Month: August 2010

Clinical Question – Ice vs. Heat

Should I apply ice or heat for pain?

First you need to determine if you have pain from an acute injury or chronic injury.  An acute injury has a rapid onset and is short-lived.  A chronic injury happens gradually and is long-lasting.  For acute injuries, you should apply ice for 10-15 minute intervals several times a day for up to 3 days.  For chronic injuries, you should apply heat for 15-30 minutes intervals as needed.  If you find your symptoms still persist after approximately 48 hours of heat/ice treatment, you should contact your physician or physical therapist for further treatment options.

Clinical Question – Stress

When I have a stressful day, why do I have more neck and back pain?

When stressed, people tend to contract their muscles.  For example, people tend to elevate their shoulders toward their ears when stressed, thus causing increased tightness at the muscle on top of the shoulder (Upper Trapezius).  This leads to increased muscle tightness, which in turn can cause more pain.

Regarding physical therapy of your neck and back.  If you continue to have increased stress in your life while receiving physical therapy, this will lengthen the amount of time it takes to have a successful treatment outcome.  During therapy, the therapist will provide you with techniques to prevent further tightening of your neck and back musculature.

Clinical Question – Length of Treatment

How often and how long do I need physical therapy?

Depending on your condition, the therapist will give you an approximate timeline.  On average, physical therapy is usually 2 days a week for approximately 4-6 weeks.  Patients that have an extensive past medical history might take longer to heal; therefore, requiring a longer duration of physical therapy.  Examples that affect the duration include: diabetes, age, smoking, history of slow healing wounds, malnutrition, previous injury to the area being treated, and previous surgery to the area or limb being treated.

Office Question – The Charm City Circulator

Have you used the **free** Charm City Circulator – Purple Route?

Baltimore’s Charm City Circulator services Harbor Physical Therapy and Macht Medical Group offices with two convenient stops.  The following is a list of Purple Route bus stops within walking distance of our offices:

  • Stop # 320 – Conway Street, Light St. & E. Conway St. (0.2 miles from office)
  • Stop # 321 – Lee Street, Light St. & E. Lee St. (0.1 miles from office)

For more detailed information on the Charm City Circulator Purple Route (stops and times), please call 410-350-0456 or go to http://www.machtmedicalgroup.com/directions/by-bus/.

Clinical Question – Home Exercise Programs

Once I finish physical therapy, will I have to continue doing my home exercise program forever?

Once you are discharged from physical therapy, the therapist will provide you with a progressive home exercise program to maintain the gains you have achieved during treatment.  Compared to the exercise program you receive while in treatment, it will not be as frequent, nor will it consist of as many exercises.  You will not have to do these exercises for a lifetime; however, if your symptoms return, you always have the exercises to get back on track.

Exercise Guidelines

There are many different opinions on the frequency and duration a person should exercise in a given week.  Therefore, in 2007, The American College of Sports Medicine (ACSM) revised their guidelines for exercise to achieve a healthy lifestyle.  These guidelines are good principles to think about when planning an exercise regimen.  They are as follows:
<ol>
<li>Do fairly intense cardio 30 minutes a day, five days a week or do energetically intense cardio 20 minutes a day, 3 days a week.</li>
<li>Do eight to 10 strength-training exercises with 8 to 12 repetitions of each exercise twice a week.</li>
</ol>
<h3>Tips for following the guidelines:</h3>
Life gets busy so sometimes it is difficult to fit exercise into our schedules.  Here are some tips to help include exercise into your life.
<ul>
<li>Mix it up:
<ul>
<li>To meet the guidelines, you can vary the cardiovascular exercise you perform. Such as, you can walk vigorously for 30 minutes twice a week, ride a bike at a moderate intensity for 20-30 minutes twice a week, and jog/run at a higher intensity one-two days a week.</li>
<li>Do it several times a day in shorter time frames:</li>
<li>If you are too busy to do 30 minutes of consecutive exercise, you can perform intense 10-minute bouts of exercise 3 times a day, equaling 30 minutes.</li>
</ul>
</li>
<li>Work out with friends/family:
<ul>
<li>To motivate you to continue your exercise routine, it is helpful to bring friends and family in on the fun!  Therefore, you can motivate each other to continue exercising.  It is also helpful to get involved in exercise classes.  You will find that it is very motivating to have an instructor pushing you to make it through your workout class.</li>
</ul>
</li>
<li>Set your schedule:
<ul>
<li>Just like you schedule a meeting with work or friends, schedule exercise!  By scheduling exercise, it helps you keep up with your routine and stay healthy.</li>
</ul>
</li>
<li>Starting an exercise program:
<ul>
<li>Some people find starting an exercise program very intimidating.  If you fall in this category, there are some options out there for you.  Harbor Physical Therapy offers <span style=”text-decoration: underline;”><strong>wellness evaluation</strong></span>.  This entails a session with Dr. Amanda working on whatever aspect of your body you feel needs expert attention.  Dr. Amanda can provide you with a workout regimen that gets you started on your healthy lifestyle.  Also, if you get bored with your routine or want to try something different, Dr. Amanda can continue providing you guidance.  <strong>Please give us a call at 443-524-0442 for details.</strong></li>

There are many different opinions on the frequency and duration a person should exercise in a given week.  Therefore, in 2007, The American College of Sports Medicine (ACSM) revised their guidelines for exercise to achieve a healthy lifestyle.  These guidelines are good principles to think about when planning an exercise regimen.  They are as follows:

  • Do fairly intense cardio 30 minutes a day, five days a week or do energetically intense cardio 20 minutes a day, 3 days a week.
  • Do eight to 10 strength-training exercises with 8 to 12 repetitions of each exercise twice a week.

Tips for following the guidelines:

Life gets busy so sometimes it is difficult to fit exercise into our schedules.  Here are some tips to help include exercise into your life.

Mix it up:

  • To meet the guidelines, you can vary the cardiovascular exercise you perform. Such as, you can walk vigorously for 30 minutes twice a week, ride a bike at a moderate intensity for 20-30 minutes twice a week, and jog/run at a higher intensity one-two days a week.

Do it several tmes a day in shorter time frames:

  • If you are too busy to do 30 minutes of consecutive exercise, you can perform intense 10-minute bouts of exercise 3 times a day, equaling 30 minutes.

Work out with friends/family:

  • To motivate you to continue your exercise routine, it is helpful to bring friends and family in on the fun!  Therefore, you can motivate each other to continue exercising.  It is also helpful to get involved in exercise classes.  You will find that it is very motivating to have an instructor pushing you to make it through your workout class.

Set your schedule:

  • Just like you schedule a meeting with work or friends, schedule exercise!  By scheduling exercise, it helps you keep up with your routine and stay healthy.

Starting an exercise program:

  • Some people find starting an exercise program very intimidating.  If you fall in this category, there are some options out there for you.  Harbor Physical Therapy offers wellness evaluation.  This entails a session with Dr. Amanda working on whatever aspect of your body you feel needs expert attention. Dr. Amanda can provide you with a workout regimen that gets you started on your healthy lifestyle.  Also, if you get bored with your routine or want to try something different, Dr. Amanda can continue providing you guidance.  Please give us a call at 443-524-0442 for details.

Can back pain be prevented?

There are several measures you can take throughout your day to reduce the likelihood of lower back pain.

1. Maintain correct posture in sitting and standing positions.

  • Be sure to sit in a chair with lumbar support (lower back support).
  • Always have your computer monitor at eye level and keyboard in front of your body.

2. Lift heavy objects with proper body mechanics.

  • Avoid bending down with twisting motions.
  • Always bend through your knees and slightly hinge at the waist.

3. Avoid repetitive lifting of weights and take breaks as needed.

  • Overtime, repetitive lifting of weights will cause a stress injury to the spine. This could lead to a disc bulge (herniated disc) and spinal degeneration.

4. Perform core strengthening exercises regularly.

  • Avoid excessive sit-ups because it puts heavy strain on the lumbar spine.
  • Avoid back extension exercises.

Example of a Basic Core Strengthening Exercise

  1. Lay on your back with your spine flat on the surface.
  2. Squeeze your stomach muscles down toward the surface to flatten your back (Note: Try not to hold your breath during this part).
  3. Hold for 5-10 seconds and repeat.
  • To help achieve the correct contraction, pretend you are putting on a tight pair of jeans and squeezing your stomach muscles to fasten the zipper.
  • This exercise is strengthening the Transversus Abdominus muscle.

Transversus Abdominus Contraction

Can sport injuries be prevented?

There are several measures you can take throughout your day to reduce the likelihood of sport-related injuries.

  1. Before playing any sport, be sure to warm up the muscles you will be using.
  2. If you are playing a sport that requires all of your body’s muscles, it is recommended that you take a 5 minute walk, while moving your arms in circular motions to the front and side of your body.
  3. While playing any sport, be sure to start slowly and work up to 100% of your effort.  For example, if playing tennis, start by playing at half the court distance with less effort per swing.  Then, progress to the baseline with your shots as you increase your effort of hitting the tennis ball.
  4. Make sure you drink plenty of fluids; dehydration can lead to muscle cramping, lethargy and dizziness.
  5. Wear proper footwear; do not play sports in sandals or bare feet unless specific to that sport.
  6. Stretch after your sporting activity.  Studies have shown that it is beneficial to stretch afterwards to prevent injury.

Examples of Basic Stretching Exercises

(To find out which muscle the below exercise is targeting, simply drag your mouse over the image)

Shoulder_Stretch Wrist_Flexion_Extension hamstring_stretch Quadricep_Stretch calf-stretch