Scoliosis – How Physical Therapy Plays an Important Role

Scoliosis - how physical therapy plays an important role - Hampton Physical Therapy NH

By LISA WHELDON, DPT

If your child gets diagnosed with scoliosis you may be a bit taken aback. It can be unsettling to get a medical diagnosis with little explanation of what it is or how it can be treated. Scoliosis means that there is a change to the “normal” shape of the spine so the spine may have moved to the side or turned. This can alter a person’s overall trunk alignment and posture. The abnormal curvature of the spine can alter other areas of the body. This may include: shoulder height, hip height, pain in area of shoulders pelvis and hip, and painful movement patterns. As physical therapists we can often be an important part of the team to help a child with scoliosis.

Scoliosis is a relatively common condition that can affect “2% to 3% of the general population, and is more common in females than males APTA”. Adolescent idiopathic scoliosis (AIS), the most common type of scoliosis, is diagnosed in children aged 10-18 years. Idiopathic means no identifiable cause is known, but 30% of children with AIS have some family history of the condition. Other types of scoliosis include congenital, neuromuscular, and early onset (infantile and juvenile). Congenital scoliosis is when a deformity to the bones of the spine happens during baby’s development in the womb. Neuromuscular scoliosis is caused by the nervous system and can occur in conditions like cerebral palsy (CP) or muscular dystrophy. Early onset scoliosis is diagnosed from birth to 3 years of age or juvenile scoliosis diagnosed before age 10. Both of these onsets have an unknown cause.

Scoliosis - how physical therapy plays an important role in screening and treatment - Hampton Physical Therapy NH

Physical therapists can even be involved in the screening and initial diagnosis of scoliosis (although an x-ray from an orthopedic physician can truly confirm). Upon screening of the patient, the PT can discuss what activities are difficult for the child due to their current condition. They will evaluate the patient’s ROM and then assess strength and flexibility of the surrounding muscles. Upon evaluation the therapist can then create a program to address areas of impairment. If there appear to be movement limitations then some gentle stretching may be appropriate to improve the child’s mobility. Areas of weakness are often an issue so the therapist would provide a proper strengthening program. This program could include exercises to strengthen weak back muscles, core, shoulders and hips.

Manual therapy can also be a part of the treatment plan. We are trained professionals to restore mobility and ROM in a joint. This can include joint mobilizations, manual stretching, and soft tissue mobilizations to gently restore motion. Education is also an important part of treatment. If a child doesn’t pay attention to their posture and they are hunched over looking at tablets or the computer (which is common at this time) they can exacerbate the curvature. Unfortunately, scoliosis isn’t really “preventable” but educating on the condition and body movement is an important piece of the puzzle.

Scoliosis - how physical therapy plays an important role in treatment - Hampton Physical Therapy NH

Typically, the goal of therapy is to do things to work on the muscle imbalances from the curvature. If a child has tight hamstrings, then we would stretch that area out in the clinic and provide the patient with proper exercises to improve the muscle length of hamstrings. Providing patients with tools to self-treat and maintain gains made in therapy is critical. Then to address areas of weakness is another important piece. Core strengthening can be important for any spinal condition. Creating a core strengthening program that the patient can perform in the clinic and then continue with following discharge is another component. Physical therapy doesn’t end once the patient is discharged from the clinic. It is important for the parent and child to remember the program created by the therapist be maintained and may even require updating/progression periodically by the therapist. So, if your child is diagnosed with scoliosis physical therapy is a viable option for treatment. Contact Hampton Physical Therapy at 603-929-2880 to learn more.

Source: https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-scoliosis

 

Osteoporosis: Physical Therapy Can Help Prevent or Erase Bone Loss

Hampton PT can help erase bone loss caused from osteoporosisBY NICOLE CARVILLE, DPT

When I meet a new patient as a Physical Therapist, I sit down, start their evaluation by asking about their current condition. Then I review their medical history and medications before we get started. It is important to me to get a solid picture of who they are and what preexisting conditions they have before I get their heart rate up and start exercising. During this process, I often see “Osteoporosis” on the list of preexisting conditions. Most of the time I ask, “When were you diagnosed with osteoporosis? Are you on any medication for bone density? Have you ever received PT for this condition?” More often than not, the answers are, “I’m not sure. Maybe at one point in time. No, definitely not”. I often end the conversation there as the patient sitting in front of me is likely there for a different reason, but at some point during a treatment session, I will ask if they have any interest in preventing future osteoporotic fractures and building their bone density. The answer is usually, “I didn’t know you could do anything other than take medication”.

So, what is osteoporosis?

“Osteoporosis [is] defined as a skeletal disorder characterized by decreased bone strength and increased susceptibility of fractures”.

Osteoporosis can be erased with physical therapy - Hampton PT

Changes in bone density and bone structure

These changes occur for a handful of reasons including, but not limited to gender, early menopause, medication use, increased caffeine consumption and smoking history. The literature shows that there are 54 million Americans diagnosed with osteoporosis (2006). Why do we care about this? One in two women and up to one in four men over the age of 50 WILL break a bone due to osteoporosis. The most common fractures associated with osteoporosis include hip, wrist and vertebral compression fractures. Statistics show that 90% of hip fractures occur due to osteoporosis and fracturing your hip is associated with a 50% increased risk of mortality during the year following fracture! Moreover, wrist fractures due to osteoporosis are just as common as hip fractures and vertebral compression fractures are twice as common as hip fractures. All of these fractures can lead to chronic pain, decreased quality of life and decreased mobility.

Vertebral compression fracture

Most of these fractures occur from simple movements that we do in our day-to-day life and fracture risk can be decreased just by changing our habits. The vertebral compression fracture pictured above is most at risk with the movement pictured below where you round the spine forward and reach to pick up something.

 

The right and wrong way to pick something up

Wrong!

Below are two better options for picking up an object off the ground. The first image utilizes a squat to get down to the ground where the spine is straighter. This is a strategy we will work on and build the strength to be able to get down to pick up the object on the ground. The second image is the Golfers reach where you pivot on one leg and have hand held support on a sturdy object nearby. This is a helpful strategy to pick up a purse off the ground or to pick up a piece of clothing off the floor. In this picture, I have my hand on the black table to steady myself. However, balance is important for this strategy and is another skill we will work on in the clinic.

The literature clearly states the seriousness of an osteoporosis diagnosis and the importance of taking action to both decrease your future fracture risk and build your bone density. Patient’s cannot always feel the changes in their bones or detect increased fracture risk until it is too late. However, the good news is that Physical Therapy can help! There are three pillars of treatment for osteoporosis:

  1. Exercise (PT!)
  2. Diet
  3. Medication

When you decide you are ready to start, we will go over all three pillars and refer you to additional health care providers based on your needs – such as a Nutritionist to discuss diet changes or an Endocrinologist/Rheumatologist to discuss medications if you are interested. We will discuss modifiable risk factors and safe body mechanics like those pictured above for all of your activities around the house.

The physical therapy pillar of osteoporosis treatment will include postural training, walking drills, balance training, site specific strengthening for the back, hips and spine, core strengthening and resistance training – all designed based on your prior level of exercise, activity and goals. The sooner you get started, the safer your spine, hips and wrists will be from a life changing fracture. At Hampton Physical Therapy, we are prepared to walk you through this education and create a bone building exercise program that is tailored to your specific needs.

 

Physical Therapy Helps People with Post Covid-19 Long-Term Effects

Hampton Physical Therapy Helps People with Post Covid-19 Long-Term EffectsBY JESSICA LEBERMAN, DPT

The COVID-19 pandemic has introduced the world to the importance of prevention.  Mask wearing,
social distancing and quarantining have become household norms.  Despite efforts, in the United States nearly 30 million people have contracted the virus with approximately 525,000 deaths. That means there are countless people living in the United States who have survived COVID-19 and are now left with a vast array of long-term side effects from the virus.

The CDC provides us with information regarding common long term side effects from COVID-19 including;
Fatigue
Shortness of Breath
Joint Pain and Muscle Aches
Headaches

Hampton Physical Therapy Helps People with Post Covid-19 Long-Term Effects

Your Hampton Physical Therapist can be an ally in your recovery from the long-term effects of COVID-19.

Physical therapists are specialists and experts of movement as it relates to quality of life.  Your Hampton Physical Therapist can be an ally in your recovery from the long-term effects of COVID-19.  Our PTs specialize in individualized programming including hands on techniques and guidance of activity to optimize patient’s return to their prior level of functioning.  Pain, stiffness, weakness and fatigue are realms in which PTs address every single day.  Although there are many unknowns when it comes to COVID-19, once recovered from the illness, your Physical Therapist can help guide you to a full and healthy return to life prior to the virus.

As it relates to the previously noted side effects PTs will utilize advanced hands-on skills to address musculoskeletal pain focusing on joint mobility and the health of the muscles that are involved.  PTs have advanced understanding of breathing techniques and optimizing the mechanics of breathing including the use of the diaphragm to aid in improving complaints of shortness of breath.  The “COVID fatigue” that many people experience persist and result in weakness, endurance and cardiovascular challenges.  Your PT has the ability to create a tailored program to address specific areas of weakness and safely implement exercise prescription.

As we all hope to return to life as we knew it pre-virus as soon as possible, for those of you who have experienced COVID and may be having some long-lasting side effects. Utilize your PT at Hampton Physical Therapy to get you back up and “running”.

Contact us at Hampton Physical Therapy at 603-929-2880 for a Free 30 Minute Discovery Visit.

Citation: Long-Term Effects of COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html. Accessed January 8, 2021.