offer treatments to help his calf strain and solutions to prevent future problems with it.

When a patient is finished with a course of physical therapy in my clinic, I tell the patient to call me first with any future problems. I explain that they can self-refer to physical therapy if they wanted to.

So the APTA should be on a mission to tell everyone about direct access to physical therapy services. We need catchy slogans like "Physical Therapy First." Perhaps we need a commercial during the Super Bowl to tell the world that direct access to a physical therapist is safe, can save money, and can help get you on the road to recovery faster. Let's spend the money now and reap the benefits for years to come.

Twisted ankle: physical therapy first. Woke up with low back pain: physical therapy first. Knee pain after running that 5k this weekend: physical therapy first.

Sure, we don't solve all problems. But a reasonable and safe first step for many people with pain and movement dysfunction is an assessment from a physical therapist.

If you are having pain or a problem with functional mobility, find a physical therapist and have your condition evaluated. You may learn that physical therapy first is a great way to quickly get on the road to recovery.

Hoosiers Now Have Direct Access to Physical Therapy

Wed, 01 May 2013 11:29:12 +0000

On April 30th, 2013, the governor of Indiana signed into law HB1034 which allows that state's residents direct access to physical therapists. This is a landmark law, as all 50 states and the District of Columbia now offer some form of direct access to physical therapy services.

The new law would allow patients to self-refer to Indiana physical therapists for evaluation and treatment. Treatments that incude sharp wound debridement and spinal manipulation will still require a referral. Patients are able to be seen for 24 days under the new law. After 24 days, patients are required to be seen by their physician or other provider.

The American Physical Therapy Association (APTA) has worked over the years to help change state laws and practice acts to allow patients to access physical therapy services without a referral from a physician. Currently, 48 of the 50 states allow evaluation and treatment from a physical therapist via direct access. Two states allow only evaluation by a physical therapist via direct access.

Paul A. Rockar Jr, PT, DPT, MS, president of the APTA remarked, "We are thrilled that Indiana has become the latest state to offer patients the choice of direct access to physical therapist services. Ensuring patient access is a cornerstone of APTA's vision and mission."

Congratulations to Indiana physical therapists and to the patients who will be able to easily access and benefit from the specialized services of a skilled physical therapist.

New York Lobby Day for Physical Therapists

Tue, 30 Apr 2013 21:28:33 +0000

Today was lobby day for the New York Physical Therapy Association in my home state. Over 300 physical therapists met with our state's lawmakers in Albany to discuss the impact of several proposed bills on our profession and our patients.

One bill (S.2319 Defransisco/A.1666 Cahill) addresses the need to control high copays that patients may be required to pay while attending physical therapy. Many insurance companies designate physical therapists as "specialists" and require patients to pay a higher "specialist" copay for each office visit. High out-of-pocket costs may lead patients to elect to not seek physical therapy care as a result. The bill would end the practice of designiating physical therapists as specialists.

What do you think? Are copays too high? Should physical therapists be considered specialists so their patients pay the higher copay rate?

Anatomy Lesson in the Clinic

Tue, 30 Apr 2013 20:11:09 +0000

This morning I evaluted a patient who had strained his calf while running about a week ago. He reported it was getting better with rest, but he wanted to learn some strategies to help it along and to prevent future problems with running.

During my evalutaion, I noted tenderness to palpation over the middle part of his calf on the back of his leg. I mentioned that his problem certainly may be a calf strain, but it may also be a plantaris strain. I told him the plantaris muscle is a pretty tiny muscle with a long tendon that attaches at the back of the heel. The long tendon looks a lot like a nerve, and the muscle is often called the "freshman nerve," since many first year anatomy students mistake the tendon for a nerve.

My patient was thrilled. He said he liked learning about anatomy. Not the boring stuff like where things attach, but the fun stuff like the freshman nerve. He asked for more.

We continued with our examination, and I told him about the sartorius muscle on the front of his hip and thigh. It is the longest muscle in the body, and it is also called the tailor's muscle. The sartorius flexes and rotates the hip and flexes the knee, and long ago tailors would sit in a crossed legged position, hence the name.

Our examination continued as I tested his hamstring strength. When I tested his gluteus medius strength, we both were surpirsed at how weak his glutes were. I told him the importance of the gluteus muscles in maintaining proper lower extremity position and how essential good strength is in this group.

After setting my patient with an exercise program for his condition, he thanked me for the anatomy lesson. I told him there would be a test next visit.

Over-the-Door Traction

Tue, 30 Apr 2013 13:00:26 +0000

If you have neck pain, your physical therapist may use traction to help separate the disc and joint spaces in your neck. This may help decrease pain in your neck and relieve pressure off of spinal nerves.

Your physical therapist may use different techniques to apply traction to your neck. He or she may use a mechanical traction machine. Your therapist may use his or her hands to apply manual cervical traction to your neck. But how can you apply traction to your neck at home?

Over-the-door traction may be a low cost, simple method to apply traction to your neck at home. It involves using a pulley system attached to a harness on your head and neck. The traction force is applied with a weighted bag on the end of a rope that is fed through the pulley system and attached to the harness on your head.

Remember that traction does not take the place of neck exercises and postural correction for the treatment of your neck. It may simply help augment a well rounded physical therapy program for your neck pain.

Electrical Stimulation: Which Type is Right for You?

Tue, 30 Apr 2013 09:15:54 +0000

If you have attended physical therapy, your therapist may have used electrical stimulation to achieve various goals during your treatment. There are various types of electrical stimulation. Some types, like TENS or interferential current, help to decrease pain. Other types, like Russian stimulation, can help your muscles learn how to contract properly again.

If you are receiving electrical stimulation, it is important to know which type you are receiving and what the expected goals of using the stimulation are. And remember, electrical stimulation and other physical agents and passive modalities should be used to augment an active rehabilitation program that includes self-care strategies and therapeutic exercise.

Exercise for Better Sleep

Tue, 30 Apr 2013 05:50:29 +0000

Are you having a difficult time sleeping? If so, you are not alone. Millions of people are having such a hard time sleeping that prescription sleep medication is one of the most widely offered drugs in America.

If you a lacking quality sleep time, perhaps your doctor should refer you to a physical therapist instead of offering medication. Here's why. A recent poll conducted by the National Sleep Foundation found that people who exercise sleep better than non-exercisers. So, a visit to your physical therapist to help you develop and stick with an appropriate exercise regimen may help improve your sleep.

While a cause and effect relationship may not be derived from the poll, it appears that those people who exercise report better sleep that those who don't. And people who exercise vigorously report better sleep than those who don't exercise at all. Non-exercisers also have the highest risk for sleep apnea when compared to exercisers.

So, if you want a better night's sleep, perhaps you should visit your physical therapist who can help you set up an exercise program to get you moving. The health benefits of regular exercise are numerous, and improved sleep may be one benefit that many people would love to experience.

Broken Ankle? Share Your Rehab Story!

Mon, 29 Apr 2013 22:31:25 +0000

Last year I wrote a blog story about when to start running after suffering a broken ankle. That piece attracted quite a few readers, and many felt like sharing their story about their running (and walking) difficulties after an ankle fracture.

Another way to share your story about your broken ankle is to submit a response to the new Broken Ankle User Answer page. This page can serve as a sounding board for you to tell your rehab story after a broken ankle. Your story may help to inspire other readers who may have suffered an injury similar to your own.

Physical Therapy Treatment: Iontophoresis

Mon, 29 Apr 2013 22:15:26 +0000

Iontophoresis. Just the name of this physical therapy treatment sounds confusing. So what it iontophoresis?

Iontophoresis is a physical therapy therapeutic modality that uses electrical stimulation to help push medication through your skin and into injured tissues. Different medications can be used depending on your specific treatment goals.

For example, if you have a frozen shoulder, your physical therapist may use iontophoresis to help decrease the pain and inflammation around your shoulder joint. This may help augment your exercise program to help improve your shoulder range of motion.

There are many different medications that can be used during iontophoresis. Each medicine works differently to accomplish a specific treatment goal. Certain medications, like dexamethasone, may help decrease inflammation, while others, like acetic acid, may help decrease calcium deposits in muscle tissue.

Have you attended physical therapy and used iontophoresis? Do you feel that iontophoresis was a helpful treatment for you? Leave a comment and let us know about your iontophoresis experience.

Quick Links:

Read more: Iontophoresis in Physical Therapy