Exercise of the month!

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Bridges…

The bridge exercise is a great basic exercise that can provide someone with strengthening in a supine (i.e., lying down) position. This is beneficial when other positions are too painful in which to exercise. The bridge will activate the hamstrings and the glutes. There are many ways to modify this exercise by adding therabands, a ball, using arm movements, propping feet up on something, doing off one leg, or performing with leg kicks or marching. This will engage different muscles depending on which modification you add. The bridge can help those with limited mobility maintain the ability to lift the buttocks up while in bed and scoot to the side of the bed. The bridge can help teach control through the hip muscles for those who struggle with lumbopelvic control. When someone can easily do this, they can graduate to hip and core strengthening in other positions which may be more functional for them. If you’ve never tried this before, go for it! If you have questions, feel free to contact us!

http://www.movewellfit.com/wp-content/uploads/2015/09/3d288-hamstrings-buttocks-bridge.gif
http://www.movewellfit.com/wp-content/uploads/2015/09/3d288-hamstrings-buttocks-bridge.gif

Dr. Laura earns new certification!

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We are proud to announce that Dr. Laura Murahashi, PT, DPT, was recently certified by the McKenzie Institute USA in Mechanical Diagnosis and Therapy® (MDT). This was the accumulation of multiple courses attended, hours of studying, and even more hours of practice. She is the only physical therapist in Mountlake Terrace with this certification!

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Here is a little info about MDT from the McKenzie Institute USA:

“Q: What is the McKenzie Method of MDT?

A: The McKenzie Method of MDT is a reliable assessment process intended for all musculoskeletal problems, including pain in the back, neck and extremities (i.e., shoulder, knee, ankle etc.), as well as issues associated with sciatica, sacroiliac joint pain, arthritis, degenerative disc disease, muscle spasms and intermittent numbness in hands or feet. If you are suffering from any such issues, then a MDT assessment may be right for you!

Q: How does it work?

A: MDT is comprised of four primary steps: assessment, classification, treatment and prevention.

Most musculoskeletal pain is “mechanical” in origin, which means it is not due to a serious pathology like cancer or infection but a result of abnormal or unusual forces or mechanics occurring in the tissue. Further, it means that a position, movement or activity caused the pain to start. If a mechanical force caused the problem then it is logical that a mechanical force may be part of the solution. The MDT system is designed to identify the mechanical problem and develop a plan to correct or improve the mechanics and thus decrease or eliminate the pain and functional problems.”

To find out more, go to info for patients. Then call us at 425-673-5220 to schedule an evaluation with Laura!

Healthier Community Conference Wrap-Up

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Last week, I had the absolute pleasure of attending the Verdant Health Commission 2016 Healthier Community Conference at the Lynnwood Convention Center. I wanted to share some of my take-aways, so buckle up!

First, we have such wonderful resources in our community to help people live healthier lives. Check out everything that the Verdant Health Commission offers: http://verdanthealth.org/ There is a wealth of information there, as well as a calendar of all of the free events that are offered. I also learned about Senior Services of Snohomish County (SSSC): http://www.sssc.org/index. They also have resources from all aspects of life (housing, social, transit, medical, etc) for seniors in our community.

I listened to a panel of providers discuss how to improve patient advocacy. First up was Dr. Blakeney of Edmonds Family Medicine. She discussed the importance of setting SMART goals—specific, measurable, achievable, realistic, and time-bound. Change is a process, not a single event. Ever small changes can have huge impacts on your health. Example: walking 30 minutes/day, 5 days/week can reduce your blood pressure by 10 points—every 5 points it drops, your risk of stroke decreases by 34%!

smart

The second speaker was Dr. Sinnett from Proliance Surgical Specialists of Edmonds. She spoke about how to manage your own advocacy when your health decisions become more complicated. She suggested that first and foremost, maintaining your health NOW can help minimize the complications during a medical emergency. For example, your tissues will heal better after an injury if your blood glucose has been managed beforehand and you’re not diabetic. She recommended that all carry a wallet summary of your health history, which could include your meds, your med history, and members of your care team. Her last point was to come to your appointments prepared—bring a second set of ears and bring a list of questions.

Emergency-Wallet-Card

The final sessions I attended were about supporting those in need, how medical and social services are working together to improve care, and how to achieve health equity. There were great discussions in each session and I left feeling inspired by the things that are happening around us. My eyes were also open to how far we have to go though, too.

Here is one example of a program in our community that has come from partnership and passion: Move 60!

Move_60!_logo_small_web

Please ask away if you have any questions for me about my experience. I would love to share more!

CSM Wrap-Up

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Last week, I attended the American Physical Therapy Association’s (APTA) Combined Sections Meeting (CSM). CSM is the largest national conference which the APTA hosts. This year, the conference was in Anaheim, CA, and over 11,000 people were in attendance! This post will be a brief summary of my conference take-aways.

Two of the sessions I attended were clinical in nature. One involved how to incorporate pain science education into clinical care, and the other was about exercise prescription for neuromuscular re-education. The pain science session was incredible! Physical therapists are experts in helping manage musculoskeletal pain, and that includes chronic pain. There can be changes in the nervous system itself, causing the system which is responsible for helping us feel pain to become extra-sensitive. When this happens, you have to treat the alarm system (i.e., the nervous system) too. This won’t work though if the patient doesn’t understand what is contributing to their pain. Their pain is real, but it may not be just from the tissues. This session gave me some strategies to help teach my patients about pain in a way that is effective.

CSM

The other clinical session which I attended was about exercise prescription. My biggest take away from this is that many PTs are not prescribing exercise in a way that will result in the desired tissue changes (whether you’re shooting for endurance, power, coordination, etc). So often, the classic “3 sets of 10 reps” is prescribed. There is a time and place for that, but we must be clinically reasoning for each and every exercise dose we prescribe.  The speaker also gave us a few clinical pearls from select research papers that can bust some myths about common PT exercises. It’s always great to learn how research is either supporting or negating what we are doing so our practice can continue to improve.

I went to a few business sessions, and lastly, I went to some soft-skills sessions. I attended one patient panel and one lecture on relationship-centered care. The big take-away here is that we need to remember that we are treating people, not just “the total knee” or the “neck pain” guy. Every person has a different story, and we have to understand that story to best connect with them. We have to ask the right questions AND listen. By first developing the relationship, we will have the best chance at the helping the person achieve their goals and enjoy the therapy process.

I will begin to implement the things that I learned immediately and I will share what I learned with my colleagues. If you have any questions about what I learned or what else was happening at the conference, feel free to ask in the comment section!

Common Physical Therapy Myths

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by Tasha Parman, PT, Board-Certified Orthopedic Clinical Specialist

Have you or a loved one ever been to physical therapy? Have you heard of physical therapy? There are many myths about physical therapy in the public domain, and Natasha Parman, Executive Director of MOSAIC Physical Therapy, is here to address some of the most common myths she hears from her clients.

Tasha and Laura treating

  • “I need a referral to go to physical therapy.” In Washington state, you do not need a referral to be evaluated by a physical therapist. Some insurance companies do require a referral for payment, however, so it is recommended that you check with your insurance company beforehand.
  • “Physical therapy is painful.” As physical therapists, our goal is to help discover why you’re in pain and then provide treatment to reduce it. We sometimes have to provoke your symptoms to determine our plan of care, but we always do our best to work within your pain tolerance.
  • “Physical therapy is only for people who have had surgery.” Physical therapy is for anyone who isn’t moving as well as desired due to surgery, injury, illness, disease, or any other cause. Physical therapy is for people of all ages and all functional abilities.
  • “Physical therapy isn’t covered by my insurance.” Most insurance companies cover some amount of physical therapy. Your physical therapist’s office can help verify your benefits to determine your coverage and work within your allowed benefits.
  • “Any medical provider or trainer can provide physical therapy treatments to a client.” While some providers may advertise that they provide physical therapy (or physical rehabilitation, rehab therapy, etc), only licensed physical therapists or physical therapist assistants can provide and bill for physical therapy services.
  • “Surgery is my only option.” For many conditions, physical therapy has been shown to be as effective as or more effective than surgery. If your physical therapist thinks you are a candidate for surgery, then he or she will discuss that with you and the other members of your healthcare team.

If you have any questions about physical therapy, feel free to contact MOSAIC Physical Therapy at 425-673-5220. We would be happy to answer any of your questions.

Exercise of the month: shoulder external rotation with shoulder blade squeeze!

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This month, we will move up to the upper body! One of my favorite and most prescribed exercises is shoulder external rotation with a shoulder blade squeeze. The muscles around the scapula (shoulder blades) and the rotator cuff are often found to be weak in those with shoulder impingement, rotator cuff pathology, and neck pain. The muscles around the scapulae help the scapulae move properly and provide a stable base for arm motion. The rotator cuff muscles center the ball of the shoulder joint into the socket, again providing stability and allowing for correct motion to occur. To perform this exercise, grab a resistance band and hold it between your hands. Keep your shoulders down and relaxed, and keep your elbows tucked in. Rotate the forearms away from the body and draw in the shoulder blades together. Return to the starting position. This shouldn’t be painful or cause tension in the upper shoulders. Perform until you feel fatigue in the shoulders and then rest. Aim for 2-3 sets to fatigue, every other day. This will help provide a strong foundation for your arms! As always, feel free to contact us with questions anytime!

TB-shld-BilER-Ret-1-2__051404_113816 Scapular-Retraction

Exercise of the month: resisted side steps!

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For the month of December, the exercise of the month is resisted side steps! Along with hip rotator weakness, many people with leg injuries have weakness in their hip abductors. These are the muscles that control the angle of the legs as you walk, run, jump, squat, etc. Many people demonstrate a “valgus” alignment where the upper leg deviates towards the midline.

valgus

Strengthening the hip abductors is one thing that may help minimize this movement pattern and optimize biomechanics. To perform resisted side steps, placed a loop of resistance band around above your knees (easier) or above your ankles (harder). Take steps to one side until you feel fatigue in the outside of your hips, then start stepping back the other way. Perform 2-3 sets of steps to fatigue every other day. You’ll begin to notice fatigue later during the workout as you get stronger! As always, feel free to contact us at MOSAIC Physical Therapy with questions about this exercise, injuries, or physical therapy.

side step