Doctor of Physical Therapy

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!

mckenzie-v6

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!

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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.

May is National Arthritis Awareness Month

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Osteoarthritis (OA) affects an estimated 27 million Americans. Physical therapists can help those with OA have reduced pain, improved function, prevent disability, and learn self-management techniques. PTs and PTAs do this by prescribing individualized therapeutic exercise, neuromuscular re-education, manual therapy, and patient education. At MOSAIC PT, we also provide aquatic therapy, which can decrease the weight-bearing load through the joints and improve a patient’s ability to exercise. Consider referring your patients to PT to help them improve their quality of life.

“There is high-quality evidence that exercise and weight reduction reduce pain and improve physical function in patients with osteoarthritis…”

Jamtvedt, G. et al. Physical Therapy Interventions for Patients With Osteoarthritis of the Knee: An Overview of Systematic Reviews. Physical Therapy 2008 88: 123-136. 

 

Phone: 425-673-5220

Fax: 425-673-1597

http://www.mosaicrehab.com/MLT

 

Exercise for Low Back Pain (Ab strengthen)- part 3

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My continuing work on my low back pain and another exercise to help with the anterior chain (abs):
Hollow Hold (is what I think most people call it)- I call it HARD!

Sally PT Hollow Hold neutral spine

Sally Moores, PT, DPT, OCS

This, like most exercises, is easy to do wrong.
The essence is to keep your back in neutral (more about this below), while raising your legs, arms (which are reaching overhead) and your head 1 inch off the ground.
Hold for up to a minute- if you start to feel compensation- stop and rest, it is more important to do it right.

Some tips:

Neutral spine: There are a lot of fitness professionals that have you do this exercise with a posterior pelvic tilt, or flattening your back into the floor- I disagree with this because it’s not functional. You don’t want to be strong but walking around like Urkel. And- if you have a little bit of meat on your tush (ehem, or a lot), you have to really put your pelvis into a BIG tilt to put your back on the floor. It’s just not practical.
To find a neutral spine, lie flat on the floor. Put your hands on your front hip bone (ASIS) and your fingers on your pubic bone- they should be level, if not, adjust- this should be your starting position.
Pull your ribs DOWN- without tucking your tail- you can see in the picture, that my right shoulder is tight and is pulling my ribs up a little (I am working on it!). If you can’t figure out how to get your ribs down, try laughing. Seriously, laugh. This should pull them down- if not, we may have some work to do. Physical Therapy will help with that.

Neck– make sure you roll your head up, by bringing your chin to your throat before you lift your head up.
Now- lift and hold- make sure that your back does not move!

#physicaltherapy #abs #anteriorchain #gym #backpain

Low Back Pain Exercise for Anterior Chain(Abs) – part 2

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I, Sally Moores, PT, DPT, OCS, share with you, my own experience as I continue to work on my own low back pain and strengthening my abs without crunches. 
Here is another exercise that I am incorporating into my workout to help my less that stellar anterior chain. I think this one is harder than the plank because I can’t use my quads . Try it, and see what you think.
We have heard a few names for this one:
  • All fours with knee lift
  • Pre-crawl
  • Quad hover

Sally PT Quad hover

Start on your hands and knees and then lift your knees UP one inch off the floor:
Head– neutral position- look at the floor beneath you.
Hands– should be shoulder width- not touching each other- try to roll your shoulder bones so that your elbow pits (they’re a thing) face your hands
Shoulder Blades/Upper back– FLAT- you attain this by pushing your elbows into the floor and your torso up through your shoulder blades
Lower Back– neutral
Knees– directly under your hips
Feet– toes tucked under and heels facing toward ceiling. Lower leg in line with knees.

You can hold it statically. If you don’t feel challenged by this, you can throw in a controlled crawl as in this video:https://www.youtube.com/watch?v=hp8wJwEDl_Q  by Dr. Ryan DeBell of Pacific Sport and Spine. The primal crawl is a very challenging core stability move.
This should be PAIN FREE! If you have pain, stop.

Physical Therapy Myth #7: I can do physical therapy myself.

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Physical therapy myth #7: I can do physical therapy myself

Really?– how well does that work out for you?
I had a patient tell a friend: “Dude, you can’t rehab your (surgical) ankle fracture from stuff off of YouTube. Go to MOSAIC”.

diy pt 1 (sample of what you may find if you search for “do it yourself PT”)

Physical Therapy is not just about “exercise”- there is a huge clinical decision and diagnostic piece, that the lay person would be missing if they did it on their own. Make sure if you have movement issues, see a skilled physical therapist- to not only address the present condition, but the reason for it.

Fact: Your participation is key to a successful treatment plan, but every patient still needs the expert care and guidance of a licensed physical therapist. Your therapist will leverage his or her specialized education, clinical expertise, and the latest available evidence to evaluate your needs and make a diagnosis before creating an individualized plan of care.

Physical Therapy Myth #6: Surgery is My Only Option.

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AWESOME hamstring tear- the MD diagnosed it as Sciatica- the patient told her- I have pain in the back of my leg. The MD never even looked at the patient's leg. Taping, manual work and graded exercises had this patient back on the tennis court in 6-8 weeks.
AWESOME hamstring tear- the MD diagnosed it as Sciatica- the patient told her- I have pain in the back of my leg. The MD never even looked at the patient’s leg. Taping, manual work and graded exercises had this patient back on the tennis court in 6-8 weeks.

Myth #6: Surgery is My Only Option. Not necessarily– (see my baby rant below)

Fact: In many cases, physical therapy has been shown to be as effective as surgery in treating a wide range of conditions—from rotator cuff tears and degenerative disk disease, to meniscal tears and some forms of knee osteoarthritis. Those who have recently seen a physical therapist know this to be true, with 79% believing physical therapy can provide an alternative to surgery.

I have had this conversion countless times:
Patient- I need a knee replacement
Me- really- does your knee bother you? Can you (insert- sit, squat, stair-climb etc)
Patient- I can do all those things. It only bothers me sometimes
Me- then why do you think you need a knee replacement (BTW- not a little surgery)
Patient- because my surgeon told me I’m bone-on-bone
Me- but you have no pain….you will for quite a bit of time after

Remember- just because a picture “says” something- it has to match with the complaints. These patients (I can think of 3 in the past few months) have all gotten better with PT.

Now– I’ve also had a patient say- of course you don’t think surgery is necessary, your a PT. Valid point, and there are times when surgery is absolutely necessary! Got a mensicus folded like a taco that wont budge and you can’t bend or straighten your knee- sure have that chunk removed. HOWEVER- I strongly believe that all patients going through elective orthopedic surgery should PREHAB before their surgery- even if it’s just a few visits. The difference after surgery in pain and function is dramatically different.

Phew that was a long post- thanks for reading!

#physicaltherapy vs #surgery #backpain #rotatorcufftear #hamstringtear