3 Components of Balance: Physical Therapy Implications

Human balance is very important in performance and safety during functional activities. Maintaining your balance is a complex process that uses sensory information to create muscle responses to keep you from falling.

There are 3 basic components that affect your balance:

vestibular system

1. The Vestibular System: Complex mechanism in the inner ear that controls balance by monitoring the position of your head.

2. The Visual System: Uses input from your eyes to detect the changes in the floor surface.

3. The Somatosensory/Proprioception System: Uses sensory input from your lower extremities to give your brain feedback about the floor.

How do these systems affect your balance?

If you have an inner ear disturbance, such as an infection, it causes your body to react incorrectly when your head position changes. This will present as dizziness during movement.

If you have visual impairment, you might have difficulty detecting changes in the ground surfaces during low light situations, such as going to the bathroom in the middle of the night.

If you have sensation problems in your feet, such as neuropathy, you will not get accurate feedback to your brain about the ground surface.

Why is this important and can physical therapy help?

Knowing which of these 3 systems might be impaired can help physical therapists set up the plan of care. For example, a patient who has diabetic neuropathy in his feet relies heavily on the vestibular and vision systems to maintain balance. It would be important for this patient to know that he should turn a light on if he needs to use the bathroom in the middle of the night. This will reduce his risk for falling.

Understanding the 3 systems also helps physical therapists improve balance. One way to improve balance is to improve the function of the impaired system. There are specific techniques to improve vestibular function and proprioception/balance training can improve lower extremity feedback.

Another way to improve balance is by compensating to enhance the function of the systems already working well. For example, proprioception activities, such as standing on one leg or standing with eyes closed, can teach the body to rely more on sensory feedback from the legs. This can be very helpful in a patient who has difficulty with vision in low light.

Understanding and training these 3 components of balance, can greatly improve balance and reduce fall risk.


Examples of Determination

The Merriam-Webster dictionary defines determination as a “firm or fixed intention to achieve a desired end.” Over the weekend, we saw an excellent example of determination as Michael Phelps completed his quest for eight gold medals in this summer’s Olympic Games. He set his goals, worked hard, stayed focused, and achieved the goals.

In sports, we often see such great displays of determination. However, there are many daily examples that we might overlook. As a father, I have watched my son show incredible determination to overcome many challenges. He was born with Down Syndrome and his primary challenge has been gross motor skills (crawling, walking, running, etc). He learned to walk at age 3 and soon after tried to run. Of course, he fell quite often in the early stages, but he was determined and never gave up. Now, he can throw a football, kick a soccer ball, or throw a round ball with ease. He can even hit a wiffle ball when pitched to him. In fact, he is a more consistent hitter than many professional baseball players – of course, I don’t pitch 100mph fastballs.

As a physical therapist, I have seen outstanding examples of determination from my patients. Many of them have overcome significant impairments and functional limitations to improve their quality of life.

Some examples include:

– A 73 year old runner who became deconditioned when she stop training to take care of a family member who was ill. In relatively short time, she worked hard to regain her strength and her ability to race. The result: successful completion of a 5 mile race.

– An 85 year old overcame a sprained ankle to be able to return to dancing. The result: successful return to her line dancing class.

– A man who lost his lower leg in a motorcycle accident, worked very hard to return to riding. The result: 8 months after his amputation, he was riding a motorcycle again.

Whether you’re an elite athlete or an average person, you can achieve your goals if you have determination.


Living with Multiple Sclerosis – Physical Therapy Impact

Living With Multiple Sclerosis

March is National MS Education and Awareness Month. Multiple Sclerosis (MS) is a clinical condition characterized by a loss of the myelin tissue that surrounds the nerves and aids in normal conduction of electrical impulses.Multiple Sclerosis

Common symptoms include weakness in the arms or legs, loss of balance and problems with mobility and bladder function. While the condition itself cannot be cured, treatment is aimed at slowing down the progression of the disease and helping patients recover to a point where they are independent at home. Physical therapy plays an important role in the rehabilitation process and improves quality of life for patients with MS.

The purpose of physical therapy is to ensure that the patient maintains a degree of functionality and is able to perform daily activities without too much difficulty.

The Various Stages of Multiple Sclerosis

Stages of MSPhysical therapy is an important part of the treatment process during the different stages of MS. During the initial evaluation, the therapist will determine if there are any limitations with skin sensation, muscle strength and overall function.

As the disease progresses, acute attacks are likely to occur and the patient may need to be hospitalized. In such cases, a physical therapist will work closely with physicians and other specialists in the healthcare team to complement their efforts and to ensure quick recovery for the patient.

MS can also present as a slow, progressive condition that relapses a number of times and seems to ‘go away’. Don’t be fooled, because it can cause severe limitations over time.

In some situations, the side-effects are minimal and daily life is not impaired. Each person’s progression is different. Your physical therapist will always assess the most important functional problems affecting you and will address those needs in a comprehensive, customized treatment program.

This is How We Help…

Supervised, controlled exercise is the foundation of physical therapy treatment. As patients tend to fatigue quickly, exercise plans are designed to be simple and gradual. Exercise programs are also designed to be intermittent to prevent sudden ‘attacks’ of pain and discomfort. Here are some of the benefits of physical therapy in MS.

  1. physical therapist helping MS patientCorrection of posture and improved trunk control – Patients with MS are at risk of falling, so physical therapy is aimed at controlling posture and balance to minimize the risk of falls.
  2. Increasing functional independence with walking aids – To improve independence and movement, a physical therapist may prescribe aids including walkers, canes, and custom made foot orthoses (supports). Conditions such as foot drop and loss of sensation in the lower extremities may warrant the use of additional orthoses.
  3. Enhancing mobility – Mobility is an important prerequisite to patient independence. Joint and muscle stiffness (especially in the legs) can be corrected with stretching exercises. Stiffness in the neck muscles can affect neck and head posture and control, which can also be corrected with supports and exercise.
  4. Restoration of muscle tone – Increased tone (hypertonia) or decreased muscle tone (hypotonia) is a result of the impact of MS on the nerves. A physical therapist may use manual techniques to improve joint sensation and restore normal muscle tone.

Physical therapists play an important role in the management of patients with MS and several other conditions affecting the nerves, muscles, bones, and joints. There is a lot that physical therapists can do to help you (and everyone you know) live an independent, pain-free lifestyle.


Can Physical Therapy Help Brain Injury?

Can Physical Therapy Help Brain Injury?

brain, skullMarch is brain injury awareness month. A traumatic brain injury (also known as TBI) occurs as a result of trauma to the head, leading to damage to the brain itself. Traumatic brain injuries can result from numerous types of injuries including automobile accidents, contact sports, or falls. Symptoms can vary from mild to severe; ranging from headaches and general confusion to partial paralysis and loss of sensation. In fact, any injury to the brain is a serious condition that requires hospitalization and immediate medical attention.A mild TBI may be associated with a change in the mental state of the individual or a short-term loss of consciousness. A severe TBI may result in a coma, memory loss and loss of muscle control. Over a period of time, this can cause loss of muscle strength and a deterioration of balance, which can lead to falls.Although the severity of a brain injury can vary immensely, the importance of physical therapy cannot be overstated. Some brain injuries may require a few weeks of rehabilitation; while severe injuries can require several months of neurological re-education under the supervision of an experienced physical therapist.

Five Benefits of Physical Therapy in Traumatic Brain Injury

girl in wheelchairEvery instance of TBI is unique and different and a physical therapist can conduct a detailed evaluation to determine the extent of impairment. This initial evaluation will help determine extent of sensation, consciousness, body awareness, memory, muscle tone, movement, balance and gait.

Based on the evaluation, the physical therapist may design a program consisting of neuro-developmental training, joint mobilization, functional training and self-stretching exercises. The five most common benefits of physical therapy include:

  1. Memory assessment and improvement.
  2. Motor function and muscle strength increase.
  3. Improved responsiveness to sensation and awareness of the surrounding.
  4. Lifestyle counseling to enhance independence with daily activities
  5. Improved balance to facilitate standing and walking.

With brain injury, time is of the essence. Don’t delay – seek medical attention and start working with a physical therapist as soon as possible.

It’s All In Your Brain

physical therapy signA brain injury has the potential to affect the quality of life and limit the individual’s ability to do simple things. Expect your physical therapist to work closely with other members of the healthcare team to improve your ‘brain health’ and speed up the recovery process.

The goal is to help the individual resume full function in a gradual, controlled manner under the supervision of the physical therapist. Your therapist can recondition your brain and nervous system, bridging the gap between medical intervention and full recovery.

The bottom line – physical therapy treatment will help regain function and improve quality of life. As your physical therapists, there is a lot that we can do a lot for you; including boosting your ‘brain health’.


Children, Sports and Exercise

Children, Sports and Exercise

Getting your child involved in sports is an excellent way to encourage exercise and prevent childhood obesity. This is a proud feeling for every parent, and the expectation is that the child will have fun, gain confidence and interact with other children in the process.

To determine what your child will enjoy participating in, help him / her decide by accompanying the child to different games and a variety of sports. The more sports and environments the child is made aware of, the higher the probability that the

Children Sportschild will be able to pick a sport and enjoy it.

It is important to make sure that the child’s sporting activity is age appropriate. In general, toddlers (aged 2-5) are too young to comprehend most organized activities and the importance of ‘rules’. They need unstructured play to develop movement skills, attention span and social maturity. From the age of 8 and above, children can participate in team sports and group exercise.

If your child does not like athletic activities, take the opportunity to spend more time with your child and encourage physical activity with regular walks, swimming, tossing a ball around, or simply kicking a ball back and forth. Be creative and mix it up so your child does not get bored.

Importance of Safety First

Unfortunately, children can get injured while playing sports. When this happens, consult a physician immediately. In most cases, the physician may recommend the services of a physical therapist with extensive training in anatomy and physiology. The therapist will work closely with the physician to help your child recover as quickly as possible.

Specially trained in anatomy and physiology, a physical therapist will design a delicate, yet effective exercise program to help restore muscle balance and improve mobility in your child. The therapist will be aware of the child’s limitations and will do everything possible to facilitate recovery as quickly as possible. Children tend to get restless during recovery, and a physical therapist will patiently work with the child to achieve compliance during the recovery process.

Physical therapy helps to heal, strengthen, and improve motion by treating your child’s injured area with a variety of exercise techniques that incorporate fun and playful activities. With physical therapy, you can expect your child to recover quickly and resume athletic activity.

The Right Physical Therapist For Your Child

Although physical therapy can help children in the recovery process following an injury, there is a lot more that the therapist can do. As a parent, you can expect the physical therapist to use a variety of techniques to strengthen muscles and improve joint mobility. The therapist will make the exercises fun and interesting, and your child won’t realize that he or she is ‘being treated.’ As a parent, you should encourage your child to participate and ‘play along’ with the treatment. The physical therapist may use play techniques including crawling, playing follow the leader, facilitating balance and coordination activities using beams, balls and other objects.

After an injury, a physical therapist will help your child regain full potential, allowing your little bundle of joy to experience the pleasure of sport and grow physically and emotionally in the process. Your child will look forward to the ‘play sessions’ and be an active participant in the recovery process. If your child (or another child that you know) is recovering from an injury, physical therapists can help the child return to normal as quickly as possible.


Can Physical Therapy Train Your Brain?

Can Physical Therapy Train Your Brain?


We exercise to keep our bodies fit, but did you know that exercise can also train your brain? You have likely heard of the effect of endorphins on your mood, and you probably know that you feel better after exercising. Exercise can improve clarity, increase brain function, and possibly stimulate the formation of new brain pathways by restoring and stimulating

Mental exercises can keep you alert, and must be accompanied with physical exercises for best results. Exercise helps improve circulation in your cardiovascular (heart), pulmonary (lungs) and nervous (brain and spinal cord) system.nerve cells, called ‘neurons’.

The Mind-Body Connection

As one grows older, the human brain starts to lose nerve cells and this can result in varyingmind body exercise degrees of mental decline. Exercise is one of the most effective ways to challenge your nerves. Your brain function is improved through mental stimulation as well as through physical exercise. The inevitable mental declines often associated with the aging process can be minimized with a well-designed exercise routine.

Exercise triggers communication between (and blood circulation to) brain cells, which interact with other parts of the nervous system. The processing system of the brain is challenged during workouts, as certain chemicals such as adrenaline are triggered.

Regular exercise can help keep brain cells healthy and functioning properly. An active lifestyle can improve mental focus, accelerate the healing process for patients with brain or nerve injuries and can reduce the risk of dementia as we grow older.

There is a strong correlation between physical exercise and good mental health as people age. Individuals who stimulate their nervous system through exercise tend to function at a higher level physically and mentally.

Physical Activity and Brain Training

Exercise at low to moderate levels is best for training the brain. Very intense workouts can leave you exhausted physically and mentally. Ideally, you need at least half an hour of moderate exercise 3 times a week. Longer sessions may provide added benefit. You can also consider shorter, more frequent exercise during the day.

Moderate activities like brisk walking, hiking, biking, and swimming are beneficial, as are calming activities like yoga and deep breathing exercises. Your physical therapist will help you determine what’s best for you.

If you want to maintain mental acuity well into advanced age, contact your physical therapist. Physical activity can help ready the brain for new information, leading to increased interest, improved attitude, and better learning outcomes.


The Healthy Living Formula – Exercise, Nutrition, & Stress


The Healthy Living Formula

Healthy food

Healthy living involves discipline and a strategic approach towards exercise and nutrition. It requires small, consistent changes every day to increase

your metabolism and fuel your body with the right types of nutrients.
Here are some simp

le ideas to help you live a healthier life:

  • Take frequent breaks when sitting for long periods of time. Avoid staying in one position in front of your computer or television. Cha
    nge positions at frequent intervals so you’re not sedentary all day.
  • Get on your feet and move an hour or two a day to decrease cholesterol levels and reduce blood pressure. Moving around gets your blood flowing and your body working.
  • When you’re on the phone, try to walk around while you’re talking.
  • Park further away from your destination so that you will be required to walk a little bit more than usual.
  • Get a good night’s sleep (at least 7 hours). Your body relies on rest to rejuvenate and heal itself.
  • Eat only when you truly feel hungry or consume small portions every 2-3 hours instead of 3 large meals.
  • Drink plenty of water.
  • Cut down on smoking and drinking.
  • Relax with a regular routine of yoga and meditation.

Nutrition For Healthy Skin

Nutrition plays an important role in helping maintain and improve skin tone. Smooth and healthy skin is a sign of good health. The phrase “you are
what you eat
” holds true as far as the health of your skin is concerned.

The following foods will facilitate healthy skin:

  • Antioxidant-rich foods. Antioxidants play a key part in the prevention of diseases like heart disease and cancer. Some of the foods in this group include blueberries, cranberries, strawberries, plums and apples.
  • Foods rich in Vitamin-E. Vitamin-E protects against cardiovascular diseases by defending against plaque formation in the arteries. Some of the foods that are rich in Vitamin-E include various members of the nut family, including peanuts, almonds and hazelnuts. Other types of food included are spinach, broccoli, kiwi, mango and tomatoes.
  • Selenium-rich foods such as fish, brazil nuts, liver, and sunflower seeds help to keep the skin fresh and looking youthful.
  • Foods rich in Beta Carotene. Some of the foods that are rich in beta carotene include hot peppers, kale, carrots, sweet potatoes and spinach.

Most of these foods can easily be found in your local grocery store. There are many ways to introduce them in your diet. Please remember that all foods should be eaten in moderation, and it’s best to combine healthy foods with an exercise program for best results. A physical therapist will be able to help you with an exercise program that compliments a healthy nutrition program.

Stress Management With Exercise

Stress is a part of day-to-day life, but the manner in which you handle your stress is a key factor. Stress management is the best way to minimize strain on your cells and live a healthy life.
Stress is a normal psychological and physical reaction to the increasingStress free demands of life. At some point, everyone experiences stress. If you are uncertain about how to handle stress, begin with a positive mindset. Surround yourself with family and qualified health professionals. A physical therapists, for example will provide support, expertise and design exercise programs (muscle relaxation techniques, for example) to help you deal with stress.
Learn to relax physically and mentally. A massage can help you release muscle tension, and it’s best to ask your physical therapist if a massage is right for you. In many cases, this can help reduce stress, leaving you relaxed and rejuvenated. A massage is just one component of stress release, and it can be used in addition to full body strengthening and relaxation program.
Physical Therapists can quickly get you on the road to a healthy and stress-free lifestyle.


The Benefits of Stretching to Improve Wellness


Make Time to Stretch at Work

An eight-hour work day, especially when associated with sitting in one position, can cause muscle tightness. The simple solution is to stretch your body at regular intervals whether you’re at the office, at home, or outdoors. Here are some tips to remember when stretching.

• Don’t rush. Start stretching slowly. Do not overstretch.

• Breathe normally. Never hold your breath.

Yoga stretch

• When stretching, hold the stretch for about 15 to 20 seconds and feel the tension in your muscles subside as they stretch.

• Repeat the same stretch 2 to 3 times to improve your muscle flexibility.

• Avoid sudden movements when stretching.

• Enjoy stretching. Use the time to relax.

• Maintain good posture while stretching.

• If you feel any discomfort, pain, tingling, numbness, or loss of strength, stop stretching and contact your physician or physical therapist immediately.

Stretching helps improve blood circulation, release tension, and boost energy. Don’t forget to take a few minutes to stretch every day.

Benefits of Stretching

It’s simple and easy to stretch your muscles. Regular stretching has several benefits including:

• Improved circulation. Stretching increases blood flow which brings nourishment to your muscles and gets rid of waste products. This helps reduce recovery time for muscle injuries.

• Decreased muscle tension, anxiety, stress, and fatigue.

• Increased flexibility and joint range of motion. You feel refreshed and relaxed after you stretch.

• Improved exercise performance. Stretching before exercise is a good way to increase the effectiveness of exercise.

A Simple Office Chair Stretch

Working in an office uoffice stretchsually means sitting in one area for several hours. This ultimately leads to bad posture and low back pain due to tight hip flexors and shortened hamstrings. You can help prevent these aches and pains by performing the following simple stretches:

• Finger and Hand Stretches. Place your hands on your desk, and stretch your hands while spreading your fingers until you feel a stretch. Hold for 10 seconds. Repeat 5 to 10 times.

• Wrist Stretches. Sit upright in your office chair. Lift one arm and stretch it out in front of you with your palm facing upward. Gently grab your fingers with your other hand. Slowly pull the hand of your extended arm down. Hold 10 seconds. Repeat 5 to 10 times.

• Shoulder Stretches. Lift your right arm and reach behind your head. Place your hand on your upper back making certain your arm is as close to your ear as possible. Use your left hand to gently hold your right elbow while pulling it towards the back of your head. Hold for 15 seconds.

• Spine Twist. While sitting upright in your chair, place your left arm behind your left hip. Hold onto your chair as you twist your upper body to the left. Place your right hand onto your chair to increase your stretch. Hold for 10 seconds. Repeat this exercise five times with each side.

Maintaining flexibility is a key component to maintaining health.


Diabetes Getting On Your Nerves?


diabetic meds

A majority of people who suffer from diabetes are affected by type 2 diabetes. Diabetes occurs when your body either ignores insulin or your pancreas won’t create enough insulin. This can trigger multiple health problems.

The onset of type 2 diabetes can be delayed, possibly even prevented, with a healthy lifestyle. If left unchecked, diabetes can lead to serious health problems which include kidney failure, heart disease, circulatory problems and nerve damage, just to name a few.

Once diabetes starts affecting the nerves (also known as neuropathy), individuals may experience one or more of these symptoms:

• Loss of muscle control and sensation

• Numbness, tingling, burning or pain in toes, feet, legs, hands and fingers

• Sharp cramps

• Extreme sensitivity to touch

• Loss of balance or coordination

Losing sensation can be a dangerous situation for some diabetics because small cuts and bruises go undetected, which can trigger infections that can spread to the bone due to a weakened immune system.

In these situations, a physical therapist can help reduce the risk of injury, regain muscle control and improve the quality of life.

Can It Be Treated?

Unfortunately, there is no ‘cure’ for diabetic neuropathy. Most treatments focus on slowing the progression of the neuropathy by controlling blood sugar using lifetyle modification techniques. Physical therapy is crucial since regular exercise plays a big role in the management of diabetic neuropathy.

The management of diabetes requires self-discipline and regular monitoring of one’s glucose levels. In addition to maintaining a healthy weight and controlling blood sugar, it’s important to exercise regularly, control blood pressure (take all your prescribed medication at the right time), quit smoking and minimize alcohol.

If you suspect that you, or a loved one, might have diabetic neuropathy, call our office and we will guide you towards your next step.

Physical Therapy & Diabetic Neuropathy

Physical therapists play an important role in controlling your diabetes and the damage it can cause with a structured exercise and injury prevention program.diabetic foot

The process starts with an evaluation to determine the extent of damage to your nervous system. The treatment objective is to retrain your muscles to function the way they are supposed to. This may involve a combination of exercises to challenge your muscles, electrical therapy, positioning techniques and support from your family members.

This makes the physical therapist a critical component of your healthcare team and your biggest ally in the battle against diabetic neuropathy.


Our New Year Resolution: Physical Therapy & A New You


Our New Year Resolution: A New You

As we begin 2012, people start making new year resolutions. In our case, our new year resolution is all about you and what we can do to make 2012 a healthy and pain-free year for you.

new year resolution

As the premier providers of physical therapy in our community, we value your trust in us. Our goal is not only to maintain but also to improve the high standard of care you’ve experienced with us.

As part of our resolution, we are going to teach you how to live a healthy, pain-free life. Please pay close attention to this newsletter because it will help you set the stage for optimum health and wellness in the next 12 months. Your success is ours, and we are committed to your health and well-being.

Here are a few tips to help you stay injury-free in the new year:

  • Consult a physical therapist to evaluate and, if necessary, improve your strength and flexibility.
  • Learn the right techniques to lift heavy objects, including heavy backpacks and handbags.
  • A physical fitness and injury assessment evaluation is the best thing you can do to keep yourself healthy and pain-free in 2012.

New Year Resolution Tips

Here are some ideas for new year resolutions. Please keep in mind that some of these suggestions may need to be modified depending on your individual needs.

  1. When lifting objects, I will use the correct technique (as instructed by my physical therapist) so that I can protect my back.
  2. As I perform my exercises, I will monitor my technique, breathing pattern, and range of motion during each repetition.
  3. I will maintain an upright posture and practice postural awareness exercises at regular intervals throughout the day.
  4. I will make it a habit to stretch at regular intervals while at work.
  5. I will follow the home exercise program provided to me by my physical therapist.

Physical Therapy & The New You

This is the time of the year when most individuals get gym memberships and plan to start regular workouts. It’s also the time of the year when the body is least prepared for unsupervised, sudden exercise which can cause injuries.man jump

Your physical therapist will teach you how to perform an exercise with the correct technique, breathing pattern, and range of motion. We will always answer your questions and help you exercise in a safe, progressive manner.

Don’t hesitate to contact us to ask for help with finding a routine that will work for you.

Now it’s your turn to make some new year resolutions for a healthy and pain-free year ahead!

From all of us to you and your family: We wish you a happy new year and hope you have a safe, pain-free, and injury-free year ahead in 2012.