From the time we learned to walk we fell a lot, but our parents picked us up and we kept going. So, why on earth was it a natural instinct to break our falls with our hands, and, how come we never learned at that time how to fall without FOOSH’ing? Good question, right?

What is a FOOSH, and how can we not do it?

Well, FOOSH is the nickname for an injury caused by Falling Onto an Out Stretched Hand. These injuries ¹ are among the most common injuries affecting the hands and wrists that occur when trying to break a fall.

The severity of FOOSH injuries can vary greatly depending on various factors. These include:

• the force of your impact with the ground
• the type of ground you’ve fallen on
• the way in which you’ve fallen
• whether you have any existing health conditions or injuries affecting your hands and wrists.

FOOSH might be a silly Nickname, but it can have serious consequences.

FOOSH injuries often happen to people who participate in sports where falls are common, such as downhill mountain biking, skiing, and football.

But, really anyone can get a FOOSH injury if they fall on a hard surface and try to brace themselves with their hands or arms. Incorrect footwear can create tripping hazards and also lead to falls. So can scatter rugs and electrical cords in the home. A lack of balance or coordination, poor vision, or medications that cause drowsiness, may also cause falls with FOOSH injuries.

The Art of Falling Safely.

Believe it or not, there are ways to fall and not FOOSH. And we’re all going to fall down: The world is full of banana peels. So while avoiding a fall is job one, knowing how to take a fall when it’s inevitable is a crucial skill.

An article by Michael Zimmerman, AARP The Magazine, gives a 4-step explanation with pictures on the Art of Falling Safely with suggestions to help improve your footing and practice mindfulness. An added bonus in the article has a link on how to how to prevent falls in your home.²

The take-a-way is bittersweet. Remember – we’re all going to fall so let’s try to learn the art of it. However, there is still a 50/50 chance are we’re gonna FOOSH, and if you do we are here to help you!

____________________

sources:

¹Treating and Recovering from ‘Fallen Onto an Outstretched Hand’ Injuries: https://www.healthline.com/health/foosh

The Art of Falling Safely: www.aarp.org/health/conditions-treatments/info-2017/how-to-fall-safely.html

 

 

By: Kevin Flood, PT, DPT

 

Since we still have a ways to go before we get to warmer weather and school-aged kids are in between their hybrid school schedules, it’s possible you are running out of indoor physical activities for them after their virtual days and there might be weekends you can’t make it to Compass.

So here are some creative and old-school activities to do as a family, or independently if Mom and Dad are working from home or,  well, let’s be real….need a break!

And, of course, there isn’t any activity on here that the younger brothers and sisters can’t join in on too——did you say snowball fight?

Snowball Fight: Use ‘socks’ for snowballs!

 

Balloon Tennis: Keep the balloon off the floor, with your hand or with homemade rackets using a paper plate and tongue depressor/craft sticks; decorate them for added bragging rights!

 

Hallway Bowling: Fill up plastic beverage bottles with colored water and use any ball you have to knock them over!

 

52 Card Pickup: A different variation of the game some of us grew up with! Choose 4 exercises to correspond with each card suit. (examples: squats, high knees, push-ups, sit-ups, jumping jacks, mountain climbers). Draw a card,  and then you complete the number of reps for that exercise. (face cards count at 11 or 15, your choice).

 

Dance/Freeze! Have a dance party, and when the music stops you have to freeze in place!!

 

Tape Maze:  Use streamers (painter’s tape works too) to create a maze in a hallway;  like lasers in a spy movie! Then have the kids try to make it through the maze without tearing them down.

Back pain is a huge problem in developed nations worldwide. It has or will affect most of us. The current estimate is that 80% of people will experience back pain at least once. It is the single biggest cause for disability, the third most common reason for doctor visits, and one of the most common reasons for missing work.

It’s also expensive. Back and neck pain makes up the biggest healthcare expense in the US, totaling $134 billion spent in 2016. The next two most expensive conditions were diabetes —$111 billion in spending — and ischemic heart disease at $89 billion.

Diabetes and heart disease being so expensive to treat doesn’t surprise most folks – they can both lead to other major problems, require long term medication, could require surgery, and both can be fatal. Back pain won’t kill you, usually doesn’t require long term medication, and usually doesn’t require surgery either.

Why is it so expensive?

The first reason is that it’s so common. The second reason is that our current system isn’t very good at treating it. Current recommendations include starting with activity modification, and active treatments like physical therapy. Research backs this up, showing better outcomes and lower costs with early PT. Unfortunately, only 2% of people with back pain start with PT, and only 7% get to PT within 90 days. At the same time, a study looking at about 2.5 million people with back pain in the Journal of American Medicine (JAMA) showed that 32.3% of these patients received imaging within 30 days of diagnosis and 35.3% received imaging without a trial of physical therapy. Both of these things go against current practice guidelines for treatment of back pain.

Try before you buy!

A new pilot program being rolled out by TRICARE, the insurance system used throughout the US military is waiving the payment owed by the patient for up to three PT sessions in an attempt to improve the use of what the Defense Health Agency calls “high value” treatment for low back pain. The theory is that once a person sees some benefit from PT treatment, they’re likely to go back for more. This is the “try it before you buy it” approach – think of the 7-day free trial Netflix offers, free samples poured in wineries and craft breweries, or the folks you see standing around in supermarkets with food on toothpicks. TRICARE’s data seems to indicate that it works just as well for healthcare as it does for other businesses. In a press release they state that once people attend one session of physical therapy, they’re likely to go back for more, no matter what their co-pay is. But TRICARE found that higher co-pays could be a barrier to people trying that first visit. For the group of patients with the highest co-pays in the system, only 38% of the people prescribed PT attended the first visit. That’s about half the rate of attendance found in
the lowest co-pay group.

What’s next?

The fact that such a major insurer is looking into the value of PT is great news for everyone. If TRICARE can show that lowering the cost of PT for patients can improve outcomes and save insurance companies money, other major insurers will likely follow. This could improve the lives of millions of people every year while reducing the huge cost of treating low back pain for the country.

That seems like a win for everyone involved.

By: Vicki VerMeer, MSPT and Owner

In 2021 the American Physical Therapy Association (APTA) is celebrating 100 years as a member association, raising awareness about our great profession.

As Franklin D. Roosevelt once said, “A smooth sea never made a skilled sailor.” That statement is a reminder to us all that life will have its ups and downs, but it is precisely these rough seas that make us compassionate, resilient, and dynamic people and professionals. Roosevelt should know as it was Alice Lou Plastridge, an experienced physical therapist in the field of polio who had been successfully treating him when he began visiting Warm Springs, Georgia, to swim in the thermal spring waters.

Strange that 100 years ago we were battling the influenza pandemic; and here we are combating the COVID-19 pandemic that keeps packing punches with new strains being recognized. The global focus is on the vaccine that we all hope will slowly get us back to normal.

Despite the pandemic, we are still here and doing our jobs day in and day out, doing our very best to CARE for you both in person and virtually in some cases. As our current APTA president Sharon Dunn stated, “Responding to hardship with purpose and progress is what we do, it’s who we are.” It’s the only control we have at the helm, for now, to help all of us continue to adapt and overcome the twists and turns we will continue to navigate in the foreseeable future.

The APTA’s vision statement for the physical therapy profession continues to be transforming society by optimizing movement to improve the human experience. So here we are 100 years later amidst a pandemic to help you; to be an extension of the care you need when surgeries are postponed, you become deconditioned from quarantine, or develop complications such as Acute Respiratory Distress Syndrome from COVID-19.

In closing, my hope is that each of YOU are taking good care of yourself physically and emotionally! Because as we all know if we don’t take care of ourselves, we are no good for those who need us the most!

By: Jenifer Walker, PT, DPT, CHT

Since the title of our next blog is in the form of the question. The answer is, if you are currently experiencing any pain, swelling, or functional limitations with one or both of your hands, then the answer is an emphatic YES!

Most people these days know that when their back is bothering them, or they have elected to have surgery on one of the joints in their body, that they can follow up with their favorite PT at Carousel.  But did you know that some physical therapists choose to specialize in the treatment of the hand and upper extremity?  I have been working towards becoming a CHT (Certified Hand Therapist) for the last few years of my practice, and in December I completed my studies and passed a rigorous certification exam!

CHTs are highly skilled in evaluating edema, pain, range of motion, strength & endurance, sensibility, activities of daily living, work activities, avocational activities, and sports activities.  We commonly manage conditions such as:

• • • • • • • Amputations
            • Arthritis
            • Burns
            • Disease processes
            • Fractures & dislocation,
            • Sprains & strains
            • Infections
            • Joint contractures
            • Nerve compressions
            • Nerve injuries
            • Rotator cuff injuries
            • Impingement syndrome
            • Tendinitis
            • And tendon injuries

One of the major skillsets developed by CHTs is the fabrication of customized orthotic devices for the upper extremity.

These are commonly required for carpal tunnel syndrome, cubital tunnel syndrome, tendinitis, basilar joint arthritis of the thumb, finger dislocations, finger fractures, tendon injuries, lateral epicondylitis, and joint sprain/strains. Orthotic devices are often required following surgery for the fingers/hand/wrist as well.

So, if you are unsure whether you should see a CHT, you can have a FREE consultation with me, and with your doctor as well! See you soon!

Colder weather means some changes to how we exercise. Of course, it’s harder to motivate
yourself to get outside for a run or bike ride when the temperature drops and the shorter days
compress our schedules, but there are changes in your body that affect your ability to exercise
too. For many people with arthritis or other joint problems, cold weather brings more complaints of pain. To stay warm, our bodies narrow blood vessels to reduce blood flow to the skin, and more superficial muscles. That means that there is an increased risk of muscle strains in the cold. There is also an increased strain on the heart because of the narrowed blood vessels. This isn’t to say that you shouldn’t be active outdoors in the cold, it just means you may have to make a few changes to your routine. Here are a few to consider:

Warm Up Right

A good warm-up is always important, but because of the tendency for joints to be stiffer, and
blood flow to muscles to be reduced in the cold, it’s even more important that you do it right this time of year. To start, do something to get your heart rate up a bit, maybe a brisk walk or light jog. Follow that up with a dynamic warm-up rather than static stretches. This could include walking or jogging while pulling your knees up high to your chest. Maybe some high kicks in front of you with straight knees to get your hamstrings loosened. A walking lunge with an upper body twist can get your whole body moving. Cater your warm-up to what you have planned in your workout. If you’re not sure how it should look, ask your physical therapist!

Dress For Success

Dressing in layers allows you to adjust your insulation to your activity level. After you warm-up, you might want to take off a layer to avoid getting too hot during your main activity. You’ll have it there later to put back on when your activity level drops and you start getting too cold.
Don’t forget about the sun either – just because it’s cold doesn’t mean the UV rays are gone.
Sunscreen and sunglasses aren’t just for the summer. A lip balm with SPF can protect you not
only from the sun but from the wind too.

Stay Hydrated

Drink water before, during, and after your workout. The temperature may be down, but you’ll still sweat and you’ll still lose water vapor in your breath. The drier air in winter lets your sweat evaporate more quickly, so it’s easy to underestimate how much fluid you’ve lost.

Cool Down

When you’re done, don’t rush to get inside and crawl under a blanket. Cool down properly. Keep moving with a walk or another form of active recovery to let your heart rate come down. After exercise is the right place for static stretching. You can also head inside for some foam rolling or self massage.

The days being shorter and the temperatures being lower don’t mean you’re stuck inside for all of your exercises. If you follow these tips, you can safely keep moving outside. If you’d like a customized warm-up or cool down or have questions about your exercise routine, your physical therapist is a great person to ask!

by: Crystal Bondurant-Salisbury, LPTA 

Some of my favorite tools in my “toolbox” as a clinician are cups. They can be plastic, silicone, or glass cups that use negative pressure or vacuum pressure to provide therapeutic benefit. Their versatility allows me to treat conditions ranging from simple to complex, from more recent injuries to chronic conditions. Although they aren’t for everyone they can really improve function and reduce pain. They’ve become pretty popular nationwide, starting a few years back when a certain swimmer took the podium with a few strange, dark circles scattered across his back. If you missed that, it was Micheal Phelps taking the gold in the Olympics in 2016. Cupping isn’t a new thing, though it may be newer to us here in the west.

So, What is Cupping?

Cupping has been around for a long time and all over the world. Originally seen as a way to remove unwanted sickness, pains, disease, or even evil spirits from the body, it was an important part of historical medicine. Ancient medical texts from Egypt describe using cups to treat vertigo, pain, and other issues. Hippocrates, known as the “Father of Medicine”, used cupping in ancient Greece to heal the body of musculoskeletal pain and illness. Cupping in-general is known as an eastern medicine and in China references to cupping were found in the Bo Shu, an ancient book found in a tomb of the Han Dynasty. But, it’s not just a medicine from far away. Cupping can be found a lot closer to home.¹ From Europe to throughout the Americas medical practitioners have been carrying around cup sets as part of a standard inventory.

Why Choose Cups?

Practicing physical therapists, athletic trainers,² massage therapists, and others all use cups today to treat their patients and clients. Modern practitioners use cups in a variety of ways including reducing restrictions like scars,³ improving symptoms of chronic conditions like rheumatoid arthritis and fibromyalgia, as well as addressing swelling after surgeries.⁴ Many studies have been done over the last 50 years on the uses and efficacy of cupping and they demonstrate a variety of benefits. A systematic literature review by Cao, et al. showed benefits for pain conditions and herpes zoster (shingles). Other systematic reviews also supported the treatment of pain conditions with the use of cupping and including one review focusing on both amateur and professional athletes. The athletes featured in the studies reported improved perception of pain and disability and increased range of motion in comparison to untreated control groups.  In a study on the effects of cupping for chronic neck pain,⁵ patients reported benefits up to 2 years later.

Cupping can be used as a stand-alone treatment for some professions like massage therapy, but in physical therapy, we integrate it into a personalized treatment plan. In “An Updated Review of The Efficacy of Cupping Therapy”⁶ from 2012, cupping was found to be better paired with other treatments like traction than the other treatments alone.

Physical therapists and physical therapist assistants using research-supported techniques can provide a diverse and unique treatment with the use of cupping techniques.

_________________________________________________________________

References:

1. Fundamentals of Modern Cupping Therapy. In Proceedings of Modern Cupping Therapy Educational Company Course. Virginia Beach, Va., 2019
2. Bridgett, Rhianna, et al. “Effects of Cupping Therapy in Amateur and Professional Athletes: Systematic Review of Randomized Controlled Trials.” Mary Ann Liebert, Inc., Publishers, 1 Mar. 2018, www.liebertpub.com/doi/abs/10.1089/acm.2017.0191.
3. MCT for Pathology and Scar Tissue. In Proceedings of Modern Cupping Therapy Educational Company Course. Virginia Beach, Va., 2019
4. Therapeutic Cupping for Lymph Drainage. In Proceedings of Modern Cupping Therapy Educational Company Course. Virginia Beach, Va., 2019
5. Leem, Jungtae. “Long-term effect of cupping for chronic neck pain.” Integrative medicine research vol. 3,4 (2014): 217-219. doi:10.1016/j.imr.2014.10.001
6. Cao, Huijuan, et al. An Updated Review of the Efficacy of Cupping Therapy. 28 Feb. 2012, journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0031793.

By: Kara Everett, PT, DPT, CSCS, CKTP
LSVT BIG Certified
Operations Director, Hartfield Location

The likelihood of falling increases as we age. Each year, 30-40% of people aged 65 years and older fall and roughly half of all falls result in an injury. Falls are a major threat to older adults’ quality of life and can often lead to a decrease in participation in physical and social activities. The fear of falling (which develops in 20-39% of those who have fallen) can further lead to activity limitations.

Don’t Trip! Check Off Hazards.

The way your house is set up and the things in your home could be increasing your fall risk. Do you have a lot of rugs that could be a trip hazard? Do you have cords or electrical wires across or running in areas where you frequently walk? Do your stairs have handrails? Is there good lighting for your nighttime walk to the bathroom from your bedroom? Here is a check for safety brochure by the Centers for Disease Control (CDC) to help you find out.

Home Assessment: Why You Should Have One!

Our therapists at Carousel can come to your home for a personalized home assessment. During this assessment, we will evaluate each room of your house to identify any potential fall risks and how to address these problems and improve the overall safety of your home.

To schedule your home assessment today, give us a call at 435-3435 for our Kilmarnock office and 776-8500 for our Hartfield office.

 

by: Kennan Wyne, PT, DPT
Women’s Health Specialist

 

Constipation is obviously uncomfortable, but did you know it can lead to health issues like fecal impaction, colon cancer, digestive problems, and pelvic floor issues.

Constipation occurs when the colon absorbs too much water, or when the colon’s muscle contraction is slow or sluggish delaying transit time. The result is a hard and dry stool, which can lead to straining and the inability to release your movement with ease. So, trying to avoiding the pain and discomfort caused by being constipation should be high on your prevention checklist.

The colon is oriented in your abdomen in an upside-down “U” shape, as shown in the picture below. Performing massage to the abdominal area is an effective and easy way to help relieve constipation, and is safe to perform daily!

To begin, I recommend applying 10 minutes of heat to your abdomen (optional) before massaging your abdomen. Then start massaging 10 times in each direction with firm pressure.

I. Start in the center of abdomen at your navel and perform small circular motion in clockwise direction (10 circles total).

II. Next, place hands at right hip bone and perform 10 small circles in clockwise direction then move up working towards the right ribs. Spend more time massaging areas of blockage, tightness, hardness, pain, cramping, or tenderness.

III. Next, when you reach the right ribs perform 10 small circles in clockwise direction then move across working towards the left ribs.

IV. Last, when you reach left ribs perform 10 small circles in clockwise direction then move down working towards left hip.

Perform these techniques 1-2x daily as needed.

Workplaces in the United States (U.S.) now house a number of jobs that require computer work, driving, and telephone-based activities. Office workers may spend up to three-fourths of their workday sitting.  If you are sitting for hours on end without taking frequent breaks, like getting up and walking around, your hips will eventually start complaining and you will start having pain.

What is hip impingement?

Hip impingement is when two bones rub against each other in the hip joint.

Why does it happen?

Most people with hip impingement have an unusually shaped hip joint that causes the bones to press against each other.

How can I tell if I have it?

Hip impingement typically causes pain in the front and outside of the hip area. You might have pain when you sit for a long time, lean forward to put on socks or shoes, get in or out of a car, or pivot when playing sports.

Hip impingement may cause you to experience:

• Pain that begins gradually and may worsen with time. People with hip impingement often describe their pain by making a “C” with the thumb and hand and placing it on the fold at the front and side of the hip. This is called the “C” sign.
• Groin pain or discomfort in the outside of the hip, thigh, low back, or buttocks.
• Sharp, stabbing pain when squatting, sitting and standing, or performing athletic moves like running, “cutting,” jumping, twisting, pivoting, or moving side to side.
• Loss of motion or a stiff feeling when rotating your leg inward and/or lifting your leg.
• Pain that increases after sitting for long periods or leaning forward.

Practice Sit-to-Stand!

So, if you have a sedentary work/life balance. Set an alarm and get moving; take a brief walk, and do some sit-to-stand exercises. Any movement will be good in reducing the risk of long-term pain and injury associated with sitting for long periods of time.