Monday, January 7, 2013

Dry Needling

Ascent Physical Therapy offers dry needling to manage pain. Read the faq below to find out if dry needling could be for you.

What is Dry Needling?

Dry needling is a procedure where solid filament (acupuncture) needles are inserted into the skin and muscle directly at a myofascial triggerpoint (also known as a knot).

The approach is based on Western anatomical and neurophysiological principles which are not to be confused with the Traditional Chinese Medicine (TCM) technique of acupuncture .

What can Dry Needling help?

Dry needling can be used for a variety of musculoskeletal problems. Conditions which respond to dry needling include, but are not limited to:

Tennis elbow
Carpal tunnel syndrome
Golfer's elbow
Leg pain
Hamstring strains
Shin splints
Muscle Spasms
Sciatic Pain
Hip Pain
Knee Pain
Repetitive Strain Injuries

How does Dry Needling work?

The pioneering studies by Dr Shah and colleagues at the National Institutes of Health suggest that inserting a needle into trigger points causes favorable biochemical changes which assist in reducing pain. It is essential to elicit a Local Twitch Response which is a spinal cord reflex and is the first step in breaking the pain cycle.

How does Dry Needling stop this cycle?

A spasmed muscle becomes a damaged muscle. Spasm reduces blood flow in the muscle. This means less oxygen and nutrients to the muscle. Muscle fibers die off and get replaced by scar tissue. This in turn holds the muscle tight, prevents muscle metabolites from leaving the muscle and causes continued spasm and pain.

Putting a needle into a spasmed muscle causes the muscle to relax.

What does Dry Needling feel like?

Generally, needle insertion is not felt, the local twitch response may provoke a very brief pain response. This has been described as cramping sensation. During treatment, patients commonly experience either a heaviness in the limbs or a pleasant feeling of relaxation.

The benefits of dry needling frequently include more than just relief from a particular condition.

Many people find that it can also lead to increased energy levels, better appetite and sleep as well as an enhanced sense of overall wellbeing.

Are the needles sterile ?

Yes, only sterile disposable needles are used.

Are there any side effects?

Most patients report soreness in the treated area and referral zone lasting from a few hours to two days.

How long does it take for the procedure to work?

Typically, it takes several visits for a positive reaction to take place. We are trying to cause mechanical and biochemical changes without any medication. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.

Once I am feeling better, how often do I need to come back to maintain my progress?

The musculoskeletal system is under constant pressure from gravity, stress, work etc. A regular exercise program combined with good posture can prevent many problems. If the pain returns, tune-up visits are recommended to treat and prevent injuries.

For further information or for an appointment please contact Ascent Physical Therapy (970) 949-9966

Wednesday, January 2, 2013

Prevent That Back Problem

Prevent That Back Problem
By Ellen Wlody, Originally posted on Lifescript
Published December 01, 2012

Back pain is one of the most common ailments women face. And a variety of everyday activities can increase your risk, from how you sleep to how you hold your purse. Learn the top 10 causes of a nagging back problem, along with expert advice on avoiding each one...
Whether it’s a dull ache or a sharp, shooting sensation that travels down your leg, back pain makes getting through the day harder. About 39% of adults said low back pain “affected their ability to engage in daily tasks,” according to a survey by the American Physical Therapy Association (APTA).

What’s more, women with back problems experience slightly higher pain levels than men, according to The Journal of Pain. On a pain scale of 1 to 10, women reported an average of 6.03, while men averaged 5.53.

Treating back pain can be expensive and difficult, so your best protection is to stay healthy and prevent it from occurring, says E. Kano Mayer, M.D., a physical medicine and rehabilitation specialist at the Cleveland Clinic Center for Spine Health in Ohio.

For example, “extra weight puts you out of balance,” so staying trim will reduce the strain, he explains. So will regular exercise, including strength and core training.

Avoid cigarettes, he says, because they promote degeneration of discs in your spine.

“Smoking seems to injure those cells that would ordinarily help repair an injury in the back,” Dr. Mayer says.

Other activities can exacerbate back problems, such as carrying a heavy purse or even lifting your tote. Here are doctor-recommended ways to avoid the 10 most common back-busters.

Back problem cause #1: Sitting for long periods
Whether you’re in the office or at home in front of the TV, sitting for too long can damage your back. About 54% of people with low back pain spend most of their workday sitting, according to the APTA survey.

That’s because “sitting actually puts 40% more pressure on discs in the low back than standing,” says Mary Ann Wilmarth, P.T., chief of physical therapy at Harvard University Health Services in Cambridge, Mass.

If you slouch on the sofa or hunch over a computer, you put even more stress on your back, adds James Wyss, M.D., P.T., a physiatrist (rehabilitation specialist) at the Hospital for Special Surgery in New York City.

“When you slouch for too long, the muscles that support your spine get fatigued,” he explains. “This puts more stress on the underlying structures: the discs, ligaments and joints.”

Get back pain relief: First, properly set up your workstation, Dr. Wyss says. Get a chair with good lumbar support and adjust it so you can sit in a “90-90” position – with a 90-degree angle between your trunk and hips, as well as a 90-degree angle between your knees and the floor, he says.

Wilmarth advises against sitting on a soft couch at home. When possible, choose a firmer chair or recliner, which will offer more support for your spine.

No matter where you’re sitting, “get up every 30 minutes just to stand and stretch,” she says.

“Stand up, pull your belly button in and just reverse the seated, possibly slouched, position you’ve been in,” Dr. Wyss adds.

At your desk, do small exercises to loosen your shoulders and neck.

“Circle the shoulder backward to loosen your blades and open the front of your chest,” Wilmarth says.

Also, shrug your shoulders up, then slowly release them while exhaling.

“While you sit, your shoulders will creep up; this will relax them into a better position,” she explains.

 Back problem cause #2: Holding a heavy purse
Carrying too much weight on one side of your body pulls you into an asymmetrical position, Wilmarth says.

“It pulls the muscles on one side and makes it harder for you to stay balanced,” she says. “It tends to torque your neck and upper and lower back.”

Get back pain relief: Never carry more than 20% of your body weight on your back and shoulders, advises Jeffrey Goldstein, M.D., director of spine service at New York University Hospital for Joint Diseases in New York City.

Ideally, you should use a backpack to tote your things. Though it can pull on straps and add pressure to the shoulders, it distributes weight more evenly across your back, he says.

But when you carry a purse, avoid large ones – people tend to fill up the available space, Wilmarth says.

“The bigger they are, the heavier they get,” she notes.

If you have a large bag, go through it periodically and remove items you don’t need, Dr. Goldstein says.

Also, alternate the side you carry it on, Wilmarth adds.

“It will be hard to do [this] at first, but your body will get used to it,” she says. “It helps to balance you out.” 

Back problem cause #3: Lifting grocery bagsIf you overfill the bag or carry more than one at a time, you’re lifting more weight than your back can handle, Wilmarth says.

Get back pain relief: Pack bags lightly, and make more than one trip to carry groceries into the house, Wilmarth suggests.

If you’re carrying plastic bags, don’t bring them all at once on one arm. This can cause one side to tip or tighten, increasing your chance of injury, Wilmarth says. Instead, carry them close to your body.

“If you hold them out [from your body], you’ll put more strain on your back,” she says.

Also, use proper back-saving techniques to lift bags out of the car: “Slide the bag as close to you as possible,” Wilmarth says.

Then bend your hips and knees, lean in and lift the bag, using leg and abdominal muscles to rise.

When turning away from the car, pivot your whole body from your feet; don’t twist from your back.

Back problem cause #4: Doing laundry
Most people lift wet clothes out of the washer and then twist and bend to put them in the dryer. This twisting motion puts a lot of stress on the lower back, Wilmarth says.

Get back pain relief: Instead, put a laundry basket on top of the dryer and transfer the wet clothes into it. Then carefully – holding the basket close to your body and bending from the knees – lower the basket to the floor. Squat and put the clothes in the dryer.

If you have a lot of wet, heavy laundry, transfer small amounts at a time. 

Back problem cause #5: Lifting a babyWhen you bend from the waist to lift a child off the floor, you put pressure on your lower spine and risk pulling back muscles, Dr. Goldstein says.

Get back pain relief: Squat down to the floor and hold the child close to your body, he says. Then carefully stand up, using your legs and stomach muscles to do the work.

Avoid carrying your child on one hip, Wilmarth advises.

“That tends to torque the hip and pelvis,” which puts pressure on the lower spine, she says.

It’s best to use a front carrier, which spreads the baby’s weight evenly across your body. If you must carry the baby on your hip, Wilmarth suggests occasionally switching sides to equalize the strain.

Back problem cause #6: Multi-tasking while on the phone
If you cradle the phone between your head and shoulders while on the computer or cleaning the house, you “really tighten the muscles on that side,” Wilmarth says.

You also compress the vertebrae, she says, which can lead to inflammation. The result: tightness, numbness and tingling symptoms in your arm.

Get back pain relief: Use a headset, speaker phone or Bluetooth device, Dr. Goldstein suggests. That keeps your head and neck in a neutral position and your hands free.

When holding the phone to your ear, keep your head and neck as straight as possible, he says. Switch hands occasionally, so you don’t spend too much time leaning to one side. 

Back problem cause #7: Sleeping on your stomachWhen you sleep on your stomach and turn your head to breathe, the rest of the spine twists too, Dr. Wyss explains.

Also, discs in your spine are filled with fluid, which replenishes at night. Sleeping in positions that compress the discs doesn’t allow fluid to move into them. It may put pressure on all the structures in your back: muscles, ligaments, fascia (connective tissues) and discs, Dr. Wyss says.

Get back pain relief: Sleep on a moderately firm mattress, Wilmarth says.

“If the mattress is too soft, your body will sag,” she says.

Then find a comfortable position to keep your spine neutral – either on your side or back. In both positions, keep your knees bent to relax your hip flexors (a group of muscles that connect the hip to the thigh bone) and take pressure off your spine, Dr. Wyss says.

If you’re on your back, put a pillow under the knees. Side sleeper? Keep a pillow between your knees or use a full-length body pillow.

Back problem cause #8: Poor postureWhen you slouch, hunch or tilt to one side, you put more pressure on the muscles and ligaments in your back, as well as the vertebrae, which can compress discs in your spine, Wilmarth says.

Get back pain relief: Do exercises to build abdominal stability and strength, she suggests.

“This will allow you to keep your spine in a neutral position,” she says. “Start with a simple isometric exercise: Just tighten the abdominals and hold for five seconds.”

If you have any back pain, check with a physical therapist before starting a more aggressive strengthening program, she advises.

During the day, check your posture periodically. “While standing, look in the mirror: You should see your ears, shoulders, hips, knees and ankles all in a straight line,” Wilmarth says.

Back problem cause #9: Wearing high heels
Wearing heels “changes the way you walk and puts more stress on your low back,” as well as on the ankles and knees, Dr. Goldstein says.

Get back pain relief: When possible, wear flat shoes or ones with lower heels, he suggests.

If you’re struggling to balance in your shoes, the heel is probably too high. Avoid stilettos or heels that are over 5 inches, he says. Back problem cause #10: Moving too quickly in the morning
“Many of my patients injure themselves first thing in the morning,” Wyss says.

That’s because spinal discs, which have been replenished with fluid during the night, are fuller in the morning, causing added pressure on them, he says.

When you move the wrong way, the extra pressure can be just enough to trigger a tear or rupture in the disc, Wyss explains.

Get back pain relief: “Allow your body to wake up” and don’t make sudden movements or immediately plunge into housework or exercise, Wyss says.

“Give yourself at least 15 minutes just to move around and warm up before you start doing things,” he adds.

Also, do warm-up stretches before starting vigorous exercise, Dr. Goldstein advises. Spend at least 10-15 minutes stretching, he says. When weight training, opt for more repetitions and a lower weight.

“This puts less stress on your spine,” he says.

If you are experiencing back pain call Ascent Physical Therapy at 970-949-9966.

Monday, October 10, 2011

True of False? No pain - No gain

While our kids are growing rapidly in their pre-teens and teens, their bodies change in many ways. They grow taller, their hips widen, their feet change, and they gain significant weight. All of these changes place new stresses on their musculoskeletal system which takes time to adapt.

For those who are active and sports oriented, these changes may cause “growing pains” making participation in their activities painful. More stress is added through increased intensity of activity as they begin to compete at higher levels of competition, leading to repetitive stress and overuse injuries. These injuries may include tendonitis, stress fractures, sprains and strains throughout the body. If not addressed, these problems can derail a sports season or become lifelong problems.

What To Look For…

As a parent, the best sign to look for is pain. Some muscle soreness is to be expected, especially at the beginning of a season. Soreness should subside quickly as the body gets used to the new workload. Pain in a specific joint is rare in healthy adolescents therefore, if their soreness increases or becomes painful, your child may have an injury. Local pain in a joint is frequently the sign of an injury. Common injuries in teens are chondromalacia patella (pain under the knee cap), Osgood Schlatters (pain just below the knee on the tibia), shin splints, stress fractures, and ankle sprains.

As a parent it is important to listen to the concerns of your child. “No pain, No gain” is not always true, and can be harmful. It is important to monitor training schedules and have breaks to recover between seasons and large tournaments. If problems do arise, have your child evaluated by a physician or physical therapist. Once a problem is identified solutions such as exercise training, stretching, or bracing can usually solve the problem and get your child back on the field safely.

Thursday, July 7, 2011

TOPIC OF THE MONTH - Selective Functional Movement Assessment

Do you ever wonder why you suffer from repetitive or chronic injuries that seem to be unrelated to any injury? Or do you ever wonder why you don’t perform as well athletically as other people? Do you feel like you work out and you don’t progress as well as you feel you should. Then the SFMA could be for you.

SFMA stands for Selective Functional Movement Assessment .This is a test designed to look at movement throughout your entire body to determine any limitations in mobility and stability you may have. These limitations may be underlying factors in any chronic problems or reduced performance you may be experiencing in your life. Frequently a restriction or weakness in one joint or area of your body can lead to limitations in a movement pattern that affects your whole body. The SFMA can help you pinpoint these limitations.

Once the SMFA identifies specific restrictions, your physical therapist can design a program to specifically address them. With a more individualized program you can be sure that you are doing the most effective work out routine and not wasting time and energy exercising areas that don’t need it. This will also allow you to address an area that may be leading to chronic pain and dysfunction and eliminate some unneeded aches and pains.

The SMFA is now available at Ascent Physical Therapy. Call 970.949.9966 to schedule an appointment and get your-self fit for summer.

Ascent Physical Therapy is GROWING

We are excited to announce that we will be opening a second clinic on July 11th 2011 in Eagle at 341 Broadway. The new facility, in the heart of downtown Eagle will benefit our local patients living or working in the Gypsum/Eagle region. With clinics in Avon and Eagle, we feel we are providing our patients with a greater choice of health care provision. We look forward to having the opportunity to serve our patients in this new location.

Your input is very valuable to us! We welcome any suggestions you may have as to what we should incorporate into our new clinic. Please feel free to leave a post or email us with any information you believe will help us obtain the results for our patients that they deserve.

New PT to the team!

Ashley Dentler received her Doctorate of Physical Therapy from Northeastern University in Boston, Massachusetts. She is certified as a Strength and Conditioning Specialist through the National Strength and Conditioning Association. She has had training in the areas of outpatient orthopedics, neuromuscular rehabilitation and functional movement therapy.

While at Northeastern, she succeeded in enhancing the learning and teaching environments for Physical Therapy curriculum as well as serving as a Teaching Assistant in multiple courses.

Rhode Island native, Ashley is an avid runner, skier and swimmer and is looking to continue her love of the outdoors in Colorado. “I am thrilled to be a part of a community of people who share my passion and love of an active life style. It is an honor and privilege to join this team of professionals as we work to better the lives of our community.”

Ashley will be working at our Avon office Tuesdays and Fridays and the new Eagle office on Monday and Thursdays. To schedule appointments with her call 970.949.9966

Wednesday, June 1, 2011

TOPIC OF THE MONTH - Exercise for a Better Golf Game

The golf season is here and many of us are ready to hit the links and start golfing. We all want to stay healthy and play the best that we can. Five areas determine how well a golfer can play:

  1. Natural talent - the athletic ability and talent we are born with
  2. Skill - which can be improved through working with a pro and practicing
  3. Equipment - which can add accuracy and distance
  4. Mental game - such as course management and maintaining composure while playing
  5. Physical preparation - addressing your body’s physical characteristics through exercise and stretching to improve your game

Many golfers spend considerable time and effort on practicing, taking lessons, and buying the best equipment. But, many golfers never address their most important piece of equipment, their body. Golf requires specific physical conditioning like any other sport.

The ideal golf swing requires flexibility, strength, balance and endurance. Many golfers neglect some of these critical components when attempting to improve their game. If a golfer has weaknesses in any of these areas they may make compensations in their swing, causing inconsistency or increased physical stresses on their body. These stresses can lead to pain and injury if they continue.

A regular exercise routine can address most of these strength, balance, and flexibility issues. Strength is important to control the club, maintain proper postures, and generate power. The key areas of strength to work on are core strength including lower abdominals and back muscles, scapular muscle strength, rotator cuff strength, and wrist and grip strength. Flexibility is important to allow proper set up posture and to maximize your ability to turn. Areas that frequently cause problems are hip rotation, thoracic spine extension and rotation, neck rotation, and shoulder flexibility. Balance is important to allow a full transition of weight throughout the swing. With poor balance power is lost or severe swing compensations are made. Endurance is important to allow a golfer to play a full round. Golfers with poor endurance will notice their play deteriorating toward the end of their round.

A physical therapist trained in proper golf technique can evaluate your body for the physical components of a proper golf swing. From this evaluation an individualized program can be developed to improve your game and keep you healthier.