Joint Ventures' Blog

Many people assume that aquatic therapy is only for low level activity, non-impact, or only geriatrics.  WRONG!! 

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Hey Ladies!  What are you doing this Wednesday and Thursday? Joint Ventures will be at StyleFixx Girls’ Night Out October 6-7, 2010, giving free massages! Join Boston’s most fashion-forward women for two nights of dream shopping, featuring over 55 cutting-edge designers and brands. Indulge in complimentary makeovers, hair treatments, cocktails, manicures, massages, Swag Bags and more!  www.StyleFixx.com 

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The literature states that shoulder pain accounts for approximately 16% to 21% of all musculoskeletal conditions and is second to only low back pain in prevalence.  In this article I am going to address why the shoulder joint is vulnerable to injury and briefly discuss some commonly seen pathologies

 

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Osteoarthritis is a chronic disease involving the joints, especially those bearing weight.  It leads to impaired function due to destruction of articular cartilage, and overgrowth of bone with possible spur formation.  Rheumatoid arthritis is a form of arthritis with inflammation of the joints, stiffness, swelling, cartilaginous hypertrophy, and pain.

                 Aquatic physical therapy is an optimal setting for treating these diagnoses, due to the reduction in weight bearing during the exercise.  Buoyancy reduces loading across joints affected by pain and allows the performance of functional closed-chain exercises that otherwise may be too difficult on land. Water turbulence can be used as a method of increasing resistance, and percentage of body weight one bears across the lower limbs can be decreased or progressed in proportion to the depth of immersion.  The reduction in gravitational pull on all joints including the spine, promotes improved posture and spinal extension. While moving in the water there is a promotion of joint lubrication which decreases joint stiffness and pain.  Exercise in an aquatic setting also increases proprioceptive awareness during exercise and functional task motion.  Because of the supportive effect of the water, there is an increase in amount of time to recover loss of balance and promote recovery.

                 Tools used in the aquatic setting include aqua belts, water dumbbells, resistive paddles, and gloves.  Depending on the needs of the patient, resistance is used, or buoyancy is added.  Speed of activity also plays the role of an aquatic tool.  Adding speed to specific motions, adds resistance. 

                 Aquatic physical therapy can also assist in the treatment of other diagnoses.  The unique properties of the aquatic environment enhance interventions for patients across the age span with musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary diseases, disorders, or conditions.

                 Patients with rheumatologic problems do have other options in treatment, but bringing aquatic physical therapy to your doctor’s attention may lead to the attainment of otherwise unmet goals.  By exercising in the water with a skilled physical therapist, a patient may finally be able to find a pain free form of cardiopulmonary fitness. Many people with RA and OA struggle to find a way to loose weight and improve health that does not flare up their joint pain.  By working regularly with a physical therapist, a patient my attain gains in flexibility, strength, fine motor skills, and posture.  Other goals may also include improvement in gait parameters, ability to perform ADL’s, and work tolerance.  

          If you have any questions regarding Aquatic Physical Therapy please contact Joint Ventures Physical Therapy.

 

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Achilles Tendon Dysfunction  
Achilles tendon dysfunction is characterized as pain located along the heel cord (Achilles tendon) or pain located at on the heel (calcaneus) of the foot. Pain is typically worse in the morning and is usually accompanied by stiffness of the heel cord (achilles tendon). The achilles tendon is one of the largest and strongest tendons in the body.  It consists of the gastrocnemius, plantaris, and soleus muscle which come together and attach at the heel of the foot (calcaneus).  The primary function of the achilles tendon is to transfer strength and power into the calf to assist the lower leg in activities such as walking and running.

Causes
Achilles Tendon Dysfunction is caused by soft tissue irritation of the achilles tendon. This can happen for a number of reasons including repetitive movements, a recent increase in activity level, postural problems such as over pronation of the foot, running, and a tight gastrocnemius.  Certain motions of the foot done repetitively during sporting activities can also contribute to an irritation of the achilles tendon. Sporting activities with short, sharp, quick, bursts of movements in a variety of directions such as basketball, tennis, soccer and volleyball may increase your risk of developing achilles tendon dysfunction.  Other risks for developing achilles tendon dysfunction include a recent increase in activity level, running, change of shoes with less support, exercise routine that includes running hills and/or stairs and squatting.

 Physical Therapy
A physical therapist can diagnose and treat achilles tendon dysfunction. He/She will evaluate the biomechanics of the lower leg/foot, range of motion, strength of surrounding muscles and any postural problems. Treatments may include manual therapy to promote an increase in painfree range of motion, stretching to lengthen any tight musculature of the lower leg, modalities to promote healing and possible footwear change to correct for postural problems.  A physical therapist will put you through a stretching and strengthening exercise program to eliminate the pain felt by the achilles tendon dysfunction and return you to your normal everyday lifestyle without pain as quickly as possible.  Your Joint Ventures physical therapist can perform all of these treatments to assist in the recovery of achilles tendon dysfunction.

There are 3 main stages of healing that occur after an acute sprain/strain injury:
 
The first stage is the inflammatory phase, where the body sends inflammatory cells to the injured site to help clot the wound and remove debris.  This phase usually lasts the first 4 days after injury.  The best treatment during this phase of injury is RICE: Rest, Ice, Compression and Elevation.  Physical therapy can assist at this phase to help reduce the swelling and provide gentle range of motion exercises.
 
The second stage is the scar formation phase, where the body lays down collagen tissue to repair the injured site and form a scar.  This phase usually lasts from Day 4 to Day 15 after injury.  Physical therapy is most effective at this stage to help promote regular tissue growth and minimize scar tissue development.  Treatment might consist of modalities, manual therapy, deep tendon frictions, stage to promote proper strengthening without re-injury to the healing tissues. massage, stretches, and gentle strengthening exercises.  At this stage the repairing collagen tissue is still weak and can be susceptible to re-injury if over-stressed.  Physical therapy can help guide exercises at this
 
The last stage of healing is the remodelling phase, where the body remodels and increases the tensile strength of the newly repaired tissue.  This phase lasts from approximately Day 15 and continues for up to 1-2 years after injury.  During this phase, physical therapy aims to minimize scar tissue build-up, encourage optimal orientation and alignment of the newly formed tissue, correct muscle imbalances, retain and maintain mobility of the joint, increase the stability of the joint, strengthen the repaired tissue with more difficult and challenging exercises, and prepare for return to sports or leisure activities.
 
If you have suffered an acute sprain/strain please consult your doctor or physical therapist to determine the appropriate treatment plan for you.  

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AQUATIC PHYSICAL THERAPY 

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October is National Physical Therapy Month (NPTM). This celebration began in 1981 as National Physical Therapy Week and then in 1992 became National Physical Therapy Month. NPTM, sponsored by the American Physical Therapy Association (APTA), acknowledges October as a month to recognize physical therapists and physical therapist assistants for their hard work as well as educate the community about the PT profession. This year the theme is "Physical Therapy: It's All About Movement." Movement is a vital part of physical therapy. Your physical therapist is an expert of movement and is able to help you move forward. Whether it be movement toward your goals or simply moving safely and effectively around your house and/or community, movement is essential for everyone. 

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