Why choose a myofascial release approach versus massage therapy approach to treat fibromyalgia?

Lauradonna Manno, DPT

Myofascial release is a safe and effective hands-on technique that involves applying gentle sustained pressure into the Myofascial connective tissue restrictions to eliminate pain and restore motion. This essential “time element” allows a viscous flow and the piezoelectric phenomenon: gentle pressure applied slowly will allow a viscoelastic fascia to elongate.

Fascia is very densely woven, covering and interpenetrating every muscle, bone, nerve, artery and vein, as well as, all of our internal organs including the heart, lungs, brain and spinal cord.

 Swedish Massage can be a variety of techniques specifically designed to relax muscles by applying pressure to them against deeper muscles and bones, and rubbing in the same direction as the flow of blood returning to the heart.

A study of 12 participants, 8 receiving myofascial release treatment by a licensed physical therapist and 4 participants receiving a Swedish massage by a licensed therapist.  Each treatment was 90 minutes long, 1 time per week for 4 weeks to the neck, back, legs, and arms.  

 After treatment each group completing the Fibromyalgia Impact Questionnaire Revised (FIQ-R) and the modified Nordic Musculoskeletal Questionnaire.  They each showed improvement however the myofascial release group had higher scores on the questionnaires.

Reference:

1. A pilot study of myofascial release therapy compared to Swedish massage in  

    Fibromyalgia    Liptan G, Mist S, Wright C, Arzt A, Jones KD

2. John F. Barnes’ Myofascial Release Approach

Physical Therapy, Strokes, and Depression

By: Lauradonna Manno, DPT

About 600,000 American men and women experience a first or recurrent stroke each year. Major depression is seen in about 10 to 27 percent of them. Unfortunately when depression occurs following a stroke it is frequently undiagnosed and untreated. Up to 40 percent of stroke survivors will experience symptoms of depression within the first two months.

Depression can occur in anyone, of any age; however, people who had a stroke are at a greater risk of feeling depressed. This should not go untreated and each diagnosis should be treated separately.

Treating depression will help the patient who has had a stroke improve their medical status, enhance their quality of life, reduce pain, shorten the rehabilitation process, and lead to an earlier community integration. Treatment for depression in stroke patients should be directed by a mental health professional such as a psychiatrist, psychologist, or clinical social worker who works closely with the physician providing the post-stroke rehabilitation and treatment.

Persons with stroke related depression, especially those with major depressive disorder, may be less compliant with rehabilitation, more irritable, and may experience personality change.

Although signs or symptoms of depression may overlap with post-stroke symptoms, skilled health professionals at AgeWell will:

• Recognize the symptoms of depression
• Inquire about their duration and severity
• Refer to the appropriate health care professional

Aging with Multiple sclerosis

By: Lauradonna D'Antoni, DPT

Multiple sclerosis (MS) is an inflammatory disease where myelin sheaths around the axons of the brain and spinal cord are damaged, causing demyelination and scarring as well as a broad spectrum of signs and symptoms. MS is more commonly found in young adult women approximately 75 per 100,000 people. Multiple Sclerosis is highly affected by temperature.

Those who have MS need to be cautions of their environmental temperatures.

Many people with MS experience a temporary worsening of their symptoms when the weather is very hot or humid, they run a fever, sunbathe, get overheated from exercise, or take very hot showers or baths. Some people with MS report temporary blurred vision when they get overheated. These temporary changes can result from even a very slight elevation in core body temperature. A change in temperature by one-quarter to one-half of a degree higher can impair the ability of the demyelinated nerve to conduct electrical impulses. Many years ago a “Hot Bath” test was used to diagnose MS and see if the patients symptoms would be exacerbated.

Some things to keep in mind during hot and humid temperatures:

1. You should stay in air-conditioned rooms during times of extreme heat and humidity.
2. You should use cold compresses, bandanas or hats for cooling methods.
3. It is important to wear lightweight, loose, breathable clothing.
4. It is also advised to always have cold water or an icy drink available in hot temperatures.
5. Exercise should be done in a cool environment, such as pool of less than 85 degrees.

Some MS patients notice symptoms in very cold weather, usually spasticity. At AgeWell Physical Therapy, MS is a treated diagnosis. We allow for MS patient’s to exercise in a cool controlled climate under the supervision of our professional staff to help control symptoms.

CrossFit Shared at AgeWell

By Caitlin DellaValle, MS, OTR/L

I have been training with the CrossFit program for over a year. After being introduced to the exercise regiment it has quickly become an integral part of my life. CrossFit (CF) is a principal strength and conditioning program. It delivers fitness that is by design broad, general and inclusive. CF programs are designed for universal ability, making it the perfect application for any individual regardless of experience.

Using what I was doing in my own workouts, I transferred some of the CF activities to the daily treatments I was providing at AgeWell. Clients at AgeWell were able to participate in CF derived therapeutic exercise. Using combined movements like an overhead reach with a squat, my clients received the benefit of weight training integrated with cardiovascular exercise. The movements are also functional! Think of all the times we stand up from a chair to lift an item overhead, or retrieve an object from a high shelf.

CF also taught me about new eating habits, particularly the Paelo Diet. I shared this diet guideline with some clients at AgeWell and 2 people decided to try the diet. After checking with their doctor they started eating the Paleo way. A diet high in protein, fruits, veggies and natural fats like olive oil and nuts. They reported weight loss, decreased blood sugar levels and improved energy.

I am happy to be involved in CF. I feel physically fit and full of energy. I am very proud to have had AgeWell clients participate in the CF experience!

BOWEL AND BLADDER UPDATE

By Lauradonna D’Antoni DPT, Pelvic Girdle Therapist

How can you prevent changes in your bowel and bladder?

Many of us live a busy lifestyle, too much on our mind, and not enough time for ourselves. Making minor changes in our life can prevent us from forming bad habits. Did you know that stress and time management, as well as diet play a big role in our bowel and bladder functioning properly.

At some point in our lives we may experience difficulty with our urological and gastrointestinal systems. A fair amount of the population does not seek medical attention for these changes until they are well advanced.

How do we know if a problem is really a problem?

Some guidelines to be aware of are:

Frequency/Urgency: Normal urination should be every 3-4 hours during the day and one should be able to sleep throughout the night without waking up to urinate.

JIC : “Just In Case” Many of us train our bladder to empty when it is not full. Going to urinate just in case prior to leaving the house or doing an activity is a poor habit to start. This will irritate your bladder.

Pain: We should never feel pain with urgency/frequency, urinating, or during bowel movements.

Bowel movements: Normal can be 2x/week to 3x/day. Constipation becomes a problem when our normal value decreases.

If you do experience any of these problems you should see your medical doctor, urologist, gynecologist, or gastrointestinal specialist who can evaluate, diagnose and treat you including prescribing physical therapy treatment.

How does this relate to physical therapy?

If you are seeking a physical therapist for any of these problems he or she should specialize in pelvic floor physical therapy. The pelvic floor physical therapist can teach you proper techniques to retrain your bowel and bladder issues, educate on proper diet and fluid intake as well as retraining you pelvic floor muscles. In some cases manual physical therapy is warranted to decrease pelvic pain and relax high toned muscles.

Lee National Denim Day at AgeWell

October is recognized as National Breast Cancer Awareness Month, and this year, AgeWell supported the effort dedicated to education, awareness and empowerment.

On October 8^th 2010, AgeWell participated in Lee National Denim Day. Denim Day is a single day fundraiser when participants across the country join together in wearing jeans and making a $5.00 donation to help in the fight against breast cancer. Since its inception in 1996, Denim Day has raised more than $80 million for breast cancer research and patient education.

AgeWell’s patients and employees were proud participants in the day dedicated to awareness, education, empowerment, denim and all things pink! United in the effort to recognize the importance in the fight against cancer, AgeWell raised over $260. Sincere thanks and appreciation go out to all of those who participated in such an important cause!

Medicare Cuts to Physical Therapy Benefits = No Care for Seniors?

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WSPT reposted this blog regarding the Medicare benefits that are proposed to be cut very soon. Please click on the comment below to share your thoughts with us.

Medicare Cuts to Physical Therapy Benefits = No Care for Seniors?
More than likely.

It may not be well known that insurance companies across the board have significantly cut payouts to physical therapists making it increasingly difficult for practices to accept all insurance plans as it’s become impossible to support a business or a staff based on the cuts. If you have one of these insurancecompanies, then you know precisely what I’m talking about as I’m sure you’ve had difficulty finding providers that are in network or your co- pays are so high you can’t afford to go. Private companies are, of course, free to do as they wish and PT’s are free to choose not to accept those plans. Who loses? The consumer.

Now Medicare patients may be severely affected by a new regulations
proposal. Currently, there is a government proposed regulation to deeply cut Medicare payouts to Physical Therapy providers. The cuts are so severe it will simply put practices out of business or ensure no practice accepts Medicare in the future. What does this mean for Medicare patients? No treatment. Is it fair to tell people who’ve paid into a system their entire lives that they will no longer have access to treatment? Consider how it will effect a person who breaks a hip. Without PT, the hip will certainly heal, but the musculature will atrophy to a point the patient will be disabled or on their own to figure out how to walk again. Best case scenario, the patient lives in pain and walks with a limp and the worst case is another fall, another break, another stint in the hospital. For those only interested in the bottom line, how is that cost efficient? Obviously, it isn’t a good situation for the patient.

Arguably, the lack of physical therapy will create a boom for the nursing home industry as older people with injuries won’t be able to recover without treatment and forced into homes. Again, who suffers? The consumer. Why?
Not only do they face the possibility of being debilitated, but they will
also have to give up their homes and lives to go live in a facility of
Medicare’s choosing. Sounds great, right? If you’re like me and think this sounds reprehensible, then you can have your voice heard. Medicare is NOT a private company, it is a government run (albeit into the ground) program that WE fund with every paycheck. Click the link below and let the government know this is unacceptable. We only have two weeks to fight this so spread the word and don’t let them get away with it.

Dana Tamuccio

Duffy & Bracken Physical Therapy