Clinical Conversations

How do your knees affect your stride? By Nick Rinard MPT, Cert MDT

By 16 Aug, 2018 Exercise, Physical Therapy Tips, Posture

Technically speaking your knees (the joint parts) do not affect stride since running is a “mid-range” motion.  Walking, on the other hand, does involve end range extension, so limited extension could have an effect – but not in running.  Pain in the knee is likely to affect your ability to tolerate a running stride, and your body will find ways to avoid pain – thus affecting your stride in varying ways.  There is no typical way this happens, so if you have knee pain, you need to have a good mechanical examination to find out how to best treat or manage it.

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Treating Low Back Pain with Physical Therapy First

By 08 Aug, 2018 Clinical Case of the Week, Physical Therapy Tips, Posture

 

Low back pain is one of the most common causes of disability in the world. A recent study found that “Out of 291 conditions studied in the Global Burden of Disease 2010 Study, LBP ranked highest in terms of disability (YLDs), and sixth in terms of overall burden.” With a large range of different types of back pain it can be extremely frustrating finding relief from this type of pain.

Luckily there has been a large effort to find the best approach to dealing with low back pain. A 2018 study comparing healthcare costs for patients with a diagnosis of low back pain between the ages of 18 and 64. Interventions studied included differences in opioid prescription, health care utilization, and timing of PT intervention. This study found that patients who saw a PT at first had a lower utilization of high‐cost medical services (MRI, surgical intervention, emergency room visits) as well as lower opioid use.

Another study looked at the differences in long term outcomes in patients with spinal stenosis given PT or surgery. The results of this study after 2 years found that patients “did not differ significantly between patients who had undergone surgery and those who avoided surgery.” This shows that physical therapy alone is a much safer, cheaper, and equally effective choice.

Understanding your back pain and using your own body to fix itself has proven to be the least expensive and best outcome tool when dealing with low back pain. Therefore be your own advocate when dealing with new or recurring back pain and try PT first!

 

Frogner, B. K., Harwood, K., Andrilla, C. H. A., Schwartz, M., & Pines, J. M. (2018). Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health services research.

Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., & Murray, C. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, 73(6), 968-974.

Minetama, M., Kawakami, M., Nakagawa, M., Ishimoto, Y., Nagata, K., Fukui, D., & Sakon, N. (2018). A comparative study of 2-year follow-up outcomes in lumbar spinal stenosis patients treated with physical therapy alone and those with surgical intervention after less successful physical therapy. Journal of Orthopedic Science, 23(3), 470-476.

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Beat the Heat

By 01 Aug, 2018 Exercise, Physical Therapy Tips

Beat the Heat

Recently, some of my patients have been lamenting the climbing temperatures!  Oregonian’s who thrive under silver skies and temperate seasons are being scorched with hot weather this July.  Looking ahead, August promises more of the same vivid sunshine, heat haze, and adhesive humidity.

Beating the heat requires that we plan ahead to avoid the brunt of the heat wave and minimize our chance of suffering a heat related illness.  Heat related illnesses include heat exhaustion and heat stroke. Take a look at this article for more information about heat-related illness: https://mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250

I have some simple strategies that I have recommended for our patients who are looking for ways to be active without suffering from the heat:

  • Get up and get after it. The morning offers the coolest temperatures of the day, and also the long morning shadows offer shade if you are walking/running outside.
  • Do extra laps inside the grocery store before doing your shopping. This provides an air-conditioned environment where you can get your daily step goal accomplished!
  • Hydrate! If you know you are going out to brave the sizzling afternoon heat, then plan ahead by bringing a water bottle to work with you so that you can build up a reserve of hydration before your planned activity.
  • Margo Burette, PT, DPT
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