This time of year it’s easy to do nothing. The holidays are over, we’ve forgotten our New Years resolutions and it’s cold outside. These are all excuses we use to veg out and get out of shape. During the colder months we tend to slow down, put on weight and lose mobility. Unfortunately, bad habits often lead to a downward cycle of increased weight gain and additional health problems. The deeper into this cycle we fall, the harder it is to recover and every year this challenge becomes even more difficult.
By exercising regularly or starting a physical therapy program you can start slowly. There’s very little pressure at this time of year. You won’t be trying to look good in a bathing suit for a few months. Your walking tour of Italy isn’t right around the corner. You have time to get off the couch and prepare yourself at a slow and steady pace. You can build slowly so that you’re ready to run that 5K in the spring or wear heels to your daughter’s wedding in June.
The challenges of feeling good and exercising are even more extreme if you are afflicted with a chronic condition such as Rheumatoid Arthritis (RA). It’s even more important to take control of your health. Pharmaceuticals can help, but like so many other conditions, exercise is the most effective means of battling this condition. That’s why we’ve chosen to focus on RA for our WSPT University presentation this month. If you have RA or are affected by it any way we urge you attend our valuable seminar.
Whether you’ve been meaning to do something or you’ve just recently fallen off, now’s the time to take control of your health. Take care of your joints, your muscles, your weight. Sign-up to find out more.
Rheumatoid arthritis is a chronic inflammatory disorder that typically affects the small joints in your hands and feet. This particularly painful disease can cause other than just pain, swelling and can result in bone erosion and joint deformity.
Physical therapy can be particularly beneficial to those suffering with Rheumatoid arthritis. Though it may be tempting to say, "I hurt too much today. I'll do my exercises tomorrow," a physical therapist will tell you: “don't give up!” Exercise and conditioning the muscles surrounding an inflamed joint affected by rheumatoid arthritis can be some of the best things that you can do to decrease the painful symptoms.
Treatments may vary depending on the stage of Rheumatoid arthritis that you may be experiencing at a particular time. During a “flare-up” stage, where the joints are extremely painful and warm, using cold compresses can help decrease inflammation cause by the arthritis and will help desensitize the area and joints affected. Feeling stiff and sore around your affect joints? Well warm therapy may be the perfect solution to the “calm” stage of rheumatoid arthritis. Warm compresses or even a warm aquatic pool can help relief the “stiffness” that you may be experiencing at this particular time.
Even though, currently, there is no “cure” to rheumatoid arthritis, choosing to make the right decisions, and following through with exercises and stretching guided by a skilled professional, may help you live a happier and better life and one that will have long term benefits.
For information about RA sign-up for our educational seminar and join us Thursday, February 21st, 2013 at 12PM.
Ray Kurzweil blew my mind the other night. His credentials as an inventor, scientist and entrepreneur are rivaled only by Edison and Einstein. He has his hand in so many arenas, all related to his world view of the exponential growth of technology in juxtaposition to our linear view of time. He talked about how rapidly something like computer processing is currently progressing. An iphone is billions times more powerful than the most advanced computer of 50 years ago - and it’s a million times less expensive. A teenager with a smartphone in Africa has access to more information than President Clinton did when he was the ruler of the free world.
Kurzweil’s massive theory, his “relativity,” is Singularity. He didn’t invent the concept, but he has popularized it in his writing. For Kurzweil, the Singularity is defined by a massive expansion of human intelligence and the potential for immortality facilitated by computer superintelligence.
Factors influencing this nearing possibility are:
- The falling cost of manufacturing transistors
- The rising clock speed of microprocessors
- The plummeting price of dynamic RAM
- The falling cost of sequencing DNA
- The decreasing cost of wireless data service
- The rising numbers of Internet hosts and nanotechnology patents
If these predictable trends continue, he anticipates the Singularity to occur around 2045.
What does that mean for our physical existence? I can foresee a distant future where we just download our brains onto a hard drive and exist as heads in a jar. Even the benefits of exercise could potentially be simulated with software programming. Isn’t all experience just our perception of what is happening? How is doing something any different than simply thinking, feeling and believing that we are actually doing it?
Imagine your brain could be programmed to simulate the experience of you riding a mountain bike through the woods of Aspen, programmed in such detail that you experience every sensation that you would if you were actually on that trail. You could even have the full sensation smelling the trees and feeling the bumps or falling off your bike and bruising your shoulder. Except your shoulder wouldn’t be bruised and you could get right back on the trail, at least in your mind.
That may be a bit far-fetched. So, more realistic is the arriving prevalence of
nanotechnology in medicine. As per Sahoo in “Nanomedicine: Nanotechnology, Biology and Medicine,” “...materials and devices designed to interact with the body at subcellular (i.e., molecular) scales with a high degree of specificity. This can be potentially translated into targeted cellular and tissue-specific clinical applications designed to achieve maximal therapeutic efficacy with minimal side effects.” The applications are endless. What if there were procedures that instantly cured patients with either rejuvenating cell injections or microbots that mended broken bones and ligaments and eradicated diseases. That time may not be far off. It may be sooner than you think.
I have to wonder when PTs will become obsolete. (Hopefully, not in my lifetime.) For now, we help our patients recover from injuries, regain normal function, and manage arthritis and complications from diabetes. We are an adjunct to medications and surgery for many patients. We are an essential piece of the medical puzzle. Even if physical recovery is significantly expedited, neural and muscular re-education still has to occur. People still need to relearn how to walk, run, throw a ball.
Technology has the ability to change lives with health improvements, but even an amputee with a new arm faces the massive challenge of learning how to integrate it into their life. A NY Times article this week told the story of a US Marine with a $110,000 prosthetic arm and the work he’s doing with his therapists to learn how to use it.
In Kurzweil’s world, maybe technology advances us to the point where the Marine is given injections to recreate his original arm, but we’re not there yet. Maybe there won’t even be any more war. We’re definitely not there yet. For now, we still have injuries, diseases and traditional rehabilitation. Medicine and surgery works wonders and PT is an important piece of the medical solution.
The late comedian Patrice O’Neal is now famous for saying, “My doctor has told me that if I don’t lose weight, it will kill me. That’s not motivation enough for me.” O’Neal had severe diabetes, which led to a stroke that killed him in November 2011 at the young age of 41.
Obesity can affect every system in the human body. In physical therapy we most commonly see obese patients who have complications associated with diabetes, arthritis and heart disease. There is a genetic component to each of these diseases, but for the most part, they are preventable. Diabetes, arthritis, and heart disease are non-communicable diseases. You don’t catch them from being in a room with someone who has them. You don’t get them from kissing or getting sneezed on.
The human condition is such that the possibility of being sick or dying is not enough to persuade most people to change the way they live. Most of us need to get a diagnosis from a professional or see someone close to us get sick or die to make significant changes in the way we manage our health. Diabetes, arthritis and heart disease are acquired subtly; you don’t just wake up with arthritis in all your joints one day. They take time to make their way into your life, usually without you even knowing. This can be a double-edged sword. If you choose to make a change, this can be a positive. Small tweaks in your diet and increases in your exercise volume can decrease your weight and improve your overall health. On the other hand, the slow creep of these obesity-related diseases allow people to rationalize doing nothing, with the excuse that they have plenty of time before it gets serious.
Obese patients usually see a Physical Therapist because the arthritis in their knee is so bad they can’t climb steps or the diabetic neuropathy in their feet is so painful that they barely walk any more. By this stage, these symptoms are very challenging for the PT to treat. Multiple medical issues coupled with a lack of mobility creates a complicated scenario. This patient has to get moving despite the pain.
Arthritis is caused by a constant wear and tear on a joint to the point of irritation and chronic inflammation. The inflammation leads to breakdown of cartilage and bone, causing pain and dysfunction. Obesity makes it nearly impossible to allow that joint to rest and heal. The patient’s de-conditioned state also makes it very challenging for them to get active enough to lose weight.
The complications associated with diabetes and heart disease are similar. A major element of healing is blood flow. Blood supplies oxygen to the body and oxygen fuels chemical interactions, including cell reproduction and growth. Healing is essentially growth of new, healthy cells and it can’t happen without ample blood supply. Heart disease prevents sufficient amounts of blood to be pumped throughout the body while diabetes affects the quality of that blood supply. Both diseases make it extremely challenging for the body to heal itself.
Movement and exercise are the key components of helping obese patients improve. A Physical Therapist is extremely aware of the risks and complications associated with obesity, arthritis, diabetes and heart disease. The major obstacle that most of these patients face is a fear that they are too overweight to exercise. This couldn’t be further from the truth. In fact, it’s necessary that they exercise. They just need to be guided by a professional.
Every patient is different and a PT will always do a thorough evaluation before designing a custom plan of care for each patient, but here is a typical program for someone who is experiencing complications related to obesity:
1. Pain control modalities if necessary
2. Cardiovascular exercise
3. Strengthening exercise
4. Balance training
5. Gait training
6. Aquatic exercise
7. Functional activity (ADL) training
8. General nutrition education and consult to nutritionist/dietician if necessary
Ask the Physical Therapists at WSPT how PT can help you manage Obesity and Obesity related conditions.
This is my response to a blog on stretching.............
http://toddhargrove.wordpress.com/2010/11/24/quite-a-stretch-guest-post-from-paul-ingraham/
Great blog - very specific info on the effects of stretching prior to performance. Most of the article is backed by quality evidence that has become accepted throughout the physical therapy and fitness community. What is not addressed here and in much of the literature is the long-term effects of stretching (or not).
The author suggests that most people do not need to be more flexible. According to a recent study by the CDC, the risk of having symptoms of osteoarthritis in at least one knee by age 85 was 45.5 percent. That's only in the knee, suggesting that more than 1/2 the population will live with arthritis in their lifetime.
There are several ways to prevent arthritis and stretching is one of them. Now I 
don't believe that stretching alone is the cure for arthritis, but increasing flexibility and relieving stress on the joints is one element of a joint preservation program. A stretching program can also improve exercise performance as indicated by this article from the ACSM
Stretching has gotten a bad rap lately. I've recently read several articles and blogs downplaying the value of stretching. The bottom line is that stretching is not a quick fix. Over the long haul it will increase muscle elasticity, overall flexibility, and performance.
This is my response to a blog on stretching.............
http://toddhargrove.wordpress.com/2010/11/24/quite-a-stretch-guest-post-from-paul-ingraham/
Great blog - very specific info on the effects of stretching prior to performance. Most of the article is backed by quality evidence that has become accepted throughout the physical therapy and fitness community. What is not addressed here and in much of the literature is the long-term effects of stretching (or not).
The author suggests that most people do not need to be more flexible. Stretching my have other value though. According to a recent study by the CDC (http://goo.gl/TsKrX), the risk of having symptoms of osteoarthritis in at least one knee by age 85 was 45.5 percent. That's only in the knee, suggesting that more than 1/2 the population will live with arthritis in their lifetime.
There are several ways to prevent arthritis and stretching is one of them. Now I don't believe that stretching alone is the cure for arthritis, but increasing flexibility and relieving stress on the joints is one element of a joint preservation program. A stretching program can also improve exercise performance as indicated by this article from the ACSM - http://goo.gl/Q9Rix
Stretching has gotten a bad rap lately. I've recently read several articles and blogs downplaying the value of stretching. The bottom line is that stretching is not a quick fix. Over the long haul it will increase muscle elasticity, overall flexibility, and performance.
This spring, WSPT was fortunate to have a dedicated team of student interns working in our office. Our goal was to provide them with real-world experience, and we asked them to work on various projects surrounding our annual Arthritis Walk. We sought to educate them on the disease, on the treatments, and on the ways WSPT works to help patients with arthritis in and out of our office.
Omwattie Sukhraj, 17, was surprised to learn about the scope of arthritis. “While working on the project, I learned that absolutely anybody can be affected with arthritis,” she said. “The most surprising piece of information I found out was that many young adults and infants are diagnosed with the disease.”
Omwattie currently attends the High School of Medical Science and hopes to one day be a pediatrician. Her experience at WSPT has taught her a lot about “the joints, the human body and the way healthy lifestyles are made.”
Another intern, Babita Buddy, 16, also felt her internship help
ed her gain experience in a professional atmosphere and in the medical field. “My plan for the future is to work in the medical field helping patients in the hospital. My experience at WSPT influenced my plans even more because it exposed to an environment similar to a hospital, where there are patients,” she said.
Sonia Seeteram worked with Babita and Omwattie, and tried to make the most of her time here. “Working in the office gave me insight into both the business world and the medical world as well,” Sonia explained. “This project taught me how to work with other students, how to be a leader, and gain support from my community.”
For more information on becoming a WSPT intern...
If you’ve been to WSPT in the past year, you know that we have a special affection for TRX. Since we discovered suspension training 18 months ago, we’ve incorporated it into all levels of exercise from early stage post-op, to chronic pain, to high intensity interval training. One population that benefits greatly from the unique qualities of suspension training is seniors with arthritis.
TRX can be an effective exercise tool for most body parts. It is safe and effective, even for elderly people with multiple conditions, dysfunctions, and limitations. I have a few exercises that I like to do with deconditioned patients who may be limited in motion and have functional deficits due to weakness.
1. Walk-Outs - this exercise is excellent for increasing shoulder flexion, assisting overhead reach, and engaging abdominal muscles
2. Chest Press - standing in an off-set leg position creates a stable base for a patient to strengthen the pushing muscles of the chest and arms.
3. Rows - this is a basic pulling exercise, but the TRX adds the element of core stabilization when the patient is required to maintain a plank position as they do it.
4. Squats - the suspension straps of the TRX assist a patient who is easing into squatting exercises. A mini-squat can be progressed into a sit-to-stand exercise over time.
The TRX is a fun, safe, and effective piece of rehab equipment.
Take a look for yourself!
For years patients suffering from arthritis looked at joint replacements as the last resort after medication, physical therapy, arthroscopies and injections. In addition, orthopedists had always coached patients to “hold out as long as possible” before electing for a joint replacement as the replacement joints were thought to last 10-15years, after which a revision surgery would be necessary.
This trend has changed recently as half of all hip replacements this year will be patients under 65, and the majority of them are extremely active people. This same statistic will be true of knee replacement patients by 2016. 
Weekend warriors who are not ready to give up basketball, surfing, skiing and tennis are opting to have surgery in order to be able to continue with the activities that have become an integral part of their life. The thought of adjusting their lifestyle in order to avoid having an additional surgery later in life does not make sense to this new breed. They would rather be able to continue with these recreational activities, some of which are high impact, and live a more fulfilling life now, and worry about what happens down the line when they get there.
The orthopedic community seems to be a bit split on this new line of thinking. Some surgeons have given their patients the go ahead to return to skiing, surfing and basketball, while others have warned their patients that if they want to maximize the use of their new knee or hip that they’ll need to find a new outlet for their athletic needs.
In order to accommodate this new breed, manufacturers of the hardware that is implanted in these patients are attempting to come up with material that will last longer under higher impact conditions. Most implants use a combo of metal and polyethylene parts, and continuous motion wears away at the polyethylene portions. Researchers have found that irradiating the polyethylene parts removes free oxygen radicals that contribute to degeneration, and as a result allow for longer use.
Both patient and doctor agree that another new trend that has shown improved post op results is “Pre-hab” ; that is maximizing range of motion and strength prior to surgery. There is no getting around the intense, often painful rehab that awaits these patients following surgery, however looking at the pros and cons, and determining what activities are most important to them, many patients are opting to have surgery now and face the consequences later. The new mantra seems to be, do what you love to do while you can still do it.
Joints got you down?
*submitted by Jason Ruta, MSPT
People pass on things they hear from someone, who heard it from someone else, with no confirmation of its truth. As with any common and complicated subject, there are many myths and half-truths about arthritis floating around the general population. This makes treatment and management of the disease more challenging for practitioners and patients. I will attempt to dispel several of the most common myths in an effort to ease the process. Firstly, it should be known that arthritis is broken down into three major categories:
- Osteoarthritis (OA) - a chronic condition characterized by the breakdown of the joint’s cartilage.
- Rheumatoid Arthritis (RA) - a chronic disease, mainly characterized by inflammation of the lining, or synovium, of the joints.
- Juvenile Arthritis (JA) - any form of arthritis or an arthritis-related condition that develops in children or teenagers who are less than 18 years of age.
Some common myths about arthritis are:
1. Only old people get arthritis.
Arthritis can strike anyone. It can happen to someone after surgery, from excessive wear and tear, and JA affects about 300,000 American children. RA typically strikes between the ages of 30 and 55.
2. Exercise is the worst thing to do if you have arthritis.
Actually the best medicine for arthritis is movement. Immobile joints stiffen and become more painful. Your body's own lubricants are activated by the flexing and extending of a joint. Physical therapy involving stretching and gentle, low-impact exercise improves joint health and strengthens the muscles that support your skeletal structure. Aquatic therapy can also be very effective in promoting movement with minimal force on affected joints.
3. No pain, no gain.
Whoever invented this expression did not have arthritis. The reality is that people with arthritis, as with most people without arthritis, should experience minimal pain from exercise. If an exercise hurts, than it can be modified to not be painful, or maybe it's just not the exercise for you. There are plenty of others that can work.
4. Pills or surgery are my only options to treat arthritis.
Actually, in many cases, increasing flexibility and strengthening the muscles around an arthritic area will result in significantly decreased pain and increased function. There are many options for people with arthritis. You can discuss them with your doctor or physical therapist.
5. Arthritis is hereditary and there's nothing I can do about it.
Genetics may play a part in your susceptibility to arthritis, but just because your mother and her sister had a bum knee, doesn't mean you're doomed to experience the same affects of the disease. Maintaining proper weight and remaining active throughout your life will significantly reduce your risk of acquiring OA.
6. Arthroscopic surgery will alleviate your arthritis.
Dr. Geoffrey Westrich, an orthopedic surgeon at Hospital for Special Surgery in NYC says any doctor who says arthroscopic surgery to repair a torn cartilage or clean out a joint will relieve arthritis pain is doing a huge disservice to a patient. This type of minimally invasive surgery does nothing to relieve arthritis pain, according to Westrich. Not only is it useless and unnecessary, but some patients are actually worse off because their joint becomes inflamed after surgery.
7. If you have arthritis, you're going to end up in a wheelchair.
People with arthritis, probably including many you know, live normal lives and are not disabled just because they have arthritis. The disease's many forms can be progressive and symptoms are likely to increase if you don't manage them. But lifestyle changes, including a proper diet and regular exercise can assist you in continuing to live a fulfilling, painfree life.
DONATE NOW - Help support the Arthritis Foundation's efforts to dispel myths, assist people with arthritis, and find a cure for the disease. Thank you.