A recent blog post at the Parker College of Chiropractic highlights one of the most prevalent factors in neck and low back pain: forward head posture.
On the Alumni Voices blog at Parker College of Chiropractic, Dr. Gregory Johnson outlines the mechanics of gravity as a primary source of stress on the ligaments, muscles, disc, and joints of the spine. Forward Head Posture (FHP) is a reality of our modern age, and Dr. Johnson says it is a factor that can have significant health consequences over a long period of time.
Constantly leaning forward into computer screens, phones, and other handheld devices not only causes serious postural problems, he says, but can cause compression of the upper cavity and lower cavity, affecting lungs and heart, and can even cause gastrointestinal issues.
Gravity is always pulling us down towards the earth 24/7, whether you’re sitting, standing, sleeping, walking or doing any other activity a human being might do during their everyday activities of living, both at work and at home. We have become a sedentary society for the most part, sitting most of the day as we work on a computer or at a desk with our heads leaning or bent forward from our shoulders. This means FHP is very prevalent in our society.
In addition to adults sitting at desks and workstations during the day, Dr. Johnson says this is also something that affects children from an early age, and should prompt us to be mindful of posture to prevent long-term health problems.
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Among the immense discord around the world, some goals seem universal: live longer, look better, and prevent disease. Many companies have capitalized on these goals by selling new creams, producing new medications, or promoting fad diets promising to help individuals live healthier and feel good. However, even if some of these solutions may have merit, there are easier ways to achieve these goals. An individual searching for better health will find success not in reaching for a magical product, but in lacing up tennis shoes. Incorporating exercise into daily life increases an individual’s overall health and wellbeing.
New technologies and research continually back the benefits of exercise as one of the most fundamental health realities. Study after study has revealed how crucial movement is for overall health. In fact, research has shown even minimal movement throughout the day has significant benefits over sitting sedentary. Small steps towards increasing physical activity can translate to large health improvements over time.
The CDC recommends at least 150 minutes of moderate-intensity physical activity per week for adults, however, any movement is better than nothing!
Studies have repeatedly shown exercise may help with prevention, treatment, or helping relieve symptoms of many adverse health problems. Some benefits including:
The old adages of “motion is lotion,” “rest is rust,” “movement is medicine,” and “use it or lose it” all speak truth. The cause for movement has never been louder. For those dealing with injury or physical discomfort, take the time to meet with a Chiropractor or Physical Therapist as soon as possible. The advancements of adjustment tools and measuring devices allow health professionals to better diagnose and treat patients. With the proper tools and methods, even those with serious injuries have a chance at full recovery. Whatever ability you’re now at, get moving!
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The information age changed how individuals interact with the medical world. In addition to scheduling appointments online and tele-health appointments via video calling, patients are much more likely to research their diagnosis to learn more about causes and treatment. Becoming informed about an ailment helps a patient better articulate their questions and possible concerns to health care professionals. This access to information significantly changes how patients and professionals interact. As patients spend more time researching their ailments, they are more likely to spend time looking into what kind of health care professional will best help them (chiropractor, physical therapist, athletic trainer, M.D. etc.). However, many clinics have adapted to mitigate this task. In a full service health clinic, a patient can visit one health center for evaluation and to work with multiple health professionals for treatment. These multi-disciplinary health clinics help shift patients to the center of attention and elevate their personal care.
In a multi-disciplinary practice (or sometimes called a wellness clinic) several medical specialists work alongside each other to provide a “one-stop-shop” style clinic. The Mayo Clinic famously provides many different services to help a patient in their fight against cancer. Their staff includes doctors, researchers, and scientists all working within their specialties under a united patient-first philosophy. Boston Pain Care provides multiple specialists at the same location to help patients in their fight against chronic pain. Their services include treatment for sleep trouble, medication management, arthritis, neuropathy, herniated discs, migraines, functional rehabilitation, and more.
A full service health practice uses co-located (or closely located) clinics with different specialties coming together under a single patient care philosophy. This type of clinic condones an environment for an advanced and diverse medical team to work together for the benefit of an individual patient. A “one-stop-shop” style allows a patient to walk in the door with multiple health issues and leave the clinic with a comprehensive wellness 'game plan' for all ailments.
Although all independent wellness clinics may work in different ways, the idea of many medical professionals all working together is universal. For an example, imagine a patient entering the full service health care clinic in need of treatment. A chiropractor would objectively evaluate the patient and collect data and medical history for the surgeons to determine when surgical intervention might best suit the patient’s treatment. At post-surgery, the chiropractor would evaluate the patient again prior to undergoing rehab to collect baseline. The patient would then work with the physical therapists for rehabilitation while routinely meeting with the chiropractor to monitor progress. Each medical professional involved still works together by sharing data and discussing processes to make sure the patient stays on the best course for healing. It has long been said that two-heads are better than one—or in this example, three medical professionals better than one. Patient experience and medical expertise both increase exponentially in multimodality clinics.
So, what benefits can a clinic glean from becoming a full-service health care practice? Many full-service health care practices enjoy the following:
The idea of becoming a full service clinic may seem daunting and unreachable at first, but it all begins with small steps. Physical therapy clinics or chiropractic practices may benefit from expanding their own services initially. This may include adding FCEs or Employer Services to the list of offered services. Even small steps toward becoming a full service health care practice will begin to garner the same benefits.
Whatever the first steps may be, JTECH is here with functional evaluation systems to help. The foundation of any practice should include objective data and accurate testing. Contact JTECH Medical today to see how we can help!
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We spend a lot of time at work, doing the same thing day in and out, increasing the risk for repetitive injuries. Employee general well-being seems to be of increasing interest to employers. As a result, more and more employers are opting into wellness plans and offering incentives for those who participate. Some companies even go as far as to bring wellness to work and allow employees to participate during work time.
While it may seem counterintuitive to have employees doing anything but work during work hours, to these employers the benefits are clear.
According to a blog post by TodayinPT, loss of productivity due to strains and injuries has had a measurable impact on businesses, and even skeptical employees have noticed improvements from on-site therapy programs.
We have an onsite manufacturing plant [...] where a lot of our employees are male and wouldn’t make appointments to see a doctor until they were in a lot of pain,” Vissers said. “We want to help them to avoid long-term health problems by being proactive about their health, and realizing that pain isn’t an inevitable part of aging.”
While some of the manufacturing plant workers were unsure whether they actually could benefit from stretching [...] they were taught their roles at the company were as “industrial athletes” because of the lifting and physical labor required. Six months later, when their reach and other outcomes were measured again, employees saw the benefits of stretching. In the maintenance department pilot of 90 employees, only one strain was reported in a 10-month period, compared with 21 strains and sprains in the period before the pilot began.
Although a potential initial investment upfront, it seems wellness programs can offer a big return; employees receive preventative care and healthier employees tend to take fewer sick days. Identifying and reducing potential on the job injuries is a huge incentive as well and may encourage employers to implement pre-employment screenings or ergonomic evaluations once empoyees are on the job.
Some questions to consider:
As an employee, do you feel your employer provides adequate wellness incentives/resources?
As an employer, do you feel wellness programs are realistic and beneficial?
As a clinician, are you approached by employers to participate in similar programs or do you market to employers for these services?
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As we start a new year, we often reflect on the progress we've made in the one coming to an end. Some of us may measure progress as trips to the gym, others in dollars earned, while others may keep track in more abstract measurements.
When it comes to the field of physical therapy, results are often measured by a patient's perceived changes. Am I stronger? Has the pain subsided? Can I perform functions I could not previously perform? But a patient's feelings are subjective, and can often be ambiguous, or influenced by emotions or perceptions. Objective findings become a powerful tool for a clinician in determining a patient's treatment plan and progress, while also serving as an easily understood and quantifiable value for the patient and referring parties.
In order to better understand the role that objective findings can play in a physical therapy practice, JTECH Medical sought out an expert. Jonathan Reynolds, PhD, PT, has been practicing physical therapy for over 25 years. During this time he has worked for hospitals and in private practice, worked on the design and development of two different software programs—JobSite 2 and the FCE module of the Northstar Occupational Medicine system—in conjunction with JTECH, designed his own lifting evaluation, taught continuing education seminars on Functional Capacity Evaluations and Job Site Analysis, created a tool—the TOLA System®—which allows patients to augment their therapy sessions at home, and developed research protocols for testing the functional capacity of dancers and musicians. Reynolds opened his clinic, Reynolds Rehab, with locations in Minneapolis and Eagan, MN. More recently, Reynolds Rehab partnered with Orthology. These clinics specialize in treating professional performing artists (dancers and musicians) alongside general orthopedic outpatient rehabilitation and industrial rehabilitation. With a background in research—having earned his PhD in Rehabilitation Science—Reynolds approaches his practice with objective data in mind, an approach that he thinks could benefit all practices.
"In our practice, we strive to provide evidence-based care," said Reynolds. "And while an evidence-based approach is often associated with research, it is also a powerful method with which to approach rehabilitation. If something can be proven effective, then it is evidence. Objective findings allow us to prove that a particular treatment plan has efficacy, and this evidence then qualifies what we do, while also helping us provide better and more productive care."
Including objective findings in a practice can help to build trust in relationships; and relationships are what Reynolds points to as a major contributor to his practices' ability to compete with larger clinics, which tend to refer within. Along with great treatment and care, Reynolds and his therapists ensure that they are constantly providing objective feedback to the referring parties, assuring them that the treatment is warranted and achieving results.
"Our success as a small practice is multi-faceted. Our therapists are well-trained and we have great communication. We are clear about the goals we want to meet and what outcomes we expect," said Reynolds. "Objective findings, like those we get with JTECH Medical's products, provide a platform for this critical communication. It allows us to build relationships with our patients, referring physicians, case managers, insurance companies, etc. And being able to track these outcomes objectively founds these relationships upon trust."
Orthology also uses manual therapy techniques as an integral part of rehabilitation. In the United States, most physical therapy is heavily exercise focused, but many people come to rehabilitation lacking the ability to immediately begin to exercise comfortably and effectively. To this end, Orthology helps patients arrive at a point in which they are comfortable with the exercise before they begin an exercise regimen. To help determine this point, the clinic incorporates objective findings alongside patient feedback.
"We can collect objective measurements when the patient first comes to our clinic, and then track their progress as we use manual therapy techniques," Reynolds said. "With the algometer and range of motion tests in particular, we are able to track the improvement and better decide when a patient will be able to be more comfortable and compliant with prescribed exercises. We then see strength gains with exercises performed at improved comfort levels."
At Orthology, each patient receives an objective evaluation before and after physical therapy, which allows the therapist to monitor the patient’s progress throughout treatment, and track outcomes. Depending on what outcomes they are tracking for a given patient, they will also perform a mini-discharge at the end of the treatment program, providing objective data that clearly points to a plateau in improvement, signaling the end of the physical therapy program.
"The objective findings are a critical component of our rehabilitation programs, but they can be a double edged sword," said Reynolds. "The person doing the evaluation needs to know what they are doing and how to interpret the data they receive. Education and ongoing practice is crucial to an evaluator's ability to accurately collect data, compare it from visit to visit, and interpret these results."
Reynolds stresses the need to use these systems that provide objective findings judiciously. At Reynolds' clinics, they make sure to use only the tools that are appropriate to a patient's injury and the targeted outcomes. In other words, even if they are able to completely test a patient's functional ability, their particular situation may not call for that, and it is important to use objective tools to validate the treatment plan that is required.
Incorporating objective findings into a practice can take on a variety of forms. Reynolds used JTECH's products when working on his doctoral dissertation, which focused on the shoulder mechanics and injuries in professional violin players. Since then, he has used the tools in other research projects aimed at grip strength as well as further research into shoulder mechanics. He also incorporates objective findings in other more traditional ways, such as for Functional Capacity Evaluations (FCEs), as well as work hardening, ergonomic, and job site evaluations.
"From an FCE standpoint, an evaluator's most powerful tools are his or her eyes. A system that you can rely upon to accurately collect objective data about the performance allows you to keep your focus entirely on the patient, observing their behavior and effort," said Reynolds. "You can also take the equipment to a job site and tell the employers the relative risk of workplace activities. Using the JobSite 2 software tools, such as the NIOSH Lifting Equation tool, or the Cumulative Trauma Disorder risk assessment tool, I can pinpoint the issue. Is it repetition? Too much weight? Is the worker reaching too high or too low? With the objective findings, you can point out which changes need to be made right there on the spot."
These skills require proper training and constant practice. Reynolds first received his FCE and ergonomic training through seminars, and he continues to use these skills every day, including teaching them to other practitioners. His therapists, too, receive training, are constantly practicing, and receive periodic in-house training sessions to ensure that they are able to use these tools to obtain meaningful data.
"I could teach my sixteen-year-old son to use the equipment to collect all of the data, but he wouldn’t know what he was doing," said Reynolds. "He could make the evaluation look and feel legitimate, but the data would be meaningless. It is imperative that the evaluator be skilled and properly trained in obtaining meaningful objective data, and that this education remains an ongoing process."
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