June, 2010 Archive

Physio for a Fractured Ankle

A patient arrived to physio for a fractured ankle after seeing his surgeon and having his cast removed.  Rehabilitating a post fracture typically requires a standard assessment and treatment. However, upon first observation of the unusual swelling in his calf, I probed further and discovered he had occasional discoloration, tenderness in the calf muscle and some other classic signs of a Deep Vein Thrombosis (or blood clot). After completing my basic examination, I explained the concerns I had to the patient and recommended that he immediately visit the urgent care for further investigation.  The next day I received a phone call from the patient thanking me, as they had discovered a massive blood clot in his leg that could have led to a potentially fatal pulmonary embolism. As a physical therapist we are trained not only rehabilitate the obvious injury or illness, but rather look at the patient in a holistic manner and take into consideration the patient’s well-being in it’s entirety.

McKenzie Method at Work :: Neck Pain Casestudy

I recently had a client (50 yrs old) who came to the clinic complaining of a stiff neck of over 6 months duration. She said the pain was not too bad and that it tended to come and go. She could not remember any particular incident where she injured it. She delayed coming in because the pain was tolerable and she thought it would just “go away on its own”.

When I began taking her history, it came out that she was also suffering from occasional dizziness and nausea. She was not sure if it was related to her stiff neck or not. When I looked at her posture I noticed a significant forward head position. As she tended to spend a lot of time sitting and in the car, I could imagine this was a posture she spent quite a bit of time in. Her range of motion was limited as well. I assessed her using the McKenzie Method and during the assessment, it became apparent that her nausea was indeed related to her neck as we were able to turn it on and off with movement. I was able to identify an exercise that worked for her (ie. Her movement was better after this exercise) and prescribed it for a home program. She was instructed in how to properly support herself in a chair to improve her posture as well.

After 3 days, I followed up with this client who reported that her nausea did not return and her neck was much better. I progressed her exercises and saw her once more for follow up. At her last appointment, she had full range of motion and no nausea. Both the client and I were happy with the results but she regretted not having come in sooner. She was impressed it only took 2 sessions to sort out and treat the problem effectively.

This is a great example of how well MDT can work! For very little time and money, we can show you what to do to fix and or manage your problem. Call for an appointment today! 403 278-0705.

Kari Lambden

Back Pain

Over 80% of adults suffer from back pain at some point in their lifetime. Audrey Long, a Calgary researcher is gaining international attention for her innovative study on a proven and effective way to treat back pain.

Answers for Back Pain Found in New Study

Calgary, AB – Eighty percent of adults will experience back pain in their lifetime. Calgary researcher and physical therapist, Audrey Long has received international attention by demonstrating that “one size does not fit all” when prescribing exercises for low back pain. Her study “Does it matter which exercise?” demonstrates that the wrong exercises can hinder recovery; while the right ones can enhance pain reduction and recovery of function.

Previous studies have stated that there has not been enough evidence favoring certain exercises over others therefore, international guidelines simply recommend advice to stay active. Although activity is typically painful, the new study shows that if certain movements can cause pain, other movements can also relieve pain. The fault in most prior studies was the assumption that most back pain is “non specific”. The trend was to prescribe the same exercises to all patients in the group studied.

The key feature of the new study is 30-45 minute individual assessments. “A skilled assessment makes all the difference,” says Long. Those likely to benefit start seeing results in the first session with highly significant pain reduction in back and leg pain within four visits. It does not take weeks of exercise to see the results in pain reduction and the techniques and exercises taught in the assessments are tools that patients take away with them and can treat their own pain. The ultimate goal is that the clients become independent and can both prevent and self treat recurrences. This will minimize the need to see the health care provider, which saves the patient time and money in the long run.

Part two of the study, released by Long in June 2005 at an international conference in Greece, shows that if patients were originally prescribed ineffective exercises, this assessment can lead to a change in the exercise prescription that can reverse the poor result and bring significant pain relief in an average of four visits. Co-author of the study, orthopedic surgeon Ron Donelson, says, “It is no longer appropriate to say that this exercise is good for a bad back, the key is to skillfully assign the right exercise to the right patient”. Many Alberta physical therapists are trained to conduct this form of assessment and more information can be found at www.McKenziemdt.org

Contact Information
Audrey Long
BScPT, Dip MDT
Bonavista Physical Therapy
739 Lake Bonavista Dr. S.E.
Calgary, Alberta
Phone: (403) 278-0705
Email: bonavistaphysio@telus.net
Website: www.McKenziemdt.org

Headaches

Checklist – Could your headaches be coming from your neck?
  • Do you tend to have headaches that start from the base of your skull?
  • Do you spend more than four hours a day reading, computer, driving,
  • fine hand work?
  • Do you have stiffness/pain with shoulder checking?
  • Do you have bifocals/trifocals?
  • Are you prone to aching at the “bump” of the lower neck?
  • Are you prone to pain between the shoulder blades?
  • Is there often aching or sharp pain under one shoulder blade?
  • Are you prone to neck pain, aching, or simple stiffness?

If you answered yes to any of these questions you should make an appointment to see a physiotherapist.

Posture and Pain

Have you ever linked posture with pain?  For example, does your back or neck hurt after a long drive?  Do yousuffer frequent headaches?  Do you have rotator cuff problems or frequent tendonitis?  Do you have tennis elbow even though you don’t play tennis?  All of the aboveproblems can be caused or aggravated by poor posture.

Although there are many causes of poor posture, by far the most common causes we see are:

a) poor habits
b) poor physical condition and
c) poor ergonomics.

The problem with bad posture is that over time, a person can become “stuck” in that position. If not corrected, you can get a permanent “hump” in your upper back.

A simple test to check your posture can be done while standing or sitting. Get someone to stand to the side of you and see if your ear lines up with yourshoulder, your hip bone, middle of your knee, and your ankle bone.

The most common problem we see in the clinic is “head forward” or “poking chin” posture. This position increases tension in the neck muscles, nerves andjoints. Over time, it can lead to tension headaches, upper back ache, “knots” in the shoulder muscles and tendonitis in the arms.

Brisk walking and the use of a lombar roll can help alleviate complications of postural problems. However, if you suffer from any of the above problems,you may want to consult your family doctor or physiotherapist.

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