Bluegrass Doctors of
Physical Therapy, PLLC

Concierge Manual Physical Therapy and Interventional Dry Needling Experts

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March 2018 Newsletter

Posted on March 2, 2018 at 10:20 AM

What is Musculoskeletal Ultrasound?

Ultrasound imaging uses sound waves to produce pictures of muscles, tendons, ligaments and joints throughout the body. It is used to help diagnose sprains, strains, tears, and other soft tissue conditions. Ultrasound is safe, noninvasive, and does not use ionizing radiation.

 

What is Ultrasound Imaging of the Musculoskeletal System?

Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show structures under the stresses they endure with normal movement. It is this unique property that allows us to see compromises of ligaments and tendons quite easily.

 

 

What are some common uses of the procedure?

Ultrasound images are typically used to help diagnose:

• Tendon tears, or tendinitis of the rotator cuff in the shoulder, Achilles tendon in the ankle and other tendons throughout the body.

• Muscle tears, masses or fluid collections.

• Ligament sprains or tears.

• Inflammation or fluid (effusions) within the bursae and joints.

• Early changes of rheumatoid arthritis.

• Nerve entrapments such as carpal tunnel syndrome.

• Benign and malignant soft tissue tumors.

• Ganglion cysts.

• Hernias.

• Foreign bodies in the soft tissues (such as splinters or glass).

• Dislocations of the hip in infants.

• Fluid in a painful hip joint in children.

• Neck muscle abnormalities in infants with torticollis (neck twisting).

• Soft tissue masses (lumps/bumps) in children.



 

Mindful Observation

This exercise can be simple but powerful by helping you start to appreciate seemingly simple elements of your environment.

 

The exercise is designed to connect us with the beauty of the natural environment, something that is easily missed when we are rushing around in the car or hopping on and off trains on the way to work.

 

1 Choose a natural object from within your immediate environment and focus on watching it for a minute or two. This could be a flower or an insect, or even the clouds or the moon.

2 Don’t do anything except notice the thing you are looking at. Simply relax into watching for as long as your concentration allows.

3 Look at this object as if you are seeing it for the first time.

4 Visually explore every aspect of its formation, and allow yourself to be consumed by its presence. Notice the color, shapes, textures, movements, and sounds.

5 Allow yourself to connect with its energy and its purpose within the natural world.

Throughout the month of March give your mindful observation a try. When waiting for a friend or family member practice this observation. Don’t forget about your breathing and continue to practice the mindful breathing you practiced last month.




 

 

CoQ10 and Migraines

Posted on January 31, 2018 at 9:10 AM

An article appearing on January 3, 2018 in Nutritional Neuroscience describes a randomized, double-blind, placebo-controlled trial that resulted in a reduction in migraine duration, frequency and severity, as well as a lower levels of calcitonin gene-related peptide (CGRP) and tumor necrosis factor-alpha (a marker of inflammation) among participants who received daily supplements of coenzyme Q10 (CoQ10)


The trial included 45 women aged 18 to 50 years diagnosed with episodic migraine. In addition to migraine prophylactic medication, 23 participants received 400 milligrams CoQ10 per day and 22 participants received a placebo for three months. Serum CoQ10, CGRP, tumor necrosis factor-alpha (TNF-a), and other factors were measured at the beginning and end of the study.


Migraine severity, duration, and frequency per month were lower at the end of the study among those who were given CoQ10 compared to the placebo. In addition to a rise in serum CoQ10 levels, women who received CoQ10 experienced a reduction in TNF-a and CGRP at the end of the treatment period. “There is a correlation between neurologic inflammation and CGRP release in migraine,” Monireh Dahri and colleagues explain. "Likewise, CGRP transcription can be stimulated by endogenous inflammatory molecules, such as TNF-a, which increases the CGRP promoter activity and actuates MAPK pathway. In our study, reduction of TNF-a in CoQ10 treated group was accompanied with CGRP decrease, which can be explained by the above-mentioned mechanism."


"As migraine patients have higher level of inflammation and have been reported to have CoQ10 deficiency, CoQ10 supplementation may be a beneficial complementary treatment in migraineurs," they suggest.

Reciprocating Gifts.

Posted on September 15, 2017 at 10:00 AM

Great Tumblers a patient made us. We are so fortunate to work with such a great group of people!

TMJ the hard case!

Posted on August 24, 2017 at 10:15 AM

Temporomandibular joint dysfunction

 

 

Introduction

The temporomandibular joints (TMJ) connect your lower jaw to your skull. There are two matching joints, one on each side of your head, just in front of your ears. They let your jaw move up and down and from side to side.

The abbreviation "TMJ" refers to the joint but is often used to refer to any problems with the joints. Such problems include:

Popping sounds in your jaw

Not being able to completely open your mouth

Jaw pain

Headaches

Earaches

Toothaches

Other types of facial pain

Most people with TMJ problems have pain that comes and goes, but some have chronic (long-term) pain.

 

Signs and Symptoms

TMJ problems often cause the following symptoms:

Pain, particularly in the chewing muscles or jaw joint or an ache around your ear

Limited movement or locking of the jaw

Pain in the face, neck, or shoulders, or near the ear

Clicking, popping, or grating sounds when opening your mouth

Trouble chewing

Headache

A sudden change in the way your upper and lower teeth fit together

Also, sometimes earaches, dizziness, and hearing problems

 

What Causes It?

Sometimes TMJ dysfunction can be caused by an injury, such as a heavy blow, to the jaw or temporomandibular joint. But in other cases there may not be a clear cause. Other possible causes include:

A bad bite, called malocclusion

Orthodontic treatment, such as braces and the use of headgear

Wearing away of the disk or cartilage in the joint

Stress or anxiety. People with TMJ problems often clench or grind their teeth at night, which can tire the jaw muscles and lead to pain.

 

Who is Most At Risk?

The risk for TMJ problems may be higher with these factors:

Gender: more women than men seek treatment

Age: people ages 30 to 50 have the most problems

Children and adolescents with arthritis

Grinding teeth, clenching jaw

Malocclusion (bad bite)

High stress levels

 

What to Expect at Your Provider's Office

 

Your health care provider will check muscles in the area of the TMJ, and will:

Look for asymmetry or inflammation in your face

Listen for joint clicking or scraping sounds

Test the range of motion in your jaw

Look at your teeth for evidence of jaw clenching or teeth grinding

If you are having any neurological symptoms, such as numbness, your provider will give you a neurological exam. Your provider may also order imaging tests, such as an x-ray, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) scan to look for degenerative disease or disk problems.

 

Treatment Options

 

Prevention

Reducing stress and keeping yourself from grinding your teeth or clenching your jaw may help prevent TMJ problems or lessen the symptoms.

 

Treatment Plan

In many cases, you can treat TMJ dysfunction at home. Your doctor may:

Ask you to change your eating habits: cut food into small pieces, avoid too much chewing, and stop chewing gum.

Give you exercises that stretch the muscles around your jaw.

Your doctor may also recommend:

If your bite is out of alignment, your dentist may suggest you wear a biteplate over your teeth to help bring your upper and lower jaw into alignment.

If you grind your teeth in your sleep, you may be asked to wear a night guard over your teeth.

If stress is causing you to clench your jaw, your doctor may suggest stress reduction techniques or cognitive behavioral therapy to help you manage anxiety and tension.

 

Drug Therapies

Your doctor may recommend the following medications:

Nonsteroidal anti-inflammatory drugs (NSAIDs): to relieve pain. These drugs include ibuprofen (Advil, Motrin) and naproxen (Aleve).

Minor tranquilizers or muscle relaxants at bedtime to reduce spasms and pain.

Injections of a local anesthetic.

Corticosteroid injections, for severe cases.

Botox (botulinum toxin A) injections: can reduce muscle spasms

 

Surgical and Other Procedures

In some cases, removing fluid from the joint may help reduce pain, especially for people whose jaws lock. When other measures have failed, surgery may be needed to repair or take out the disk between the temporal bone and the jaw.

 

Complementary and Alternative Therapies

A comprehensive treatment plan for TMJ dysfunction may include a range of complementary and alternative therapies (CAM). Work with a health care provider who has experience treating TMJ and be sure to tell all of your doctors about any medications, herbs, and supplements you are taking. Treatments, including physical medicine, may help.

 

Nutrition and Supplements

The following nutritional tips may help prevent or reduce symptoms of TMJ dysfunction:

Eat soft foods high in flavonoids, such as cooked fruits and vegetables. Flavonoids are plant-based antioxidants that may help decrease joint pain.

Avoid saturated fats, fried foods, and caffeine. These foods may increase inflammation.

DO NOT chew gum.

 

Some supplements that may help:

Glucosamine: may reduce pain and help rebuild cartilage in the joint, which helps improve range of motion. Some studies show that glucosamine helps reduce pain in people with arthritis, which involves painful joints. One study found that glucosamine worked as well as ibuprofen (Advil, Motrin) for relieving pain and other TMJ symptoms. Glucosamine is often combined with chondroitin sulfate. Glucosamine may increase the risk of bleeding, especially if you also take blood thinners like warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Some doctors think glucosamine might interfere with medications used to treat cancer. Ask your doctor before taking glucosamine and chondroitin.

Vitamin C: is also used by the body to make cartilage. It may improve range of motion in your joints, including your jaw, although there are no scientific studies investigating vitamin C for TMJ problems. Vitamin C supplements may interact with other medications, including chemotherapy drugs, estrogen, warfarin (Coumadin), and others.

Calcium and magnesium: may help the jaw muscle relax, although there are no scientific studies using them for TMJ problems. Magnesium and calcium interact with several medications, herbs, and supplements. They can also affect your heart and blood pressure, so be sure to tell your doctor before you take them.

 

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects, and can interact with other herbs, supplements, or medications. For this reasons, take herbs with care, under the supervision of a health care provider.

Cramp bark (Viburnum opulus) and lobelia (Lobelia inflata) may help reduce muscle spasms, although there are no scientific studies to support using them for TMJ problems. Rub 5 drops tincture of each herb into joint. Use on the skin only and do not apply to broken skin. DO NOT take these herbs by mouth (orally).

 

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of TMJ dysfunction based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

Causticum: for burning pains

Hypericum perforatum: for sharp, shooting pains

Ignatia: for tension in the jaw

Kalmia: for face pain, especially with other joint pains or arthritis

Magnesia phosphorica: for muscle cramps

Rhus toxicodendron: for pains that feel better in the morning and in dry weather, and worse after movement or in wet weather

Ruta graveolens: for pains from overuse or injury

Physical Medicine

Contrast hydrotherapy, which is alternating hot- and cold-water applications, may:

Lower inflammation

Provide pain relief

Speed healing

Use hot packs and ice wrapped in a clean, soft cloth and apply to area. Alternate 3 minutes hot with 1 minute cold. Repeat 3 times for 1 set. Do 2 to 5 sets per day.

 

Acupuncture

Very good evidence suggests dry needling can treat TMJ dysfunction. Several well-designed studies found that needling therapies can relieve pain long term for TMJ problems.

 

Manipulation

There is some Evidence that Cervical manipulation as well as manipulation to the TMJ as well can help with TMJ dysfunction and restore range of motion

 

Craniosacral Therapy

This therapy is a very gentle form of body work. Practitioners use their hands to get rid of restrictions in the craniosacral system, the fluid and membranes surrounding the spine and brain. Although there are not many studies, some people say they feel better after craniosacral therapy. Find a practitioner who has training and experience with TMJ problems. You can interview several practitioners before deciding which one is right for you.

 

Massage

Some types of massage and chiropractic manipulation may help:

Reduce muscle spasms

Provide pain relief

Prevent symptoms from coming back

 

 

Biofeedback

Biofeedback teaches you how to reduce muscle tension through relaxation and visualization techniques. At first, sensors are placed on your jaw, and a machine shows the amount of tension in your muscles. Using relaxation and visualization techniques, you learn to reduce the amount of tension around your jaw while the machine provides instant feedback so you can see how you are doing. Once you have mastered the technique, you can do the relaxation and visualization techniques anywhere, without the machine.

Improving posture

Two types of movement therapy can sometimes help treat TMJ problems: the Alexander technique and the Feldenkrais method.

The Alexander technique teaches you how to properly align your head, neck, and spine, and move your body. It can help relieve tension in your head and jaw muscles, which may reduce the symptoms of TMJ dysfunction.

The Feldenkrais method teaches you to recognize bad posture habits and movements that cause your body to tense. It is a gentle therapy aimed at making you more aware of how your body moves, and helping you develop an inner awareness of your body. Feldenkrais is popular with dancers and musicians, who often do repetitive motions that can lead to overuse injuries.

 

Prognosis and Possible Complications

About 75% of people with TMJ problems who follow a treatment plan with more than one treatment find relief. In rare cases, long-term teeth clenching or grinding, injury, infection, or connective tissue disease may cause degenerative joint disease or arthritis. If you have severe grinding, a nighttime bite guard worn inside your mouth may help.

 

Following Up

You may need to see your health care provider regularly to make sure your treatment plan is working for you.

 

Quick Blog about working out....AT WORK!

Posted on February 7, 2017 at 7:55 AM



 

Mini Workouts You Can Do At Work!

What does exercise have to do with running a successful healthcare business?

More than you think. Everyone knows exercise has significant health benefits, but what about its cognitive benefits?

Research shows that regular exercise dramatically improves job performance and productivity. According to a study cited in Harvard Business Review, it "enables us to soak in more information, work more efficiently, and be more productive." Here are some of the perks:

Improved concentration

Sharper memory

Faster learning

Prolonged mental stamina

Enhanced creativity

Lower stress

Although many healthcare professionals know and preach the benefits of exercise, finding the extra time to do it themselves can be a challenge. They're already overstretched and overworked as it is, running a successful healthcare business and taking care of family responsibilities. But, there is a solution!

Make short bursts of exercise part of your daily routine. A few minutes every couple of hours isn't going to sabotage your schedule or quality of patient care. In fact, it will increase your energy and focus, so you can deliver the level of care and service your patients and customers deserve.

 



Other Ways To Sneak In Exercise At Work

 

Do a set of 20 push-ups every morning when you wake up.

While you’re waiting to use the bathroom at work, do 30 squats.

Set your timer to go off every 30 minutes to an hour. Then, run up and down the stairs or do push-ups for 1 minute.

Ride your bike to work.

Grab a fellow employee and take a walk around the block or the parking lot.

Park farther away, so you increase the number of steps you walk.

Take the stairs instead of the elevator.

For your next meeting, have a walk-and-talk around the block or parking lot.

Have a daily or weekly push-up challenge with everyone at the office.

Before each meeting, have everyone do 30 squats or 30 push-ups.

Run up and down the stairs for 3 minutes 3 times a day.

Switch out your office chair for a stability ball.

All It Takes Is A Few Minutes A Day

 

Research shows it can take as little as 10 minutes a day to see results. You may not become the next Ironman, but you and your medical team will be in better shape to deliver quality care and superior service.




Cupping our way to victory?

Posted on August 8, 2016 at 8:00 PM

If you have watched any of the Olympics as of late, the big buzz is Michael Phelps Circular bruises. Almost covered more intensly than the events themselves. He undergoes a procedure called Cupping. Cupping has been around for centuries. Used in various cultures around the world it is thought to improve blood flow (reducing stagnation), improve Chi, (energy) and liberate toxins from an area that is haing pain or dysfunction. There are many ways to utilize myofascial cups to aid in pain reduction and to improve tissue texture. We can lengthen fascia, and improve flexibility as well as reduce pain. The mechanisms that are truly happening are a bit ore enigmatic but are thought to involve actually causing a localized inflammatory response to allow a chronic injury to heal appropriately and thus pain can be alleviated. 

However, one does not have to come out looking like he/she had a hot date with an octopus to get benefit from this technque. At Bluegrass Doctors of PT we utilize cupping techniques that most often do NOT leave bruises. Unlike Dry Needling this technique is non invasive, completely safe with relatively no contraindications. It is a wonderful adjunctive therapy, to needling, Laser therapy, manipulation and exercises. It however, in my opinion is not a stand alone technique.

Follow us on Twitter, and Facebook. #OlympicCupping. 

Can't Sleep?? Come in and see us.

Posted on July 16, 2016 at 8:40 AM

In the past 10 years, computers and cellphones have become one of the most important factors in our lives, and one which has a tremendously negative impact on our muscles. Muscle tension may be one of the causes of sleep disturbance. Tension in the shoulders and neck can affect blood circulation to the muscles. This research uses a dry needling treatment to reduce muscle tension in order to determine if the strain in the head and shoulders can influence sleep duration. All 38 patients taking part in the testing suffered from tinnitus and have been experiencing disturbed sleep for at least one to five years. Even after undergoing drug therapy treatments and traditional acupuncture therapies, their sleep disturbances have not shown any improvement. After five to 10 dry needling treatments, 24 of the patients reported an improvement in their sleep duration. Five patients considered themselves to be completely recovered, while 12 patients experienced no improvement. This study investigated these pathogenic and therapeutic problems. The standard treatment for sleep disturbances is drug-based therapy; the results of most standard treatments are unfortunately negative. The result of this clinical research has demonstrated that: The possible cause of sleep disturbance for a lot of patients is the result of tensions in the neck and shoulder muscles. Blood circulation to those muscles is also influenced by the duration of sleep. Hypertonic neck and shoulder muscles are considered to impact sleeping patterns and lead to disturbed sleep. Poor posture, often adopted while speaking on the phone, is one of the main causes of hypertonic neck and shoulder muscle problems. The dry needling treatment specifically focuses on the release of muscle tension.



Check out the full article here! 

http://www.waset.org/publications/10004906

Replace CPR?

Posted on July 13, 2016 at 8:35 AM

Can new devices match Heimlich to stop choking?

Published July 13, 2016

The Wall Street Journal

The Ache: Nearly 5,000 people a year die from choking in the U.S., according to the nonprofit National Safety Council.

 

The Claim: Two new easy-to-use devices work like plungers to suck out obstructions in the airway, providing another option if standard treatment—such as abdominal thrusts developed in 1974 by Henry Heimlich—fail to clear the airway, say the companies who sell them.

 

The Verdict: A recently published laboratory study showed the LifeVac, from LifeVac LLC of Springfield Gardens, N.Y., dislodged simulated obstructions. So far there haven’t been any scientific publications detailing lives saved with the LifeVac or another device, from Dechoker LLC, of Salisbury, N.C.

 

More on this...

96-year-old Heimlich uses namesake maneuver on choking woman

Autistic NYC boy says 'SpongeBob' taught him Heimlich

The ubiquitous choking poster gets a makeover

Both the Dechoker, $89.95, and the LifeVac, $69.95, have a plastic mask that provides a seal over the mouth and nose while suction is provided. The Dechoker looks like a large syringe, while the LifeVac’s plunger is shaped like a small accordion. In both devices, one-way valves allow air to only travel out of the mask and not into it, which avoids pushing the object deeper in, says LifeVac Chief Executive Arthur Lih.

What we do in the spine and extremities affects our brain.

Posted on July 7, 2016 at 9:35 AM

Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study


LINK: 

 

http://www.hindawi.com/journals/np/2016/3704964/



Above is a title of a new article looking at what happens we apply joint manipulation in the spine, on the brain. Amazing. Again, this is yet another article that shows interventions that are applied to the spine and extremitieis affect our BRAIN. This in time could induce neuroplastic changes. Good stuff! 

Wellness Programs

Posted on June 29, 2016 at 11:10 AM

Employee Satisfaction Linked to Wellness Programs

The prevalence of wellness programs in today’s work environment was examined in the 2012 Aflac WorkForces Report, an online survey of more than 1,800 benefits decision-makers and more than 6,100 U.S. workers. The study included findings about the impact of wellness programs on employee satisfaction, well-being and productivity. Compared to workers who are not offered wellness programs, employees who are offered wellness programs and participate in them are more likely to have a higher level of job satisfaction, feel happier with their employer, and be more satisfied with their overall benefits.  

The bottom line is that companies can help increase employee satisfaction by focusing on the well-being of their workforce. For example, 28 percent of workers said they would feel more satisfied and more loyal to their employer if their company offered more options to improve their health and lifestyle. Workers also recognize the fact that they need to take an active role in workplace wellness. Thirty-five percent of employees were willing to change their lifestyle habits if it meant they could lower their health insurance premiums.

 

Financial Benefits of Implementing Wellness Programs

While companies certainly care about the well-being of their employees, benefits decision-makers admit that a primary reason their company maintains a wellness program is to help curb health care costs, and 59 percent of companies agree that wellness programs can help reduce these costs.

 

Despite the benefits of wellness program, nearly a quarter (22 percent) of companies do not offer them for their workforce due to the difficulty in quantifying the return-on-investment (ROI). However, a comprehensive analysis of 42 published studies of worksite health promotion programs showed that companies that implemented an effective wellness program realized significant cost reductions and financial gains, including:

 

· An average of 28 percent reduction in sick days

· An average of 26 percent reduction in health costs

· An average of 30 percent reduction in workers’ compensation and disability management claims

· An average $5.93 to $1 savings-to-cost ratio.

 

The 2012 Aflac WorkForces Report found similar results. Nearly all (92 percent) of the companies with a wellness program in place agreed that these programs are effective, and 47 percent reported the programs are very or extremely effective. In addition, 44 percent of employers agree they are able to offer lower health insurance premiums as a result of their wellness program, and six in 10 (61 percent) agree they have a healthier workforce as a result of having a wellness program in place.

 

Recognizing the Role Financial Stress Plays in Overall Health

Creating a healthy workforce requires more than physical health. Financial security is another factor that influences overall wellness. Many American workers today are facing financial predicaments and high debt as a result of the current economy and a lack of education about financial principles. These situations can lead workers to enormous amounts of stress which in turn can lessen overall wellness.

 

For instance, only eight percent of workers strongly agree that their family will be financially prepared in the event of an unexpected emergency, while 51 percent are trying to reduce debt. Nearly six in 10 workers (58 percent) don’t have a financial plan in place to handle the unexpected, and the same amount either don’t consider health insurance a part of their financial plan or consider it a minor part. Clearly, many Americans are in a difficult financial position and that often means turning to their employer for help.

 

Workers facing debt and unstable financial situations reported their stress has caused occurrences of ulcers, digestive problems, migraines, anxiety and depression. Results even showed heart attacks occurred at rates between two and three times the national average for these overstressed workers.

 

As a result, employers are also feeling the effects of their employees’ anxiety, beyond higher health care costs. One in five (20 percent) workers have experienced a health issue that has affected their ability to get their work done, which can result in higher productivity losses for companies. Additionally, nearly half of companies (43 percent) surveyed estimated their average productivity loss stemming from employees’ concern over personal issues is between 11 and 30 percent, and productivity losses related to personal and family health problems cost U.S. employers $1,685 per employee, per year, or $225.8 billion annually.

 

These statistics show the negative impact companies face if their workers are not adequately protected by their current benefits coverage. Voluntary benefits options are beneficial because they allow businesses to add coverage options at no direct cost to their company and, at the same time, help protect workers.

By making voluntary plans available to workers, companies can help alleviate financial concern and help employees feel more protected in case of an unexpected health event. Workers have more positive feelings about their benefits options when they are offered or enrolled in voluntary plans. For instance, 70 percent of employees whose benefit packages include voluntary options feel that a comprehensive benefits package safeguards their health and wellness