All Posts tagged Physical Therapy

The end of year is fast approaching.

We, at Nick Rinard Physical Therapy, hope that everyone had a great holiday.

After Thanksgiving the end of the year seems to go by a little faster than usual.
You have lots to do and you don’t need to do it in pain.


Get your results today!


“Lumbar pain – was a deranged disc.
Katie fixed me right up in a couple of weeks.
And now my range of motion is better than before the injury.
Resuming running / yoga….”
Andrew

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What are you doing to improve yourself in 2018?

‘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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Total Knee Replacement (TKA) and the Importance of Physical Therapy by Nick Rinard

At Nick Rinard Physical Therapy a lot of patients come to see us with knee pain and/or knee arthritis, both before and after various knee surgeries, including total knee replacement surgeries.

Since 2010, knee replacements have been the most performed surgery on people over 45 years of age. Knee replacements are performed at the rate of 700,000 per year. Because of this increasing rate, the efficacy of pain relief and improvement of function should be investigated.

100 patients with knee arthritis

A researcher, Soren Thorgaard Skou, has done just that. In his study, he looked at 100 patients with knee arthritis and assigned them to a surgical group or non-surgical group (which received physical therapy, medication and diet education). After one year, 85% percent of the surgical group had significant improvements in pain vs 68% of the physical therapy group. The surgical group and larger gains in their ability to climb stairs and walk. However, the study also showed that the surgical group is at greater risk for complications that the physical therapy group is not. The surgical group is more likely to have blood clots or a manipulation (another procedure performed by the surgeon to increase range of motion). The surgical group had more adverse side effects vs the physical therapy group (24 vs. 6).

Physical therapy is effective

Physical therapy is effective and should be considered a viable option before jumping to surgery. If the first knee replacement can be delayed, this can decrease the necessity for a second surgery (current replacements last 10-15 years).  We urge our patients to remember that we are always here for you before or after surgery.  Nick Rinard Physical Therapy is a phone call away 503-244-6232 !

1/3rd of knee replacements are unnecessary

This, taken into consideration with the study that came out last summer that found nearly 1/3rd of knee replacements are unnecessary, should be considered when deciding to have a knee replacement or a trial of physical therapy to determine effectiveness.

Sources:

http://health.usnews.com/health-news/articles/2015/10/21/knee-replacement-brings-less-pain-better-function
Dr. Skou’s report (N Engl J Med. 2015 373;17:1668-9)

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Balance and Aging

It is general knowledge that, as we age, our sensory systems start to decline. This includes sight, smell, temperature regulation and balance mechanisms.  It’s important to have good balance because if it declines, you are at a higher risk for falling.  And falling, results in injuries that can greatly affect your life.

Exercises that Challenge your Balance

What many people don’t know, is that you can work on making your balance stronger, just like you do a muscle: by exercising it!  What physical therapy aims to do, is find exercises that challenge your balance system, so that your body must learn to adapt to certain situations and re-train itself on what to do.

Static and Dynamic Exercises

Physical Therapists can provide both static and dynamic exercises for you, depending on what is most challenging.  Exercises can be very simple and integrated during daily routines- like balancing on one leg while brushing your teeth.

If you are having trouble with your balance, come in to Nick Rinard Physical Therapy and have an assessment by a physical therapist! 503-244-6232

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Why is it important to start therapy after a motor vehicle accident (MVA)?

RinardPT recommends immediate treatment after Auto AccidentThis is a question that seems to be in debate.  At our clinic, we advise our patients to come in for treatment as soon as possible when experiencing pain in order for the fastest results.  I have experienced push-back from other health care practioners who want the person to “rest” for 4-6 weeks before starting therapy.  The problem with this? There are many things a person can be doing immediately after the MVA to facilitate healing and prevent dysfunction.  All too often, we see people 6 months or longer after the MVA. If the patient has not been given anything to work on for exercises at home, the picture is this: limited, painful movement of the spine or joint, global weakness, and poor posture that becomes painful if corrected.

What does therapy look like in the first few weeks after an MVA?

  • Initiate gentle range of motion exercise to prevent loss of movement
  • Manual techniques including passive range of motion and soft tissue mobilization to promote blood flow and healing.
  • Ultrasound modalities that decrease inflammation/swelling and promote tissue healing</li class=”rinardptli”>
  • Education and training on how to prevent dysfunction

Here at Nick Rinard Physical Therapy, we see a lot of patients who have suffered an MVA. In fact, we see it so much we have a protocol for it that is very successful for treatment.  Don’t wait! Start healing and feeling better today!

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Mechanical Pain versus Muscle Soreness

Sports Injuries require Physical Therapy TreatmentA mistake that people often make is waiting too long to start physical therapy treatment for their aches and pains. This commonly occurs because you may be thinking, “this will go away on its own,” or, “it’s just normal for me to feel like this at my age.” I want to clear up some confusion on mechanical pain versus normal muscle soreness that does not require skilled therapy or treatment.

Muscular Pain:

  • Experienced after a sudden increase in activity or exercise.
    • Running 6 miles when you typically only run 2 miles
    • You increased the intensity or length of time to your typical workout
  • Will be experienced 1-2 days after the increased activity has been performed and will typically begin to dissipate or be gone in 3-5 days after onset.
  • Is typically vague pain or experienced in a general area. The pain will not be sharp or pin-point to a specific area.
  • If you’re educated on what muscles perform which actions, the sore muscles will correlate with what activity you were performing.
  • Does not have increased or decreased pain associated with positions.

Mechanical Pain:

  • May have a sudden onset without explanation of occurrence (you woke up with pain for no apparent reason).
  • Will typically have a loss in range of motion. For example: it may be difficult to stand up straight in the morning or after prolonged sitting or driving.
  • Will have positions that will increase or decrease symptoms. For example: pain increases with sitting, pain is better while lying down.

If you’re experiencing mechanical pain the sooner you seek physical therapy treatment, the better! A good Physical Therapist can determine which exercises will reduce your symptoms and get you back to doing the activities that you love!

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Pseudo Tennis Elbow: A Commonly Misdiagnosed Mechanical Problem

Lateral epicondylitis, more commonly known as “tennis elbow,” is a pathology that is familiar to physical therapists and the general public. What is lesser known is “pseudo tennis elbow,” a mechanical problem with a very simple solution! Unfortunately, therapists whom are not familiar with the utilization of mechanical diagnosis may unknowingly miss this common elbow derangement. As a therapist practicing the McKenzie method of mechanical diagnosis, I have diagnosed BOTH of my current elbow pain patients as derangements (or pseudo tennis elbow).

SYMPTOMS

Portland area patient presented to physical therapy with intermittent right elbow pain, worsening over the last 3 months. Patient reported difficulty with gripping, lifting, carrying and global limited function of the right arm. Patient described symptoms as “variable” meaning he could perform a task that produced his elbow pain. Then, perform the same task or movement again without experiencing any pain at all! This variability of pain is the hallmark of a derangement and should not be misdiagnosed as a tendonitis (also called tendinitis), which would indicate inflammation (in which case pain would be constant). Patient rated worst elbow pain as a 6/10.

THERAPIST’S EVALUATION AND FINDINGS

Mobilization with Movement with GripObjective findings included pain with passive elbow flexion and extension as well as pain with active wrist extension and with gripping a tennis ball. Because of my experience as a mechanical therapist, I am familiar with a technique called a mobilization with movement (MWM), developed by Brian Mulligan (a colleague of Robin McKenzie). The mobilization provides a lateral force over the ulna at the elbow joint. While the patient applied this force, he was able to grip the tennis ball PAIN FREE! This same technique was applied for other painful baselines and achieved the same results of ABOLITION OF ALL PAIN! This ability to turn symptoms off with a mobilization indicates an elbow derangement and the MWM is used as the treatment strategy.

PATIENT HOMEWORK and OUTCOMES

The patient was asked to perform the MWM utilizing the lateral glide while gripping a tennis ball to be performed 10-20 times every hour. The theory is that this mobilization is re-positioning the joint in order for it to articulate correctly, resulting in improved range of motion and strength after. The patient returned to the clinic the next day with reports of at least 25% improvement! Objective findings were retested and nearly all baselines had improved in less than 24 hours! The patient returned 1 week later and reported an 85% overall improvement with symptoms.

GET YOURSELF EVALUATED

Don’t be misdiagnosed! Straightforward pathologies which require one exercise to treat are commonly missed with standard treatment. This results in extra physical therapy visits, and more of your time and money. It is worth your time to see if your pain has a MECHANICAL component, otherwise a simple solution may otherwise be missed.

If you are experiencing elbow pain and are living in the Portland/Vancouver metro area, get the best results by calling us today at 503-244-6232 to schedule a physical therapy evaluation.

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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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Ankle pain from the spine?!

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

Picture of woman running wearing RinardPT logoDuring 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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RinardPT Monthly – March 2014 – Happy St. Patrick’s Day!

Nick Rinard Physical Therapy Logo Traced Outline Image of Man

RinardPT Monthly

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

Volume 6, Issue 2
March 2014

Change Your Clocks! | Happy St. Patrick’s Day! ECLATT Leprechaun Girl Hat Logo

Why Wait?

Too often, we get patients in our office who have been in pain for months (or almost a year in Michael’s case!  Read his story below).  If your pain is not improving on its own, there is NO NEED TO SUFFER!  It could take just 3 visits, like it did for Jane, and you can have the tools to treat your pain and get back to living your life to the fullest.  Most of our patients are able to self-treat their problem in just 6-8 visits.  Get the tools you need now.

Are you currently suffering from pain or injury?
Call 503-244-6232 today!

RinardPT patients get Results:

Don’t take our word for it

“I hurt my knees in October 2013 while in Mexico.  I wish I had called MDT sooner and saved myself four months of pain & difficulty walking.  Going down stairs was especially painful.  In three sessions I am pain free; getting out of bed, walking, and stairs are no longer painful.  Many thanks! ”-Jane 02/12/2014 “I was in a car accident in May 2013.  I had neck pain and stiffness every day after the accident.  I came to MDT of Portland in hopes of being cured.  Within roughly 7 sessions, I would say I no longer have any pain.  Thank you guys very much-you’re all incredible!”-Michael 02/04/2014

 

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.

 

Remember to “SPRING FORWARD” by one hour on Sunday, March 9th!

ECLATT Reminds you to Change Your Clocks

March Events around Portland

RinardPT Happy St Patricks Leprechaun Girl

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