‘Tis the season for making resolutions, focusing on self-improvement, and charting the course for the year ahead. What are you doing to improve yourself in 2018? One small step that can make a tremendous impact in many areas of your life is simply to establish good self-accountability. How credible are you? Many of us are loyal to commitments we make to our friends, family, and coworkers but we may routinely neglect to fulfill our promises to ourselves. When was the last time you put off a work out, failed to follow through with a diet goal, or simply lost momentum with a good training program?
Creating the discipline of good habits is beneficial to all of us! Whether you are looking to reboot your home exercise routine or seeking to redeem your diet after an avalanche of holiday feasts – consistency is the key. Daily diligence defines the difference between crashing through a fad and building a foundation of good habits that can improve your life. In some areas of life, this need for consistency is obvious, for example: brushing your teeth. If you wish to have fresh breath for your date on Friday night, is brushing your teeth just once on Tuesday going to cut it? Nope! Good oral hygiene requires that twice a day commitment every day of the week. Other areas of our health will benefit from applying this daily discipline as well.
So, here are 5 easy ways to help build credibility with yourself and to insure you follow through with all of those good intensions.
- Make an appointment with yourself – Schedule time on your calendar each day, even if it is just 20 minutes, to do your home exercise program. Honor this time the same way you would honor any other medical appointment.
- Reward yourself when you follow through – Improving your health is its own reward, but you may need other tangible incentives to keep you motivated on your course. Make a barter system with yourself – “For every 10 minutes I spend on this treadmill, I will get 10 minutes of guilt-free Netflix ve
- Get friends and family onboard – One of my patients found the best way to correct his posture was to recruit his children, “It’s open season, kids – anytime you can catch me slouching, call me on it and I will give you a dollar.”
- Keep it visible – Put those running shoes in a high visibility area of your home so that you have a visual reminder to gear up and get outside for a jog. Are you using a theraband for your exercise routine? Don’t hide it – hang it in plain sight so that you are prompted to put it to good use!
- Teach what you’ve learned – If you have mastered a new exercise or healthy recipe, share it! Pay it forward and reap the benefit of better understanding through teaching. You know you have truly mastered a technique when you can teach it effectively to someone else.
So let me know – what do you do to encourage yourself to follow through with your commitments to yourself? Have you tried any of these suggestions before? Do you have new ideas you’d like to share with us? Let’s support each other in making 2018 a year of abundant good health!
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By Megan Plante, DPT
12 Jun, 2014
Clinical Case of the Week
exercises, inactivity, Knee pain, MDT, medical education, Nick Rinard, OA pain, Portland Oregon, quadricepts, quick answers
Quick Answers Are Never a Guarantee
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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By Nick Rinard Physical Therapy
19 May, 2014
RinardPT Newsletters
15 minute consultation, Heat, ice, MDT, Nick Rinard, Nick Rinard physical therapy, Open house, pain, Portland Oregon, source
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RinardPT Monthly
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Nick Rinard Physical Therapy
9700 SW Capitol Hwy Suite 140
Portland, OR 97219
Volume 6, Issue 3
April 2014
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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. |
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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 |
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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.
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Clinical Conversations NOW at RinardPT.com
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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/
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RinardPT Monthly
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Nick Rinard Physical Therapy
9700 SW Capitol Hwy Suite 140
Portland, OR 97219
Volume 6, Issue 3
April 2014
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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 |
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.
Join the Walk to Cure Arthritis! We’ll Meet you There!
Saturday, 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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By Nick Rinard Physical Therapy
14 Mar, 2014
Clinical Case of the Week
ankle pain, clinical presentation, Nick Rinard, Nick Rinard physical therapy, pain-free, Physical Therapy, Portland Oregon, relationship, results, Spine, treatment
By MiKayla Sanocki, SPT
Did you know a back problem can cause symptoms such as pain, decreased strength and decreased sensations into the thigh, calf, ankle or foot? Physical therapists trained in Mechanical Diagnosis and Therapy (MDT) here at Nick Rinard Physical Therapy can determine during the evaluation if any of these lower leg symptoms are coming from your back.
Check out this bizarre clinical presentation we treated at Nick Rinard Physical Therapy:
She did not remember any trauma to the ankle
The patient came to physical therapy for an “ankle sprain” that occurred 3-months earlier. She stated she woke up unable to put any weight on her right foot. The pain had remained constant in her ankle, so bad at times that she couldn’t walk! Upon further questioning, the patient revealed what she had been doing the day before: She had driven 2 hours, on her way home from helping clean a house. During the drive she had discomfort in her buttock and hamstring that made her want to pull the car over to stretch. She did not remember any trauma to the ankle, however, but the ankle pain was the only pain she was experiencing now.
Her ankle pain has caused her to quit running and yoga — two of her favorite activities.
Mechanical Evaluation finds cause in spine
During the mechanical evaluation we found that certain directions of low back movements decreased the pain in her ankle. After being sent home with 1 simple exercise to perform every waking hour – which she did perfectly – she returned within 24 hours reporting 90% recovery in pain! Over the next week we were able to progress her exercises and now the patient reports no ankle pain at all. In only 4 visits we were able to abolish her ankle pain, and she is now getting back to running and yoga!
The patient reports, “I now have the tools to prevent the return of my back and ankle pain”.
Treatment at Nick Rinard Physical Therapy vs Traditional PT
In contrast to MDT, traditional PT would not have uncovered the spinal cause of the patient’s ankle pain. Treatment would have been ineffective since it would have focused only on trying to treat the symptom.
Do you know if your pain in the legs or arms could be coming from the spine? Come see us at Nick Rinard Physical Therapy and find out!
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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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Medical Advisory: MDT is a Superior Form of Physical Therapy
This is page 2, continued from <<Choose your Physical Therapist Wisely
If you sustained your injuries in a motor vehicle accident, or work-related injury, then your chances of getting better are improved if you choose an MDT therapist. There is a financial advantage also since the total cost of your therapy will be less, based on the fewer number of visits MDT uses. Your PIP money will go further, and you will not have to sacrifice a large amount of money out of your settlement just to pay high physical therapy bills. If you are a worker, your case will be less likely to be denied if you are getting better faster, than if your recovery drags on. Believe me, insurance adjusters are less likely to keep your case open if you are not improving in physical therapy.
So you can see that MDT is a superior form of physical therapy. What about MDT compared to Chiropractic care? I tell my patients that Chiropractic treatment is indeed mechanical, but there are two distinct reasons it is not superior to MDT. The first reason has to do with the evaluation, and the second reason has to do with the treatment. A chiropractor first must take an X-ray to make the diagnosis. Unfortunately, there is little evidence to suggest a chiropractic diagnosis is reliable, and therefore, treatment based on an unreliable diagnosis is a guess at best. Secondly, chiropractic treatment is performed to the patient, not by the patient. Any improvement in the patient’s condition, therefore, is dependent on them going back for more visits! As mentioned, MDT treatments consist primarily of exercises that the patient performs so you can treat yourself when not in the clinic. This obviously results in less pain, a speedier recovery, less visits, and money saved!
By reading this essay, you are now equipped with knowledge to seek out the best care possible for your injuries. Don’t waste time going to traditional physical therapy, or chiropractic for many visits. It is better to get an MDT evaluation to determine if your condition will respond mechanically or not, and if it is mechanical, then the treatment is more effective and takes less time!
In closing, I would like to mention how MDT compared to traditional physical therapy in an objective study conducted by a third party. The average improvement in traditional physical was only 78 percent, and it took an average of 11 visits to achieve this. By contrast, MDT got patients 93 percent better in only 6.5 visits! The data speak for themselves. Don’t settle for less effective treatment for your injury – find a Cert MDT therapist who is using the MDT method properly, and get better faster!
Nick Rinard is president of, and a therapist at, Nick Rinard Physical Therapy, a private physical therapy clinic.
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