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PT & Business People

While it is common (and obvious) when you get hurt running, lifting weights, or playing in that weekend softball game (“I knew I shouldn’t have tried to steal home!”) – people that work in a business setting are just as prone to injury, but the tricky part is the issues can develop over years and may be “invisible” until all of a sudden your neck starts hurting, or your back starts aching.  Whether you sit at a desk all day or rack up hundreds of thousands of airline miles, there are plenty of things that you should be cognizant of to avoid long term detrimental health issues.

Here are some common issues that you may face:

  • Degeneration of the muscles
  • Chronic fatigue and stress
  • Neck Pain
  • Early onset of sciatica
  • Arthritis
  • Shoulder Pain
  • Back Pain
  • Overall body stiffness

The good news is, there are ways to put yourself in the best position possible to avoid these issues.

  1. Make sure your computer monitor, keyboard, chair, and desk are at the correct height.
  2. Invest in an ergonomically sound chair.
  3. Get up and walk around every 30 minutes, even if it’s to get a glass of water or use the restroom.
  4. Put an extra emphasis on stretching throughout the day.
  5. When you get the opportunity, stand up at your desk….especially good for people that are on the phone a lot.
  6. Take the stairs instead of the elevator.

 

Last but not least, visit a  physical therapist once a year to ensure there is nothing major building up.  Often times these issues are not real issues until it is too late.

Navigating Insurance

While physical therapy is rarely fun (excluding ESPT 🙂 ), it can be challenging to figure out your insurance benefits before even starting your program.  We’ve tried to outline some of the information below to help you navigate the waters.

Before diving into everything, the best thing to do is to either call your insurance company or talk to someone at the PT clinic and they will get the information for you.  Doing this can save a lot of headaches…and money too!

Most insurance plans do in fact cover PT services that are medically necessary.  The number of sessions you are allotted for and your copay can vary.

The catch is that even if your insurance company covers physical therapy, the clinic you want to visit may not accept your insurance.  ESPT outlines the various insurance companies we work with on our website, but it is always good to call and check.  If the PT practice does not accept your insurance, you can either go out of network (in which insurance pays less) or pay cash per visit.

Likewise, if you do not have health insurance that covers physical therapy services, you can still receive services from a physical therapist by paying cash for the services directly.

While therapy may be covered, other activities that one might think are “therapy” may not be. This could include fitness or wellness programs, sports performance enhancement, health education classes, etc…

Here are some tips to ensure you are using your plan to the most of its capabilities – especially if you have a discrepancy in your claim and the insurance company will not pay.

  1. Call your PT clinic and/or insurance provider before starting.
  2. Go to a PT clinic that you trust
  3. Be proactive
  4. Draft a letter
  5. Consider paying on your own
  6. Hire an attorney

How to Successfully Set Goals

As we’ve talked about in the past, many people are not set up to succeed with their physical therapy treatment plan.  The best way to succeed is to be consistent.  It is actually pretty simple:  Go to your appointments, listen to your therapist, do the exercises, and be patient.  It is four simple “rules” but we constantly see people falter for the same reasons over and over again.

So what is the solution?  How do we set our client up for success? One of the things we do is make goal setting a priority.  What is the patients “why?”  Sometimes it may not always be what they initially say.  For instance, we had a client that hurt their back a few years ago and he wanted to get healthy so his back would stop hurting. Sounds logical, right? Come to find out, he had a 9 year old that was into baseball and he really wanted to play/coach with him.  THAT was his goal. We had to ask a few questions, but being emotionally connected to your “why” should give you that boost and commitment you need to be successful with your program.

Here are our goal setting rules:

  1. Emotionally Connect to Your Goal. Come up with something that is not just on the surface, but something that is important to you.  Whatever your initial goal is, keep asking “why” and it will help you get to the root of it.
  2. Set SMART Goals
  • Specific
  • Measurable
  • Attainable
  • Relevant
  • Time Bound
  1. Write it down. It has been scientifically proven that when goals are written down there is a higher rate of success. It may help to read the goal daily to keep it at the forefront of your mind.
  2. Action plan. This should be done in cohesion with your therapist. Come up with a plan and then execute on that plan.  Sounds simple right?!

How do I pick a Physical Therapist?

Seems like an easy question, but there are a lot of factors you should consider.  Of these factors, you will have to prioritize and move forward accordingly.  The first mistake that someone can make is just going with the closest PT clinic solely because of its location – something we see time and time again.  While convenience is important, the amount of time you could save by going to the RIGHT physical therapist, as opposed to the closest physical therapist, can be monumental.

 

Factors to consider:

  • Insurance: If you are going to go through health insurance, does the practice accept your provider? If not, what does it cost if you pay in cash?
  • Specialization: There are many generic PT’s and many generic injuries.  If there is a particular clinic that does specialize with your injury, they will likely be more knowledgeable (I.e. Pediatrics).  If you have a generic injury, you should ask if there is someone at the clinic that specializes in what you are looking for.
  • PT Attention: You may not know this, but every clinic is different in terms of how much time the Physical Therapist ACTUALLY spends with you.  If your appointment is an hour, you will likely see the Therapist as well as a PT Assistant or PT Aide.  At ESPT, our main therapist is with you for 45 minutes, but some clinics may only have their PT with you for 15 minutes.
  • Clinic Reputation: Likely, your doctor will refer you to a trusted clinic, but going online (Yelp or Google) can also be helpful.
  • PT Consistency: Will you see the same Therapist each visit?  At ESPT you will – but there are a lot of places that just put you with whomever is on the schedule.  We wholeheartedly believe in consistency, as the therapist that knows you the best will learn how to treat you the best.
  • Healing Philosophies: ESPT believes in movement.  There is ample research that has been done on why we do what we do.  The equipment, techniques, and exercises are all thought through with one goal in mind – to help you accomplish your goals. Some clinics out there will put ice or heat on you for half your session, which can be beneficial, but not if that is the main form of therapy (ALL of the time).
  • Customer Service: You can sometimes get a good idea of how customer service friendly the clinic is by simply calling and asking a few questions.  If they get back to you right away, the person is friendly, all of your questions are answered etc…it may be a sign of how good their customer service is – something that can be a vital part of your physical therapy experience.

 

Top 10 Health Hacks

Being healthy is hard.  It is time consuming. It can be expensive.  For many of us it is an ongoing effort to do something out of our comfort zone.  It takes a long time just to learn what to do. By the time you try to START executing the plan, you are exhausted.  The truth is, being healthy is hard.

Over the years, we have put together a list that we share with our patients that makes things a bit simpler.  This is not a full on workout or meal plan.  These are shortcuts that you can incorporate into your everyday life.

 

  1. Drink two cups of water within 15 minutes of waking up. This is a game changer! Your body is dehydrated when you wake up. This will help get your metabolism going as well!
  2. Drink your weight in water.  How much do you weigh? Instead of “lb,” put “oz” and drink that much water each day. Weigh 150 pounds?  Drink 150 ounces of water.  This is hard to do.  You likely won’t do it. But if you try, you may get close.  Effort is everything 🙂
  3. Workout first thing in the morning. It is hard to wake up early. However, it is also hard to work out after work.  Doing your exercise first thing in the AM, will get the blood flowing and will bring you confidence throughout the day as you know you got your workout in.
  4. Eat 3 meals a day with a few snacks in between. Try to eat balanced meals.  Skipping two meals and then eating all of your calories at dinner is not the way to lose weight.
  5. Don’t eat after 8:30 PM. Your body wasn’t built to digest food while you are sleeping.
  6. If you sit at a desk, walk every 90 minutes. It is easy to be at the office all day and not move around. Make an effort to get up, even if it’s to walk down the halls.
  7. Color your food. Your food should have color in it. I.e. Fruit and vegetables 🙂
  8. Eat and drink in moderation. Enough said. It also sounds easy, but it is not.
  9. Figure out your goals and execute from there. Half the battle is figuring out what you want for your life.  Audit your food, exercise, and drinking and figure out what you want to accomplish.  Many people go through life without a plan.
  10. Take the stairs. I love the elevator, and escalator too! But just going up the stairs is an easy way to burn more calories!

The 5 Most Common Runner’s Injuries

 

Anyone that is a “runner” knows how much it stinks when you catch the injury bug. Many of these injuries can be prevented, but if one of the following sounds familiar, see your local doctor, physical therapist, running store etc…and address the issue as soon as possible.

Hip Pain

What is it: In the hip joint, where the femur articulates with the hip – that’s called the femoral acetabulum. There’s cartilage in the joint for smooth motion, a suction effect, and some load transfer. If one or both of the surfaces of the bones is misshapen or doesn’t match up to the other side, the joint won’t move smoothly and can grind away at the cartilage. This can also happen artificially if muscles that move the hip are tight, causing an asymmetrical grinding of the joint.
Where it hurts: It’s typically a deep rear glute pain that can radiate throughout the hip. It may feel painful to sit, climb stairs, or cross your legs, and may hurt when squatting or lunging.
Why it happens: It can be a muscular imbalance that does not support the joint, or a congenital malformation.
How to rehab it: Rest and rehab work can help overcome this issue. The rehab work can include stretching, strengthen and soft-tissue work. The grinding can cause inflammation so if it is not addressed, the issue can get worse and possibly turn into a tear.
What you should’ve done before you got injured: If there is a malformation then there is nothing you could have done. Strength training and rest are two of the best things you can do to avoid this injury.

Gluteus Medius Tendinosis

What it is: Inflammation of the gluteus medius muscle
Where it hurts: Usually the lateral side of the hip when you’re standing or stepping on the affected leg. It can also feel tender along the sacrum. As you jump from one leg to the other, one hip may drop and not remain level.
Why it happens: Lack of strength in the glutes and core. Body mechanics may also become out of whack when you are running which could cause various muscles to worker harder than they should.
How to rehab it: Work on your running form, strengthen your hip, glute, and core. Single leg squats etc… are great for this.
What you should’ve done before you got injured: Working on strong hips, glutes, and core. Running drills to ensure you are running properly as well.

Stress Fracture or Reaction
What it is: A stress reaction is inflammation in the bone without evidence of a fracture. A stress fracture is the next level up: inflammation with a fracture.
Where it hurts: Could happen in many places, but the most common for runners are: femur, tibia, small toe, pelvis.
Why it happens: Diet – decreased bone density due to restricting calories. Overuse and not getting proper rest.
How to rehab it: Rest is the number one thing you can do. Also, look at your nutrition and have blood work done to see if there are any abnormalities with hormones, blood cells, etc…
What you should’ve done before you got injured: Have a balanced diet and ensure you are getting enough rest. Running is hard and the pounding your body will take is inevitable. It is important to run slow on certain days and to take days off.

Runner’s Knee
What it is: Knee pain that can result from improper tracking of the patella on the femur.
Where it hurts: The inside of the kneecap.
Why it happens: Muscular imbalances during a repetitive activity – like running – can cause pulling of the patella, causing it to track over the femur improperly. That causes friction, which leads to inflammation, which leads to pain.
How to rehab it: REST! Soft tissue work of the quads, hips, calves, and hamstrings. You should also get your biomechanics looked at. A common theme with this injury is that the knee collapses inward when you are running – commonly due to a hip weakness. There should be focus on strengthening this area. Lastly, orthotics may be able to help with the knee collapsing. Your local running store should be able to assist you with this.
What you should’ve done before you got injured: Foam rolling every day, leg strengthening, yoga, and knowing when to rest your body. If you have a biomechanical issue, those problems are magnified when your body is fatigued.

Plantar Fasciitis
What is it: Inflammation of the connective tissue on the plantar (underside) surface of the foot.
Where it hurts: The heel when you stand up after sitting. It usually gets better after taking a few steps and can even feel good in the middle of the run. The start and the end however are generally painful.
Why it happens: Overuse
How to rehab it: Rest is the number one thing you can do. Non-impact activities are also okay such as swimming or cycling. The underlying issue could be related to a weakness in the hips or core and the runner’s biomechanics should be monitored.
How to rehab it: It all starts with strength in the core, hips, and glutes. When there is a strength deficiency in one of these areas, or if something is not “firing” correctly, it can often lead to injuries in the lower extremities. Weightlifting, yoga, and stretching can be helpful in preventing this issue.

The #1 Key to Successfully Completing Your PT Plan

 

There are countless elements that go into completing a physical therapy plan.  There is the “buy in,” the resources, the relationship with the staff, but there is one thing that we have seen over the years that has continued to be a main reason why some of our clients are successful, and others are not.  That reason is: Consistency.  It sounds obvious, but the number one thing someone can do to get healed, is to actually do the work 🙂 !  Showing up for every appointment, ready to do what is asked of them over a long period of time. This also includes home exercises and even after the therapy sessions are “done.”

That sounds great, but how do I stay consistent?

This answer varies for everyone, but our big discussion with our clients is about goals.  This could range anywhere from wanting to dunk a basketball to just being able to walk again. The point being, what is the goal and how are you going to get there?  Talking with your therapist throughout the recovery process can be a motivating factor as you will see tangible progress each week.

The 1st few week are easy, but then…..

One of the most common mistakes we see clients make is that they will come to our facility and once their pain starts to fade they stop coming in.  This could be after 3-4 sessions or even 7-8 sessions.  While part of the goal is to make the pain go away, the other part is to ensure the pain does not come back.  The latter part takes time as you are building up various body components but people may not have the patience to get to the allotted 15 (or whatever the number is) sessions.  Having a “buy-in” on the entire program from the start can be a key factor here.

Positive Reinforcement

Our therapists are BIG on positive reinforcement.  We truly understand that you are taking time out of your busy schedule and that some of things we may ask you to do will be out of your comfort zone.  As we say, GROWTH COMES FROM BEING UNCOMFORTABLE.  Gaining positive reinforcement throughout your program should help you remain engaged and motivated.

If you find yourself struggling with keeping yourself on track outside of your sessions, speak up!
Experiencing struggles, for any reason, during recovery is normal. It happens to the best of us. Taking the initiative and opening that line of communication between you and your Physical Therapist will help. Being honest about those struggles and communicating with your Physical

Keep working hard! 

 

6 Exercises to Relieve Lower Back Pain

The reason people might experience lower back pain typically is from compensation. The anatomy of our lumbar spine is meant for stability. There is very little degrees of motion associated in the lumbar spine compared to other segments in the body. If we look at our body as a whole kinetic chain, our ankles were designed for mobility, knees for stability, hips for mobility, lumbar spine for stability, thoracic spine for mobility, cervical spine for stability and shoulders for mobility. When this sequence is disturbed we tend to have more pain.

Early Specialization Versus Diversification in Youth Athletes

In recent decades the landscape of youth athletics has changed. Increased participation in competitive athletics has been seen over the past 50 years (National Federation of State High School Associations, 2016-2017).1 Another recent phenomenon is the increasing number of young athletes concentrating on a single sport, commonly referred to as early specialization. Early specialization is often sought out by these young athletes due to sensationalized, highly successful athletes who specialize early including Tiger Woods, Tara Lipinski, Venus and Serena Williams to name a few. Additional influences towards early specialization include parents, coaches, and peers whom often believe that sport specialization is needed to compete with other athletes at the highest level.

The Mystery of a Foot Stress Fracture

From an outsider’s point of view, it looks like running is a low-risk sport. There’s no contact, no jumping, and no fancy footwork necessary. But runners know that this is just a facade, and that running creates plenty of risks for the runner. The good news is that there are a number of ways to tweak training, conditioning, technique, and so forth that can help runners stay well. The bad news is that even the most prudent of runners can often find themselves at the mercy of common injuries, like a stress fracture in the foot.