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Category: Newsletter

Drug-free Relief for Chronic Pain: Physical Therapy as an Alternative to Opioids

Physical Therapy as an Alternative to Opioids

No one wants to put their health at risk from the medical side effects of prescription pain pills. That’s why so many physicians recommend physical therapy as an alternative to opioids. Healthcare providers want to help patients manage pain without relying on habit-forming drugs. PT is a low-risk, minimally-invasive way to handle a variety of pain. A physical therapist treats pain through hands-on manipulation, education, and physical activity.

What are CDC recommendations for pain management?

Centers for Disease Control recommends primary care providers maximize non-opioid treatments for chronic pain. Before starting drug treatments, consider alternatives such as physical therapy. When prescribing pain killers, use the lowest possible effective dosage and closely monitor patients for side-effects.

Avoiding Opioids for Chronic Pain

Opioids have long been accepted for their role in acute and terminal pain. However, their use in treating chronic pain is controversial. The opioid epidemic has revealed the dangers of masking long-term pain with drugs rather than treating the deeper cause. Therapists work with clients to the root out of the underlying problems. Using physical therapy as an alternative to opioids is a long-term solution for managing chronic pain. 

Side Effects of Opioids 

Opioids have dangerous side effects such as addiction, depression, overdose, and withdrawal. Other common side-effects are:

  • Sleepiness
  • Dizziness
  • Nausea 
  • Vomiting
  • Constipation
  • Physical dependence
  • Respiratory problems

The only “side effects” of physical therapy are improved mobility and a reduction in health problems. PT may reduce the need for more invasive procedures, or it can support post-operative recovery when surgery is warranted.

Benefits of Physical Therapy as an Alternative to Opioids 

Physical Therapy improves the overall quality of life for patients. Sessions help get to the root cause of the pain, rather than masking it with medication. Therapists can identify and treat a variety of health concerns beyond the initial presentation or pain. Patients tend to see better results because they are active participants in their recovery process. 

Referring for Physical Therapy as an Alternative to Opioids 

When patients present with chronic or post-surgical mobility issues, physicians may decide to temporarily prescribe medication to get the pain under control initially. Quickly referring to physical therapy gets individuals off pain meds quickly before addition and adverse side effects set in. To refer a patient for pain management, call our office at 201-833-1333.

How to Avoid Surgery with Non-operative Rehabilitation

Non-operative Rehabilitation

Torn ligaments and injured joints can render a person immobile. Non-operative rehabilitation is a non-invasive way to return you to daily activities safely. Physical therapy will guide you through progressive steps designed to strengthen the affected area and return to normal functioning over time. Rehabilitation typically happens in three phases. Therapists will personalize each program depending on the patient’s needs and activity goals.

What activities should I avoid after tearing a ligament?

Following a sprain, which is a tearing of some of the fibers in a ligament, you want to avoid anything that overextends the affected joint. For torn knee ligaments, pain-free ROM and isometric strengthening is the first order as guided by your therapist. You don’t want to start more vigorous exercises too early on in the rehabilitation process, or re-injury may occur.

Phase One – Increase Protection and Decrease Pain

The first four to six weeks are designed to protect the affected area and decrease pain and swelling. The first phase requires multiple therapy sessions per week. Many clients require the use of a brace and/or crutches. Therapists will educate you on how to use assistive devices and will begin manual manipulation to increase mobility. You will also start light exercises such as hip activation, ankle pumps, and isometrics.

Phase Two – Regain Strength and Mobility

You will most likely begin to wean off the crutches in this phase. Your therapist will continue hands-on manipulation for mobility support. You will introduce new exercises such as lunges, squats, and leg presses to build strength and flexibility. Riding a stationary bike is another way to workout injured knees. Phase two aims to return to a full range of motion and improve stability and gait. 

Phase Three – Ease Back to Normal Function

Typically, it’s safe to stop using the brace after about 12 weeks of non-operative rehabilitation. Your physical therapist will direct the adding of resistance to your leg presses and guide progression to more advanced lunges and squats. In phase three, we aim to return to full functioning and meet your doctor’s clearance criteria. 

Getting Back in the Game after Non-Operative Rehabilitation

Your physician will tell you when you’ve met clearance criteria to return to functional activities. When returning to sports drills, always listen to your body. Pain and resistance are signs that your knees are not quite ready. Avoid pushing hard too soon. Over-exertion can cause re-injury. Returning to training or work takes more than physical healing. There is a psychological element to recovering from injury as well. You need to be able to trust the injured part. Physical therapy takes a holistic approach to helping you get back in the game. 

Non-operative Rehabilitation in Bergen County New Jersey

Churchill Orthopedic Rehabilitation offers rehabilitation options without surgery for torn ACL, PCL, and MCL. Our highly-trained physical therapists will work with you to design a program that meets your personal recovery goals. Schedule a consultation today.

Regaining Mobility: Joint Replacement Rehabilitation for Knee, Hip, and Shoulder

Joint Replacement Rehabilitation

Surgical joint replacement is a last resort to heal chronic pain and mobility issues after non-surgical treatments proved unsuccessful. It takes severe pre- and post-surgery joint replacement rehabilitation to restore your quality of life. Getting moving again is a crucial part of recovery. Physical therapy helps bring back your mobility and range of motion following joint replacement. 

What are the joint replacement surgery risks?

Joint replacement has the same risks as other surgeries such as infection and blood clot. More likely problems are stiffness, swelling, and range-of-motion issues. Active rehabilitation before and after surgery can reduce some risks.

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Pre-operative Physical Therapy 

Completing pre-surgery exercises prepares the body for the upcoming operation and leads to shorter recovery times. A PT can determine advanced exercises for strength, endurance, flexibility, and balance. Support your joint by strengthening the surrounding muscles. Endurance training helps your body recuperate faster. Improved balance keeps you steady on your feet and reduces falls. 

Training your body is just part of the preparations. A skilled physical therapist can also provide education for the patient on what to expect following surgery. Your PT can teach you how to use assistive devices such as walkers and crutches and how to prepare your home to help you live as independently as possible. Recovery is safer and faster when you prepare ahead of time. 

Post-operative Joint Replacement Rehabilitation 

The physical therapist at the hospital will get the rehabilitation process started. At first, you’ll learn how to get out of bed and chairs safely. During the initial days following surgery, your physical therapy needs will focus on reducing pain and swelling. Your PT can show you how to use ice, compression, and elevation to control swelling around the affected joint. 

When you can move freely without pain, your physical therapy program can focus on returning to full function. Depending on the joint—knee, hip, or shoulder—your PT will design a specific recovery program including strength, balance, and mobility exercises. You will start range-of-motion exercises right off the bat. These restore movement to the joint so that you can perform activities of daily living. Still, you may need to use a cane or other assistive device for a while.

Joint Replacement Rehabilitation at COR

When you are recovering from joint replacement, the experienced physical therapists at Churchill Orthopedic Rehabilitation can provide techniques to reduce swelling and maximize comfort. Schedule a consultation to talk about your joint replacement rehabilitation needs. 

Sports Injury Rehabilitation: Getting Back in the Game

Sports injury rehabilitation

Your feet fall rhythmically in step as you run. Your body moves with effortless focus until a stray rock rolls under your arch. Your ankle turns, and you tumble onto your side. Pain ends the training session, and you go home for some rest, ice, compression, and elevation. When you get hurt while exercising, ice packs and wraps aren’t always enough. To get back in the game, you may need sports injury rehabilitation.

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Which sports injuries are most common?

There are around 8.6 million sports injuries each year in the US. According to CDC data, approximately 40% of sports-related diagnoses include sprains and strains, making them the most common sports injuries by far. The next are fractures, which account for 20% of sports injuries. Others include superficial injuries and concussions.

What are Sports Injuries? 

Sports injuries are bodily harm or damage that occurs during recreation, exercise, or athletic events. They are often caused by accident or direct impact. However, a lack of proper warm-up, stretching, form, or equipment use can also lead to training injuries. If you are hurt while working out, seek medical attention—untreated injuries can lead to more significant future problems. 

What is Sports Injury Rehabilitation?

Recovering from sports injuries requires a multi-disciplinary approach to prevention, evaluation, and treatment. The goal is to restore the athlete to optimal form and function. With the right therapy, some clients return to the game better than ever. Once the injury is accurately diagnosed, a sports injury specialist can work with the athlete to develop an individualized treatment plan involving manual therapy techniques and strengthening exercises.

Sports Injury Rehabilitation at COR

At Churchill Orthopedic Rehabilitation, therapists, clients, and specialists work together to quell pain and improve mobility and strength. We work with referring physicians and coaches to ensure a continuum of care before, during, and after therapy. Our physical therapists use research-based methods to help with recovery from a sports injury. We develop a plan specifically designed for you to get you back in the game. If you are ever in need of sports injury rehabilitation, schedule an appointment to work with our highly-trained PTs.

COR’s Essential Personnel Program

Hello Everyone!
 
Our office re-opened after being closed for approximately two months and during that time we have been developing a performance program to give back to all our essential workers.  Through this program, our team wants to help people who have been dealing with nagging pains that have not been resolved and be relieved with appropriate physical therapy services.  If you have any questions about this promotion, please feel free to reach out to us.
 
Kind regards,
The Churchill Rehab Team

Churchill’s New Standard of Care!

Hello Churchill Family!

We want to be sure you feel safe for your physical therapy visits as our community starts moving again. Some of the steps we are taking include frequent washing of tables/equipment/handles, utilization of masks by everyone in the building, adhering to social distancing guidelines, and having our room sanitized daily.  If you have any questions or concerns please feel free to reach out to us.  We have returned to the office and seeing limited in-office visits at this time. We are here to help with all your orthopedic concerns!

Here is a round-up of recent content, enjoy!

Office Virtual Tour…We have implemented new changes in our clinic to keep our team and patients safe…https://www.instagram.com/p/CAbCj1unilr/?igshid=tr5fui50sjsb

Office Setup and Safety Protocol…Check out our new office design and use of personal protective equipment (PPE)…https://www.instagram.com/p/CAgBxYNssUa/?igshid=pw4hmkxlwcod

Quarantine Upper Body Edition…Here is a short demonstration of several exercises that you can do at home to stay active and strong!…https://www.instagram.com/p/CALAe-FnL-l/?igshid=n17giv1kkako

Kind Regards,

The Churchill Orthopedic Rehab Team

Churchill Reopening May 20, 2020

To Our Churchill Family,

We hope you and your families are well and safe during these very trying times.  Above all else, these are the things that are most important.

We wanted to take a moment and thank all of you who have helped us with our telehealth program.  Your willingness to allow us continue your care in a new format for everyone just reinforces how wonderful our patients are and how much you trust us.  We’ve always known how special our patients are and we truly value and appreciate each of you.

Now that the state is beginning to reopen, we wanted to let you know that we are in the process of reopening the practice and what we are doing to keep everyone safe.  We are going to open on a “limited” basis in the beginning.  We will have a staggered schedule to ensure no more than 2 therapists and 2 patients in the facility at a time.  We have rearranged the equipment to ensure proper social distancing and we have secured masks, face shields and gloves to ensure the risk of exposure is minimized for patients and staff alike.  The office is being professionally disinfected and it will continue to be done on a regular basis as well as our own between patient sanitizing procedures.   We have also purchased a new air filtration system which filters 99.97% of contaminants to the size of 0.3 microns.  This is smaller than the virus particles and is a significant added measure of safety.

We are looking to reopen on Wednesday, May 20.  You can call the office at 201-833-1333 or talk to your therapist directly to set up you schedule.  We can’t wait to see you all again!!

Yours in good health,

The Churchill Rehab Family

Ways to Reduce Swelling

Ways to Reduce Swelling

In our last blog, Dr. Breitinger defined what makes up the components of inflammation. In our next segment, we will briefly discuss ways to control and reduce joint inflammation whether acute (new injury) or chronic (lasting more than one month).

First, and most importantly, you need to identify the reason for a swollen joint.

  • Did you sustain an injury?
  • Was a new activity performed?
  • Did you perform TOO MUCH of that new activity?

Sometimes it can be the cumulative stress of a regular activity that pushes your joint behind its normal capacity. Often times, the new or repetitive stress lowers a joints normal tolerance, and then your daily activity keeps the joint irritated.

Classically, we have been conditioned to use the mantra, RICE, for inflammation control:

  • Rest
  • Ice
  • Compression
  • Elevation

Complete REST, which some may take literally, is not the best method. First you need to stop or reduce the activity that is causing the overstressing. Mobility WOD founder and Physical Therapist Kelly Starrett uses the phrase to “Decongest the joint”.  He emphasizes light, or non-stressful activity as a way for your muscles to pump the fluid out of the joint. If you are just lying on your couch, the fluid in that joint has the potential to remain.

For decades, ICE has been the preferred method for reducing inflammation. I completely agree with this statement, especially if you sustain a new injury, which causes immediate swelling and/or bruising. However, after 48 hours of that cycle starting, the arguments can me made to use either ice or heat.  There continues to be a discrepancy on which method is better, with the research still lacking on which is superior, despite the aforementioned conventional wisdom that ice is better.  Because ice and heat can both work as pain control methods, I always defer to my patients which method they prefer.  In my eyes, it’s better to use what typically works for them, instead of getting resistance for something they dislike.

Disclaimer: Superficial heat or ice treatments can irritate the skin if too hot or cold, and left on for prolonged periods of time. Please check skin integrity regularly and avoid over treating (For ice, greater than 20 min).

COMPRESSION, in the form of wraps, neoprene bracing, or ACE bandages are excellent ways to control swelling from worsening, especially after an initial injury. They act as subtle barriers to restrict increasing joint volume. They also keep the area warm and stimulate skin receptors, which can be soothing for some.

Disclaimer: Compression should not be tight enough to cut off circulation or leave marks on the skin.

ELEVATION, can also aid in swelling reduction by limiting blood from pooling in the joint, especially in the lower leg (if indicted). Keeping the involved limb above the heart has shown beneficial results, especially with acute swelling.

Medication: While it is not within a physical therapist scope of practice to recommend specific types of medications, over the counter NSAIDS (Non-steroidal anti-inflammatories) can have a big impact on swelling and pain complaints associated with a joint injury, should it not cause significant side effects.

 Disclaimer: NSAIDS should not be used more than 4-5x/week or over two-week period. If so, they should see a physician for further consultation, if they haven’t already done so.

Lastly, swelling can persist for other non-injurious reason including;

  • Decreased sleep
  • Increased life stress
  • Poor nutrition

A physical therapy consultation can further meet your individual needs and help get to the root cause of your issue.

Schedule an appointment today!

Gabriel Scher, DPT, SCS