Physical and Occupational Therapy

To aid in the rehabilitation process, Flagstaff Bone and Joint facilitates out-patient physical and occupational therapy treatment. Our physical and occupational therapists are highly trained in the treatment of extremities and spine disorders as well as postoperative rehabilitation.

What is a Physical Therapist?

Physical therapists, sometimes referred to as simply PTs, are healthcare professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions, illnesses, or injuries that limits their abilities to move and perform functional activities as well as they would like in their daily lives. Physical therapists examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness and wellness-oriented programs for healthier and more active lifestyles.

What type of conditions do Physical Therapists treat?

Physical therapists provide care to people of all ages who have functional problems resulting from, for example, back and neck injuries, sprains/strains and fractures, arthritis, burns, amputations, stroke, multiple sclerosis, conditions such as cerebral palsy and spina bifida, and injuries related to work and sports. Physical therapy care and services are provided by physical therapists and physical therapist assistants who work under the direction and supervision of a physical therapist.

What do Physical Therapists do to help their patients?

Physical therapists evaluate and diagnose movement dysfunction and use interventions to treat patient/clients. Interventions may include therapeutic exercise, functional training, manual therapy techniques, assistive and adaptive devices and equipment, and physical agents and electrotherapeutic modalities.

Physical therapists often consult and practice with a variety of other professionals, such as physicians, dentists, nurses, educators, social workers, occupational therapists, speech-language pathologists, and audiologists.

What type of training and education do Physical Therapists undergo?

Physical therapist education programs include foundational science courses, such as biology, anatomy, physiology, cellular histology, exercise physiology, neuroscience, biomechanics, pharmacology, pathology, and radiology/imaging, as well as behavioral science courses, such as evidence-based practice and clinical reasoning. Some of the clinically-based courses include medical screening, examination tests and measures, diagnostic process, therapeutic interventions, outcomes assessment, and practice management. In addition to classroom and laboratory instruction, students receive supervised clinical experience.

What Are Sports Injuries?

The term sports injury, in the broadest sense, refers to the kinds of injuries that most commonly occur during sports or exercise. Some sports injuries result from accidents; others are due to poor training practices, improper equipment, lack of conditioning, or insufficient warmup and stretching.

Although virtually any part of your body can be injured during sports or exercise, the term is usually reserved for injuries that involve the musculoskeletal system, which includes the muscles, bones, and associated tissues like cartilage.

What are the Most Common Types of Sports Injuries?

• Muscle sprains and strains
• Tears of the ligaments that hold joints together
• Tears of the tendons that support joints and allow them to move
• Dislocated joints
• Fractured bones, including vertebrae

What's the Difference Between Acute and Chronic Injuries?

Regardless of the specific structure affected, sports injuries can generally be classified in one of two ways: acute or chronic.

Acute Injuries

Acute injuries, such as a sprained ankle, strained back, or fractured hand, occur suddenly during activity. Signs of an acute injury include the following:

• Sudden, severe pain
• Swelling
• Inability to place weight on a lower limb
• Extreme tenderness in an upper limb
• Inability to move a joint through its full range of motion
• Extreme limb weakness
• Visible dislocation or break of a bone

Chronic Injuries

Chronic injuries usually result from overusing one area of the body while playing a sport or exercising over a long period. The following are signs of a chronic injury:

• Pain when performing an activity
• A dull ache when at rest
• Swelling

What Should I Do if I Suffer an Injury?

Whether an injury is acute or chronic, there is never a good reason to try to "work through" the pain of an injury. When you have pain from a particular movement or activity, STOP! Continuing the activity only causes further harm.

Some injuries require prompt medical attention while others can be self-treated. Here's what you need to know about both types:

When to Seek Medical Treatment

You should call a health professional if:

• The injury causes severe pain, swelling, or numbness
• You can't tolerate any weight on the area
• The pain or dull ache of an old injury is accompanied by increased swelling or joint abnormality or instability

When and How to Treat at Home

If you don't have any of the above symptoms, it's probably safe to treat the injury at home—at least at first. If pain or other symptoms worsen, it's best to check with your health care provider. Use the RICE method to relieve pain and inflammation and speed healing. Follow these four steps immediately after injury and continue for at least 48 hours.

• Rest – Reduce regular exercise or activities of daily living as needed. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle.
  
  
• Ice – Apply an ice pack to the injured area for 20 minutes at a time, four to eight times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes. (Note: Do not use heat immediately after an injury. This tends to increase internal bleeding or swelling. Heat can be used later on to relieve muscle tension and promote relaxation.)
  
  
• Compression – Compression of the injured area may help reduce swelling. Compression can be achieved with elastic wraps, special boots, air casts, and splints. Ask your health care provider for advice on which one to use.
  
  
• Elevation – If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling.

Who Should I See for My Injury?

Although severe injuries will need to be seen immediately in an emergency room, particularly if they occur on the weekend or after office hours, most sports injuries can be evaluated and, in many cases, treated by your primary health care provider.

Depending on your preference and the severity of your injury or the likelihood that your injury may cause ongoing, long-term problems, you may want to see, or have your primary health care professional refer you to, one of the following:

• Orthopaedic surgeon – A doctor specializing in the diagnosis and treatment of the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.
  
  
• Physical therapist/physiotherapist – A health care professional who can develop a rehabilitation program. Your primary care physician may refer you to a physical therapist after you begin to recover from your injury to help strengthen muscles and joints and prevent further injury.

How do Physical Therapists treat Sports Injuries?

Rehabilitation (Exercise) –  A key part of rehabilitation from sports injuries is a graduated exercise program designed to return the injured body part to a normal level of function.

With most injuries, early mobilization—getting the part moving as soon as possible—will speed healing. Generally, early mobilization starts with gentle range-of-motion exercises and then moves on to stretching and strengthening exercise when you can without increasing pain. For example, if you have a sprained ankle, you may be able to work on range of motion for the first day or two after the sprain by gently tracing letters with your big toe. Once your range of motion is fairly good, you can start doing gentle stretching and strengthening exercises. When you are ready, weights may be added to your exercise routine to further strengthen the injured area. The key is to avoid movement that causes pain.
As damaged tissue heals, scar tissue forms, which shrinks and brings torn or separated tissues back together. As a result, the injury site becomes tight or stiff, and damaged tissues are at risk of reinjury. That's why stretching and strengthening exercises are so important. You should continue to stretch the muscles daily and as the first part of your warm-up before exercising.

When planning your rehabilitation program with a health care professional, remember that progression is the key principle. Start with just a few exercises, do them often, and then gradually increase how much you do. A complete rehabilitation program should include exercises for flexibility, endurance, and strength; instruction in balance and proper body mechanics related to the sport; and a planned return to full participation.

Throughout the rehabilitation process, avoid painful activities and concentrate on those exercises that will improve function in the injured part. Don't resume your sport until you are sure you can stretch the injured tissues without any pain, swelling, or restricted movement, and monitor any other symptoms. When you do return to your sport, start slowly and gradually build up to full participation.

Rest

Although it is important to get moving as soon as possible, you must also take time to rest following an injury. All injuries need time to heal; proper rest will help the process. Your health care professional can guide you regarding the proper balance between rest and rehabilitation.

Other Therapies

Other therapies commonly used in rehabilitating sports injuries include:

• Electrostimulation – Mild electrical current provides pain relief by preventing nerve cells from sending pain impulses to the brain. Electrostimulation may also be used to decrease swelling, and to make muscles in immobilized limbs contract, thus preventing muscle atrophy and maintaining or increasing muscle strength.
  
  
• Cold/cryotherapy – Ice packs reduce inflammation by constricting blood vessels and limiting blood flow to the injured tissues. Cryotherapy eases pain by numbing the injured area. It is generally used for only the first 48 hours after injury.
  
  
• Heat/thermotherapy – Heat, in the form of hot compresses, heat lamps, or heating pads, causes the blood vessels to dilate and increase blood flow to the injury site. Increased blood flow aids the healing process by removing cell debris from damaged tissues and carrying healing nutrients to the injury site. Heat also helps to reduce pain. It should not be applied within the first 48 hours after an injury.
  
  
• Ultrasound – High-frequency sound waves produce deep heat that is applied directly to an injured area. Ultrasound stimulates blood flow to promote healing.
  
  
• Massage – Manual pressing, rubbing, and manipulation soothe tense muscles and increase blood flow to the injury site.

What Should I Do After Hip Surgery?

Soon after surgery, you will meet a respiratory therapist and a physical therapist. The respiratory therapist may ask you to breathe deeply, cough, or blow into a device to check your lungs. Deep breathing helps to keep fluid out of your lungs after surgery.

The physical therapist will teach you how to sit up, bend over, and walk with your new hip. The therapist will also teach you simple exercises to help you get better. In some cases, within 1 to 2 days after surgery, you may be able to sit on the edge of the bed, stand, and even walk with help.

Most people spend 10 days or less in the hospital after hip replacement surgery. To be completely well takes about 3 to 6 months, based on:

• The type of surgery
• Your health
• How quickly exercises help

After you go home, be sure to follow the doctor's instructions. Tips for getting better quickly are:

• Work with a physical therapist
  
  
• Wear an apron to carry things around the house. This leaves your hands and arms free for balance or to use crutches
  
  
• Use a long-handled "reacher" to turn on lights or grab things you need. Your nurse at the hospital may give you one or tell you where to buy one

Will Exercise Help After a Total Hip Replacement?

Exercise can reduce joint pain and stiffness. It can increase muscle strength and joint range of motion (how much you can move the joint). Most physical therapists begin with exercises that:

• Increase range of motion
• Make muscles strong

Your doctor or physical therapist will decide when you can do harder exercises. Your doctor may say not to jog or play basketball or tennis. These can damage or loosen the new hip joint.

Exercise goals after hip replacement surgery are to:

• Increase muscle strength
• Increase your blood circulation and overall fitness
• Avoid injuring the new joint

The types of exercise that may help you meet these goals are:

• Walking
• Bicycling (on a bike machine)
• Swimming
• Cross-country skiing

Fighting Osteoarthritis with Exercise

You can use exercises to keep strong and limber, improve cardiovascular fitness, extend your joints' range of motion, and reduce your weight. The following types of exercise are part of a well-rounded arthritis treatment plan.

• Strengthening exercises – These exercises strengthen muscles that support joints affected by arthritis. They can be performed with weights or with exercise bands, inexpensive devices that add resistance
  
  
• Aerobic activities – These are exercises, such as walking or low-impact aerobics, that get your heart pumping and can keep your lungs and circulatory system in shape
  
  
• Range-of-motion activities – These keep your joints limber
  
  
• Agility exercises – These can help you maintain daily living skills

Ask your doctor or physical therapist what exercises are best for you. Ask for guidelines on exercising when a joint is sore or if swelling is present. Also, check if you should (1) use pain-relieving drugs, such as analgesics or anti-inflammatories (also called NSAIDs or nonsteroidal anti-inflammatory drugs) to make exercising easier, or (2) use ice afterward.

Occupational Therapy/ Hand Therapy

What is occupational therapy?

Occupational therapy (OT) is a health profession which promotes health and well being by helping people engage in things they want to do and need to do to function throughout their life span. Occupational therapy is a type of rehabilitation therapy recommended for patients with conditions affecting the upper and lower extremities. The main goal of occupational therapy is to enable people to participate in the activities of everyday life.

What is the role of an occupational therapist?

Occupational therapists, also called OT’s, are individuals who are trained in the practice of occupational therapy. The role of an occupational therapist is to work with individuals who suffer from mental, physical, developmental, social or emotional disabilities and improve their ability to perform daily activities. This is accomplished through training, exercise, education, and home modifications to encourage an independent lifestyle.

Occupational therapists work in the following settings:

• Hospitals/Clinics
• Private practice
• Special schools
• Rehabilitation centers
• Mental health facilities

Who needs occupational therapy?

Occupational therapy can benefit a wide variety of people including those with:

• Work related injuries including lower back problems
• Spinal cord injuries
• Fractures or other injuries from sports or accidents
• Mental health or behavioral problems and learning disabilities
• Arthritis
• Limitations following a stroke or heart attack
• Cancer
• Wound scars and burns
• Birth injuries or birth defects
• Injured nerves
• Amputations
• Post surgical conditions

What is the need for occupational therapy in children?

Occupational therapy is for both adults and children. Occupational therapists evaluate children’s skills for playing, functioning in school, and performing daily activities and develops a customized plan for intervention to meet specific goals. Occupational therapy helps children develop fine motor skills and educates family members about safe and effective methods to care for their child. OT’s work with a variety of conditions including birth defects, orthopedic injuries, and mental health or behavioral problems. Occupational therapy can help improve a child’s cognitive and physical abilities while enhancing their self- esteem and sense of accomplishment. OT’s help to improve a child’s development and performance and allows children to regain function.

Occupational therapists help children with:

• Severe developmental delays
• Behavioral disorders
• Physical disabilities

Hand Therapy

What is hand therapy?

Hand therapy is a type of rehabilitation therapy performed by a hand therapist on patients with conditions that affect the use of their hands.

Hand therapy plays an important role in the recovery from hand injuries and hand surgeries. Hand therapy is a merging of occupational therapy and physical therapy combining comprehensive knowledge of the structure of upper limb with function and activity.

Hand therapists work in

• Hospitals
• Rehabilitation center
• Private clinics
• Sports medicine facilities
• Industrial medicine facilities
  

Who is a candidate for hand therapy?

• Patients with the following conditions may benefit from hand therapy:Acute or chronic pain conditions
• Patients affected by an accident or trauma
• Scars, burns, and injured nerves
• Fractures
• Amputations of fingers, hands, or arms
• Patients suffering from conditions such as carpal tunnel syndrome and tennis elbow
• Arthritis
• Neurological conditions (stroke)

What does hand therapy provide?

The hand therapist can evaluate, treat and effectively rehabilitate the patient in the following areas:

• Post operative rehabilitation
• Preventive, non-operative or conservative treatment
• Industry consultation

Post operative rehabilitation:

Management of open and sutured wounds (prevents infection and assists healing)

• Reduction of swelling
• Control of raised, swollen, or sensitive scars
• Education in exercise program

Preventive, Non-operative or Conservative treatment:

• Acute or chronic pain management
• Nerve desensitization following nerve injury or trauma
• Sensory re-education following nerve injury
• Splint fabrication for prevention or corrections of injury
• Life skill training through adaptive methods and equipments

Industry Consultation:

Hand therapists may consult with various industries to establish preventive programs for workers with upper extremity disorders.