August 2021 COVID Update – COR continues to follow COVID safety protocols

Best Practices for Medically-based Running Analysis in a Physical Therapy Clinic

Medically-based running analysis

Running and jogging are excellent forms of exercise that help patients stay healthy—so long as they follow proper techniques. Unfortunately, poor mechanics and an improper balance of strength and flexibility  can contribute to pain and injury. By using a medically-based running analysis, physical therapists can identify factors that can contribute to pain with running. Once we identify the underlying causes, we can integrate evidence-based safe running practices to optimize musculoskeletal care.

What is a biomechanical analysis?

Modern biomechanical analysis software uses motion capture to analyze athletic performance and technique. An experienced physical therapist can use this information to develop personalized interventions.

Medically-Based Running Analysis 

When a patient presents with running-related pain or an injury, often more information is needed to determine the cause. While they might be using poor running techniques, there could also be an underlying medical condition. Physicians can then refer the patient to a physical therapy clinic for further examination. A running-specific assessment consists of:

  • A comprehensive medical review
  • A complete history of training
  • A physician’s examination of injuries
  • A biomechanical analysis
  • A physical therapy consultation

Medical and Training History

Both recreational and elite runners can develop musculoskeletal pain. However, seasoned runners may seek treatment for different reasons than novice runners. Thus, a comprehensive training history provides crucial insight into the patient’s assessment. Part of intake includes a Physical Activity Readiness Questionnaire to address any significant risk factors for participating in exercise. In addition, the cumulative effects of exercise can play a role in the injury. So, when working with a new patient, the physical therapist finds out about the frequency and duration of training sessions as well as experience, pace, cross-training, running surface, and running shoes. 

Functional Movement Assessment

Functional movement screenings help the physical therapist determine the strengths and weaknesses of motion. For example, a series of squats, lunges, and hurdles can demonstrate the runner’s motor control. The therapist’s carefully trained eye can assess lower body  and core strength based on these motions. The functional assessment can also reveal symmetry imbalances that may contribute to joint pain. 

Motion Capture Analysis

Motion capture involves digitally reconstructing a three-dimensional model of the runner. For example, while the patient jogs on a treadmill, multiple cameras capture markers on specific anatomical landmarks—knees, hips, etc. The software then converts the footage into a computer model for further analysis. Full-view video capture from all angles provides the best information. 

Referring Patients for Assessment 

When referring patients for a medically-based running analysis, find a physical therapy clinic that operates best practices to identify underlying causes of pain and injury. At Churchill Orthopedic Rehabilitation, we combine functional movement assessment with the use of our unique biomechanical analysis software to determine contributing factors to runners’ pain. To refer a patient for evaluation, call our office at 201-833-1333.

Baby Belly: Diastasis Recti Abdominis During and After Pregnancy

diastasis recti abdominis

Women’s bodies are designed to grow and change during pregnancy. The abdominal muscles soften and stretch to accommodate the growing baby. When the connective tissue between the left and right abdomen gets stretched out, we call it diastasis recti abdominis (DRA). Abdominal widening is a natural part of pregnancy, and the muscles slowly come back together after the baby is born.

How do you fix diastasis recti abdominis?

The key to healing postpartum DRA is core strength. Start by strengthening the transverse abdominal and pelvic floor muscles to create stability from within. Also, physical therapy during and after pregnancy promotes optimal functioning and reduces the risk of impairment.

Exercises for Diastasis Recti Abdominis

Strengthening your core muscles during and after pregnancy can help support your organs and connective tissues as your body changes. Superficial exercises such as sit-ups won’t do much for DRA, and may in fact make diastasis rectus worse. Instead, what you want to do is reinforce the deep core stabilizers below the “six-pack.” Some exercises that you may do with your physical therapist include:

  • Deep Breathing  
  • Postural Training
  • Kegel Exercises  
  • Isometric Abdominal Contraction 

Individualized Treatment Plans for DRA

A trained physical therapist can work one-on-one to develop a personalized exercise program to help elevate the symptoms of diastasis recti abdominis during and after pregnancy. Talk to one of our Women’s Health experts to learn how we can help your baby belly bounce back. Schedule an appointment today!

Treating Uterine Prolapse without Surgery: The PFPT Approach

Treating Uterine Prolapse without Surgery

Pelvic floor physical therapy (PFPT) is the first step in treating uterine prolapse without surgery. Rigorous research shows a clear benefit of physical therapy as a first-line treatment for specific women’s health issues. In the PFPT approach, the physical therapist gives instruction on muscle strengthening, relaxation, and coordination exercises. Strategies also include manual therapy, biofeedback, and home exercises.

How do you fix a prolapsed uterus without surgery?

PFPT is the first-line treatment for uterine prolapse. A trained therapist can develop an effective treatment plan in most cases. However, surgery should be a last resort if less invasive treatments were unsuccessful or severe symptoms affect daily life.

What Causes Uterine Prolapse?

Uterine prolapse happens when weak pelvic floor muscles allow the uterus to descend into the vagina. This abnormal descent can cause a feeling of heaviness or fullness in the pelvic region. It can also cause back pain and problems using the restroom. Causes include:

  • Pregnancy and vaginal childbirth 
  • Weakening of pelvic muscles and tissue with advanced age and menopause
  • Conditions that put additional strain on the abdomen and pelvic area including obesity, chronic cough, and constipation.
  • Major surgery that causes decreased support in the pelvic region.

Is Treating Uterine Prolapse with PFPT Effective?

In 2014, the International Consultation on Incontinence report cited level 1, grade A evidence supporting the effectiveness of physical therapy in treating uterine prolapse. For example, a large study found PFPT improved prolapse symptoms after 12 months compared to those who received an educational leaflet or no treatment. Likewise, women who participated in a large Norwegian study showed improvement after pelvic floor muscle training under the supervision of a physical therapist. In addition, a meta-analysis published in the International Urogynecological Journal concluded that patients who received PFPT subjectively and objectively improved their pelvic organ prolapse symptoms and severity. 

Treating Uterine Prolapse without Surgery 

Uterine prolapse is not going away on its own. The best scenario is to treat it early and avoid surgery. Physical therapy can prevent pelvic organ prolapse from worsening and correct underlying causes. Pelvic floor muscle training such as Kegels strengthens the supporting structures around the uterus. An additional treatment option includes support pessaries—flexible devices inserted into the vagina. 

Physical Therapy for Uterine Prolapse

Physical therapy takes a multi-faceted approach to treatment. First, the therapist assesses the patients’ symptoms and lifestyle to develop an individual plan. The therapist begins with patient education, teaching them to avoid heavy lifting, reduce intra-abdominal pressure and engage core muscles when coughing, sneezing, and laughing. PT also includes core strengthening exercises and pelvic floor muscle training.

At COR, we have experts on staff to create and implement PFPT treatment plans. If your patients are interested in treating uterine prolapse without surgery, contact our referral office at 201-833-1333.

Enjoy the Run, Stop the Leakage: Physical Therapy for Runners’ Incontinence

Physical Therapy for Runners' Incontinence

Does going for a jog always make you need to pee? You’re not alone—over 40 percent of female athletes experience urinary incontinence. Fear not! The problem is usually treatable with specifically designed physical therapy for runners’ incontinence. 

Why do I need to pee every time I run?

Physical activity, such as running, puts pressure on the bladder, which may lead to leakage. This can occur when muscles of the pelvic floor, which work to support the bladder and reduce leakage, are weak or inefficient. Runners’ incontinence can happen to anyone at any age. However, it is most common in women, especially after vaginal delivery.

Let’s Talk about Urinary Incontinence

Most women don’t want to talk about leakage. Even though runners’ incontinence is uncomfortable and frustrating, 95% of athletes don’t speak to their doctor. Instead, they use the restroom before running to avoid leakage. Even with preventative urination, the problem can affect overall athletic performance. The good news is: you don’t have to live with leakage—effective treatments are available. 

Physical Therapy for Runners’ Incontinence 

With the help of physical therapy, you can learn to gain control over your symptoms and reduce the need for pads and medical interventions. A physical therapist can create an individualized treatment program based on your needs. The PT may help with pelvic floor muscle coordination and bladder habits. The PT may also work to strengthen the pelvic floor muscles through specifically designed exercises. In addition, your PT will talk you through how to sense the movement of your pelvic floor and improve bladder control. Some methods include:

  • Bladder training/ behavioral modification – The therapist may use a “bladder diary” to learn about bladder habits. You may then learn various methods to improve bladder retention and urine emptying to improve function.
  • Kegels — These exercises involve tightening and releasing your pelvic muscles as if you are trying to stop urine flow. 
  • Strengthening Exercises — Specific exercises build muscle strength for surrounding muscles that support bladder function. It is difficult for many people to perform kegels correctly; a pelvic floor physical therapist can help. 
  • Biofeedback — Depending on your level of comfort, your PT may gently employ electrodes to measure muscle activity and give insight into how to best use your pelvic floor muscles. 

At Churchill Orthopedic Rehabilitation, we have expert PTs who know best practices when it comes to physical therapy for runners’ incontinence. Let’s talk about peeing. Schedule an appointment today.

The Importance of High-Quality Postoperative Physical Therapy

High-Quality Postoperative Physical Therapy

What a patient does after surgery is almost as crucial as the operation itself. The procedure lasts a few hours, but the rehabilitation takes months. High-quality postoperative physical therapy is crucial for restoring mobility and strength. Therapy only works when done correctly. Improper healing could make the area worse and lead to complications. When referring to post-op PT, providers want to know that their patients are getting the best care possible. 

Why is physical therapy important after surgery?

Improper exercises put increased strain on the joint. The healing process slows, and range of motion can diminish over time. Those who don’t engage properly in post-op rehab may see atrophy of supporting muscles and soft tissue. 

The Importance of Personalized Support

Physical therapy improves overall health following an operation. Personalized support means proper healing and faster recovery times. Patients who actively participate in their rehabilitation process have better outcomes than those who don’t. A good PT teaches patients the best recovery methods and helps them maintain wellness over time. 

Consistency is key. When patients see the same PT every time, their progress is monitored and tracked by a single provider. The therapist and patient get to know each other and develop a therapeutic relationship. Each learns to trust that the other is working hard to contribute to the treatment’s success. Over time, patients will return to their daily lives better than before. 

Evidence-based Best Practices

High caliber PTs integrate the best available evidence, clinical expertise and patient values into post-op care. Clinicians who provide the best care for patients will take the time to find and apply the latest research. Moreover, knowledge and skill are a key aspect of evidence-based practice. 

Each PT has a unique body of knowledge. A clinician’s education, training, and competency all factor into their quality of care. Taking the patient’s needs and wants into account is an important part of care following surgery. A skilled PT will consider the person’s values, culture, and needs when developing a comprehensive treatment plan. 

Common Types of Surgery Requiring Postoperative Physical Therapy

Any type of surgery can be traumatic for the mind and body. So, patients  need excellent post-op care especially following joint replacements. Common types of surgery that require physical therapy include:

  • Total Knee Arthroplasty
  • Total Hip Arthroplasty
  • Shoulder Labral repair
  • Spinal Laminectomy and/or Fusion
  • Rotator Cuff Repair
  • Meniscus Repair
  • Knee Arthroscopy for various problems

        Total Shoulder 

         Replacement 

Benefits of High-Quality Postoperative Physical Therapy 

A carefully supervised rehabilitation plan is crucial. Therapy helps patients reduce pain quickly and avoid relying on opioids. It also improves emotional and psychological states. Exercise releases endorphins that improve mood. Plus, having the support and encouragement of a PT means patients don’t feel like they are recovering alone. Other significant benefits include:

  • Improved circulation and reduction in swelling
  • Reduced risk of postoperative pulmonary complication
  • Faster recovery time and return to prior level of function
  • Balance and coordination training
  • Gait analysis and instruction in proper mechanics
  • Manual therapy
  • Self-care education
  • Home exercise instruction

The COR Difference 

At Churchill Orthopedic Rehabilitation, we create treatment plans specific to each patient. Our trained PTs have in-depth knowledge of the different types of orthopedic surgery. In addition, we understand the importance of continuity of care. At COR, patients see the same PT every time they come in. If your patients need high-quality postoperative physical therapy, call our office at 201-833-1333.

Bladder After Baby: Physical Therapy for Postpartum Urinary Incontinence

Physical Therapy for Postpartum Urinary Incontinence

Millions of women struggle with incontinence following childbirth. Physical therapy for postpartum urinary incontinence can improve the quality of life for these mothers. For some, pelvic floor dysfunction limits their daily activities, including caring for baby. Many women don’t feel comfortable talking about bladder problems. They try to juggle taking care of a newborn while wearing heavy pads, rushing to the bathroom, and bracing for coughs.

Will my bladder go back to normal after pregnancy?

Postpartum incontinence does not always clear up on its own. If left untreated, it can get worse over time. If symptoms persist following delivery, mothers should seek further treatment in order to regain bladder control.

Types of Incontinence after Childbirth

Not all cases of postpartum incontinence are the same. For example, women who delivered vaginally have different needs than those who had a c-section. The two most common types of bladder issues are stress incontinence and urge incontinence. 

  • Stress Incontinence —Bladder leaks caused by pressure on the abdomen from sneezing, laughing, exercising, etc. This is common following vaginal childbirth. 
  • Urge Incontinence — The sudden, strong desire to urinate associated with leakage. Scar tissue from c-sections can pull on the bladder and make women need to go more frequently.

Physical Therapy for Postpartum Urinary Incontinence 

A physical therapist can help you control your symptoms and reduce the need for pads, medication, or surgery. Kegel exercises are often prescribed for postpartum incontinence, however, this is just one piece of the puzzle. Because conditions vary from person to person, the PT will create an individualized treatment plan. Interventions include:

  • Education — learning to sense the pelvic floor muscles and how to do home exercises.
  • Kegel exercises — strengthening pelvic muscles by squeezing then releasing.
  • Biofeedback — gentle electrodes that monitor muscle activity check if exercises are correct.
  • Core exercises — strengthening your abdomen is vital to supporting the pelvic area. 
  • Lifestyle changes — Maintaining a healthy bathroom schedule and avoiding food, drinks, and activities that may exacerbate symptoms.

At Churchill Orthopedic Rehabilitation, we have experts on staff who specialize in pelvic floor and women’s health issues. If you need physical therapy for postpartum urinary incontinence, give us a call at 201-833-1333.

Physical Therapy for Arthritis: Causes, Symptoms, and Treatments

 Physical Therapy for Arthritis

Living with arthritis can be a nightmare—pain and stiffness prevent you from opening the jelly jar in the morning, or your knees burn as you climb the stairs for bed each night. Fortunately, Physical therapy for arthritis relieves symptoms and slows disease progression. The physical therapist works to alleviate aching, stiff joints through manual therapy, targeted exercises, hot and cold therapy, and massage.

How effective is physical therapy for arthritis pain?

Physical therapy is highly effective in relieving pain and stiffness associated with arthritis. In a study published in the Physical Therapy & Rehabilitation Journal, patients who received clinical treatment improved twice as much as those who did home exercise.

Arthritis Types and Causes

Arthritis refers to a couple of different conditions characterized by joint pain and range of motion difficulty. While the symptoms are similar, the causes differ. For example, Rheumatoid arthritis is an autoimmune disorder that causes painful swelling that often feels worse in the morning or after rest. On the other hand, osteoarthritis comes from the wear and tear of the cartilage lining the joints and irritation of soft joint tissue. Different types of arthritis require individual treatment plans. A PT can help identify and alleviate the causes of pain based on the patients’ needs. 

Symptoms of Arthritis 

Arthritis can occur in many joints from the shoulders to the feet. Osteoarthritis most commonly affects weight-bearing joints in the knees and hips. In comparison, rheumatoid arthritis starts in the fingers and toes and migrates to larger joints such as ankles, knees, elbows, and hips. Moderate to severe arthritis can impair your ability to complete activities of daily living such as bathing, cooking, and walking. Early signs and symptoms include:

  • Pain
  • Stiffness
  • Swelling
  • Redness
  • Reduced range of motion

Arthritis Treatments

Stretching, massage, and physical therapy are the least invasive treatments for arthritis. Other interventions include medication such as anti-inflammatories, steroids, and/or immunosuppressives for rheumatoid. Extremely severe cases of each type may require joint replacement surgery. Physical therapy is often the preferred treatment for arthritis because it is most effective and least invasive in the early stages of the disease. 

Physical Therapy for Arthritis 

The most significant benefit of working with a physical therapist is individualized treatment plans. Medications treat all pain the same—they treat  the symptoms rather than treating the cause. In contrast, physical therapy has the tools to provide targeted solutions to each individual’s pain. Manual therapy, hot and cold therapy, and therapeutic massage can dramatically improve the range of motion for most arthritis patients. 

Getting Help for Arthritis Pain

Is chronic joint pain impacting your life? It’s time to talk to a PT about tailored treatment options. If you need physical therapy for arthritis, schedule an appointment with one of our expert therapists today. 

Increased Time Spent in Physical Therapy Improves Outcomes

Time Spent in Physical Therapy

The amount of time patients spend with their Physical Therapist makes a huge difference when it comes to healing. Increased time spent in physical therapy sessions correlates with improved recovery rates. Patients have better outcomes when the PT gives time and attention to provide quality care and education. Rehabilitation outcomes and patient satisfaction increase when patients spend more time with their PT.

How Long Should Physical Therapy Last?

Physical Therapy lasts as long as it takes to reach individual recovery goals. Each case is different, and the amount of PT will depend on the patient’s needs and rate of healing. Factors such as overall time spent in therapy and adherence to home education speed recovery.

Impact on Rehabilitation 

Patients need to spend a lot of time in physical therapy when recovering from injury or surgery. The more time, the better. There is a positive correlation between total therapy time and regaining functional independence. According to a 2021 retrospective study, each additional hour of physical therapy was associated with “an increase of 7.55 functional independence measure (FIM) point gain.” All in all, more time spent in treatment produced improved rehabilitation outcomes. 

Patient Satisfaction

High-quality interactions with the PT improve patient satisfaction. The patient gets the most out of each session when the therapist takes time to explain, instruct, and educate thoroughly. Cost-cutting measures, high patient volume, and care extenders take time away from direct contact with the therapist. A survey published in the Physical Therapy & Rehabilitation Journal found a strong correlation between patient satisfaction and quality interactions with the physical therapist, including spending time with the patient, strong listening skills, and clear explanations of treatment. 

Time Spent in Physical Therapy 

At Churchill Orthopedic Rehabilitation, we spend time getting to know each patient’s needs. Our highly-skilled PTs give each person time and attention. We know that time spent in physical therapy is essential for rehabilitation outcomes and patient satisfaction. Call us at 201-833-1333 to refer patients for treatment.