Preventing ACL Injuries in Female Athletes

In-School Prevention Programs May Be A Viable Solution To Reduce The Risk For ACL Injuries

Injuries to the anterior cruciate ligament (ACL) are one of the biggest problems in sports. Approximately 100,000–200,000 ACL tears occur each year in the U.S., and one of the most at-risk populations is adolescents, particularly females. ACL injuries account for about 21% of knee injuries in young athletes, and young females have a two to eight times higher risk for these injuries compared to their male counterparts.

Differences in Development & Behaviors May Lead to Increased Injury Risk

There are several reasons for this disparity, including differences in the structure of the knee joint—which is looser and more flexible in females—landing patterns in sports, genetics, and hormonal and neuromuscular differences between males and females. Strength also develops at different times during puberty for females compared to males, which is believed to be another important contributing factor.

To make matters worse, ACL injuries are often not isolated incidents, as they may damage surrounding tissue and increase the likelihood of chronic knee problems like secondary injuries and early osteoarthritis in the future. But the good news is that research suggests many of these injuries can be prevented because about 70% of ACL tears occur without contact.

For this reason, numerous prevention programs have been established to reduce the rate of ACL injuries in high-risk populations, including adolescent female athletes. ACL prevention programs incorporate interventions like balance training, stretching, strength training, and plyometrics (jumping exercises) into a comprehensive framework that’s performed regularly, and research has shown that these programs are beneficial.

Recent study shows why these programs are frequently recommended

For example, one recently published study investigated the effectiveness of a strength-based prevention program for reducing the risk of ACL injury in adolescent females. For the study, a team of researchers identified 30 healthy female middle school students between grades 6 to 8 and matched them with another group of 30 healthy females of similar age, height, and weight. The first group served as the strength-training group and the second group served as the control group.

Individuals in the first group underwent a six-month strength training program administered through a gym class curriculum that targeted the muscles of the hips and knees, with the intention of improving hip extension and knee extension and flexion. The control group did not undergo any specific interventions. All patients were evaluated before and after the six-month period for various measures of strength and range of motion (ROM).

Study Results – Improve Strength & Agility

Results showed that females in the strength training group had greater strength values in hip extension, hip abduction, and knee flexion compared to the control group. The strength training program also led to significantly lower scores compared to the control group in a test called the Landing Error Scoring System (LESS), which is used to the risk of non-contact injuries during jumping and landing movements. These findings show that a strength training program for middle school females leads to several improvements that are associated with a reduced risk for ACL injuries. This program is also easy to implement since it was performed during gym class and could therefore represent a practical option for addressing the issue of frequent ACL injuries in youth sports.

Contact Us Today for Help

If you’re currently dealing with symptoms suggestive of knee osteoarthritis, Bacci & Glinn Physical Therapy can help.

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Physical Therapy for a Frozen Shoulder in Visalia and Hanford

Are you searching for a specialist that treats frozen shoulder treatment in Visalia or Hanford?  You may not know, but our physical therapy treatment for frozen shoulders is some of the best you’ll find in the area.

Understanding a frozen shoulder/adhesive capsulitis diagnosis is important, so we wrote this article below to help those in need.

Comprehensive Review Finds That Several Types Of Exercise
Lead To Improvements For Patients With Frozen Shoulder

Adhesive capsulitis, or frozen shoulder, occurs when scar tissue forms within the shoulder. This causes the shoulder capsule to thicken and tighten around the shoulder joint, which means there is less room to move the shoulder normally. Although frozen shoulder affects up to 5% of the population, the reasons why it develops have not yet been clearly established. It is generally believed that not moving the shoulder normally for long periods is a leading factor, as most people who get frozen shoulder have kept their shoulder immobilized due to a recent injury, surgery, or pain. People between the ages of 40–60, women, and patients with arthritis, diabetes, cardiovascular disease, and other health conditions are also more likely to develop frozen shoulder.

Frozen shoulder usually develops slowly and gets progressively worse over time with more pain and loss of motion. It is typically divided into the following four stages:

  • Stage 1: consists of the onset of symptoms, which gradually get worse over 1–3 months
  • Stage 2: the “freezing” stage, which generally occurs 3–9 months after symptoms begin and is very painful
  • Stage 3: the “frozen” stage, which involves the shoulder becoming even more stiff and difficult to move
  • Stage 4: the “thawing” stage, which occurs within 12–15 months and involves pain decreasing significantly and range of motion starting to improve

Adhesive Capsulitis Treatment in Visalia & Hanford – Clinical Research Supports Physical Therapy

Physical therapy is commonly used and often recommended for frozen shoulder because it’s effective for addressing symptoms at every stage; however, there are some questions about the exercises used in physical therapy that have not yet been clearly answered. Therefore, a comprehensive study called a systematic review and meta-analysis was conducted to 1) compare the effectiveness of exercises alone and exercises in combination with other interventions and no exercises and 2) determine what kind of exercises are most effective for frozen shoulder.

Researchers review 33 studies on exercise therapy for frozen shoulder

To conduct the study, researchers performed a search of three medical databases for relevant studies about exercise therapy for frozen shoulder. This led to 33 studies being accepted into the review, which saw patients treated with a variety of exercises, some prescribed individually, and others prescribed as part of a comprehensive treatment program. The findings of all included studies were then reviewed and compared to one another with the goal of answering the two main research questions.

Results showed that exercises—both on their own and as part of a program—improved range of motion (ROM), function, disability, and pain, and the type of exercise performed had little to no impact on these improvements. Also, adding physical modalities to exercises did not provide any benefits to treatment outcomes, and programs that included exercises resulted in larger active ROM gains than programs that did not.

Frozen Shoulder Physical Therapy Visalia & Hanford – Physical Rehab is the Key

These findings support the effectiveness of physical therapy for frozen shoulder and suggest that the type of exercises performed and whether they are completed alone or combined with other interventions may not be important, so long as they are featured in a rehabilitation program.

Therefore, if you’re currently dealing with symptoms that may suggest the presence of frozen shoulder, Bacci & Glinn Physical Therapy can help.

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

PT vs Surgery for SIS – Research Says Try Conservative First

 

Are you searching for a specialist that treats shoulder impingement in Visalia or Hanford? You may not know, but our physical therapy care for shoulder impingement is some of the best you’ll find in the area.

Understanding rotator cuff problems and shoulder impingement is important, so we wrote this article below to help those in need.

Physical Therapy Is Just As Effective As Surgery In The Long Term For A Common Shoulder Condition

Most shoulder conditions—about 85%—involve the rotator cuff, which is a group of muscles and tendons that keeps the shoulder stable. Among these common shoulder conditions is shoulder impingement syndrome (SIS), in which rotator cuff tendons become compressed—or “impinged”—as they pass through a small bone on top off the shoulder blade called the acromion. Over time, this causes the tendons to become irritated and inflamed, and will lead to bothersome symptoms like swelling and tenderness, loss of strength, restricted movement, and pain.

SIS is most common in individuals that regularly perform lots of overhead activities like golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. The condition can also result from an injury that compresses the structures of the shoulder—like a fall—or from frequently sleeping on your side. Sleeping in this position regularly can strain the shoulder and cause impingement over time.

SIS is closely related to rotator cuff tendinitis and subacromial pain, and in some cases, the terms may be used interchangeably. When any of these conditions develop, the best course of action is a comprehensive physical therapy program, which helps patients work through their pain to regain strength, flexibility, and physical function; however, many patients undergo a surgical procedure called arthroscopic subacromial decompression (ASD) to treat their shoulder pain. An abundance of research has shown that this procedure does not lead to any significant benefits, but it remains one of the most frequently performed procedures in the world, and some professionals still advocate for it. Therefore, a study was conducted to compare the return-to-work rates for patients with subacromial pain who underwent different interventions.

More than 200 patients are monitored periodically for 5 years in this research study

A total of 210 patients with subacromial pain for more than 3 months were enrolled in the study and randomly assigned to one of three treatment groups: exercise therapy, diagnostic arthroscopy, or ASD.

Patients in the exercise therapy group underwent a supervised, individually designed physical therapy program that included daily home exercises and 15 visits to the physical therapy clinic. Patients in the diagnostic arthroscopy group underwent a “sham” procedure in which an examination of the shoulder was performed with a small camera inserted surgically, but no repairs were made to the shoulder. Patients in the ASD group were treated surgically with the ASD procedure, which involved the careful removal of some portions of bone and a structure called the bursa. Patients in the diagnostic arthroscopy and ASD groups also participated in a postoperative physical therapy program. All patients were assessed at the beginning of the study and then again 2 years and 5 years later.

Two years after the interventions, 78% of patients in the exercise group, 80% of patients in the diagnostic arthroscopy group, and 82% of patients in the ASD group were actively working.

Five years after the intervention, these figures were 66% for the exercise group, 69% for the diagnostic arthroscopy group, and 67% for the ASD group.

These results show that there were NOT significant differences between the three groups 2 years and 5 years after the intervention. Therefore, based on these findings, physical therapy can be considered just as effective as ASD for helping patients with subacromial pain recover and maintain their improvements in the long term.

Subacromial Impingement Pain Treatment is Something We Specialize In…

At Bacci & Glinn Physical Therapy, we frequently see patients with subacromial pain and related shoulder conditions and help them regain their abilities in a safe and cost-effective manner.

Therefore, if you’re currently dealing with any type of shoulder pain, we recommend giving us a call.

You can reach us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Physical Therapy for Pinched Nerves in Visalia & Hanford

Physical Therapy Leads To Significant Benefits For Radiating Neck Pain

The spine contains nerves that send messages to and from the brain and all other parts of the body. For this reason, any time one of these nerves is affected, it can lead to problems not only in the spine, but in other body parts as well. One condition that involves spinal nerves is called cervical radiculopathy, in which pain and other symptoms radiate out from the neck to other areas of the body.

A Brief Anatomy Review

The spine is made up of 24 bones called vertebrae that are stacked on top of one another. Together, these bones connect to create a canal that protects the spinal cord from damage. The uppermost portion of the spine that begins at the base of the skull is called the cervical spine. It contains nerves that carry messages between the brain and muscles in the shoulders, arms, and hands. This is achieved through nerve roots that travel through the spinal canal and branch out through openings in the vertebrae called foramen.

Pinched Nerves Cause Radiating Pain

Cervical radiculopathy, which is also referred to as a pinched nerve, occurs any time one of the nerve roots in the neck is compressed or pinched when it branches away from the spinal cord. This is caused by any condition that injures or irritates nerves in the cervical region, including a herniated disc, spinal stenosis, or degenerative disc disease. In most cases, patients with cervical radiculopathy experience a burning pain that starts in the neck and travels down the arm. This pain can get worse from turning or straining the neck. Other symptoms include tingling, as well as weakness or loss of sensation in the shoulders, arms, or hands.

Some patients with cervical radiculopathy will get better on their own over time, while others will continue to be affected by symptoms for extended periods. For patients that fail to improve, conservative treatments—particularly physical therapy—are typically recommended as the first step. A standard physical therapy program for cervical radiculopathy will include a variety of stretching and strengthening exercises, as well as a manual therapy component. Manual therapy involves numerous hands-on mobilization and manipulation techniques that are intended to alleviate pain and improve mobility and function.

Big study conducted to better define effects of physical therapy

To assess the effectiveness of this intervention, a high-quality type of study called a randomized-controlled trial was conducted on patients who had cervical radiculopathy for at least three months, which was defined as neck pain that radiated to only one upper extremity with ≥1 level of root involvement. A total of 28 patients who fit the necessary criteria were randomly assigned to either the experimental group or the comparison group.

All patients participated in a verbal education session about pain and a unique program designed by a physical therapist that took place during 6 treatment sessions over 3–5 weeks. Patients in both groups also completed strengthening exercises that targeted the deep flexor muscles of the neck, but the manual therapy component of these programs differed. Patients in the experimental group were treated with a cervical mobilization technique in which the physical therapist applied pressure to various painful areas of the spine for several minutes at a time. For patients in the comparison group, the therapist only applied a minimal amount of pressure to one location of the spine and did not perform the actual cervical mobilization technique used in the experimental group.

Patients with Pinched Nerves in the Neck Did Better

Results showed that patients in the experimental group experienced greater improvements than the comparison group in pain intensity, neck function, and neck range of motion, as well as local pressure hypersensitivity, which means they were less sensitive to stimuli. Based on these findings, it appears that a manual therapy technique frequently used by physical therapists can lead to short-term benefits for this patient population. When combined with the other interventions typically featured in a physical therapy treatment program, the gains are likely even greater for patients.

Contact Us Today for Help with a Pinched Nerve in the Neck

Therefore, if you’re currently bothered by radiating neck pain, it may be time to see a physical therapist, and we can help.

Contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

PT for Breast Cancer Patients

Physical Therapist-Led Exercise Boosts Function
And Improves Quality Of Life In Breast Cancer Patients

Breast cancer is the second most common type of cancer in women, as about 1 in 8 women will be diagnosed with it at some point in their lives. Each year, about 240,000 new cases of breast cancer are detected, and about 40,000 women lose their lives to the disease. Over the past 10 years, the number of women diagnosed with breast cancer has remained stable, while the associated death rate has declined slightly. Still, breast cancer remains a major health concern for women today.

Many women diagnosed with breast cancer will undergo a surgical procedure at some point, such as a breast biopsy, lymph node biopsy or removal, lumpectomy, mastectomy, or breast reconstruction. Frequently, this is in addition to other common cancer interventions like radiation and/or chemotherapy. After completing these treatments, a sizable percentage of women go to experience various side effects, such as pain and stiffness in the chest, shoulder, and back muscles, or nerve irritation that can cause numbness, pain, and tingling.

Each patient’s recovery differs depending on the severity of the cancer and what treatments were used, but side effects often reduce flexibility and range of motion, which can prevent women from returning to their normal daily activities. In addition, many women that undergo various treatments and hospitalizations become deconditioned due to lack of physical activity, which can have further repercussions on their health.

Lack of research prompts new study on exercise for breast cancer patients

Therefore, general exercise and physical therapy are strongly recommended for women recovering from breast cancer treatment. A carefully designed physical therapy program will focus on improving qualities like strength, range of motion, and endurance to allow these women to reestablish their previous level of activity; however, research is lacking on structured exercise for breast cancer patients and if there are any safety concerns in high-risk patients. In response, a robust type of study called a randomized-controlled trial was conducted to evaluate the effectiveness of a physical therapist led exercise program for women at high risk for disability after breast cancer treatment.

For the study, 392 women newly diagnosed with breast cancer who were scheduled to have surgery and considered to be at high risk for upper limb disability served as the primary study group. These women were randomly and evenly assigned to either exercise plus usual care or usual care alone. Women in the usual care alone group received information leaflets recommending exercise and general advice for after surgery, and no further interventions were performed. Women in the exercise plus usual care group underwent a structured exercise program supervised by a physical therapist. The program consisted of various upper extremity exercises targeting the shoulder and was intended to restore range of motion of the shoulder, improve strength, and increase physical activity levels. All patients were assessed before and after completing these programs with various outcome measures.

Patients in the Exercise Group had a Better Outcome

Twelve months later, patients who underwent the exercise program reported significantly better scores on a questionnaire that measured disability of the shoulder, arm, and hand. These patients also reported less pain intensity and fewer activity limitations, participation restrictions, and impairments than the usual care alone group, and the intervention did not lead to any increase in complications or lymphedema symptoms. Finally, the exercise program, which only cost an average of $178 per patient, was found to be significantly more cost effective than usual care.

Call Us to Schedule Your Appointment

This study shows that physical therapy can lead to improved upper limb function, postoperative pain, arm symptoms, and physical quality of life at 12 months compared with usual care alone in women at high risk of upper limb disability after breast cancer treatment. So if you’re affected by breast cancer and scheduled to have surgery, we strongly encourage you to reach out to us to get set up for your postoperative program.

Contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Patients and HCP Perceptions about LBP

Patients’ And Healthcare Providers’ Perceptions On Back Pain Do Not Always Align

Low back pain is jarringly common. About one-half of all working Americans will experience related symptoms at least once every year, and roughly 31 million are affected by it at any given point in time. In essence, low back pain is just “one of those things” that we will all probably face in the eventual future if we haven’t already faced.

Dealing with low back pain can be troublesome and place a strain on everyday life. Typical movements like bending over to pick something off the ground or twisting your torso when looking to the side might suddenly give you pause and make you less mobile. This regular reminder naturally leads to frustration and often creates a shift in focus to one question: “what’s causing my pain?”

As a result, many patients with low back pain start to place a particularly strong—sometimes unhealthy—emphasis on obtaining a diagnosis. This desire may be explained by several factors, such as the assumption that the diagnosis will provide a clear explanation of what is causing the pain and what treatments will improve it, even though this is rarely true. Nonetheless, not receiving a diagnosis can lead to anger and frustration in patients who feel that they are not being heard or understood. Some healthcare providers may also experience frustration with low back pain patients who expect their problem to be “fixed” by certain interventions, regardless of how realistic these expectations are.

Healthcare providers underestimate the importance of an explanation for pain

A study was therefore conducted to evaluate the expectations of patients with low back pain and compare these expectations to the assumptions of the healthcare providers who treat them. This was a survey-based study, which administered one survey to 419 patients who were visiting a doctor for low back pain for the first time. In addition to questions about demographics and pain characteristics, this survey included 8 variables frequently related to the medical care of low back pain (eg, improvement in pain/function, explanation of what is causing the pain, diagnostic testing, medication, physical therapy, and surgery), which patients were asked to rank in terms of personal importance on a 5-point scale. A similar survey was given to 198 healthcare providers, who were asked to rank the same 8 variables in terms of their importance to patients.

Patients considered an explanation for what is causing their pain to be far more important

Results showed that both patients and healthcare providers attributed similar—and high—levels of importance to the improvement of pain and the improvement of function; however, there were also several key differences in the assessment of expectations. Patients considered an explanation for what is causing their pain to be far more important than healthcare providers believed, while patients attributed much less importance to diagnostic tests, medications, and surgery compared to healthcare providers. This suggests that healthcare providers are more driven to act by ordering tests and administering treatments for their patients, while patients appear to be more interested in receiving a diagnosis.

Unfortunately, a clear diagnosis for low back pain is not always possible, or helpful.

Approximately 70–80% of all low back pain cases do not have a specific identifiable cause and are classified instead as “non-specific back pain,” which patients could contribute to patients’ frustration because it does not explain their pain. It’s also worth noting that some apparent back pain diagnoses—like a herniated disc—may not truly be responsible for the patient’s pain, which can lead to unnecessary and unhelpful treatments being undertaken.

Nonetheless, this study shows that it is essential for healthcare providers to clearly communicate with patients and educate them on the nature of low back pain, particularly by explaining that not all pain is dangerous or a reflection of injury.

As physical therapists, we incorporate these methods into our practice, and explain to each of our patients with low back pain that a diagnosis is usually less important than they might think. Instead, we start patients on a comprehensive treatment program right away that will address their pain and functional limitations without the need for other diagnostic tests that could possibly do more harm than good.

Contact Us Today for Help

So, if you’re dealing with low back pain, we invite you to contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Postoperative Opioid Use After Spinal Fusion

Opioid Use Persists In Many Patients After Common Spine Surgery

The prevalence of pain is far greater in the spine than anywhere else in the body. In fact, back pain ranks only behind skin disorders and osteoarthritis/joint disorders in top reasons to visit a doctor. Up to 80% of the general population will experience at least one episode of back pain in their lives, and about 65 million Americans report dealing with a back-related issue recently. So, if your back is bothering you right now, you’re far from alone.

Most cases of back pain will resolve on their own over time, and studies consistently show that patients with persistent or chronic back pain can improve from conservative interventions like physical therapy. But research has also shown that opioids represent one of the most prescribed treatments for back pain, either along with other conservative interventions or independently. The high risk for abuse and addiction with opioids is well documented by now, and these drugs also fail to truly resolve patients’ pain by only masking the sensation and tricking the brain that it has dissipated.

Surgical procedures like lumbar spinal fusion—which joins together two moveable bones in the lower back—is typically regarded as a last resort for chronic back pain, but rates of this surgery have been steadily increasing over the past few decades.

In addition, up to 70% of patients who decide to have surgery have already begun taking opioids by this point, with nearly 20% being dependent on opioids prior to their procedure. The use of opioids may affect outcomes, and most patients would prefer to not take opioids for an extended period after their procedure. But statistics show that continual use is somewhat common, both in patients taking opioids before surgery and in those who do not.

More than one in three patients are taking opioids six months after surgery

Therefore, a study was conducted to determine how many patients who undergo lumbar spinal fusion continue to take opioids in the long term. This type of study was called a systematic review, in which researchers performed a comprehensive search of four major medical databases to identify relevant studies that tracked the use of opioids in patients for at least six months after a lumbar spinal fusion procedure. A total of 329 studies were identified in the search that met all inclusion criteria. Of these, only 32 (9.7%) included data on the use of opioids, and only 21 (6.4% of all included studies) tracked the use of opioids for at least six months.

Analysis of this data revealed that the long-term use of opioids after surgery varied greatly from 6% to 86%. The average across all studies was 35%, with an average follow-up of 34 months. This suggests that more than one in three patients were taking opioids for at least six months after undergoing lumbar spinal fusion. The percentage of patients who were on opioids before the procedure also varied substantially, from 23% to 76%.

Based on these findings, it appears that many patients who have spine surgery continue to rely on opioids for pain relief for six months or more after their procedure. This contradicts with most patients’ expectations, as it is a common conception that surgery will automatically alleviate pain and eliminate the need for continual pain medication.

This information is particularly valuable for patients with chronic low back pain who are weighing the pros and cons of surgery.

While surgeries like lumbar spinal fusion may be appropriate and beneficial for certain patients, this study shows that it may not always lead to the outcomes that most patients expect, and it could maintain or create a reliance on opioids in the long term. For these reasons, we believe physical therapy is a much safer and more effective option for most cases of low back pain, since it can often produce long-term relief without the need for opioids.

Experiencing Lower Back Pain? Give Physical Therapy a Try

If you’re dealing with low back pain, we invite you to contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or to schedule an appointment today.

Rheumatoid Arthritis Treatment in Visalia

 
If you need rheumatoid arthritis treatment in Visalia or Hanford, we can help.  This post describes how our physical therapy expert clinicians assist patients with their rheumatoid arthritis care in Hanford and Visalia.

Physical Therapy Should Be An Integral Component
Of Any Treatment Plan For Rheumatoid Arthritis

The ends of most bones are covered by a smooth, shiny surface called articular cartilage. The cartilage protects bones where they meet one another—at a joint—and provides a smooth surface that allows the bones to slide freely and not contact one another during movement.

Arthritis is general term that’s used to describe the loss of articular cartilage in one or more joints. About one in four Americans—which equates to nearly 59 million people—currently has arthritis, making it one of the most common medical conditions in the U.S. There are over 100 different types of arthritis, but osteoarthritis and rheumatoid arthritis are by far the most common of these.

Rheumatoid arthritis is an autoimmune disease, meaning it’s caused by the body’s own immune system mistakenly destroying healthy cartilage in joints. It occurs for reasons that are not completely understood, but a combination of genetics and hormonal or environmental factors likely play a role in its development. Rheumatoid arthritis can affect any joint of the body, but usually starts in the small joints of the hand. Women are about three times more likely than men to get rheumatoid arthritis, and it usually occurs in middle age—with an average age of onset of 30-60 years—but it’s also seen in younger individuals.

Rheumatoid arthritis can lead to a variety of symptoms, with some of the most common including:

  • Stiffness, swelling, and/or redness in joints, which is usually worse in the morning
  • Weakness and/or loss of range of motion
  • A sensation of “cracking” or “crushing” in the hand joints
  • Increased size or deformity of the hand
  • Fatigue and general discomfort

Unfortunately, there is no cure currently available for rheumatoid arthritis. Instead, most patients are managed with medications and other interventions designed to help them move more easily and efficiently, and physical therapy is one of the best tools to help them get there.

Physical Therapy as a Choice for Rheumatoid Arthritis Treatment in Visalia

Our physical therapists are movement experts that work with each patient individually to identify their biggest limitations from rheumatoid arthritis that are holding them back. From there, we design a personalized treatment program to address these symptoms, which will usually consist of:

  • Manual (hands-on) therapy: may include soft-tissue massage, stretching, and joint mobilizations to reduce pain and improve alignment, mobility, and range of motion
  • Stretching exercises: to improve the flexibility of joints affected by arthritis
  • Strengthening exercises: to build back up strength of the muscles of the hand and any other affected joints
  • Pain-relieving modalities: ultrasound, electrical stimulation, ice, and/or heat to decrease pain and inflammation of the involved joint

Research Supports the Use of Physical Therapy – Therefore, We Provide for Rheumatoid Arthritis Care in Visalia & Hanford

The benefits of physical therapy for rheumatoid arthritis have been confirmed in the medical literature, including one study of 490 patients. Results from this study showed that physical therapist-led hand exercises led to significant improvements in pain and hand function, and the intervention is likely to be cost-effective.

Rheumatoid arthritis can prove to be a nuisance that interferes with your ability to function normally in everyday life. So if you’re affected by symptoms that sound like rheumatoid arthritis, we can help.

Contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford)

 

…to learn more about our rheumatoid arthritis experts in Visalia and Hanford…or to schedule an appointment today.

Community Exercise for Arthritis

Exercise Reduces Pain And Improve Function In Patients With Arthritis

As we discussed in our last blog, arthritis is a major healthcare issue in the U.S. Of the roughly 59 million adults who have arthritis, nearly half—or 26 million—report that their condition makes daily activities more difficult. As a result, many of these individuals’ quality of life is negatively affected, making arthritis a pressing concern for them.

Research has also shown that arthritis-related disability does not impact all racial, ethnic, and socioeconomic groups equally. According to recent statistics, more than half of low-income adults and about two-thirds of those living near the poverty line are negatively affected in their daily lives due to arthritis, compared to about 30–40% of wealthier individuals. In addition, about 60% of American Indian and Alaskan Natives experience arthritis-related limitations, compared to only about 40% of White individuals and about half of all other racial and ethnic groups.

One way to help individuals that are more likely to be physically impaired from arthritis—chiefly lower-income individuals and persons of American Indian/Alaskan Native descent—is through a targeted approach. This type of approach aims to identify at-risk patients, encourage them to seek out treatment, and then manages them appropriately. Physical therapists, for example, are movement experts who frequently treat arthritis patients with comprehensive treatment programs that feature exercise, education, and other interventions intended to alleviate pain and improve function.

Exploring the role community exercise in patients with arthritis
Understanding the value of a targeted treatment approach, researchers conducted a meta-analysis to evaluate the effects of community exercise on pain and physical function in adults with arthritis and fibromyalgia. A meta-analysis is a study that collects and assesses all available research on a particular topic to obtain a comprehensive overview of the effectiveness of a particular intervention. In this meta-analysis, researchers identified 33 relevant studies on 3,180 adults with arthritis and fibromyalgia who underwent an exercise program delivered in their community. Of the exercise programs analyzed, most included both aerobic and strengthening exercises, while some focused on either aerobic or strengthening exercises alone.

Results showed that these community-delivered exercise programs significantly reduced pain and improved physical function in adults with arthritis or fibromyalgia. These findings were further strengthened by a lack of bias observed by researchers in these studies, and the fact that similar results were obtained when analyzed at both the study and group level. Finally, results from a test called the intention-to-treat analysis indicated not only that exercise was effective, but that it would also be effective in a real-world setting.

This study is important because it highlights how a targeted approach with a community-based exercise program can help patients with arthritic conditions improve. Physical therapists prescribe these types of interventions and promote exercise- and movement-based strategies for patients with impaired mobility due to arthritis. Therefore, if arthritis is currently interfering with your ability to complete normal daily activities, we strongly encourage you to contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or to schedule an appointment today.

Shoulder Impingement Syndrome

Sore Shoulders Are Common In Swimming,
But Physical Therapy Can Get You Back In Line

Swimming is a great form of exercise because it strengthens multiple regions of the body and improves both flexibility and endurance. In addition, the lack of impact on joints makes it a safe choice for avoiding lower-body injuries that are common with land-based exercises. Water polo, which involves swimming, passing a ball, and other active movements, features many of the same attractive characteristics as swimming and is commonly regarded as an excellent workout. However, neither sport is risk-free, and an injury called shoulder impingement is quite common in both.

A Quick Review of the Anatomy

The shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). The humerus and scapula are surrounded and connected by the rotator cuff, a group of muscles and tendons that keeps the shoulder stable and allows the ball-and-socket movements of the joint. There is also a fluid-filled sac called the bursa between the rotator cuff and a bony prominence on the top of the scapula (acromion), and this bursa provides a cushion during movement.

What Exactly is Impingement?

In shoulder impingement syndrome (SIS), the tendons of the rotator cuff become compressed—or “impinged”—as they pass through the narrow space beneath the acromion. Over time, this causes the tendons to become irritated and inflamed, eventually leading to bothersome symptoms like swelling, tenderness, loss of strength, restricted shoulder movement and pain that’s most common at rest, when moving the shoulder overhead, and when sleeping.

If You Use Your Shoulder, You Might Get SIS

SIS is most common in individuals that regularly perform lots of overhead activities like golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. Competitive swimmers are at a particularly high risk for shoulder impingement syndrome because of the repetitive overhead motions involved in most strokes, which can cause continuous wear and tear on the structures of the shoulder. It’s estimated that year-round competitive swimmers cover 10,000–24,000 meters per day, and more than half of these athletes suffer from shoulder pain.

Water polo players also swim large distances on a regular basis, while also passing and shooting a ball, which are overhead motions. As a result, these players are frequently affected by SIS and other shoulder problems, with one study finding that the rate of shoulder pain is about 80% in these athletes.

Physical therapy for swimmers and water polo players with SIS
If SIS develops, physical therapy is strongly recommended as the safest and fastest route to recovery. Physical therapy for SIS typically consists of the following:

  • Activity modification/functional training
  • Stretching exercises
  • Strengthening exercises
  • Hands-on (manual) therapy
  • Posture education

The effectiveness of physical therapy for SIS has been consistently confirmed through published research, including a recent study called a systematic review and meta-analysis. This study reviewed the findings of 11 high-quality studies called randomized-controlled trials that compared physical therapy to surgery for patients with SIS. Results showed that there were no significant differences between patients in measures of pain or function up to 10 years later, which suggests that physical therapy can lead to comparable outcomes to surgery while also avoiding the high costs and potential risks of a surgical procedure.

Whether you’re a swimmer or water polo playing dealing with shoulder pain, or if your shoulder is bothering you for some other reason, Bacci & Glinn Physical Therapy can help you get back on track.

Contact us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or to schedule an appointment today.

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