Physical Therapy First?

Since October is National Physical Therapy Month, we would like to dispel a persistent myth about physical therapy.  That myth is that you always need to see a physician first to get referred to a physical therapist.

Current Pennsylvania law allows consumers to access certain physical therapists without a physician referral for up to 30 calendar days of care.  The catch here is knowing which physical therapists are legally allowed to practice under these “direct access” laws.  Here at Advanced Physical Therapy and Fitness all of the physical therapists have direct access licenses and are therefore legally allowed to examine, evaluate and treat patients for up to 30 calendar days without a physician’s referral.  Physical Therapist who possess this license have special training and continuing education to help them recognize “red flags” or signs or symptoms that may be indicative of a more serious condition or a non-musculoskeletal condition while examining and treating you. Unfortunately, patients’ that have Medicare or Medicare Advantage Plans must have a referral because that is a federal law.  A few insurances also require a physician referral for treatment from a physical therapist to be paid so you may want to verify with your insurer prior to making your appointment to see a physical therapist.

So, next time you hurt your back, have a stiff neck that doesn’t get better, sprain a knee or ankle being a weekend warrior, or hurt your shoulder painting that ceiling, consider seeing your physical therapist first.  Check out this YouTube video and see how physical therapy can help you manage pain:

Get started on the healing track sooner and avoid complications.  Stay active, stay healthy and choose physical therapy first!


Kayaking Fun and Fitness

Recreational kayaking is an enjoyable activity here in central Pennsylvania due to many easily accessible waterways located close by.  It is a way to get away from the general population and experience wildlife, flora and fauna that an individual walking or biking may not be able to access.

It is important for a beginner kayaker to have a proper fitting boat and paddle to make the activity more enjoyable and decrease risk of injury.  It is also very important to be educated in basic paddling skills as well as safety measures to take as both moving water and lakes and ponds can be hazardous.

It is advantageous for both beginner and experienced paddlers to begin a conditioning program for the upper body prior to paddling season to maximize enjoyment and prevent injuries.  Kayaking is mainly an upper body activity which requires that the shoulder musculature be in good condition as well as shoulder position be optimal to prevent impingement injuries.  Forward positioned shoulders are at risk for injuries involving the rotator cuff tendons and at times the long head of the biceps tendon.  Ensuring that the shoulders are positioned back and down, and the joint has good mobility will decrease the risk of overuse injuries.  It is best not to ignore pain in and around the shoulder and think that you can just work through it.  No pain, no gain is not the appropriate approach when dealing with overuse injuries.  Shoulder stretches include a doorway stretch which improves flexibility of the pectoralis major which is a large contributor to the forward position of your upper arm.  Also, a sleeper stretch to improve the mobility in the posterior capsule of the shoulder will improve shoulder position.  I recommend holding stretches for up to 30 seconds and completing 3 times when your body tissues are warm.

Strengthening exercises for shoulders

Important strengthening exercises for the shoulders include the internal and external rotators of the shoulder joint, the middle trapezius, posterior deltoid and rhomboids in the back to help maintain good posture  There are many other exercises to help improve shoulder function and prevent injury.  We recommend seeking advice and/or treatment from the movement experts, the physical therapists of Advanced Physical Therapy and Fitness.  As always, stay active and have fun!

By Land or By Sea: Why water may not be the best for all rehab needs.

Water-based exercise or therapy has many benefits, including easing of stiff joints and muscles, improving endurance, reducing pain, and possibly enhancing your sense of well-being, mood and sleep quality.

But is it the answer when strengthening is required to recover from an illness or injury?  A recent review and analysis of numerous studies on the effectiveness of aquatic-based exercises in improving lower limb strength in people with musculoskeletal conditions indicates that it may not yield the results at the same rate it is being practiced currently.

The review studies indicated that there was no difference in the strength of the studied lower limb muscle groups between aquatic exercise and no exercise.  The analysis concluded that there is inadequate application of resistance in water exercise which likely leads to minimal to no strength gains.  More research is needed to help determine if using methods of greater resistance in the water along with appropriate resistance training principles can be more effective at improving muscle strength.

The take-away message from this may be that if your physical therapist or doctor feels your condition needs strengthening to improve, your best bet may be land-based therapy or a combination of land and water-based treatment.

Thank you for reading.  Stay active and give us a call today to see if we can help.

Stephany Primrose, PT

Reference: Effectiveness of Aquatic Exercise in Improving Lower Limb Strength in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis 2016


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  Disclaimer:  The information in this medical library is intended for informational and educational purposes only and in no way should be taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.