All Posts tagged MDT

Practical and Effective Treatment

Nick Rinard Physical Therapy continues to get patients results with “practical and effective treatment” since 1996!

Getting patients better in as little as 3 visits with only an average of 6-8 visits per patient. 

 

“After a hit + run accident on my bile, I have spent the last year recovering to the point where I could focus on a shoulder injury.

The orthopedic surgeon referred me to PT and I am delighted that after only three visits, my range of motion has returned and my pain has disappeared.

Thanks to the office staff for promptly scheduling me + to the PT for practical and effective treatment.”

Jennifer

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Have you moved out of state and looking for a physical therapist that is as good as Nick?

If you have moved out of state Nick Rinard Physical Therapy offers telehealth that gets great results, but if you find yourself with a condition that needs in-person visits, here are some questions you might want to ask when looking for a physical therapist.

Is the PT known among patients and providers for getting the best results in the fewest visits?

Does the PT prioritize teaching the patient how to actively self-treat rather than provide a lot of passive treatment to the patient?

Is the PT disciplined in using evidence based care and applying logic to their assessments to find the most likely source of the problem and treat it with the simplest intervention possible?

Is the PT certified in MDT at a minimum?

Has the PT been successfully practicing at the above level for 20+ years?

Does the PT have a lot of patients who choose to return to them for their other issues?

Has the PT taught the methodology to other PTs?

Does the PT put their patients’ outcomes above their own ego and ambition?

Is the PT quick to refer out to another, more appropriate practitioner as soon as the patient fails to show improvement?

The list could go on.


Nick Rinard, Owner, Physical Therapist

 

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Heal faster! Go to Nick Rinard Physical Therapy First!

“I had seen a previous PT for a few visits and didn’t feel any better – I thought my sprained ankle was a lost cause.

On my first visit with Dr. Rinard, he diagnosed my issue and provided immediate relief.

I had several PT appointments and felt constant improvement.

I’m back to running and playing volleyball and I could have done it without his help/patience/understanding and knowledge.

Thank you so much! ”

Gloria

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Is your sleep becoming compromised?

Get your sleep back by calling and scheduling your evaluation at Nick Rinard Physical Therapy today.

“I was not able to walk my usual 2 miles a day and I was having pain all day and night in the thigh.

Because I could not massage it out, I figured it was a spinal referral pain.

Having been “fixed” by the McKenzie Method of lower back pain after a fall in 2014, I asked my provider for a referral here.

I can walk as much as I want now. I can sleep with no pain.”

Tenny

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Quadriceps Strengthening Exercise Routine Decreases Pain Associated With Osteoarthritis and Meniscus Injury

Quick Answers Are Never a Guarantee

Picture of woman running wearing RinardPT logo

We live in a culture that seeks immediate results and quick answers to solutions. Most of the time, unfortunately, we also want what requires the least amount of effort on our part. In the medical community, this boils down to people deciding to have surgery to fix the problem. Unfortunately, surgery is never a guarantee. Time and time again I treat patients here at Nick Rinard Physical Therapy who were advised to have surgery and, after the procedure was performed, their pain remained. This happens because of both the general public and medical practitioners’ lack of understanding about how the body moves and heals. Recently, there was a man referred to our Portland airport (PDX) clinic by his friend for knee pain. He was scheduled to have knee surgery the next week, but wanted to have a second opinion. My colleague diagnosed him with a very simple problem: knee capsulosis, and he was reporting decreased pain and improved range of motion by his 2nd visit. He cancelled his surgery and is expected to have a great outcome with conservative care.

Regimented Exercise Can Decrease Knee Pain without Surgery

I recently came across a study that found simple regimented exercise routine focusing on quadriceps strengthening and cardiovascular endurance decreases knee pain associated with osteoarthritis. What a great concept: exercise can decrease pain and improve function and avoid surgery! The authors of the study concluded: “Optimal exercise programs for knee OA should have one aim and focus on improving aerobic capacity, quadriceps muscle strength, or lower extremity performance,” the authors concluded. “For best results, the program should be supervised and carried out three times a week. Such programs have a similar effect regardless of patient characteristics, including radiographic severity and baseline pain.”

Physical Inactivity is THE Major Public Health Problem of the 21st Century

I came across a quote that really resonates with these findings: “…most medical schools only allocate a perfunctory hour to the fact that physical activity is medicine. This is a major failing of medical education when physical inactivity is the major public health problem of the 21st century.”

Resources

Meta-analysis: Quadriceps exercise best reduces knee OA pain:
http://news.todayinpt.com/article/20140329/TODAYINPT04/140328005&SearchID=73533945353381?utm_content=sf25084815&utm_medium=spredfast&utm_source=facebook&utm_campaign=social2013&sf25084815=1
Accessed on May 1st, 2014
Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. K M Khan, A Scott. Br J Sports Med 2009;43:247-252

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RinardPT Monthly – May 2014

Nick Rinard Physical Therapy in Portland Oregon Logo White

RinardPT Monthly

Nick Rinard Physical Therapy
9700 SW Capitol Hwy Suite 140
Portland, OR 97219

Volume 6, Issue 3
April 2014

SW Portland Open House

Should you be resting?

ICE or HEAT?

Should you be ‘working through’ the pain?

Is the source of your pain serious?

Ask an experienced MDT Physical Therapist at Nick Rinard PT! With a 15 minute Free Consultation, we can often find the cause of your pain and give you advice to help treat your symptoms.

Xray highlighting region of severe back pain

Join us for a special Open House and ask about your pain “while you’re here.” Light refreshments will be offered, and appointments are encouraged though WALK-INS are always welcome!

Tuesday, June 17th – 5:00pm-8:00pm

Call 503-244-6232

for your Evaluation or Free Consultation

RinardPT patients get Results:

Don’t take our word for it

“I came into Nick Rinard PT because of a car accident in December that I sustained a neck injury in. I had very limited neck motion, & had pain when I tried to move my neck. I had severe pain when sitting for long periods of time, trouble driving, and doing other everyday activities. I also had random headaches every day that kept me from doing normal tasks. Now I feel much better. My headaches have almost gone away, I have my range of motion back, and I am not in pain anymore.”-Lauren 04/28/2014 “I was referred for treatment after PT elsewhere was not improving my symptoms for a post-operative L5-S.1 discectomy/laminectomy. Once starting treatment at Nick Rinard PT I knew it was the right fit. After my 1st visit I had increased symptoms and called that evening. I was immediately helped over the phone and scheduled to return the next day. From then on, it was steady improvement with detailed explanation of exercises and physiology. I’m beyond grateful for the care and staff at Nick Rinard PT.”-Shelley 04/17/2014

 

Nick Rinard Physical Therapy 4 people jumping on the beach

FREE CONSULTATION COUPON

MENTION THIS COUPON AND SCHEDULE YOUR FREE SCREEN TODAY (503) 244-6232
In just 5-10 minutes, MDT can determine if your pain is mechanical or not. If so, we can help get you out of pain and back to enjoying your life.

 

Clinical Conversations NOW at RinardPT.com

From low back pain, hip pain, ‘pseudo tennis elbow’…

We’ve seen it all at
Nick Rinard Physical Therapy!

Come see our success stories, get advice for how to avoid pain, and what to do while you wait for your physical therapy visit with us.

http://RinardPT.com/clinical-conversations/

Mobilization with Movement with Grip
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RinardPT Monthly – April 2014

Nick Rinard Physical Therapy in Portland Oregon Logo White

RinardPT Monthly

Nick Rinard Physical Therapy
9700 SW Capitol Hwy Suite 140
Portland, OR 97219

Volume 6, Issue 3
April 2014

New Look, Same Great Care!

MDT of Portland is Now Nick Rinard Physical Therapy

With a new name and a new logo, we’ve had a lot of exciting changes. We hope that you like our new look, and rest assured that the changes stop there.

Nick Rinard Physical Therapy is committed to continuing to provide specialized McKenzie (MDT) based personal care for you and your loved ones-just like we have since we opened our doors in SW Portland, Oregon in 1999.

Nick, Natasha, and the entire Nick Rinard PT team are here for you!

Call 503-244-6232
for your Evaluation or Free Consultation

RinardPT patients get Results:

Don’t take our word for it

“When I first came for PT, my lower back was very stiff & it was painful to do side-bends. I my lower back became fatigued from walking/running I would experience muscle spasms in my back.Now I can walk/run my normal 45 minutes or hike and I feel good-no spasms!”-Maureen 03/14/2014 “I was referred by my doctor after 6 weeks of going to another PT clinic with no results. I wasn’t hopeful that Nick Rinard PT would get any better results. After 4 visits, I could tell things were changing for the better. My pain while standing was a 10 at worst, down to a 3 at the end of my day. The people and staff are amazing and friendly. I loved how they put their ‘thinking caps’ on before they start. Thank you so much.”-Teresa 03/26/2014

 

Nick Rinard Physical Therapy 4 people jumping on the beachFREE CONSULTATION COUPON

MENTION THIS COUPON AND SCHEDULE YOUR
FREE SCREEN TODAY
(503) 244-6232
In just 5-10 minutes, MDT can determine if your pain is mechanical or not. If so, we can help get you out of pain and back to enjoying your life.

 

Join the Walk to Cure Arthritis! We’ll Meet you There!

 

Oregon and SW Washington Walk to Cure ArthritisSaturday, May 17th in Vancouver, Washington
Nick Rinard Physical Therapy will be at the Health Fair from 9am-1pm.

Esther Short Park
Columbia St
Vancouver, WA 98660
  • Choose to walk a 1 or 3 mile loop

Registration and more information at :
http://vancouverwalktocurearthritis.kintera.org/

Can’t make it? You can make a donation for the cause at the the link above to show your support!

 

 

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Vertigo: A mechanical cause and treatment!

The most common cause of vertigo (dizziness) is benign paroxysmal positional vertigo (BPPV) and it is a mechanical disorder. A trained clinician can evaluate and treat this condition based off of the patient’s symptoms. The evaluation consists of moving the head into specific positions. Symptoms of BPPV include vertigo with change in head position, nausea with or without vomiting and disequilibrium (poor balance).

Curable

Image of Inner Ear and Vestibular System edited by Dan Yedinak

Vestibular System

BPPV is a curable condition affecting the vestibular system (inner ear). Your inner ear is comprised of 3 semicircular canals (SCC) and 2 otolith organs. These structures detect head movements (acceleration). Crystals called otoconia are embedded in the otolith organs. Sometimes, the crystals can become dislodged and misplace into the semicircular canals. The misplaced crystals result in increased sensitivity to head movements.

Hopes for a Positive Response

I was treating a patient for low back pain when she mentioned that she was experiencing severe episodes of dizziness. I informed her about BPPV and mentioned that the treatment was very simple and effective. She agreed to have an evaluation in hopes for a positive response.

My patient tested positive for BPPV utilizing the Hallpike-Dix test for the left semicircular canals. I also performed a few other tests and exercises to rule out other potential causes for symptoms. Once we had our diagnosis of BPPV, the treatment was very simple.

Improvement in just one week

I took my patient through a series of head movements that reposition the crystals back into the otolith organs (the saccule and ultricule). After performing the repositioning maneuver, baseline symptoms were decreased and she returned the next week without having any severe episodes of vertigo.

BPPV – A Common Vertigo that is Easily Treated

BPPV is the most common cause for vertigo. Luckily, it is very easy to diagnose and treat with a trained therapist. If you or someone you know has vertigo as a result from head movements, have a physical therapist evaluation so that you may start feeling better today!

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Post op shoulder pain was really coming from the neck

Nick Rinard PT ExerciseVery interesting clinical presentation today!  The patient had been treated for neck pain here (Nick Rinard Physical Therapy) in the past with good results.  Later, she developed shoulder pain and consulted her MD, who referred her to an orthopedic surgeon.  There were “findings” on MRI and she ended up getting arthroscopic surgery.  She returned to us for physical therapy to rehabilitate after surgery.

No Surgery Needed

Interestingly, she reported that her surgeon was surprised that her rotator cuff tendons were in “good condition” and did not require a repair – he had noticed that during the surgery procedure itself, apparently.  So, physical therapy should be easy in such cases, right?  No big surgical repair to worry about.  

However, 6 weeks after the operation, her shoulder pain was not subsiding as it should have.  Inflammation normally resolves in that amount of time and she should have been strong enough to resume normal office work duties consisting of keyboard and filing.

Finding the True Cause of the Pain

We had to take a closer look at her neck.  It turned out that her neck was referring pain to the shoulder!  In one neck treatment, the shoulder pain was abolished!  The patient probably had had a recurrence of her old neck problem, it referred pain to her shoulder, and neither she, her MD, nor the orthopedic surgeon considered the true cause of the pain…

This is a frequent occurrence here at Nick Rinard Physical Therapy, where we use the Mechanical Diagnosis and Therapy (MDT) system of evaluation and treatment.  Robin McKenzie started this method and it is the best method – and most supported by research – at getting to the true cause of pain.

Save time, money, and maybe avoid surgery!

If you or someone you know is having any problems that could be mechanical, a thorough mechanical assessment should be performed.  In as little as one visit the problem might be identified and solved, saving a lot of time, money, and suffering!  Plus, the patient might avoid unnecessary surgery!

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Can TMJ Pain and Dysfunction be Purely Mechanical?

TMJ pain can be a real problem for its victims, limiting their ability to chew and talk, and interrupting sleep. Often, headaches even limit the person’s ability to concentrate! Various treatments have been proposed to alleviate the symptoms of TMJ (Temporomandibular Joint) pain, many of which are very complex and even invasive. Looking at the TMJ as “just another joint” and not predetermining that it has to be complicated has been very freeing for me in using a mechanical approach. Let me explain using a patient example from this week in clinic.

My approach is modeled after the McKenzie Method of Mechanical Diagnosis and Therapy, although very little about TMJ specifically has been written or published about it. (1)

Symptoms and Experience

Now, about the patient. (Name and other identifying information has been omitted to protect privacy). This patient complained of intermittent left jaw pain with wide opening of the mouth. He stated it only occurred then, and otherwise it really was not painful. However, chewing tough foods, he admitted, was sometimes painful. His worst pain occurred with rapid opening of the mouth and could be as intense as 6 on a scale of 1-10.

Therapist’s Evaluation and Findings

Objective findings were limited and painful opening with slight left deviation, limited and painful protrusion, limited and painful right deviation, and no pain or limitation with retraction, or left deviation. Repeated tests performed actively by the patient of protrusion first, then of right deviation resulted in producing the patient’s symptoms, no worse after, but also no change in baseline ROM or pain. Forces were progressed to patient applied over-pressure to right deviation. The patient reported that this produced his pain initially, then decreased pain as he performed more repetitions. Subsequently, he reported wider opening with less pain!

Patient Homework

Home exercises were assigned, which naturally consisted of patient applied over-pressure into repeated right deviation every hour or two as per typical McKenzie protocol. On the second clinic visit two days later, the patient stated he was already 50% improved! This finding confirmed the mechanical diagnosis of derangement syndrome. In this classification, there is a good prognosis for rapid and lasting recovery from the problem.

Get Yourself Evaluated

This is only one clinical example of a purely mechanical TMJ problem. While there are examples of TMJ issues that are not derangements, or even mechanical, often a mechanical cause of the pain can be found and the patient helped by mechanical therapy. It is well worth a thorough examination to determine if your TMJ pain has a mechanical component, and to get appropriate treatment which would otherwise be missed.

(1) http://www.sciencedirect.com/science/article/pii/S1356689X1100230X

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