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Understanding and Managing Peripheral Neuropathy

Peripheral neuropathy is a condition that affects the peripheral nerves, which transmit signals between the brain and the rest of the body. This can lead to a range of symptoms, including pain, numbness, tingling, and weakness, particularly in the hands and feet. For those living with peripheral neuropathy, physical therapy can be a crucial part of managing symptoms and improving overall quality of life.

Causes of Peripheral Neuropathy

Peripheral neuropathy has many possible causes, including:

– Diabetes

– Chemotherapy treatment

– Vitamin deficiencies

– Injuries or trauma

– Autoimmune disorders

Identifying and treating the underlying cause is an important first step in managing neuropathy symptoms.

How Physical Therapy Can Help

Physical therapists can create a customized treatment plan to address the specific symptoms of peripheral neuropathy, which may include:

– Exercises to improve strength, balance, and flexibility

– Techniques to reduce pain and numbness, such as manual therapy and electrical stimulation

– Education on ways to protect the feet and hands to prevent further nerve damage

– Recommendations for assistive devices like braces or custom orthotics

By working closely with their physical therapist, patients can learn to manage their symptoms and maintain their independence.

Tips for Living with Peripheral Neuropathy

In addition to physical therapy, there are steps patients can take at home to help minimize the impact of peripheral neuropathy:

– Inspect feet and hands daily for any cuts, sores, or injuries

– Wear properly fitted, protective footwear

– Quit smoking and maintain healthy blood sugar levels if diabetic

 Apply gentle heat or cold to reduce pain and swelling

With the right treatment approach and self-care strategies, many people with peripheral neuropathy are able to manage their symptoms and continue doing the activities they enjoy.

Pickleball Injuries- It Might be Time for Physical Therapy!

Pickleball has gained popularity in the past several years. Many people of all ages are jumping into the sport. At the same time, many healthcare providers are seeing an increase in pickleball injuries. These injuries range from foot/ankle injuries, falls, shoulder injuries, Achilles tendinitis, knee injuries, and elbow injuries. The majority of these injuries happen due to the person not having enough muscle strength/endurance as they push their body to play at a higher athletic level.

To avoid a pickleball injury, you want to warm-up before playing and perform appropriate stretches after playing. You also want to make sure you wear appropriate shoes for the sport. There are several sneaker brands that make shoes specific for pickleball. You also want to make sure you don’t go from living a sedentary lifestyle to immediately jumping into the sport. You want to condition your body for the sport. This is where a physical therapist can help you on your pickleball journey.

A physical therapist can perform a thorough evaluation to determine your baseline level of strength and flexibility. Then, your physical therapist can educate you on specific exercises to start performing so you improve your strength and flexibility to decrease your likelihood of injury on the pickleball court.

How To Treat Frozen Shoulder

Frozen Shoulder: Understanding and Treating This Condition

“Frozen Shoulder”, often called Adhesive Capsulitis, is a disorder that causes stiffness and pain in the shoulder joint. It usually begins gradually, worsens over time, and then slowly improves.

What is Frozen Shoulder?
Frozen shoulder develops when the capsule enclosing the shoulder joint gets inflamed and tightens, causing restricted movement and pain. The condition develops in three stages:

1. Freezing: Leads to increased pain and stiffness.                 
2. Frozen: Reduced pain but still stiff.
3. Thawing: Leads to gradual increase in range of motion.

Causes and Risk Factors

The actual etiology of frozen shoulder is frequently unknown, however risk factors include:

• Age (40-60 years)

• Gender (more prevalent in women)

• Diabetes and thyroid diseases.

• Long-term shoulder immobilization.

Physical Therapy Interventions

Physical therapy is essential for treating frozen shoulder. Treatment approaches could include:

1. Perform range of motion exercises; gentle stretching to increase flexibility.

2. Strengthening exercises to support the shoulder joint.

3. Manual treatment uses hands-on approaches to mobilize the joint.

4. Pain management options include ice, heat, and electrical stimulation.

5. Patient Education: Home exercise routines and activity changes.

Recovery Timeline:

Recovery from frozen shoulder might take months or years. Adhering to a physical therapy program on a regular basis can greatly enhance outcomes and perhaps accelerate recovery.

When to Seek Help:

If you have persistent shoulder discomfort or stiffness, see a physical therapist or doctor for an evaluation. Early intervention can help prevent the illness from deteriorating and speed up recovery.

Scoliosis: Definition and How Physical Therapy can Help

A lateral curvature of the spine, known as scoliosis, frequently involves rotation. It may arise in infancy or adolescence, or it may be brought on by illnesses like neuromuscular diseases or degenerative changes that occur in old age. The symptoms of the curvature might range from slight pain to severe physical limits, depending on how severe it is.

Scoliosis Symptoms


–Visible Curvature: If the spine is visibly curved, it can cause unequal hips, shoulders, or a protruding rib cage.
– Back Pain: A pain or discomfort in the back, especially where the curve is located.
– Breathing difficulties may arise from severe scoliosis if the curvature compresses the chest cavity, so impairing lung function.
– Problems with Mobility: Slowed range of motion and flexibility in the surrounding muscles and spine.

What Benefits Can Physical Therapy Offer

1. Postural Correction: To help improve posture and correct spinal alignment, physical therapists evaluate patients’ posture and recommend exercises and treatments.
2. Strengthening Exercises: By focusing on the muscles that support the spine, particular exercises can assist to increase stability and strength.
3. Range of Motion and Flexibility: Increasing range of motion and flexibility in tense muscles and joints impacted by curvature is the goal of stretching exercises and methods.
4. Pain Management: To lessen pain and inflammation, methods like heat/cold treatment, therapeutic ultrasound, and manual therapy may be applied.
5. Education and Lifestyle Modification: In order to reduce pain and stop the curvature from progressing, physical therapists instruct their patients on ergonomics, correct body mechanics, and lifestyle changes.

Preventing Progression and Enhancing Quality of Life

Early intervention with physical therapy can help prevent the progression of scoliosis and alleviate associated symptoms. By improving spinal alignment, strengthening muscles, and promoting flexibility, physical therapy aims to enhance mobility and overall well-being.

Written by: Dr. Onyedikachi Ude

After C-section- How to Prevent Injury?

A C-section consists of a surgeon making a cut across the belly and above the pubic area. The healing process of the incision takes about 6-8 weeks. During pregnancy, your core muscles are weakened and then weakened further by the C-section procedure. However, physical therapy is typically never prescribed by gynecologist after this procedure. The reason for this is most likely due to lack of knowledge of the aftermath of the mother’s physical health 6 to 8 weeks after a C-section.

After giving birth, you are expected to care for your child which requires lifting, bending, and squatting. These are all activities that require core strength. Therefore, physical therapists usually end up seeing patients post C-section that develop lower back pain from a weak core.

To stop this trend, people that receive a C-section should all consult with a physical therapist to learn how to safely build back core strength! A physical therapist will provide you a safe progression of exercise to work toward your ultimate goals of taking care of your child and or back to your sport of choice. If you know anyone that will be receiving a C-section, please mention to them that after they are released back to activity by their physician they should make an appointment for physical therapy.

Who Benefits From Physical Therapy?

Myth: Physical therapy is only for people who are experiencing pain. 

Answer: FALSE- Physical therapy can be beneficial to people experiencing a wide variety of conditions. While we do treat a lot of people that have some sort of pain, we can also help those who are not in pain but still limited in their ability to move and get around. Some of these conditions are listed below. Physical therapists are considered “movement experts” and are well equipped to help you reach your movement goals and achieve a higher quality of life. 

  • Muscle weakness due to aging or chronic neurological conditions – Physical therapists will help develop a program that promotes recruitment and strengthening of weakened muscle areas to help make day to day life both easier and safer. 
  • Injury prevention – Some patients come to physical therapy because they are prone to injury and want to take the necessary steps to avoid injury prior to starting a new exercise routine.
  • Walking abnormalities – Whether due to a genetic abnormality or acquired from a certain illness or injury, physical therapists analyze how you walk and work to improve your walking to be more safe and efficient. 
  • Decreased balance/stability -A physical therapist helps to decrease your risk of falling by improving your balance and stability through prescribed exercises.
  • Deconditioning – This is commonly seen in physical therapy and can be due to a variety of reasons (aging, prolonged hospital stays, chronic injury, etc). A physical therapist will evaluate you and determine and create an exercise plan to improve your muscle strength and endurance.

Can I Exercise While I am Pregnant?

A simple answer is yes, exercising while pregnant can be very beneficial to expecting mothers. There are certain instances, such as high risk pregnancies, where your doctor will likely tell you to avoid non-essential physical activity, but for most pregnant women it is recommended. Below are some guidelines and tips on how to exercise safely while you are expecting. 

  • Talk with your doctor – make sure you are aware of any restrictions or guidelines your OB-GYN wants you to follow. 
  • Pre-pregnancy activity levels should equal pregnancy activity levels – being pregnant is not the time to go from couch to 5k if you were sedentary previously. Performing very strenuous exercise such as running a marathon or playing contact sports is not recommended. If you are unsure, always contact your physician.
  • Adjust as necessary – as your body changes, your physical activity may also change; be sure to listen to your body and make good/safe choices. 
  • Avoid exercising on your back – as the baby grows, it can place more pressure on major blood vessels if you exercise on your back for a prolonged period of time.
  • Avoid excessive stretching – to help with the birthing process, a woman’s body produces hormones that increase the flexibility of your ligaments. This is something to be aware of while exercising since it puts you at a slightly higher risk of injury.
  • Remember to breathe – while it is always important to breathe throughout an exercise, it is particularly important while exercising when expecting. Holding your breath causes increased pressure in your abdominal cavity and can decrease the amount of oxygen being brought to the placenta

When To Get Imaging For an Injury?

Maryland is a direct access state for physical therapy. This means that you do not have to see a physician before receiving physical therapy unless your health insurance requires it. As physical therapists, we are trained to be able to determine whether your presentation requires you to also consult with a physician. One of the reasons a physical therapist might refer you to a physician is for you to receive imaging. A physical therapist would suggest this if we feel your injury might have resulted in some type of fracture or tear to a ligament, tendon, or muscle. The only way to determine if this actually happened is through imaging. Your physician will then let you know the results of the imaging and their recommendation for a further plan of care.

Even if you did sustain a fracture or tear, that does not mean surgery is the only option. Depending on the severity of the injury, your physician will recommend your options and many times it is continued physical therapy without a surgical intervention. As physical therapists, we have vast experience with working with patient with positive imaging outcomes that have successful results with only physical therapy. Therefore, it is important to listen to all your health care providers to determine the right course for your treatment.

How to Decrease Lower Back Pain

Many people suffer from lower back pain. Back pain is so common as the majority of activities we perform throughout our day involve activation of the lower back muscles. Back pain can be caused by poor posture, lack of core strength, improper lifting technique, and muscle weakness. Most of the time, physical therapy can help to decrease your lower back pain and get you back to your daily activities. However, if your back pain is too severe and physical therapy does not seem to help, the next step is to consult with an orthopedic surgeon who will most likely refer you for imaging to determine if there is an underlying condition at your spine causing the majority of your back pain. A physical therapist will help you to be able to navigate your treatment path to achieve the most optimal result.

Benefits of Physical Therapy for Arthritis

Physical Therapy is a great option for patients with arthritis. Physical Therapists will evaluate your joints that are affected by arthritis to determine your baseline level of motion and strength. Physical Therapy will help to ease your symptoms associated with arthritis by improving your strength and stability through prescribed exercises. With increased muscle strength supporting your joints, it will decrease joint stress and improve overall function. Physical therapist might also recommend certain modalities along with exercises to help decrease your discomfort. Examples of these modalities are heat, massage, and electrical stimulation. The most common joints that are affected by arthritis are the hands, knees, hip, and spine. The good news is all these joints can benefit from physical therapy.