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Managing Low Back Pain Upon Completion of Physical Therapy: Consider the Benefits of Yoga

By Debra Anderson, DPT

The World Health Organization estimates the lifetime prevalence of non-specific low back pain will affect 60-70% of individuals. Low back pain is also the leading cause of limited activity and one of the most common reasons for missing work. Physical therapy is known to be very effective in treating low back pain. Whether through exercises, stretches, manual interventions, or a combination of the three, physical therapy will help you learn more about the possible cause of your low back pain and how to decrease or omit the pain. When you complete your course of physical therapy, it’s possible you still might have a little pain, but you will have exercises and other tools to help manage or improve any residual pain. 

But what if you want something more you can do on your own to maintain all of the gains you achieved in physical therapy? What if you now feel you are able to exercise more, but you aren’t sure what would be a good type of exercise to continue targeting your chronic low back pain? While there are many ways to continue getting stronger and more active to manage residual pain, one well researched type of exercise stands out: Yoga.

Physical Therapy and Yoga

How Yoga Can Help Alleviate Lower Back Pain

Yoga is something we all have different opinions on. Some of us love it and practice it daily, others aren’t fond of the idea as it seems far too easy. Then there are those of us who dabble in it here and there but have never really committed. But if there’s one thing all of us can agree on, it’s that yoga is good for you. But what is it that makes it so good for you? Is it all the stretching? The calming effect that accompanies it? The core stabilization? Yes to all of the above, and one more that we don’t always think about – the benefits of helping manage chronic low back pain.

There have been numerous studies examining the connection between yoga and the benefits it provides to managing low back pain. The general consensus is that yoga is a safe and effective method to reduce pain and improve confidence.

Why Yoga Is Helpful for Managing Chronic Pain

Yoga has been around for thousands of years. It is a practice that encompasses several different components: strengthening, stretching, postural awareness poses, relaxation and meditation, and breathing techniques. Research shows that the approach of combining mind and body for the treatment of chronic pain is much more effective than only focusing on the pain and exercises or medication to treat it. Yoga is a perfect melding of this biophysiological approach of addressing chronic pain.

Another positive aspect of yoga is the many different types of yoga that enables one to choose the style that works best for them. Additionally, each pose the teacher instructs you to achieve is just a suggestion. If a pose does not feel good to you, there are modifications you can make for improved comfort. Instructors encourage you to listen to your body and only practice poses that feel right for you.

Common Types of Yoga

A few of the most common types of yoga:

Hatha 

  • A great type of yoga for beginners, Hatha yoga is a slow paced class focused on learning different postures and focusing on breathing techniques. This technique will build on the core stabilization exercises you learned in physical therapy. You will work on maintaining a stable core and holding it for prolonged time during different positions.

Restorative

  • Restorative yoga uses props such as blankets and blocks to enable you to easily rest into poses without having to put forth too much effort. You will work on holding deep stretches for several minutes to achieve the maximum benefit. These classes can be very calming and are a good way to unwind after a long week of work.

Vinyasa 

  • No two Vinyasa classes are the same, so if you dislike routine this may be the class for you. This style of yoga focuses on fluid movement between poses while focusing on breathing techniques linked to each move. You will work on challenge your core stability while smoothly transitioning from pose to pose. 

If none of these styles sound like they’re up your alley not to worry. There are several more traditional styles not listed above that may fit into your goals and preferred exercise method. There are also quite a few non-traditional styles of yoga including aerial yoga, stand up paddleboard yoga, acro yoga, and goat yoga – yes, this style has baby goats joining you all through the class.

Yoga is an all inclusive style of exercise that can benefit anyone who is willing to give it a try. So if you still have occasional nagging low back pain, it might be worth signing up for a yoga class or two at your local gym after completing your physical therapy course of care. Talk to us and we can help you find a yoga instructor or studio that is right for you. If you find that you enjoy it, it can be a great way to keep your mind and body healthy throughout your entire life. 

Yoga and Physical Therapy

Summary:

Yoga not only increases your flexibility and core strength, it also improves your confidence. Simply knowing that you have the power to manage your residual low back pain can make a monumental difference when it comes to the frustration that can accompany the seemingly never ending battle of low back pain. 

Whether you choose to stick with yoga videos you can complete in the privacy of your living room, or venture out to an Ashtanga or a Hot Yoga class, you now know you are doing even more for your health and well being.

The physical therapists at Rose City Physical Therapy would love to work with you and help guide you along a functional program targeted at addressing your low back pain. After completing your course of physical therapy, we would be happy to help connect you with local yoga studios with instructors that will guide you through yoga poses and techniques suited to your individual goals.

REFERENCES: 

httpss://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878447/

Chang DG, Holt JA, Sklar M, Groessl EJ. Yoga as a treatment for chronic low back pain: A systematic review of the literature. J Orthop Rheumatol. 2016;3(1):1–8.

httpss://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805350/

Holtzman, S., & Beggs, R. T. (2013). Yoga for chronic low back pain: a meta-analysis of randomized controlled trials. Pain research & management, 18(5), 267–272. 

httpss://www.pennmedicine.org/updates/blogs/neuroscience-blog/2017/april/physical-therapy-for-spine-pain

httpss://www.gaiam.com/blogs/discover/a-beginners-guide-to-8-major-styles-of-yoga

httpss://www.doyouyoga.com/the-4-most-popular-types-of-yoga-explained/

httpss://www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf

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Physical Therapy for Arthritis

Physical Therapy for Arthritis

Article Featured on Arthritis.org

May is National Arthritis Month and Rose City Physical Therapy would like to spread the word about joint health, prevention, and treatment. Arthritis is one of the most widespread health conditions in the United States affecting one in four adults – over 54 million men and women. We’ve selected a few articles that highlight the important relationship between arthritis and your diet – including which diets can reduce arthritis inflammation, what foods to avoid, and how physical therapy can reduce joint inflammation.

A physical therapist (PT) can help you get moving safely and effectively. Physical therapists are licensed professionals with graduate degrees and clinical experience who examine, diagnose and treat or help prevent conditions that limit the body’s ability to move and function in daily life, according to the American Physical Therapy Association (APTA).

Physical therapy focuses on the body’s ability to engage in movement. Movement can be anything from getting in and out of chairs to climbing stairs, walking in your neighborhood, playing a sport or doing recreational activities.

Goals of physical therapy in arthritis include improving the mobility and restoring the use of affected joints, increasing strength to support the joints, and maintaining fitness and the ability to perform daily activities.

What Can a Physical Therapist Do for You?

  • Develop an individualized plan of exercises to improve flexibility, strength, coordination and balance to achieve optimal physical function.
  • Teach you proper posture and body mechanics for common daily activities to relieve pain and improve function.
  • Show you how to properly use assistive devices such as walkers and canes.
  • Recommend different treatment options, such as braces and splints to support joints, shoe inserts to relieve stress on the lower extremities, and hot and cold therapy to ease joint pain and stiffness.
  • Suggest modifications to your environment, such as ergonomic chairs or a cushioned mat in your kitchen, to relieve pain and improve function.

What Does a Physical Therapy Session Look Like?

The goal of a physical therapy session is to teach you how to do things in your treatment plan – such as performing certain exercises, or learn to adapt functional activities – for yourself. The visits are often short and focus on identifying problems with your physical function and giving strategies for care that you can do at home.

The key to a successful outcome is learning the exercises from a physical therapist and practicing them at home over the long term. Improvement is gradual – the body gets stronger and more adept slowly over time – so consistent practice is essential.

When visiting the PT, think clearly about what your complaint is and what you would like to be able to do after physical therapy. Your goal can be getting in and out of your car without pain, raising up on your toes or raising your arms to reach items in your kitchen cabinets, taking a walk or performing your job without pain in the hips, knees and feet. Your PT can then work with you to develop a plan that is right for you to achieve your goals.

In most cases, you don’t need to see the PT every week. Periodic visits every few months are sufficient to update your program if necessary. When you experience a change in your health – such as a flare in your arthritis that causes you to fall behind in your exercise program or involvement of a different joint that affects another area of function – you can return to the physical therapist to update your exercise program and treatment strategy.

How to Find a Physical Therapist?

If you are interested in seeing a PT, ask your doctor for a recommendation. You may not need a doctor’s referral to see a PT, but check with your insurance to make sure it will be covered. Your insurance may also limit the number of sessions for a particular problem, so make sure you know this information before you see a PT.

If you’d like to know more about reducing arthritis inflammation, and how physical therapy can reduce joint pain from arthritis, contact Rose City Physical Therapy today.

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Osteoarthritis & Diet: Inflammation Fighting Foods and the Ultimate Arthritis Diet

OSTEOARTHRITIS & DIET: INFLAMMATION FIGHTING FOODS AND THE ULTIMATE ARTHRITIS DIET

May is National Arthritis Month and Rose City Physical Therapy would like to spread the word about joint health, prevention, and treatment. Arthritis is one of the most widespread health conditions in the United States affecting one in four adults – over 54 million men and women. We’ve selected a few articles that highlight the important relationship between arthritis and your diet – including which diets can reduce arthritis inflammation and what foods to avoid.

If you are one of the 30 million in the U.S. who suffer from OA, or osteoarthritis, you probably spend a fair amount of time looking for ways to help reduce your joint pain and stiffness.  Of course, an individualized rehabilitation exercise program that includes specific stretching and strengthening exercises can go a long way to help increase your mobility and improve function.  You might be surprised to learn, however, that you can find some healthy solutions in your cupboard as well.  In this post, we will outline some healthy dietary tips that may be able to help you with your achy joints by introducing inflammation-fighting foods into your diet.

The Vicious Cycle of Low Nutritional Value Food

The Vicious Cycle of Low Nutritional Value Food

The human body requires a wide variety of vitamins and minerals, along with key components such as quality proteins and healthy fats in order to function most effectively.  In many cases, however, people rely on foods that offer little in the way of good nutritional value, thereby depriving their body of the fundamental building blocks it needs.  For those with diets that rely heavily on refined carbohydrates such as crackers, potato chips, and white bread, along with a continual dose of sugar found in most beverages, snacks, and candies, it means their body is receiving little in the way of proper nutritional support.  In fact, many seemingly innocuous foods like tomato sauce, canned beans, fruit juices, and condiments such as ketchup and relish, might not “seem that bad”, but looking at the label shows that sugar lurks within their ingredients.

Without a conscious effort and continual diligence to maintain a healthy diet, many people continue with the cycle of trying to feed their hunger with low nutritional value foods.  Their body is not getting what it truly needs to function well, so it calls out for more food, leading individuals to reach for the first available food, thus continuing the cycle.  Is it any wonder then that many Americans struggle with obesity, thus putting even more stress and pressure on their joints?

How to Break the Cycle

Feeding your body what it truly needs can help break the cycle of hunger, poor food choices, and weight gain, followed by increasingly achy joints.  To start, read the labels of all the foods you are putting in your body.  Pay particular attention to any added sugar, along with high levels of carbohydrates and/or saturated fat.  You might be surprised at some of the “healthy” foods you were eating are loaded with things that offer little in the way of properly fueling your body.  Focus on eating unprocessed, whole foods such as avocado or broccoli from the produce area and use spices or a little garlic to add taste appeal.  If you aren’t sure what spices will make your food taste good, read the labels of some spice mixes.  If they don’t add any salt, then buy the mix.  Otherwise, make note of the spices they include in their mix and buy them individually.  Then make your own spice mix without salt.

Supporting Joints Through Diet

Supporting Joints Through Diet

Foods that offer inflammation dampening properties are of high value for osteoarthritis sufferers.  Bone health is also important for individuals with OA, so a diet high in Vitamin D and calcium sources such as quality dairy choices is desirable as well.  This includes no or low-fat cottage cheese and Greek yogurts, along with reduced or no fat cheeses and milk, all of which will help provide sufficient amounts of calcium and Vitamin D.  Dark, leafy greens such as broccoli, chard, kale, collard greens, and spinach can help provide joints with important nutrients such as Vitamin C, Vitamin K, Vitamin D and Vitamin A.  All of these foods have wonderful inflammation reducing properties.

In addition, try to reduce the amount of red meat in your diet which is loaded with saturated fat.  Instead, focus more on including oily fish choices such as tuna, mackerel, salmon and sardines.  If you just cannot bring yourself to try fish, then at least supplement your diet with krill or fish oil pills or flaxseed oil.  For snacks, reach for nuts instead of crackers.  They are loaded with nutrients and will actually feed your body, making it less likely you will continue to crave more food.  Green tea is a great choice for a beverage.  Instead of adding sugar for sweetness, add a little stevia instead.

The Ultimate Arthritis Diet

One of the most common questions people with any form of arthritis have is, “Is there an arthritis diet?” Or more to the point, “What can I eat to help my joints?”

The answer, fortunately, is that many foods can help. Following a diet low in processed foods and saturated fat and rich in fruits, vegetables, fish, nuts and beans is great for your body. If this advice looks familiar, it’s because these are the principles of the so-called Mediterranean diet, which is frequently touted for its anti-aging, disease-fighting powers.

Studies confirm eating these foods can do the following:

  • Lower blood pressure
  • Protect against chronic conditions ranging from cancer to stroke
  • Help arthritis by curbing inflammation
  • Benefit your joints as well as your heart
  • Lead to weight loss, which makes a huge difference in managing joint pain.

Whether you call it a Mediterranean diet, an anti-inflammatory diet or simply an arthritis diet, here’s a look at key foods to focus on – and why they’re so good for joint health.

Fish - The Ultimate Arthritis Diet

Fish

How much: Health auth­orities like The American Heart Association and the Academy of Nutrition and Dietetics recommend three to four ounces of fish, twice a week. Arthritis experts claim more is better.

Why: Some types of fish are good sources of inflammation-fighting omega-3 fatty acids. A study of 727 postmenopausal women, published in the Journal of Nutrition in 2004, found those who had the highest consumption of omega-3s had lower levels of two inflammatory proteins: C-reactive protein (CRP) and interleukin-6.

More recently, researchers have shown that taking fish oil supplements helps reduce joint swelling and pain, duration of morning stiffness and disease activity among people who have rheumatoid arthritis (RA).

Best sources: Salmon, tuna, sardines, herring, anchovies, scallops and other cold-water fish. Hate fish? Take a supplement. Studies show that taking 600 to 1,000 mg of fish oil daily eases joint stiffness, tenderness, pain and swelling.

Nuts & Seeds: Fish - The Ultimate Arthritis Diet

Nuts & Seeds

How much: Eat 1.5 ounces of nuts daily (one ounce is about one handful).

Why: “Multiple studies confirm the role of nuts in an anti-inflammatory diet,” explains José M. Ordovás, PhD, director of nutrition and genomics at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston.

A study published in The American Journal of Clinical Nutrition in 2011 found that over a 15-year period, men and women who consumed the most nuts had a 51 percent lower risk of dying from an inflammatory disease (like RA) compared with those who ate the fewest nuts. Another study, published in the journal Circulation in 2001 found that subjects with lower levels of vitamin B6 – found in most nuts – had higher levels of inflammatory markers.

More good news: Nuts are jam-packed with inflammation-fighting monounsaturated fat. And though they’re relatively high in fat and calories, studies show noshing on nuts promotes weight loss because their protein, fiber and monounsaturated fats are satiating. “Just keep in mind that more is not always better,” says Ordovás.

Best sources: Walnuts, pine nuts, pistachios and almonds.

Fruits & Veggies: The Ultimate Arthritis Diet

Fruits & Veggies

How much: Aim for nine or more servings daily (one serving = 1 cup of most veggies or fruit or 2 cups raw leafy greens).

Why: Fruits and vegetables are loaded with antioxidants. These potent chem­icals act as the body’s natural defense system, helping to neutralize unstable molecules called free radicals that can damage cells.

Research has shown that anthocyanins found in cherries and other red and purple fruits like strawberries, raspberries, blueberries and blackberries have an anti-inflammatory effect.

Citrus fruits – like oranges, grapefruits and limes – are rich in vitamin C. Research shows getting the right amount of that vitamin aids in preventing inflammatory arthritis and maintaining healthy joints.

Other research suggests eating vitamin K-rich veggies like broccoli, spinach, lettuce, kale and cabbage dramatically reduces inflammatory markers in the blood.

Best sources: Colorful fruits and veggies – the darker or more brilliant the color, the more antioxidants it has. Good ones include blueberries, cherries, spinach, kale and broccoli.

Olive Oil: The Ultimate Arthritis Diet

Olive Oil

How much: Two to three tablespoons daily

Why: Olive oil is loaded with heart-healthy fats, as well as oleocanthal, which has properties similar to nonsteroidal, anti-inflammatory drugs. “This compound inhibits activity of COX enzymes, with a pharmacological action similar to ibuprofen,” says Ordovás. Inhibiting these enzymes dampens the body’s inflammatory processes and reduces pain sensitivity.

Best sources: Extra virgin olive oil goes through less refining and processing, so it retains more nutrients than standard varieties. And it’s not the only oil with health benefits. Avocado and safflower oils have shown cholesterol-lowering properties while walnut oil has 10 times the omega-3s that olive oil has.

Legumes: The Ultimate Arthritis Diet

Beans

How much: About one cup, twice a week (or more)

Why: Beans are loaded with fiber and phytonutrients, which help lower CRP, an indi­cator of inflammation found in the blood. At high levels, CRP could indicate anything from an infection to RA. In a study published in The Journal of Food Composition and Analysis in 2012, scientists analyzed the nutrient content of 10 common bean varieties and identified a host of antioxidant and anti-inflammatory compounds.

Beans are also an excellent and inexpensive source of protein, with about 15 grams per cup, which is important for muscle health.

Best sources: Small red beans, red kidney beans and pinto beans rank among the U.S. Department of Agriculture’s top four antioxidant-containing foods (wild blueberries being in the number 2 spot).

Grains & Seeds: The Ultimate Arthritis Diet

Whole Grains

How much: Eat a total of 6 ounces of grains per day; at least 3 of which should come from whole grains. One ounce of whole grain would be equal to ½ cup cooked brown rice or 1 slice of whole-wheat bread.

Why: Whole grains contain plenty of filling fiber – which can help you maintain a healthy weight. Some studies have also shown that fiber and fiber-rich foods can lower blood levels of the inflammatory marker C-reactive protein.

Best sources: Eat foods made with the entire grain kernel, like whole-wheat flour, oatmeal, bulgur, brown rice, quinoa. Some people may need to be careful about which whole grains they eat. Gluten – a protein found in wheat and other grains – has been linked to inflammation for some people.”

Nightshades: The Ultimate Arthritis Diet

Should You Avoid Nightshades?

Nightshade vegetables, including eggplant, tomatoes, red bell peppers and potatoes, are disease-fighting power­houses that boast maximum nutrition for minimal calories.

They also contain solanine, a chemical that has been branded the culprit in arthritis pain. There’s no scientific evidence to suggest that nightshades trigger arthritis flares. In fact, some experts believe these vegetables contain a potent nutrient mix that helps inhibit arthritis pain.

However, many people do report significant symptom relief when they avoid nightshade vegetables. So doctors say, if you notice that your arthritis pain flares after eating them, do a test and try eliminating all nightshade vegetables from your diet for a few weeks to see if it makes a difference.

Summary

By focusing on foods that can potentially reduce arthritis inflammation, you may find your cravings are reduced because you are finally feeding your body what it needs. In turn, you may find yourself losing some weight thus reducing stress on your joints. By searching online for “inflammation reducing recipes” or “foods for osteoarthritis”, you can open yourself up to an entirely new way of eating that is healthy and delicious.

Rose City Physical Therapy is publishing a series of articles for National Arthritis Month. Be sure to check back next week to learn how physical therapy can reduce joint pain and inflammation from arthritis. Contact Rose City Physical Therapy today if you’d like to know more about how physical therapy can reduce joint pain and improve motor function.

 

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When Diet Worsens Osteoarthritis Pain

When Diet Worsens Osteoarthritis Pain

May is National Arthritis Month and Rose City Physical Therapy would like to spread the word about joint health, prevention, and treatment. Arthritis is one of the most widespread health conditions in the United States affecting one in four adults – over 54 million men and women. We’ve selected a few articles that highlight the important relationship between arthritis and your diet – including which diets can reduce arthritis inflammation and what foods to avoid.

Read more

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Large-Scale Investigation: Falls-Prevention Exercise Interventions Work

Large-Scale Investigation: Falls-Prevention Exercise Interventions Work

Article Featured on APTA

An extensive review of more than 100 randomized controlled trials (RCTs) strongly supports exercise interventions as a way to reduce both the risk of falls among adults 65 and older and the actual number of those who experience a fall. What’s less clear are some of the nuances of that finding—such as the effectiveness of resistance training or walking programs, and the differences between interventions provided by “health professionals” versus “trained providers who were not health professionals.”

Read more

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When Can I Return To Sport After ACL Surgery?

When Can I Return To Sport After ACL Surgery?

Article by Mick Hughes | Featured on mickhughes.physio.com

This question is one that I get asked often by patients who are planning surgery after rupturing their ACL. Unfortunately for my patients, I don’t have an answer that makes them feel warm and fuzzy on the inside.

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Mechanisms of Noncontact ACL Injuries: Implications for Rehabilitation and Injury Prevention

Mechanisms of Noncontact ACL Injuries: Implications for Rehabilitation and Injury Prevention

Article by Mike Reinold | Featured on mikereinold.com

Great systemic review in the July-August issue of Journal of Athletic Training reviewing noncontact mechanisms of ACL injuries.  Actually the issue has a few articles that I like and will be reviewing in future posts. While none of the information in this article is necessarily new, the authors did a great job putting all the relevant information together in one resource.

Read more
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Concussion Rates: What Sport Has The Most Concussions?

Concussion Rates: What Sport Has The Most Concussions?

Article Featured on Complete Concussion Management

Concussion is a serious concern for all athletes, particularly for those involved in contact, high-speed or collision sports. These injuries have become a significant issue for certain sports. In fact, some contact sports, such as American or tackle football, are seeing a decline in registration and participation year over year.

But, what sport – or sports – has the most concussions? What sports have higher concussion rates? What sports pose the greatest risk to athletes?

Looking at the research on concussion rates

There have been several large-scale epidemiological studies, which have examined the incidence rate of concussions in various sports for male and female athletes. Many of these studies look at the concussion rates in practices compared to games as well as youth sports compared to adult sports.

We went through some of the research using recent systematic reviews and meta-analyses – which are basically a collection of ALL the research put together – to bring you a summary of the sports with the highest risk for concussion.

The results may surprise you…

Athletic exposures: how we measure concussion rates

The rate of concussion is generally measured in ‘Athlete Exposures’ (AE). This is defined as one athlete participating in one game or practice.

The numbers for concussion incidence rate are typically shown as “X” per 1,000 AE.

This means that there are “X” number – or a certain number – of injuries for every 1,000 times one athlete plays in one practice or game.

Let’s look at a sport like football. A football team has about 50 players on the roster. Therefore, a practice would equal 50 AE, and a game played between 2 teams would be 100 AE. In other words, 10 games is equal to 1,000 AE in American football.

Adult athletes (18 years and older)

According to a recent systematic review, examining the concussion rate in team sports, men’s rugby was found to have the highest incidence of concussion in both match play (3.00/1,000 AE) and practice (0.37/1,000 AE).[1]

Men’s tackle football came in second for match play concussion rate at 2.5 per 1,000 AE, and third for concussions experienced during practice (0.30/1,000 AE).[1]

Women’s ice hockey came in third for match-play concussions with 2.27 per 1,000 AE and second for practice concussions with 0.31 per 1,000 AE.[1]

Check out the full list below:

Game Play

  1. Men’s rugby match play (3.00/1,000 AE)
  2. Men’s American football (2.5/1,000 AE)
  3. Women’s ice hockey (2.27/1,000 AE)
  4. Men’s Ice hockey (1.63/1,000 AE)
  5. Women’s soccer (1.48/1,000 AE)
  6. Men’s football (or soccer) (1.07/1,000 AE)

During practice

  1. Men’s rugby (0.37/1,000 AE)
  2. Women’s ice hockey (0.31/1,000 AE)
  3. Men’s American football (0.30/1,000 AE)
  4. Women’s football (or soccer) (0.13/1,000 AE)
  5. Men’s ice hockey (0.12/1,000 AE)
  6. Men’s football (or soccer) (0.08/1,000 AE)

One important finding is that in sports played by both men and women, women sports typically had a higher rate of concussion. This is especially interesting in sports like hockey. Women’s hockey is non-contact, but has a higher rate of concussion compared to men’s hockey – which is full body contact.

Youth athletes (18 years and under)

Concussions in youth sports are particularly concerning as recent evidence suggests that the earlier in life a concussion is experienced, the higher likelihood of having prolonged complications. This is potentially due to injuring a brain that is still developing.

Similar to adult sports, the youth sport with the highest rate of concussion is rugby at 4.18 concussions per 1,000 AE.[2] Unlike the above study, the youth study did not separate injury rate by male or female, or by games or practice.

Ice hockey had the second highest concussion rate with 1.20 concussions per 1, 000 AE. American football came in third (0.53 concussions/1000 AE).[2] See the full list below:

  1. Rugby (4.18/1,000 AE)
  2. Ice hockey (1.20/1,000 AE)
  3. American football (0.53/1,000 AE)
  4. Lacrosse (0.24/1,000 AE)
  5. Football (or soccer) (0.23/1,000 AE)
  6. Wrestling (0.17/1,000 AE)
  7. Basketball (0.13/1,000 AE)
  8. Softball & Field Hockey (Tie) (0.10/1,000 AE)
  9. Baseball (0.06/1,000 AE)
  10. Cheerleading (0.07/1,000 AE)
  11. Volleyball (0.03/1,000 AE)

Concussion vs. other injuries

Concussions account for a significant number of injuries in high school sports. In a 2012 study, researchers found that concussions account for over 15% of all injuries in some very popular sports.[3]

  • Boys’ ice hockey: 23%
  • Girls’ lacrosse: 21%
  • Cheerleading: 20%
  • Boys’ lacrosse: 17%
  • Football: 17%
  • Girls’ soccer: 15%

There are some significant limitations to these studies. It’s important to realize that as many as 50% of all concussions are not reported. This could be for a variety of reasons such as the culture of toughness in sport or for fear of missing games, for example.

There are also many sports that are missing from these lists because they do not have reliable tracking metrics at this time. Please take the above information with a grain of salt.

Involved in sport? Concussions are bound to happen in sport, but how we manage these injuries can make a big difference. As part of our commitment to athletes and sport, we develop, implement and enhance evidence-informed concussion management programs for sports and schools. What are you doing to help keep your athletes safe? Provide the program that’s right for you and your athletes!

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Sciatica & Physical Therapy: How Rose City Can Help Reduce Your Sciatica Pain

Sciatica and Physical Therapy

Rose City Physical Therapy specializes in orthopedic and sports injury physical therapy. Please visit our staff page to learn more about our Board-Certified Orthopedic Specialists. Our highly-trained physical therapists have decades of experience in orthopedic physical therapy and will work with you to design individualized treatment programs to help reduce your pain, regain normal movement, and get back to your regular activities. Contact us to schedule an appointment today!

Article Featured on MoveFowardPT, Reviewed by Karl Kolbeck, PT

As many as 40% of people will experience sciatica during their lifetime, according to Harvard Medical School, and the condition becomes more frequent as one ages. Although sciatica is among the more common causes of pain, it is also often incorrectly categorized and misunderstood.

What is sciatica? What are its common triggers? What are the signs and symptoms? How is it diagnosed? Can it be prevented? How is it best addressed and treated?

Lumbar radiculopathy (also known as sciatica or radiculitis) is a condition that occurs when a nerve in your low back is injured, pinched, or compressed, causing pain or other symptoms that can extend from the low back to the hip, leg, or foot. Sciatica can be caused by sudden trauma or by long-term stress affecting structures in the back. It most often affects people aged 30 to 50 years.

How Does it Feel?

Sciatica can cause pain, muscle tightness and weakness, or other symptoms. The pain usually starts in your lower back, and can travel to your hip, leg, or foot. The location of the pain can vary depending on which nerve in your back is affected and how much it is irritated. Greater irritation causes the pain to spread farther. Spreading pain usually affects one leg, but may affect both legs. Pain and other symptoms can be constant or come and go, and your pain may vary in intensity.

If a nerve or nerve root (the nerve branches deep in your back at the spine level) is severely pinched or compressed it can cause severe pain, muscle weakness, or extreme movement problems. Surgery may be recommended in more severe cases. On rare occasions, nerve compression can cause bladder control or bowel function problems, in which case immediate surgery is recommended.

Rose City Physical Therapy can determine the details of your condition and discuss what a successful treatment plan consist of, and whether consultation with a surgeon is necessary. Our physical therapists will work with your physician or surgeon to determine your best treatment.

Signs and Symptoms

Sciatica can cause a variety of symptoms and signs. The type and location of your symptoms will depend on the amount of pressure being placed on the affected nerve(s). Symptoms and signs may include:

  • Pain and/or pressure in the back, hip, leg, and/or foot/feet
  • Pain that can be throbbing, aching, shooting, sharp, dull, or burning
  • Limitation in or inability to bend or rotate the back
  • Numbness or tingling in the back, hip, leg, or feet
  • Leg weakness
  • Increased pain when coughing, sneezing, reaching, or sitting
  • Inability to stand up straight; being “stuck” in a position such as stooped forward
  • Pain with sitting and difficulty getting up from a chair
  • Inability to remain in one position for a long period of time, such as sitting or standing, due to pain
  • Pain that is worse in the morning
  • Limping when walking

The pain or other symptoms can occur in one or both limbs. Your pain may present in different locations at different times, and can change depending on your activity or body positioning. For example, pain can lessen or worsen when walking versus sitting, or lying down versus standing up.

How Is It Diagnosed?

Rose City Physical Therapy will conduct a thorough evaluation including a review of your health history. Your therapist will ask you detailed questions about your injury, such as:

  • Do you have loss of control of your bladder or bowel? CAUTION: Contact a medical professional immediately if you experience this condition.
  • How and when did the pain start?
  • At what time of day is it worse?
  • What type of discomfort do you feel, and where do you feel it?
  • What are you unable to do right now in your daily life due to the pain?

Your physical therapist will perform a variety of tests to identify potential complications and assess the severity of your symptoms. These tests are designed to check for symptoms and clinical signs including:

  • Difficulty moving
  • Muscle weakness or tightness
  • Changes in skin sensation (numbness)
  • Changes in reflexes
  • Joint stiffness
  • Changes in posture
  • Difficulty walking or balancing

If your physical therapist finds any of the above problems, physical therapy treatment may begin right away. Our goal at Rose City Physical Therapy is to help get you on the road to recovery and back to your normal activities as quickly and safely as possible.

If testing indicates any concerns, your physical therapist will consult your physician or surgeon regarding the need for special diagnostic testing, such as magnetic resonance imaging (MRI).

Our board-certified physical therapists at Rose City Physical Therapy will work closely with your physicians and other health care providers to ensure you receive an accurate diagnosis, treatment, and the care you need.

How Can a Physical Therapist Help?

In all but the most extreme cases of sciatica, conservative care (such as physical therapy) often produces better, faster, and more cost effective results than surgery or pain medication (such as opioid medication).

Your physical therapist will work with you to design a specific treatment program that will speed up your recovery, including exercises and treatments that you can do at home. Physical therapy will help you return to your normal lifestyle and activities. The time it takes to heal your condition may vary, but improvement can be achieved in 4 to 8 weeks when a proper posture, pain reduction, stretching, and strengthening program is implemented.

During the first 24 to 48 hours following your diagnosis of sciatica, your physical therapist may advise you to:

  • Protect the area by avoiding activity that causes worsening symptoms, such as heavy lifting, sitting, bending and twisting, or standing.
  • Avoid too much bed rest.
  • Stay active around the house, and go on short walks several times per day. Movement will decrease your pain and stiffness, and help you feel better.
  • Apply ice packs to the affected area for 15 to 20 minutes every 2 hours.
  • Sit in supportive, firm chairs. Prolonged resting in soft couches or easy chairs may make your pain worse.
  • Consult with a physician for further services, such as medication or diagnostic tests.

Your physical therapist will educate you about specific exercises designed for patients with sciatica. For example, water exercises can be a great way to stay physically active when other forms of exercise are painful. It’s important to note that some traditional exercises, such as those that involve twisting, bending, or weight lifting may aggravate your sciatica if not conducted with the proper form. We will design an individualized exercise program to reduce your leg pain and meet your specific needs.

Rose City Physical Therapy will work with you to:

Reduce pain and other symptoms. We will help you understand how to avoid or modify the activities that caused the injury, so healing can begin. Your therapist may use different types of treatments and technologies to control and reduce your symptoms. Your treatment, based on your condition, may include specific motion exercises, mechanical
traction, and electrotherapy such as Interferential Current or Transcutaneous Electrical Nerve Stimulation (TENS).

Improve motion. We will choose specific activities and treatments to help restore normal movement. These might begin with “passive” motions that your physical therapist performs for you to move your spine, and progress to active exercises and stretches that you do yourself. You can perform these motions at home and in your workplace to help hasten healing and pain relief.

Improve flexibility. We will determine if any of the involved muscles are tight, start helping you to stretch them, and teach you how to stretch them at home.

Improve strength. If your physical therapist finds any weak or injured muscles, they will teach you the correct exercises to steadily restore your strength and agility. “Core strengthening” exercises are commonly used to restore the strength and coordination of muscles around your back, hips, abdomen, and pelvis.

Improve endurance. Restoring muscular endurance is important after an injury. Your physical therapist with work with you to will develop a program of activities to help regain the endurance you had before the injury, and improve it.

Improve posture. Your physical therapist will teach you how to improve your posture so that pressure is reduced in the injured area, and healing can begin and progress as rapidly as possible.

Learn a home program. Your physical therapist will teach you strengthening, stretching, and pain reduction exercises to perform at home. These exercises will be specific for your needs; if you do them as prescribed by your physical therapist, you can speed your recovery.

Return to activities. We will discuss your activity levels with you and use them to set your work, sport, and home-life recovery goals. Your treatment program will help you reach your goals in the safest, fastest, and most effective way possible. For spine and leg pain from sciatica, your physical therapist may teach you correct ways to lift objects (called “body mechanics”) that will help protect your spine from aggravating symptoms.

Once your pain is under control or gone, it will be important for you to continue your new posture and movement habits to keep your back healthy and pain free.

To learn more about how physical therapists treat sciatica, listen to this informative episode of Move Forward Radio. In this episode, physical therapist and researcher Mark Bishop discusses the basics of sciatica. An expert on the condition, he also addresses how physical therapists treat the condition.

Surgery

In some cases, surgery is necessary to prevent further damage. If you undergo surgery for your sciatica, your physical therapist will work closely with you and your surgeon to help you regain motion and strength more quickly than you could on your own, and help you get back to your normal lifestyle as quickly as possible.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat people who have low back and leg pain as a result of sciatica. You want to consider:

  • A physical therapist who is experienced in treating people with orthopedic, or musculoskeletal, problems.
  • A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.
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Avoid Addictive Opioids. Choose Physical Therapy for Safe Pain Management.

No one wants to live in pain. But no one should put their health at risk in an effort to be pain free. Doctor-prescribed opioids are appropriate in some cases, but they just mask the pain—and opioid risks include depression, overdose, and addiction, plus withdrawal symptoms when stopping use.

That’s why the CDC recommends safer alternatives like physical therapy to manage pain. The physical therapists at Rose City Physical Therapy treat pain through therapeutic exercise and functional movement, manual therapy (hands-on care), and patient education—and by increasing physical activity you can also reduce your risk of other chronic diseases.

Pain is personal, but treating pain takes teamwork. When it comes to your health, you have a choice. Choose more movement and better health. Choose Rose City Physical Therapy!

According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the United States, even though “there has not been an overall change in the amount of pain that Americans report.”

In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in March 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed.

But for other pain management, the CDC recommends nonopioid approaches including physical therapy.

Patients should choose physical therapy when …

  • … The risks of opioid use outweigh the rewards.
    Potential side effects of opioids include depression, overdose, and addiction, plus withdrawal symptoms when stopping opioid use. Because of these risks, “experts agreed that opioids should not be considered firstline or routine therapy for chronic pain,” the CDC guidelines state. Even in cases when evidence on the long-term benefits of non-opioid therapies is limited, “risks are much lower” with non-opioid treatment plans.
  • … Patients want to do more than mask the pain.
    Opioids reduce the sensation of pain by interrupting pain signals to the brain. Physical therapists treat pain through movement while partnering with patients to improve or maintain their mobility and quality of life.
  • … Pain or function problems are related to low back pain, hip or knee osteoarthritis.
    The CDC cites “high-quality evidence” supporting exercise as part of a physical therapy treatment plan for those familiar conditions.
  • … Opioids are prescribed for pain. 
    Even in situations when opioids are prescribed, the CDC recommends that patients should receive “the lowest effective dosage,” and opioids “should be combined” with nonopioid therapies, such as physical therapy.
  • … Pain lasts 90 days.
    At this point, the pain is considered “chronic,” and the risks for continued opioid use increase. An estimated 116 million Americans have chronic pain each year. The CDC guidelines note that nonopioid therapies are “preferred” for chronic pain and that “clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient.”

Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for nonopioid treatment.

“Given the substantial evidence gaps on opioids, uncertain benefits of long-term use and potential for serious harm, patient education and discussion before starting opioid therapy are critical so that patient preferences and values can be understood and used to inform clinical decisions,” the CDC states.

Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids. Contact Rose City Physical Therapy to learn more about non-opioid pain management.

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