I have a painful neck and back, should I see a Physical Therapist or go to a chiropractor?

By DYLAN CHISHOLM, DPT

Many people at some point in their lifetime will encounter a situation where they experience neck or low back pain. Neck and low back pain can significantly impact quality of life and make activities that were once enjoyable debilitating and unfulfilling. When someone experiences spine related pain the question to ask is “who do I see that can make my back and neck pain go away”? Two of the primary options for conservative treatment of low back pain and neck pain include seeing your local chiropractor or local physical therapy. So, who should you see?

It is important to first understand the similarities between both of these conservative treatment options for your spine pain. Both PT’s and chiropractors primarily focus on the reduction of your pain patterns through use of manual interventions to restore function and mobility to allow you to be able to do the daily activities that you enjoy. PT’s and chiropractors also go through extensive schooling requiring doctoral level entry to deliver optimal care to each patient they treat.

So, how does physical therapy and chiropractor differ, and which treatment option should I seek?

First, chiropractors primarily perform spinal manipulations often called “adjustments” on patients with goal of restoring alignment and your spines self-awareness, known as proprioception. Often individuals with back pain go to their chiropractor, get seen for ten minutes, and go home feeling great. However, after a few days, their pain often returns, and they need to go see their local chiropractor again.

Physical therapy will focus on identifying the limitations and dysfunction in the musculoskeletal system that may be contributing to your spine pain patterns. PT will perform a thorough evaluation of how your spine moves, including identifying any dysfunctions in muscle flexibility, joint mobility, strength and neuromuscular deficits including sensation and reflexes. From there, PT will work with you on how to properly gain segmental mobility through your spine with the goal of restoring functional mobility to get you back to doing the activities that you enjoy. Physical therapists in the state of NH are permitted to perform spinal manipulations, similar to that of a chiropractor.

Cervical manipulation by a physical therapist for neck pain and stiffness

However, with PT we use these adjustments as a compliment to other interventions with the goal of addressing the dysfunctional movement patterns and changing the way you move, which over time will lead to long term pain relief. These additional interventions include use of manual therapy and soft tissue mobilization to improve tissue pliability and reduce joint and muscle inflammation, therapeutic exercises specifically targeted towards your goals and your pain patterns to provide support to your spine, dry needling to address deeper muscle binding and pain and electrical stimulation to block your bodies pain signals to get you feeling better before you leave.

Physical Therapists don’t want you to have to come back every 2 weeks if we can educate you on techniques to get you feeling better ALL the time!

Physical Therapist applies instrument assisted soft tissue work for muscle pliability

Physical Therapist applies electrical stimulation for pain modulation

At Hampton Physical Therapy, our skilled licensed physical therapists are able to perform many of the skills that chiropractors use to get their patients feeling better, however that is just one component to the treatment services we provide. You get the benefits of feeling better leaving PT, like you would going to a chiropractor, with the goal of attending PT for 4-8 weeks and then not having to keep coming back to address your pain!

If you’re experiencing any low back, neck or mid back pains and are looking to get evaluated by one of our skilled doctors of physical therapy, give us a call today! 603-929-2880

 

Go-to Sleep Positions… How to Combat Injuries While Sleeping

Adjust Your Sleep Position For Better Quality Sleep & Life

By Kate Dulac Serodio, DPT, OCS

As a Physical Therapist, I see a lot of sleeping injuries. Sleeping injuries? Yes, literally sleeping injuries!

Injuries that occur while you’re sound asleep or are a result of laying in the same position night after night. We often don’t value the time that we’re sleeping because, well, we’re asleep. But even though you’re not consciously aware of what position you’re in, you’re potentially positioned poorly and laying in a position that increases your risk of injury.

We all have a position that is our go-to position. WebMD acting reports that 63% of people sleep on their side, 16% on their stomach, and only 14% on their back. The thought of changing this is not a welcoming thought for most. On a daily basis, I preach the need to modify “your go-to position” and sleep in the ideal position that allows your body to be in the best resting position that doesn’t cause impingements and allows for gravity to actually do something positive for you, stretch you while you’re asleep.

If you have a neck, shoulder, or back condition or just want to make sure you never do its time you address your sleeping habits. I truly believe this is the #1 most basic modification you could ever do for yourself. So, what is the winning position? As you may have guessed is, yes, your back! This means that 79% of you need to make a change. Even the 14% of the back sleepers will need to make one modification as well. Sleeping on your back ensures that your neck is in alignment with your body with minimal rotation. Your shoulders are being pushed back by gravity and actually help open up your chest. Your low back is also in somewhat of a neutral position without any rotation. The low back will also require a little more help to maintain that ideal resting position, you need to put a wedge under your knees. Not only will a triangular wedge open up your spine and allow for proper fluid circulation and disc nourishment but it also prevents you from rolling over!

So, as you can imagine, I often get a kickback on why is it bad to sleep on your side or stomach, let’s take a look at a few sleep methods…

The Side Sleeper:

If you have Shoulder issues and neck issues, this is the worst position of all! Let’s start with the neck, its very unlikely that you’ll keep your head in alignment with your spine, it’s going to be cranked up or down or rotated creating impingement on either side of your neck, possibly resulting in disc pathology or irritation to the facet joint where you wake up and can’t turn your neck. Next, take a look at your shoulder! That is a rotator cuff accumulative injury. Every night laying on that shoulder. What does that do? That makes the muscles in the front of the shoulder really short and elongates the back of the shoulder muscles. That’s 8 hrs in that position! Do you think a little pec stretch that you might be doing daily for 3 min will combat 8hrs of that position, absolutely not.

Now let’s look at the back, your spine is going to rotate and compress on the nerves that come out of the spine and you’ll end of with one side being tight and the other elongated. Again, just adding to the imbalances.

The Stomach Sleeper:

This position is the absolute worst for your neck or if you have TMD! Most likely you’re asleep looking to the same side every night, resulting in muscle imbalances and joint irritation. One morning you’ll wake up and probably have some tingliness in your hand or inability to rotate your neck. Your shoulders won’t have the benefit of having gravity open then up like they do when you’re on your back but instead cont to rotate forward, again, not helping your posture. Your low back will be arched and in extension compressing the disc space and bones, not allowing for the disc to fill back up with fluid while your rest.

So there you have it, you need to sleep on your back! Whether you have back pain, neck pain, or shoulder pain or you simply want to make sure you never do! And if all that isn’t convincing enough, according to the aesthetic surgical journal, sleeping on your back will help prevent wrinkles!

Here is the type of wedge I recommend. This will place your low back in the perfect position. The wedge will also make sure you stay in this position all night, not allowing you to migrate back to you go to position

Buy Yours Here

Rezilient Professional Stretching targets the muscles in your body that have become super tight from years and years of you sleeping on your side or stomach. A side sleeper will often have tightness in their upper trap, pecs, and hip flexors. Also if you’re a side sleeper you’ll often have a tight lateral fascial line and anterior line (the connection of fascia/tissue that connects all the muscles on the side of your body and all the muscles on the anterior Rezilient targets these muscles in ways that most will struggle stretching independently.

Here’s an example of some of the stretches our team can do for you, to alleviate your pain and help you be resilient.

To find out more call Kate at Hampton Physical Therapy, or fill out this contact form.

 

MASKS: Another Hurdle for Businesses to Overcome During Covid-19

MASKS: Another hurdle for businesses to overcome during Covid-19 - Hampton Physical TherapyBy KATE SERODIO, DPT – Owner/Physical Therapist Hampton Physical Therapy & Rezilient

No one is spared personal hardships during this difficult pandemic. From the fear of contracting the virus to the tough convalescence of those who do, not to mention the devastation of losing a loved one to it. There’s so many new adjustments to deal with, like working from home, or being laid off. Having to home-school kids is a huge challenge too. For those of us ‘essential workers’ it’s been extremely trying as well.

As a business owner, I have experienced the complete shutdown of a non-essential business (Rezilient) as well as the struggle of remaining open as an essential business (Hampton Physical Therapy). It’s been nothing but endless hurdles. The struggles of a complete shutdown then reopening is basically like starting a business from scratch. While remaining open during the pandemic with a skeleton crew certainly had its own challenges. From battling with the ever-changing CDC guidelines, to the additional work needed to provide a safe environment, to the laying off /rehiring of staff (with some pushback due to the unemployment stimulus funds they were receiving). Unfortunately, my businesses just aren’t Pandemic Proof.

Sadly, the continued emphasis from patients hasn’t been about how great a service we provide, but instead whether our business is safe and clean and worth the risk. The fear is understandable. Many months into Covid-19 and I still find there is still so much time and energy devoted to this virus, that the true goal of the business has lessened.

As we treat patients and clients daily, there is one other elephant in the room that is hindering us from connecting, yes, the MASK! The mask obviously has its purpose to prevent the spread but it is affecting us on a whole other level, a mental and emotional level. The mask is a constant reminder that we are in a pandemic. When a primary part of a business is about connecting with people, the facial emotional barrier of masks is yet another hurdle that we must overcome.

A huge part of providing a Great service is the ability to connect with people. Whether you’re a greeter, a waitress, a hairdresser, or a doctor you need facial visual input in order to read their reaction to your questions or comments. Their response is what drives the direction of a conversation. The mask in effect, makes you feel as if you’re talking to a wall. Yes, the eyes are expressive, but I’m finding the mouth is what I often check for nonverbal cues as to how my patient is doing. Consequently, this is a huge barrier to business as this is a fundamental of great customer service. What was once transparent is now a guessing game, an added obstacle on top of accomplishing your job.

Since the first day I started wearing a mask back in March while treating patients, I have personally felt less emotion. Perhaps even less empathetic to my patient’s needs. I believe this is because I can’t see their feelings or pain or smile, and I know they can’t see mine, so why bother. The lack of this input easily makes you have less emotion. Not only does this affect the provider but it also affects the client/patient. Research supports this: a BMC randomized control study in 2013 “Effect of facemasks on the empathy and relational continuity” found that “patients perceived doctors who wear masks as less caring and empathetic.”

Another interesting article that supports our struggles with masks and emotions is from Trends Neuroscience Education: “Masked Education? The benefits and burdens of wearing face masks in schools during the current virus pandemic.” This is an interesting article on many levels. One topic they discuss is how the face provides a universal language for communication, in particular, the communication of emotions. The mouth region on a face conveys information that is crucial for smiling, i.e., a positive emotion, which can work as social glue and facilitates positive social cognition and action. Not seeing the bottom half of the face makes it particularly difficult to recognize a mask-wearer’s positive emotions – pleasure, joy, happiness, amusement, sociability, and friendliness – as they are basically communicated by a smiling mouth. Therefore, face masks impair mainly our positive social interactions and our ability to understand, and empathize with one another.

Some other added struggles that the mask unfortunately results in is a muffled voice. Many people with hearing impairment are having an even harder time communicating because of the muffled voice as well as the inability to read lips.masks muffle voices during covid - Hampton Physical Therapy
Many people that don’t even have a hearing problem are finding that they suddenly can’t understand anyone. A number of my patients are misinterpreting what I’ve said, its often like we’re playing a game of telephone where the message is completely distorted by the end of the conversation. Who knows how many people I’ve somehow offended! There are many times that I assume someone didn’t hear me and I go to repeat myself, only to find out that they did hear me but were making a thinking face that I wasn’t able to pick up on. The normal conversation just simply doesn’t flow as it used to or should, leaving a feeling of complete disconnect.

In my line of work, recognizing feelings is extremely important. In a profession where you provide hands on services, you’re no longer able to gauge from their facial expression if you’re physically hurting them. So many cues that we have all become accustomed to are no longer available. The inability to see feelings on someone’s face and the inability to express my own feelings with a smile is a huge hurdle for me and my business.

So, whether you’re a business owner or an employee trying to provide a service, and make sure you’re able to continue to connect with your clients, you need to overcome ‘the mask’. Since March these are some of the things I’ve found useful:

1) Focus on the eyes. Attempt to read theirs and utilize your own when smiling.

2) The mask sometimes feels like the elephant in the room, so just get it out there, and talk about it. Talk about the mask and how it creates a disconnect, people will agree with you and you’ll connect. Having a conversation about how the mask affects your peripheral vision will open up a possible connection. I actually fell off the treatment table because I couldn’t see down. Have the mask be your first thing in common. It will open doors up for further discussions.

Another good topic is talking about all the great things the masks do:

– don’t have to stress about food in your teeth
– if you have bad breath, no one will know
– only need eye make up
– the obvious… less germs spread
– this list hasn’t gotten that long… we all agree it’s short but have a fun time trying to come up with positives-send them my way if you have more

3) Mask fitting: make sure your mask doesn’t hit your lips, this muffles your voice even more and makes it difficult to hear which will complicate connecting even more.

4) Give people a visual of yourself-perhaps a business card with a picture of yourself. This will allow them to feel more connected as they’ll be able to build a mental image of you

5) Wear a clear fitted mask: A clear mask for you would eliminate ½ of the problem. You’ll still struggle getting visual feedback from them, but you’ll at least be able to smile with them knowing and allow for a connection and better communication. This would also assist with someone who often needs to read lips.

*FYI this is not a shield, these do not provide the level of protection most are seeking.

6) More gestures! Air hugs: I used to give hugs, now I tell them I would love to give them a hug but I suppose an air hug will do. Hand Air Shakes: handshakes are definitely out but an air shake and just a big greeting will do. Thumbs up or head nods, all are useful to connect.

9) Discuss the need to Communicate: if you have a business that you need to know if you’re hurting someone, have a discussion about communicating. Make sure they understand their role is to speak up if they’re not happy.

10) Try harder: you have to simply try harder, dig deeper to connect. Know it and own it.

11) Mask messages – purchase one with a smile on it or a positive quote. Believe it or not, this can be powerful and allow a connection.

12) Encourage people to buy clear masks-this will allow us to feel as normal as we can in the present.

We all need to be resilient. We must accept that this is potentially our new reality and you must figure a way to overcome it. Hurdle after hurdle, whether small or big, we must move forward.
I encourage you to Be Rezilient!

REFERENCE
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3879648/
Trends Neurosci Educ. 2020 Sep; 20: 100138.
Published online 2020 Aug 11. doi: 10.1016/j.tine.2020.100138

PMCID: PMC7417296 Masked education? The benefits and burdens of wearing face masks in schools during the current Corona pandemic
Manfred Spitzer1