Effects of good health practices on therapy outcomes

I wanted to share with my readers something I have been working on to give to our new patients that come in for Physical or Occupational Therapy at our clinic.  I wanted to give the patient some additional information on other things that can help their outcome with therapy.  Here's what I have put together so far, let me know what good and bad you see in it.

Welcome to CRMC Physical Medicine and Rehab, maximizing your outcome from your Physical or Occupational Therapy treatment is our goal. Here are a few additional things you can do to help maximize your outcome, if you are not already doing them.
Stop Smoking. You probably already know that smoking affects your lungs and heart health in detrimental ways. And if you are a smoker it is not easy to quit, so talk to your doctor or therapist about options to help you quit. With the lungs and heart it affects the oxygen uptake in the lungs and narrows our arteries decreasing the blood flow to our muscles and organs. With decreased oxygen and blood flow our muscles are not getting the energy they need to repair them and work optimally. Smoking also has an effect on brain neurotransmitters (chemicals in the brain) these help our brain and nervous system function optimally. When our nervous system and brain are not working optimally it effects how our muscles work along with other systems in our body. It also affects our metabolic system (the part of our body that breaks down food and medicine into parts it can use). So our body does not get the food and medicine it needs in the same way those that do not smoke do. There are other side effects of smoking, but these are some of the primary effects that will reduce your optimal outcome with therapy and effect your healing from your injury.
Get proper nutrition and water intake. Our body uses the food we eat to help repair any damage that has been done to it on a daily basis. The better the food choices we make the improved healing abilities our body will have. Please consult with your doctor, dietician or therapist if you want specific information to help you eat better. Generally following the web site info at http://www.MyPyramid.gov is a good guideline. Water intake is also important as most of our body tissues, especially muscles and fascia (the tissue that holds all of our muscles together). Our muscles and fascia are primary reservoirs for water storage; if they are dehydrated they will become stiffer. Take a sponge as an example – when the sponge is dried up it is stiff, when full of water it is more flexible.
Get adequate sleep. Our bodies require 7 to 8 hours of sleep each night. Some people “think” they do can go on less, but every major study done on sleep always points to the body needing 7-8 hours of sleep (more if you are a child) to function optimally. Lack of sleep will affect brain function and attention. These can affect our muscles and nervous system to not work as well. Also it has been found to decrease healing when we have a lack of sleep. Unfortunately pain can be a factor in inhibiting our sleeping, so talk to your doctor or therapist if you are having difficulty sleeping due to your injury.
Decrease your stress levels. This like sleep is a double edge sword for some of you with an injury, as the injury is the cause of your added stress. Small amount of stress is good for the body as that is what makes us stronger by “stressing” our muscles. Unfortunately prolonged or too much stress puts our body into distress, which is what is detrimental. Our body uses its sympathetic nervous system to respond to stress. This system increases activation of our peripheral muscles, raises our heart rate, and over activates our nervous system making us more sensitive to everything. This is helpful in short durations, such as needing to run away or fight in a dangerous situation, but long term can cause negative effects due to increase in the chemical, cortisol, in our system which affects our brain and nervous system as well as immune, respiratory, cardiac and digestive systems. It can also lead to increase in depression, anxiety, and increase in disease (you are more likely to catch a cold when over stressed). We need an equal balance of our parasympathetic system (the opposite of the sympathetic system) to keep our body systems working properly. The increase in activation of your nervous system is one reason why when stressed your pain will most likely be more. Talk with your doctor or therapist on techniques to help improve relaxation and decrease stress.
Understand your injury and know what you can do to make it better. There is power in knowledge. We will do our best to try and explain why you are having the problems you are having, but please ask questions if you don’t understand. While we will do everything we can to help you for the half hour or hour that you are in therapy, but you will need to help yourself the other 23 hours out of the day, so in many ways you have a larger impact on your health than we will.
Make every effort to make your scheduled appointments. Obviously there are things that might come up that limit your ability to make an appointment, but we can only maximize your outcome if you come to your appointment. It is your body and your health, while we appreciate the opportunity to help you recover; you ultimately hold the key to helping that become a reality.
This is a short summary of the few effects other health practices have on your outcome with Physical or Occupational Therapy. If you want more detail on any of them talk to your doctor or therapist. We look forward to working with you to maximize your optimal movement and achieve efficient function with your body as you rehabilitate from your injury.

I'm curious to hear what everyone thinks.  I know in today's age of Twitter and 140 characters for communicating or articles that should be 500 words or less this goes beyond that, so let me know if you think it is too long or not long enough to cover in detail enough.  Also, for the normal healthy individual most of these are common practices, but unfortunately most of my patient clientele does not meet these criteria.  I am a believer that if you can plant seeds that change is possible.  So I am excited to see comments on what others think.

Lessons to learn from Olympians

With the close of the Olympics I wanted to blog about lessons learned from the games.  I saw a great article at the beginning of the games about Six Things We Can Learn from Olympians.  I had one I wanted to add to the list and would love to hear comments from everyone what things they have learned.

I often wonder in today's day and age and the emphasis put on individualism, if we forget how important it is to have good coaches.  Watching the Olympians you realize that you are truly watching the best athletes in the world at their specific sports.  Their physical feats and mental concentration is amazing.  But behind every athlete is a set of coaches, trainers and others that have prepared them to go for the Gold.  So if the greatest athletes in the world need a team of coaches to allow them to perform at optimal levels, why don't each of us also look to find some coaches to help us in our life.  Do we look for people and advice from experts to help us with our body, mind and spiritual growth and development.  Our bodies, minds and spirits are constantly changing, the question is how are they changing?  Is it for better or worse?

As a physical therapist, I enjoy the opportunity daily to help coach my patients to improve their physical health and optimize their function.  Hopefully we can all find coaches to help us on a regular basis to improve our body, mind and spirit and not have to wait until injury or ill health to search out a coach to help us.

What other lessons have any of you came away with during these Olympic games?

Back Pain - Now What?

Estimates are that 9 out of 10 people will experience back pain at sometime in their life.  Having back pain is the fifth most common reason to visit a doctor in the U.S.  So with such prevalent numbers of occurrences, one would think we would be pretty good at treating it and have some consensus on the best methods.

Sorry, I'm not going to be able to cure everyone's back pain that reads this posting, but hopefully give you some valuable insights into finding your answers.  Also I am not going to argue for the best method to fix their back pain.  Obviously there are lots of "so called" experts that through their marketing and advertising can convince you they can cure it all in just a few simple steps.  But if this was truly the case I don't think we would see the numbers of occurrences staying the same as we have over the decades with no large changes in reduction.  Remember as health care providers we have specialties that we are trained in to solve problems.  A physical therapist, like myself, is going to use exercise and manual therapy (hopefully not many modalities such as ultrasound and electrical stimulation, as the research is not very good they actually provide much change).  Chiropractors will use their manipulation skills.  Surgeons will use surgery.  Physicians will use medication.  A massage therapist will use massage.  Acupuncturist will use acupuncture.  We are going to use what we know, and believe that is what you need.  So don't be surprised if you see a surgeon and he suggests surgery and when you talked to a different health care provider they didn't suggest surgery.

The other upsetting part is that there are some usual standard care guidelines, that research has shown to be most effective are not always followed through with by many general care practioners as found in this study.  And as pointed out in another study sometimes we have become to dependent on imaging to try and diagnosis everything.  While diagnostic imaging has made great advancements in the last few decades and has given us pictures of inside the body, we need to remember that the picture doesn't always tell us all the answers.

So what should you do if you have back pain?  Find a health care practitioner that you can trust and is up to date with current standards of care.  They should be open to other methods other than their own to assist you in your back pain.  They should be able to give you detailed explanation as to why you are having pain based on their findings from their evaluation as well as other tests such as imaging.  They should be able to back up everything they plan on doing with current research (check to see if they read current research, if not I would be cautious).  Realize that most back pain is not seriously life threatening, yes an inconvenience, but not life threatening.  It can usually be treated with conservative measures and not surgery as pointed out in this study.  If you do suffer from persistent/chronic low back pain I suggest that you learn to understand more the mechanisms of pain further.  I would suggest viewing Neil Pearson's 3 part webcast or get the book Explain Pain.

Talented And Gifted - Tag your it!!!

My 13 year old son, Tyler, confirmed my longstanding disappointment with the Talented And Gifted (TAG) program in schools.  If you don't have such a program in your school district be glad in some ways.  What it is for those of you who may not be aware, is a special program for kids in school that are excelling in a subject.  They are taken out of class to participate in the TAG program where they are challenged above the other students in their class.  While in general principle this is very good. As there have been studies that show some of our best and brightest students drop out of high school since they are not challenged enough so they drop out.  The problem lies for the many students, like my son, who don't get pulled out of class for TAG.  How would you feel if you weren't labeled talented and gifted.  Unfortunately to many of us have been told that at some time and we unfortunately believe it, thus preventing us from fully achieving our maximum potential God had planned for us.  While Tyler stated he was happy for his friend that got called out of class to participate in TAG, but he admitted he was sad that he never got called out.  While I tried to reassure him he was extremely talented and gifted in many ways and listed many of them for him, there was already some damage done to his self esteem.

My simple thought is, why can't they find at least one talent and gift in every child and pull every child out at sometime for a TAG program.  Could you imagine the child that unfortunately may never be looked upon as talented and gifted by their parents being able to go home and tell them they were pulled out of class to participate in a TAG program.

Another program that could use improving is the Presidential Fitness Award.  While again a great idea for rewarding children to partake in exercise and fitness, but why not create something that everyone could succeed in instead of just a few?  Check out a program proposed by Gary Gray, PT called Free2Play.

It's hard to believe programs like StrengthQuest by the Gallop Organization wouldn't work.  Or implementing more exercise into school to help with improved test scores, check out this short news story about exercise in school - Pumping up the Brain.

As Michelle Obama has pledge to help fight obesity.  I can only hope that some of these initiatives that promote increase self esteem for our children, who are all Talented and Gifted, in academics and fitness can be used.

While this probably seems like a lofty goal, I thought it was fitting to post on the night of the opening ceremonies of the Winter Olympics and the 30 year anniversary of the Miracle on Ice.  I remember as a 9 year old listening to those words "Do you believe in miracles? YES!", and yes I always have.

So do you believe in miracles?  What ideas do you have to share on how we can improve our youths school system to help them succeed?

New Year remodel project

Well I was busy last weekend doing a little home improvement project and remodeling our master bath.  Ripping out the old outdated tile and cabinets and replacing them along with a fresh coat of paint.  So it got me thinking to see how everyone is doing one month into your personal remodeling project of your body, that is if you set any New Year's resolution to eat better and exercise more...most of us did.

It is hard to stay the course with diet and exercise even if we know it is important to help us live a longer, happier and healthier life.  Even though there is lots of research with study after study continuing to show the benefits of exercising to help improve our life.  But it is complicated to do the right thing and not as simple as having will power to do it.  An interesting study looking at people sticking to diet plans, which is usually just as hard for most as sticking to our exercise plan, had some interesting points.  It showed that the more complex your plan the more likely one would be to stop doing on a regular basis.  To take a quote from Gary Gray, PT a mentor of mine - "We need to get to the simple side of complexity".  Yes the proper diet and exercise programs can be made extremely complex especially when listening or reading some of the things that are out there, but huge gains can be made when sticking to a thought that follows the 80/20 rule.  You can get 80% of your benefits from exercise and diet by sticking to the easy 20% of simple principles in exercise and diet. Check out a few of my past posts on these core principles of exercise and diet.  Here is a great 10 step idea to help with weight loss success with your diet that can help as well.

Also for those that have gone so far and are obese we need to realize that this is a medically complex problem that needs serious attention.  We need to realize that often times an obese individual has an addiction problem and needs outside help to get going the right direction again.  Why people get obese is a very complex and individual for each person and not easily changed.  There was a great article to pointed to this mind shift that needs to change if we are to help the obese get healthy.

So you know it can be difficulty, so how do you fix it? Check this article out on setting the record straight.  We need to exercise more and eat less.  But keep it simple and realize it takes patience and persistence and if you are struggling you may need some outside help, and that's okay! - we weren't put on this earth to be alone we need each other.

What are some things you do to help keep yourself on track with your personal body remodel?