Cubital Tunnel Syndrome Part 2

Confidently overcome your carpal tunnel syndrome
by changing how you use your hands and wrist

Most people use their hands throughout most of the day, especially for work-related tasks. But in some professions—like assembly line work and jobs that use vibrating hand tools—the repetitive motions involved can actually damage the wrist over time and lead to a painful condition called carpal tunnel syndrome (CTS). This is a condition caused by compression of a nerve in the wrist that leads to symptoms in the hand and wrist, but it can be managed by making some simple changes to the way movements are performed.

The carpal tunnel is a space at the base of the palm that contains several tendons and the median nerve, which provides sensation to the fingers. If these tendons thicken or any other swelling occurs in the area, this tunnel narrows, which puts pressure on the median nerve and leads to CTS. For this reason, CTS is considered a nerve compression syndrome, and it’s by far the most common type, affecting about 5% of the population.

Symptoms usually start with a burning or tingling sensation, but eventually pain, weakness and/or numbness develop in the hand and wrist, and then radiate up the arm. As CTS progresses, symptoms usually get worse when holding certain items, and hand weakness and numbness may occur more frequently if this pressure on the nerve continues.

The greatest risk factor for developing CTS is any task that requires repetitive hand motion, awkward hand positions, strong gripping, mechanical stress on the palms, or vibration. CTS can therefore occur in any line of work that involves one or more of these components. Office work and repetitive typing may be a potential cause, but the chances of developing CTS are three times higher in assembly line work like manufacturing and meatpacking. Other professions that have a high risk for CTS include sewing, baking, cleaning, sports like racquetball and handball, and playing string instruments like the violin.

Education and exercise to combat CTS

The best way to deal with CTS is to learn how to avoid movements that will make the compression worse, and then address the damage present with exercises and pain-relieving interventions. Our physical therapists recommend the following:

  • Education
    • Change your wrist positions and avoid bending your wrist for too long
    • Use proper neck and back posture, and avoid slouching
    • Keep your wrists straight when using tools and also while sleeping
    • Try to avoid flexing and extending your fingers and wrists repeatedly
    • Minimize repetitive, strong grasping with the wrist in a flexed position
    • Take frequent breaks to rest your hands and wrists
    • Modify your tools to make a more comfortable grip
    • Use anti-vibration gloves or wraps when using vibrating tools
  • Ice/heat to relieve pain
  • Strengthening exercises for the wrist, hand, and fingers
  • Stretching exercises for the wrist, hand, and fingers
  • A night splint to reduce discomfort

If you’re dealing with any hand or wrist symptoms that sound like CTS, it’s probably time to see a physical therapist for a structured treatment program that will target your impairments and teach you how to preserve your wrist from future issues.

Cubital Tunnel Syndrome and Other Nerve Compression Syndromes

Conditions resulting from pressure on nerves can be treated with specific exercises

The nervous system is the line of communication spans the entirety of the body and allows for all of its movements and functions to take place. But when a nerve is damaged and unable to transmit its message properly, it can lead to communication issues and a range of possible symptoms that can make movement more difficult.

This is the case with nerve compression syndromes, which is a group of disorders that occur when a nerve is squeezed or compacted by another structure in the area. Nerve compression syndromes involve the peripheral nerves—those outside of the brain and spinal cord—and are usually caused by repetitive movements that eventually impinge upon the nerve. There are several different types of nerve compression syndromes, with carpal tunnel syndrome being the most common, followed by cubital tunnel syndrome.

The cubital tunnel is located in the elbow and contains the ulnar nerve, which supplies sensation to the ring and little fingers. The ulnar nerve travels from the neck down to the hand, and it can be compressed—or pushed on—by other structures at any point along the way. But the most common place this occurs is behind the inside part of the elbow, where the cubital tunnel is located.

The result of this compression of the ulnar nerve is cubital tunnel syndrome. Symptoms typically include pain, numbness, tingling, and weakness in the arm and hand, which is particularly concentrated in the ring and little fingers. Cubital tunnel syndrome is also caused by daily habits like leaning on the elbow for long periods of time, sleeping with the arms bent, or from direct trauma to the ulnar nerve, like hitting your funny bone.

Other nerve compression syndromes include the following:

  • Cervical radiculopathy: results from compression of one of the nerve roots in the neck when it splits from the spinal cord; symptoms include a burning pain in the neck and down the arm, and weakness, numbness, and/or tingling in the fingers
  • Lumbar radiculopathy: occurs due to compression of a nerve root in the lower back when it branches away from the spinal cord; symptoms include pain, numbness, weakness, and/or tingling down the leg and sometimes into the foot
  • Piriformis syndrome: a rare condition occurring when a muscle in the buttocks (the piriformis) puts pressure on the sciatic nerve; the most common symptoms are tenderness in the buttocks and pain traveling down the thigh, calf, and foot
  • Other: Guyon’s canal syndrome, radial nerve compression syndrome, and thoracic outlet syndrome; symptoms typically include aches and pains, tingling or numbness, weakness, and reduced flexibility

Physical therapy and exercise can help reduce symptoms

If you begin to notice symptoms that suggest a nerve compression syndrome is present, physical therapy is often the best option available to manage your condition. A typical physical therapy treatment program may include bracing or splinting, modalities like ultrasound and electrical stimulation, and advice on how to make modifications to your lifestyle and posture. Another important component of treatment is exercise, particularly nerve gliding exercises, which help to maintain the health of nerves and restore their mobility if it has been lost. Below are four examples of nerve gliding exercises that can address cubital tunnel syndrome by targeting the ulnar nerve:

Physical therapists can provide you with a specific set of exercises for your condition and guide you to ensure you’re performing them correctly. They can also educate you on how to avoid certain movements that will further irritate your nerves in order to alleviate your symptoms.

Failing to access physical therapy could be contributing to the significant waste in the U.S. healthcare system

First, we’d like to take a minute to wish everyone a happy and blessed holiday season and thanks to all of our patient and community for the opportunity to serve you.  

Now, let’s talk about some of the major problems with our healthcare system…and Visalia and Hanford aren’t immune to this.

It’s a common talking point by now that the U.S. healthcare system is in need of repair, and one of the biggest issues is extremely high costs. In fact, we spend more on health care than any other nation in the world, with about 18% of our gross domestic product (GDP)—and approximately $10,000 per person—going directly to this system. But it’s also been found that significant portion of the money spent on health care is wasted, meaning that much can be saved if these areas are targeted.

Several studies have looked into these costs and how much can be considered “wasted spending,” but the most recent one was published in 2012. For this reason, researchers performed an updated review of the literature to estimate the levels of waste in the U.S. healthcare system, along with suggestions on how to reduce it.

Here’s What Some of the Research Says

To conduct the review, a search was performed for studies related to health care costs or savings over the past seven years. This process led to 71 estimates from 54 pieces of literature being included. Once collected, these documents were analyzed and calculations were executed to determine how much money was wasted on health care. Below are some of the key findings of the review:

  • The estimated total cost of waste in the healthcare system was $760 billion to $935 billion
  • Interventions to address this waste could potentially save $191 billion to $202 billion
  • These estimates account for about 25% of the total health care expenditures in the U.S.

The potential sources of waste were grouped into six categories, and suggested interventions were given to address each one (“failure of care delivery,” “failure of care coordination,” “overtreatment or low-value care,” “pricing failure,” “fraud and abuse,” and “administrative complexity.” Three of these categories apply specifically to wasted costs that may occur when patients do not undergo physical therapy for a painful condition:

  • Failure of care delivery: this is waste when the best types of practices to care for patients are not adopted or poorly executed
    • Example: an elderly patient could suffer a severe fall that could’ve been avoided if the patient was properly identified as at-risk and sent to a physical therapist to undergo a fall-prevention program
  • Pricing failure: costs of services that are significantly higher in the U.S. than other countries—for various reasons—contribute to this this type of waste
    • Example: a patient with shoulder pain that sees a primary care doctor may be sent to have an expensive MRI or CT scan right away, whereas with a physical therapist, treatment would likely begin without these tests
  • Overtreatment or low-value care: this type of waste results when patients receive treatments that are not considered effective according to research
    • Example: if a patient with low back pain visits a surgeon before seeing a physical therapist, surgery may be recommended to address their condition, even though research shows that it’s better to wait

The Healthcare System is More Patient-Centric than Ever – You Have Choices!

Patients have the power to lower their healthcare costs by educating themselves about their options.  By seeing a physical therapist first before any other medical professional, you can ensure that treatment will be started right away and most likely, you will be able to avoid unnecessary tests and treatments.  Click here to contact one of our offices.

Looking for a Knee Arthritis Expert in Visalia? Read This First

If you have knee pain and are looking for a knee arthritis expert in Visalia, this is important for you to read.

It’s a sad fact that health care is no longer about conservative care first.  It’s a power struggle.  The insurance companies are paying less and less and healthcare providers are struggling to stay afloat.  As such, they will provide aggressive treatment before conservative treatment.  It’s a shame.  The research proves this.  More patients with knee arthritis are being prescribed pain medications, while fewer are seeing a physical therapist.

Our position is simple:

You should try conservative, natural care first, that is easy to access, affordable, and has little to no side effects.  If, and only if you’ve given conservative care enough time (this is important because your body takes time to heal), and conservative care doesn’t work, then you should go to the next level care i.e. diagnostic tests, prescription drugs, injections, and maybe surgery.

Arthritis is one of those conditions that responds very well to conservative care.  Here we will discuss this in detail.

Osteoarthritis (OA), sometimes referred to as wear-and-tear arthritis, is a condition in which the natural cushioning between joints called cartilage gradually wears away. Over time, this causes the bones of these joints to rub more closely against one another because there is less shock-absorbing cartilage. Once this happens, individuals with OA will begin to experience symptoms like pain, stiffness, swelling, a feeling of warmth, and a decreased ability to move the joint normally.

OA is the Most Common Form of Arthritis

OA can occur in any joint in the body, but it’s most often seen in the hips and knees. Knee OA can also occur at any age, but the risk for developing it increases with older age because the body loses its ability to heal the damaged cartilage over time. This is why about 10% of men and 13% of women over the age of 60 have knee OA. Being obese or overweight also increases the chances of developing knee OA, since the additional weight puts more pressure on the knees and accelerates the process of cartilage thinning away.

There are a number of treatments available for addressing knee OA, but physical therapy and lifestyle changes—like losing weight and exercising more frequently—have consistently been recommended as first-line interventions that are supported by evidence. Following this course and seeing a physical therapist first can in turn lead to less use of healthcare and lower costs, as it will help patients avoid surgery and other expensive treatments. But many patients with knee OA go to a primary care doctor or surgeon to be evaluated first, leaving it up to them to decide whether or not to refer the patient to physical therapy. Some doctors will prescribe pain medications—like opioids— instead, which is not recommended as a long-term solution for knee OA.

Some Doctors Aren’t Trying Conservative Care First

To get a better idea of the decisions doctors make when treating knee OA patients, a study was conducted to evaluate the referral rates for physical therapy and lifestyle changes compared to prescriptions for pain medications. After searching through medical records, researchers identified 2,297 visits related to knee OA in which patients saw a surgeon, primary care doctor, or some other specialist. Analysis of these records over an eight-year period led to the following key findings:

  • Physical therapy and lifestyle changes were not frequently recommended, and there was a trend towards fewer referrals to physical therapy and lifestyle suggestions from surgeons over this time period
  • The rate of prescriptions for non-steroidal anti-inflammatory drugs (like ibuprofen) nearly doubled in visits to both primary care doctors and surgeons
  • Prescriptions for opioids increased by nearly three-fold over this period of time, even though opioids are generally not recommended for knee OA

This study shows that despite many clear guidelines that push for non-drug and non-surgical treatments such as physical therapy for knee OA, the developing pattern is going in the opposite direction, as many doctors are not following these recommendations. One solution is for patients with knee OA to take matters into their own hands and see a physical therapist first rather than a specialist or primary care doctor. Patients do not need a referral for physical therapy and can make an appointment for their first visit on their own.

So, if you are searching for a knee arthritis expert in Visalia, and if you have questions, make sure you contact us for more information.  Simply click here.  We have two, convenient locations.

Physical Therapy First to Avoid Opioids

SEEING A PHYSICAL THERAPIST FIRST FOR LOW BACK PAIN REDUCES THE CHANCES OF USING OPIOIDS

The opioid epidemic continues to ravage the U.S. In 2015, more than 12 million Americans reported long-term use or misuse of opioids, and there were over 42,000 deaths related to opioids in the following year. These statistics—which have largely been driven by an ongoing trend of over-prescribing pain medications—are just a brief glimpse into this multifaceted issue and the toll it’s been taking on the country.

Low back pain (LBP) is one of the most prevalent health conditions that American seek out medical care for, as up to 80% of the population will experience it at least once at some point in their lives. Several studies have shown that LBP is also among the most common conditions for which opioids are prescribed, and more than half of individuals who use opioid report a history of back pain.

This is all in spite of the fact that most guidelines recommend that opioids are not used for LBP unless other recommended treatments have failed and it’s likely that the expected benefits of opioids will outweigh the risks. Instead, these guidelines recommend that patients with LBP try other non-drug treatments first, which includes physical therapy, exercise, and other similar interventions.

Physical therapy is a movement-based strategy that addresses painful issues like LBP with a variety of exercises and techniques designed to alleviate symptoms and help patients move more easily. The primary advantage of physical therapy is that it identifies the root of the problem and helps patients learn to overcome it with specific movements, while pain medications like opioids are only intended to be a short-term solution that simulates pain relief. Physical therapy is also regarded as an extremely safe intervention with minimal to no risk for side effects.

Why physical therapy is recommended first, as outlined by a recent study

Patients with LBP have several options when it comes to deciding what type of medical professional to see for their condition, and it’s possible that who they see may affect the likelihood of receiving an opioid prescription in the future. With this in mind, a study was conducted to evaluate whether there is a connection between the medical professional these patients see and their eventual use of opioids. Below is a summary of the results:

  • Over five years, there were 126,504 patient visits for LBP
    • More than half of patients (53%) initially saw a primary care doctor, while only 1.6% initially saw a physical therapis
  • About 18% of patients received an opioid prescription within 3 days of the initial visit, 22% received one within 30 days, and 1.2% used them in the long term
  • Patients who saw a chiropractor, acupuncturist, or physical therapist first all had significantly decreased odds of both early and long-term opioid use compared to those who saw a primary care doctor first
    • Patients who visited a physical therapist first had a 85% decreased chance of using opioids early after their visit compared to a primary care doctor

These findings show that it really does make a difference what type of medical professional you see first for LBP, and this applies to other conditions as well. Patients in pain are therefore encouraged to see a physical therapist before anyone else in order to begin an effective treatment plan that will lead to improvements while avoiding the risk of being prescribed opioids.

Direct Access Over Physician Referral

Before aggressive treatment with potentially harmful side effects, here’s why you should consider physical therapy

If you hurt yourself or start noticing any sort of pain, there are many decisions you’ll have to make next. Do you avoid physical activity or movements that might aggravate the pain? Do you put ice or heat on it, or take any medications to reduce your pain level? If the pain doesn’t improve after a certain period of time, do you see a professional for treatment? And if you do decide to see someone, who will it be?

It may be difficult to find the best answers to these questions, especially the last one about who to see first for  treatment. As a result, many people will end up scheduling an appointment with their primary care doctor, since it probably seems like the safest and most familiar choice when something is wrong. While primary care doctors are expected to always provide patients with the best possible treatments, it doesn’t guarantee you’ll receive treatment from a physical therapist.

Physical therapists are movement experts that are trained to optimize patients’ quality of life through carefully designed exercise and educational treatment programs. They treat a wide variety of injuries and conditions, but the most common symptom that they address is pain, and research consistently shows that physical therapy is effective for reducing it.

This is why most guidelines recommend that anyone in pain sees a physical therapist as a first-line treatment for their condition. Patients can either go straight to a physical therapist because of direct access—which allows anyone to at least have an initial consultation without a referral in all 50 states—or they can go their primary care doctor or some other medical professional and possibly get referred to therapy. Primary care doctors are strongly encouraged to direct patients with painful conditions involving the muscles and bones to physical therapy, but this does not always occur as it should.

Study highlights a major issue with the referral system for physical therapy

One of the many conditions that can benefit from physical therapy is knee osteoarthritis (OA), which has doubled in prevalence in recent years (at least 15 million Americans currently have it). As with other issues, many patients with knee OA visit their primary care doctor first, which may or may not lead to a physical therapy referral. To evaluate how many patients with knee OA are actually being referred and what other treatments patients receive, a study was conducted. Below are some highlights from its results:

  • There were 2,297 visits with a primary care doctor, surgeon, or another specialist
  • There was a significant decline in the number of referrals to physical therapy from orthopedic specialists over three years
  • The number of primary care doctors that referred patients to physical therapy was low and did not change in any significant way over three years
  • There was a non-significant increase in narcotics prescriptions and a significant increase in the number of non-steroidal anti-inflammatory drug prescriptions

This study shows that many doctors are not referring patients to physical therapy, and that the trend is actually going in the wrong direction, with an increase in pain medication prescriptions and a decrease in therapy referrals. That’s why the best way for patients in pain to avoid the risk of not getting referred is by taking matters into their own hands and accessing physical therapy directly.

TrueRelief – A New Electro Therapeutic Treatment from a Fibromyalgia Specialist in Visalia

New Information: Physical therapy (not your ordinary treatment either) plus a new electrical medical device can alleviate fibromyalgia symptoms.

Are you looking for a fibromyalgia specialist in Visalia?  We have clinicians that specialize in fibromyalgia treatment in Visalia and Hanford.

Fibromyalgia is an extremely common pain disorder that affects nearly 5 million Americans. Women are affected far more frequently than men, as about 80-90% of cases develop in females, with symptoms usually beginning to develop between ages 30-50. Fibromyalgia is also a chronic condition, which means that the majority of individuals who have it are affected over a long period of time.

The cause of fibromyalgia is not clearly understood, but it’s believed to be related to changes in how the nervous system processes pain and may be triggered by trauma, surgery, infection, arthritis, or major emotional stress in some patients. Fibromyalgia is also considered a complex syndrome that involves many components, rather than just an individual condition. This is the main reason it can include many different signs and symptoms, such as widespread pain, tender points throughout the body, muscle stiffness, fatigue, depression/anxiety, thinking or memory problems, and numbness/tingling sensations. These symptoms can really get in the way of normal functioning and may also lead to reduced physical activity levels and additional health problems in the future.

There is no cure for fibromyalgia, but physical therapy is one intervention that’s been found to significantly help patients by easing symptoms and improving their quality of life. A typical physical therapy program for fibromyalgia will consist of aerobic exercise recommendations, stretching and strengthening exercises, ice and/or heat therapy, hands-on therapy (manual therapy), and possibly water-based aquatic exercise.

TrueReliefTM is a New Treatment Tool that Can Make a Huge Difference

Another tool that physical therapists might use for fibromyalgia is a medical device called True ReliefTM. This doctor-prescribed intervention sends an electric current to painful areas of the body affected by fibromyalgia, which is intended to “reboot” the nerves in the involved area to bring back a normal impulse. Resetting these impulses leads to a release of the body’s natural pain-relieving chemicals, which in turn alleviates the symptoms of fibromyalgia. TrueReliefTM can be used as many times as are needed and is not associated with any significant side effects.

If used, TrueReliefTM will always be combined with some of the other physical therapy techniques described above to produce the best possible outcomes. Utilizing an exercise-based approach has been supported by a number of research studies, including a high-quality review published in 2017, which features the following conclusion:

This study concludes that aerobic and muscle strengthening exercises are the most effective way of reducing pain and improving global well-being in people with fibromyalgia and that stretching and aerobic exercises increase health-related quality of life. In addition, combined exercise produces the biggest beneficial effect on symptoms of depression.

So if you’re dealing with wide-ranging symptoms that may be due to fibromyalgia, we strongly recommend that you try the chronic pain and fibromyalgia experts with offices in Visalia and Hanford.  We provide laser therapy, TrueRelief, and personalized, progressive physical therapy.

For a comprehensive treatment program designed specifically with your goals and abilities in mind, contact us today to learn more.

Chronic Pain Expert in Hanford

FOR LONG-LASTING PAIN, SPECIALIZED TRUERELIEF TREATMENT AND PHYSICAL THERAPY IS A FAR BETTER OPTION THAN MEDICATIONS

If you are seeking the specialty advice and treatment of a chronic pain specialist in Hanford, you’re at the right website.

For long standing pain, specialized treatment like TrueRelief or class 4 laser therapy, combined with the expert care of one of our chronic pain specialist physical therapists is a far better option than most medications.

Even though it may seem like nothing more than a serious distraction & inconvenience, pain is actually the body’s way of informing you that something is wrong and needs your attention. In most cases, this “pain signal” goes away either on its own or after addressing it—like putting ice on a sprained ankle. But for some people, the pain signal continues long after the problem has been resolved, which is called “chronic pain” when it lasts for more than three months. Chronic pain is often a troublesome issue to resolve, but a new electrotherapy called TrueRelief plus personalized physical therapy is an effective option that will target its source rather than just mask it (like most pain medications).

When you injure yourself, pain-detecting sensors become activated in that area. These sensors then send a message in the form of an electrical signal to the brain, which processes the signal and sends out a message that something is wrong. After most injuries, this signal stops after the cause of pain is resolved, meaning the injured area has healed. But with chronic pain, these nerve signals continue sending messages that you are in pain even though there is no longer any damage to your body. It’s not entirely clear why this occurs, but the general belief is that the nervous system accidentally communicates the presence of pain because it has repeatedly sent these pain signals for a long period of time.

Chronic pain is usually far more difficult to treat than typical injuries since the problem is more related to the nervous system than a physical issue. Many patients are being prescribed pain medications like opioids to address their condition, but there are far more risks than benefits associated with this approach. Opioids are highly addictive and often lead to abuse, overdose, and possibly even death. They are also only meant to decrease the perception or sensation of pain and are not intended to actually address the factor responsible for it.

Physical therapy, on the other hand, works with patients to help them better understand their condition and how their thought process can affect the way they feel. They also provide a number of techniques and tips to overcome chronic pain through specific movements and positive habitual changes. A physical therapy program for chronic pain will usually consist of the following components:

  • Education on how chronic pain works and the importance of physical activity
  • Strengthening exercises
  • Flexibility exercises
  • Hands-on (manual) therapy techniques
  • Posture and body mechanics awareness

The effectiveness of physical therapy and exercise on chronic pain has been highlighted in a number of studies, including a large-scale review published in 2017, which concludes with the following statement on physical activity for fibromyalgia:

The available evidence suggests physical activity and exercise is an intervention with few adverse events that may improve pain severity and physical function, and consequent quality of life

Living with chronic pain can feel as if there’s a constant barrier preventing you from doing the things you love normally, but it does not have to be this way. If you’re dealing with chronic pain, contact your local physical therapy clinic and get started on a positive path to recovery that does not include pain medications.

If you would like to learn more about how we can help, you can contact us at:

Our Hanford Physical Therapy Office: (559) 582-1027

Our Visalia Physical Therapy Office: (559) 733-2478

Plantar Fasciitis Treatment in Visalia

IF YOU ARE LOOKING FOR PLANTAR FASCIITIS EXPERT IN VISALIA, WE TREAT A  VARIETY OF INTERVENTIONS FOR PESKY HEEL PAIN

If you’ve ever experienced a piercing pain in the bottom of your foot the first thing in the morning, there’s a strong chance plantar fasciitis was to blame. Before you start taking pills, you should consider seeing one of our plantar fasciitis experts in Visalia.  As one of the most common causes of heel pain in existence, plantar fasciitis can strike people who exercise too much just as easily as those who wear the wrong pair of shoes. But whatever causes it, most patients would agree that it’s a pesky problem that they’d prefer to eliminate.

The plantar fascia is a thick band of tissue that runs across the bottom of your feet and connects the heel bone to the toes. Its primary purpose is to absorb the majority of the stresses we put on our feet, but it has a limit: too much pressure or strain can damage the tissue and lead to inflammation in that region.

This inflammation results in the most typical symptom of plantar fasciitis: a stabbing pain near the heel that’s usually worse with the first few steps of the day or after standing for a long period of time. Plantar fasciitis is particularly common in long-distance runners, but can stem from repeatedly performing any weight-bearing activities or spending too much time standing every day. People who are overweight, older than 40, and those who have high arches or flat feet are also at an increased risk of developing plantar fasciitis.

As is the case with any other painful condition, trying to push through or ignore plantar fasciitis can go on to cause chronic (long-term) heel pain and may result in pain in other parts of your body if you alter the way you walk. The good news is that most cases of plantar fasciitis with some basic modifications, such as the following:

  • Limit or completely stop the activity that led to pain in the first place
  • Ice the bottom of your foot for 20 minutes, 3-4 times a day
  • Avoid walking around barefoot, which puts more strain on the foot
  • Purchase a new pair of supportive shoes with good arch support

If your pain doesn’t improve within a few weeks after making these changes, your next step should be to see a physical therapist, who can address the issue with a number of interventions and techniques. In addition to stretching and strengthening exercises, your treatment program is also likely to include manual therapy, in which the therapist uses their hands to perform a variety of movements and mobilizations to the muscles and soft tissue of the heel that will release muscle tension and reduce pain. There is strong evidence that shows manual therapy techniques to be beneficial for plantar fasciitis, including one study published last year, which concludes as follows:

According to reviewed moderate and high-quality randomized-controlled trials (high-quality studies), soft tissue mobilization is an effective modality for treating plantar heel pain (another term for plantar fasciitis)

In light of this information, we encourage you to seek out physical therapy if you’re experiencing any symptoms that suggest plantar fasciitis is present. Taking this step will put you on a path to recovery and a future with less pain.
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Prevent the cycle of ankle sprain recurrence by taking action now

Our ankles serve one of the most important roles of any of the body’s joints by supporting the weight of our entire body. With such a heavy task at hand, the ankles are also one of the most frequently injured regions, and ankle sprains are at the top of that list.

Ankle sprains result from the stretching or tearing of ligaments in the ankle and usually lead to some degree of pain, swelling, and tenderness. They are the most common injury in the athletic population, accounting for approximately 45% of all sports injuries. They are most frequently seen in basketball, football, and soccer, but can occur during any sport or activity when the ankle moves beyond its normal range of motion.

Ankle Sprains Usually Heal Quickly

Fortunately, the pain from ankle sprains will typically subside after 4-6 weeks if the patient follows the RICE protocol (Rest, Ice, Compression, and Elevation) and does not aggravate the injury further. But if the ankle sprain is not properly rehabilitated, it can lead to decreased range of motion of the ankle joint, particularly a loss of dorsiflexion motion (raising the foot upwards). This can lead to not only recurring ankle sprains, but excess stress on the knees, hips, and even the lower back, which may all be forced to overcompensate for the bad ankle in order to allow the body to move normally.

Physical Therapy Can Help in More Ways than One

For patients that do fail to recover properly from an ankle sprain and go on to experience additional sprains or other injuries, physical therapy can help prevent the problem from getting any worse with a targeted treatment program that typically includes:

  • Stretching exercises to restore ankle movement
  • Strengthening exercises to help patients regain strength and prevent long-term ankle disability
  • Balance training to improve stability and help patients to learn to deal with any potential hazards
  • Functional training, which consists of performing activities patients might have difficulty with like walking, running, or jumping

Prevention Should Be Part of Your Plan

But taking it a step further, physical therapy can also help individuals prevent a first ankle sprain from occurring altogether with a similar type of program designed specifically to prepare the ankle for increased stress loads. Athletes involved in some of the high-risk sports mentioned particularly stand to benefit from these types of program, which have been supported by research as effective for reducing the risk for ankle sprains. One study published in 2017 evaluated the effectiveness of proprioceptive exercises (which improve ones sense of where their body is in space) for preventing ankle sprains, and concluded:

Proprioceptive training programs were effective in reducing the incidence rates of ankle sprains in the athletic population, including those with and those without a history of ankle sprains

So if you’re concerned with your risk for ankle sprains and would like to reduce it, or if you’ve already suffered from a sprain and would like it to be your last, take action now by connecting with a physical therapist and addressing you risk head-on.

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