TEN POINTS PHYSICIANS SHOULD KNOW ABOUT PHYSIOTHERAPY / PHYSIOTHERAPISTS

This Post is not to Hurt Doctors, Don’t get us wrong – we love our doctors and they are a critical part of the health care team, but there are some things we hope physicians take note of here,and things we hope informs the patient about physical therapy.

1. It’s not just a sheet of exercises. Many times patients tell us that their doctor “gave them some exercises” to do for their condition. While that may work from time to time and people want “home solutions” nowadays, there is much more to physical therapy than exercises. We do a thorough physical assessment and manual therapy and mobilizations to help things move smoother and easier. Time and time again, therapeutic exercise, education, manual therapy, and pain management is the tried and true method to get people better. Physical therapists are experts at that and can significantly help patients lead healthier, happier lives following this treatment plan.
2. PT clinics ARE different – it’s not just who’s closest to work or home. Like any business, there are different levels of quality. Some clinics don’t have the “vibe” that people like. Some clinics have people that have varying degrees of specialty. Some clinics, well, don’t do such a great job. Patients should be encouraged to look for a physical therapy clinic that suits their individual needs. It would really help if physicians took the time to get to know the physical therapists in the area and help the patient make an informed decision, not leave it to front office staff.
3. Modalities don’t do a whole lot. For some reason, there are many physicians that have grasped on to the idea that physical therapy is all about ultrasound, TENS units, hot/cold packs, and electrical stimulation. While these things may help at times, the evidence supporting their use is scant at best. Physical therapy is much more than passive treatments like these. Sure, they can help someone in pain “take the edge off,” but ultimately they will need manual therapy, exercise, and education to maximize their outcome. Physical therapy is an “active” process in the end.
4. Limping is not normal. Many patients walk into our doors limping and say, “Doc said I could get rid of the crutches!” Unfortunately, that is a really bad idea. The abnormal walking pattern not only changes the mechanics of walking, but also can delay healing, increase pain, prolong swelling, and delay return of function. You should use an assistive device of some kind until gait is normalized.
5. Patients need a few visits after any soft tissue or joint surgery. We’re always surprised how many patients tell us that “doc said I didn’t need therapy after surgery.” The problem with this is that many people unknowingly compensate after a surgery and this prolongs the healing process, much like in #4 above. Mark our words – a majority of people end up needing physical therapy more later than if they would have come right away. 3-6 visits becomes 12-15. That is obviously more time and cost on the patient.
6. Physical therapists are trained to pick up “non-musculoskeletal problems.” Many patients come to physical therapy complaining of things that are systemic in origin, not musculoskeletal. Physical therapists are trained to recognize when a patient presents with symptoms that are not compatible with physical therapy and properly send them on to their doctor. Having a good relationship with a physical therapist helps facilitate this with patients.
7. Many problems patients have are in areas other than where the pain is. For example, many patients complain of shoulder pain but the problem is really in the neck. Another example is that many patients have low back pain and the patient gets MRI’s, injections, etc for the back but the problem lies in the hip. If patients aren’t responding to treatment or if MRI’s are inconclusive, consider sending them on to a PT for a thorough biomechanical assessment to determine the source of the problem.
8. Physical therapy is a better option than injections or pain medications. Several studies have shown that physical therapy is better for chronic back pain, and for tendinopathies, injections are no better than therapy after 3 months. We’re obviously a little biased but why not try the cheaper PT before an expensive MRI or try PT before a more invasive injection. Sure, injections are needed at times to help calm the pain down so the patient can do PT – we have no problem with that. However, injections aren’t a panacea for everything.
9. We can offer many suggestions about protocols. We look at protocols regularly and wonder what the heck is going on sometimes! Either outdated exercises, lack of supporting evidence for exercises, or treatments that are prescribed that are contradictory cloud the treatment plan. Most physical therapists would invite the opportunity to collaborate with physicians on protocols. Many protocols are just guidelines to be followed and many physicians leave the door open for the physical therapist to work within restrictions, but there are many things that can be adjusted to protocols to make them more effective.
10. Patients should not take months to see results. For most conditions, if physical therapy is prescribed right and done effectively, patients should see results quickly. For more chronic conditions, a great outcome can take time, but there should be positive trends. If not, #2 on this list may apply.

Alphabets for Happy Life

JUST CHECK FOR THE STATISTICS

SWINE FLU BASICS

What is novel H1N1 (swine flu)?
Novel H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.
Is novel H1N1 virus contagious?
CDC (Centers for Disease Control and Prevention) has determined that novel H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of this virus in people?
The symptoms of novel H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.
How does novel H1N1 virus spread?
Spread of novel H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods.
Prevention & Treatment

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against novel H1N1 virus. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health:
· Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
· Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
· Avoid touching your eyes, nose or mouth. Germs spread this way.
· Try to avoid close contact with sick people.
· Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

Other important actions that you can take are:
· Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious.
What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. If you are sick, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.
If I have a family member at home who is sick with novel H1N1 flu, should I go to work?
Employees who are well but who have an ill family member at home with novel H1N1 flu can go to work as usual. These employees should monitor their health every day, and take everyday precautions including washing their hands often with soap and water, especially after they cough or sneeze. Alcohol-based hand cleaners are also effective. If they become ill, they should notify their supervisor and stay home. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral drugs to prevent illness.
What should I do if I get sick?
If you live in areas where people have been identified with novel H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people. Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings
If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed
If you become ill and experience any of the following warning signs, seek emergency medical care.
In children, emergency warning signs that need urgent medical attention include:
· Fast breathing or trouble breathing
· Bluish or gray skin color
· Not drinking enough fluids
· Severe or persistent vomiting
· Not waking up or not interacting
· Being so irritable that the child does not want to be held
· Flu-like symptoms improve but then return with fever and worse cough
In adults, emergency warning signs that need urgent medical attention include:
· Difficulty breathing or shortness of breath
· Pain or pressure in the chest or abdomen
· Sudden dizziness
· Confusion
· Severe or persistent vomiting
· Flu-like symptoms improve but then return with fever and worse cough
Are there medicines to treat novel H1N1 infection?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with novel H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current outbreak, the priority use for influenza antiviral drugs during is to treat severe influenza illness.
Recommendations for Travel to Areas Reporting Novel H1N1 Flu
CDC recommends that travelers at high risk for complications from any form of flu discuss their travel plans with their doctor. Together, they should look carefully at the H1N1 flu situation in their destination and the available health-care options in the area. They should discuss their specific health situations and possible increased risk of traveling to the area affected by novel H1N1 flu.
Travelers at high risk for complications include:
· Children less than 5 years of age
· Persons aged 65 years or older
· Children and adolescents (less than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection
· Pregnant women
· Adults and children who have chronic pulmonary, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders
· Adults and children who have immunosuppressant (including immunosuppressant caused by medications or by HIV)
Healthy people may make travel plans as they normally would and take common sense precautions to protect their health during travel.
Before Your Trip
If you are planning travel to an area where cases of novel H1N1 flu are being reported, the following recommendations will help you reduce your risk of infection and stay healthy.
Prepare for your trip
· Be sure you are up-to-date with all your routine vaccinations, including seasonal influenza vaccine, when available.
· Find out about the other health risks and travel recommendations for your destination.
· Pack a travel health kit along with facemask that contains basic first aid and medical supplies.
· Identify the health-care resources in the area(s) you will be visiting.


Please travel if necessary.

NECK PAIN

NECK PAIN

The neck (cervical spine) is composed of vertebrae which begin in the upper torso and end at the base of the skull. The long vertebrae along with ligaments provide stability to the spine. The muscles allow for support and motion.

Neck pain or cervical spine pain is a common ailment occurring in all age groups affecting 50 – 70% of people. Prevalence of neck pain was diagnosed to be common in women 48% than in men 38%.

The neck can be vulnerable to injury and disorders that produce pain and restrict the motion. Since, it is less protected than the rest of the spine.

The most common cause of neck pain is soft tissue abnormalities due to injury or prolonged wear and tear. The factors which cause repetitive strain on soft tissues are prolonged sitting postures in computer professionals with out adequate support, forward head posture, faulty postures during sleep, and overhead tasks in electricians, painters and machine operators.

Proprioception is defined as the perception of positions and movements of the body segments in relation to each other. When there is damage to the mechanoreceptors in the joint, the persistent presence of pain inhibits the surrounding musculature to contract, which impairs the threshold of Proprioception leading to the recurrence of the symptoms.

Cervical spine pain is treated depends on what diagnosis it reveals and most patients are treated successfully. A better understanding of the variety of spine pain population is to cost-effective assessment and management necessary for primary spine care specialist.

To make the rehabilitation holistic, it is necessary to retrain Proprioception of the joint which helps in the reduction of neck symptoms and improvement in general health for self-experienced working ability.

OSTEOPOROSIS

Five Fundamental steps to maintain bone health

A. Encage in regular PHYSICAL ACTIVITY 30 minutes per day for 3 to 5 days per week

B. Take medications if need and do check for Bone mineral density once a year.

C. Consult family doctor about bone health and maintenance.

D. Intake of recommended amount of Calcium and vitamin D.

E. Avoid smoking and Excessive alcohol.

Geriatrics

Geriatrics is the branch of medicine dealing especially with the problems of ageing and diseases of the elderly. People are classed as elderly on reaching up to the age of 60 years, but in the 21^st century due to the high standards of living have increased the life expectancy up to 75 years.

The increasingly ageing population presents unique challenges for rehabilitation medicine. One third of the population over age 65 – 75 years experiences one fall per year. In the elderly population Falls are common in old age, Falls have been highly associated with the muscle strength, alternation, altered stride characteristics balance etc..

Frequent Falls and difficult in doing functional abilities are particularly likely to occur due to ageing process or weakness. These impairments may have an addition or interactive effect on an individual’s level of mobility mainly on doing functional tasks.

Fall is an event in which a person comes to rest inadvertently on the ground. A fall can result in disability by decrease in confidence, restricting mobility causing injury and debilitation and resulting in loss of independence. Old people need to strengthen their muscles in order to reduce their risk of falling and improve their functional ability. (Simpson 1993). Strict observation in home circumstances is necessary to achieve the sufficient intensity to the exercise program as in hospital setting.

Functional activities are highly skilled movement pattern which have been developed and refined with many years of practice. The leading factor to a decline in function in elderly people is lack of practice to these functional activities leading to a downward spiral in ability.

Exercise is a great way to keep older people active and function, but should be approached with caution. Exercises should not to be vigorous to be beneficial. Mild, regular and functional exercise is the key factor for staying healthy and happy.