Chances are, you or someone you know has had back pain. Each year, 15% of the population has their first episode of back pain, and over the course of our lives, 80% of us will have back pain. Even though back pain is common, the medical community does a poor job of managing it. Stories of chronic pain, opioid use, multiple surgeries, and a lifetime of disability are far too common. Let’s look at some of the common treatments for low back pain and see how they stack up against physical therapy.
Medication: Low back pain is the #1 reason for opioid prescription in the U.S., however, in 2016 the CDC recommended against the use of opioids for back pain in favor of “non-drug treatments like physical therapy.”
Imaging: Having an x-ray or MRI for back pain is common, however, it’s rarely needed or helpful. Research has never demonstrated a link between imaging and symptoms. As we age, degenerative changes on imaging is common.
-90% of people age 50 to 55 have disc degeneration when imaged, whether they have symptoms or not
-In 2015, a study that looked at 1,211 MRI scans of people with no pain found that 87.6% had a disc bulge
-Just getting an image increases the chances of that you’ll have surgery by 34%
Surgery: The U.S. has sky-high rates for back surgeries, 40% higher than any other country and 5x higher than the U.K. You’d think that with all the back surgeries we do, we’d be pretty good at it, but the outcomes are terrible! A worker’s comp study looked at 725 people who has spinal fusions vs 725 people who didn’t. The surgical group had:
-A 1 in 4 chance of repeat surgery
-A 1 in 3 chance of a major complication
-A 1 in 3 chance of never returning to work again
Physical Therapy:
-Current clinical practice guidelines support manual therapy and exercise
-Research proves that early PT leads to better outcomes with lower costs and decreases the risk of surgery, unnecessary imaging, and the use of opioids
-A study of 122,723 people with low back pain who started PT within 14 days found that it decreased the cost to treat back pain by 60%
-Unfortunately, only 2% of people with back pain start with PT, and only 7% get to PT within 90 days
Despite the data showing that PT is the most effective, safest, and lowest cost option to treat low back pain, most people take far too long to get there. Almost every state has direct access, meaning that you can go directly to a physical therapist without a doctor’s referral. If you see your doctor for back pain, and PT isn’t one of the first treatment options, ask for it! #ChoosePT

Just because you don’t have neck pain, it doesn’t mean that the pain going down your arm does not originate from your neck. This is something that should always be screened with physical therapist, but let’s talk about what you can do at home to best help the symptoms with your shoulder, arm, elbow or hand. This also, of course, does not mean that it is coming from one of those areas, but the neck must be ruled out, especially when you have been working with a specific area and not getting any relief.

The first and easiest way for you to rule out anything, would be to move your neck around and see if it changes the pain down your arm at all. It may either reproduce it and make it worse or take it away. Be sure to check all directions, look up, down, left and right, as well as tilting to each side. You may have to move in and out of the position 10 times or hold for 30 seconds to get any reproduction or relief of symptoms. If you get a positive result from what you do and it relieves any of your symptoms, continue to do this. The reverse is also true, but either way, now you have something you can address. So why is the problem in the neck, but the pain is somewhere else?

Nerve Entrapment
When the nerves become entrapped, it is usually one of two places. The first is in the lower cervical spine, as this is where all of the nerves are that go down into the arm. The other place is between the collarbone and first rib. As all of the nerves exit the spine they travel here first before going down further. Compression at either of these joints can leave you in a world of hurt.

Joint and Disc Referral
These are more likely to be present as neck pain but can also be out more towards the shoulder blade as well, making it easier to determine what needs to be done next.

Trigger Points
The main, larger muscles of the neck can all have referral patterns outside of the neck. The good news is that there is relief. It is hard to get into too many treatment specifics, but let’s review a few of the things that generally most people would benefit from. Things such as stretches, strengthening exercises, manual therapy techniques, McKenzie spine techniques, cervical traction and postural education should reduce your symptoms and get you back on track.

If you are having pain, it is important to know where it is coming from–and a physical therapist can do just that!

You know exercise is important to your health. It helps you feel better physically, gives you energy, and helps you deal with the stress of your busy life.
But what do you do when life gets too busy to take an exercise class, go for a run, or get to the gym?
It’s easy to start skipping exercise when life gets busy, but that leads to less energy, and aches and pains cropping up. This makes you feel like exercising even less and leads to a downward spiral. That means finding time to exercise when life is busy is even more important. If you can find 8 minutes, you can maintain your strength even on your busiest day.

Exercise doesn’t have to take lots of time. In fact, your 8 minutes don’t even have to be all together. You can break them up throughout the day. Doing one exercise for one minute every hour while at work counts just as much as doing 8 minutes of exercise after the kids are in bed and before you collapse on the couch. The following exercises use your body weight for resistance, so you don’t need any equipment. They also use many muscle groups at once, so you can maintain strength in your whole body in a short amount of time:

1. The Plank; Lying on your stomach, with your forearms on the ground, elbows under the shoulders, and arms parallel to the body. Toes tucked under, engage your stomach muscles, and lift your body up. Hold for 20 seconds, rest 5 seconds, and repeat 3 times.
2. The Push Up; (try doing these on your knees if you need an easier version). 20 seconds of push ups, 10 seconds of rest and repeat.
3. Quadruped; Start on your hands and knees with your hands under your shoulders, and your knees under your hips. Lift and reach with one arm and the opposite leg, maintaining a stable core. Hold 10 seconds and repeat on opposite side. Repeat 5 times.
4. The Bridge; Lying on your back, with your knees bent, engage your abdominals and lift your hips. Hold 20 seconds, rest 5 seconds, and repeat 3 times.
5. The Lunge; Stand tall and take a large step forward with the right leg, shifting your weight forward. Lower your body until the right thigh is parallel to the floor and your right shin is vertical. (do not let the knee shift past your right toe) Return to the start and repeat on the other side. Repeat 20 times.
6. Squat to heel raise; Feet shoulder width apart, core engaged, and arms raised high above your head. Perform a squat and return to standing then rise onto your toes. Repeat 20 times.

Are you having any pain doing these exercises? Physical therapy can help! Start your 2023 feeling strong!

Physical Therapy for Hypermobility and Ehlers Danlos Syndrome

Joint hypermobility syndrome is a condition that causes the joints to easily move beyond the normal range expected for a certain joint. This is an inherited connective tissue disorder. It is commonly referred to as having “loose joints” or being “double-jointed”.
Signs of hypermobility are pain in the knees, fingers, hips, and elbows. There is also a higher tendency for joint dislocation and sprains. People with hypermobility can many times place the palms of their hands on the floor with their knees fully extended. With hyperextension of the knee or elbow beyond 10 degrees, many have the ability to touch the thumb to the forearm. Some people with hypermobility could have a rare and inherited condition called Ehlers-Danlos syndrome, which is characterized by weakness of the connective tissues in the body.
EDS can also affect the heart, skin, ligaments, tendons, and muscles, thus causing joint pain. Looseness of the joints can result in sprains, dislocations, or spinal problems. Many people have back pain, SI joint dysfunction, and TMJ/TMD issues. These issues may also lead to decreased balance.
While there is no cure for hypermobility syndrome or EDS, improving muscle strength and fitness to protect the joints is essential in managing the condition and preventing dislocations. Physical therapy is the best at treating these issues.
Dry needling can be very efficient in reducing muscle spasms associated with EDS. Exercise for stabilizing the joints is important as well. Because of this, dry needling is most effective when followed by other manual therapy techniques to re-educate the joint on its most stable position. Muscle energy techniques and myofascial release are also typically done.
If you have any suspicion that you might have a Hypermobility Syndrome, Connective Tissue Disorder or Ehlers Danlos Syndrome, find a specialist in your area. With hEDS, knowledge truly is power and you can become a better self-advocate for your care. Though there is yet to be a “cure,” physical therapy remains the best line of treatment.

Seek treatment now while your health insurance deductible is met, here’s why!

1. Most insurance deductibles are usually met by now:
Many patients do not plan ahead in regard to their health insurance deductibles. Most of us have met our deductibles or our max out of pocket expense, making it a very good time of the year to have things taken care of. So, whether it’s a nagging injury or another medical problem, act now before the end of the year to save yourself some money.

2. The sooner you seek treatment, the quicker you get better:
Most physical ailments, although small initially, can quickly lead to more serious problems. The human body is an amazing machine as everything works together. Although, a small problem in one area can lead to compensations in other areas of the body later on thus causing other issues. At Fast Track, we often find the sooner treatment is started, the quicker the issue resolves. For instance, if you are having a problem with your knee that causes you to walk with a limp, increased stress is placed on your hip and lower back, resulting in increased pain in those areas. If you wait too long, this problem can become worse, and it could take longer to heal.

3. You do not need to see a doctor to get treatment:
Indiana is a direct access state for physical therapy services. This means that you can seek treatment for your current ailment without seeing your doctor first. Our physical therapists are experts in treating musculoskeletal conditions and can refer you on to the appropriate doctor if needed. They will also communicate all findings and treatments to your doctor as well.

Avoid the end of the year holiday season rush!
The upcoming holiday season is often a busy time for everyone between school, work, sports, family gatherings, and shopping. This can make scheduling appointments more difficult for patients. We also experience a large rush of patients who have met their health insurance deductibles the last few months of the year, so it is important to get in while you can!

The holiday season can make life a little bit busier, so make sure to take care of yourself so you can feel as good as you should!

Your sciatic nerves run from either side of your lower back down to each of your legs. That’s why a classic sign of sciatica is having a shooting pain on one side only. While compression of one of your sciatic nerves can literally be a “pain in the butt,” it doesn’t always require medical attention. Although, physical therapy is your best bet to banish sciatica symptoms if there is a flare-up. Sciatica could be caused from a herniated disc, SI joint disfunction, sudden injury or something else.

1. IF HOME TREATMENTS AREN’T WORKING
There are plenty of things you can do at home to ease a mild sciatica flare-up. Sleeping with a pillow between your knees can help. If you can’t get comfortable during the day or at night, try a reclining chair to redirect the pressure from your lower back. Going for walks often helps ease sciatica pain, because “babying” your condition can actually make it worse.
While these methods may help with mild sciatica, there are times when you should see a health care professional. One sign that you should see a sciatica specialist, such as a physical therapist, is if your home treatments are having little or no effect, or symptoms last more than a week. Of course, the worsening of pain is the most important sign.

2. WHEN SCIATICA SYMPTOMS BECOME SEVERE
If your sciatic nerve becomes seriously compressed, the resulting symptoms can go from uncomfortable to quite painful – and even embarrassing. You may become weak and numb on one side. Sometimes, even getting your leg or foot to move becomes impossible. If the pain hits you suddenly, and with great intensity, it’s probably time to visit a physical therapist to begin easing the pain.
Another issue with sciatica could be that the sciatic nerve can become compressed in the area that controls bladder and/or bowel function. If you lose control of either or both of these functions, you’ll obviously want to get professional help. Visit a doctor to rule out other problems.

3. IF THE PAIN FOLLOWS AN INJURY
Mild sciatica can build up over time, and it may even go away on its own. But when you have an onset of classic sciatica symptoms following a car accident, serious fall or sports injury, contact a doctor or a physical therapist. The symptoms are more likely to be severe because of the greater impact on the area surrounding the sciatic nerve. It’s important to determine the severity of nerve damage. Your medical team will need to evaluate if surgery or a steroid injection is needed.

Exercise is helpful in targeting the muscles that strengthen your lower back. Having strong muscles will help support the area around your sciatic nerve and can prevent future injuries. Good posture helps as well to keep away sciatica symptoms. Increasing range of motion is also good for sciatica.

The good news is that there is relief from sciatica. Relieve your symptoms with the help of physical therapy!

Whether you are a weekend warrior or a professional, the golf game can take a toll on your body.

Research shows that 65% of all golfers will sustain an injury at some time during their playing days. This is because the golf swing is a rapid, complex movement that combines flexibility, strength, balance, coordination, and endurance. If the focus is on the equipment and not enough on what is swinging the club, an injury will occur. Our physical therapists focus on the body, as it is the most important piece of equipment that can be improved!

The golf swing is a complex, full body motion that puts a lot of force through the bones, muscles, and ligaments. Jumping straight into swinging a club without properly preparing those bones, muscles and ligaments puts golfers at risk for injury. A good rule of thumb to help you remember what a proper golf warm up looks like is that you can’t swing to warm up, you have to warm up to swing.

A good warm up includes neck rotations, shoulder circles, side bends, torso rotations and will help keep you safe from injuries, although there are times especially with overuse that injuries still occur. Incorporating physical therapy can also improve mobility of shoulders, hips, knees and back. This will help with better control and help you finish your swing without pain.

At Fast Track, we will evaluate your core and limb strength and address any defects with manual therapy and exercises.

Our bodies are also impacted by our posture and other daily activities off the course. As we age, this can become cumulative and start to limit your swing. Is your handicap slowly creeping up? This may be why.

Using a combination of soft tissue mobility, manual therapy, dry needling, advanced strengthening, and dynamic stabilization drills, we work with you to optimize your body and maximize your swing. We want to give you the same treatment as PGA Tour professionals!

What is Patellofemoral Pain?

Patellofemoral pain is pain arising from the kneecap (patella) or the supporting tissues around the kneecap. It is one of the top 3 causes of knee pain we see in our practice and occurs when the patella is not moving or working correctly. Sometimes, there may be early arthritis of the patella, and often there is swelling or fluid in the front of the knee. If you have a weak hip, poor gait pattern, or a particular foot shape, this can make things worse.

How do I know if I have Patellofemoral Pain?

A diagnosis of patellofemoral pain is made based on your medical history, the location of your symptoms, and pain that is reproduced with certain physical tests versus others. An x-ray is not necessary to make a diagnosis.

What Can I do to Help Myself?

As mentioned above, often patients with patellofemoral pain have extra fluid in the front of the knee. This stops your leg muscles from working properly. Once the fluid has been addressed, we can start training your leg muscles, a very important step to getting rid of your pain.

Can Physical Therapy Help?

Patellofemoral Pain is very treatable, and the majority of patients are able to get rid of their pain and return to their normal activities after a few sessions with a physical therapist. Physical therapy sessions may include strengthening the hip and knee muscles and examining the foot to see if it is contributing to the problem. Remember: your exercises must be matched not only to your problem but also your stage of recovery and your functional goals. 

Dry Needling is considered to be an extremely effective technique in reducing muscle tension and pain, increasing motion, and promoting increased function within muscles.

This technique is just one of many physical therapy treatments and modalities that is used to relive pain associated with muscle spasms, tendonitis, migraines, and so much more. Dry needling is a treatment that involves the use of a very thin needle through the skin to stimulate a trigger point. Dry Needling is used to release tight muscle bands that are associated with trigger points, or hard “knots” within a muscle that can cause pain over a large area. Sometimes these trigger points or muscle spasms can make it difficult to perform everyday tasks due to the pain every time the area is touched. This pain can even radiate to nearby areas of the body. The needle is used to deeply treat muscles and “deactivate” or “shut down” a painful knotted area or trigger point within muscles. When someone has muscle pain or tightness, it can lead to irritation and compression of the nerves. Irritated nerves send out a protective spasm to all of the muscles to which they are connected. This can lead to decreased mobility and pain in the area. Many of us have areas in our body that constantly feel tense or have what feels like a hard ball within the muscle. This type of treatment involves inserting fine needles into the tight areas, which elicits a brief contraction or “twitch response” followed by an immediate and long-lasting feeling of relaxation. This deep treatment can help patients achieve amazing pain relief they never thought possible.

“Before I started physical therapy at Fast-Track, I had been treated at various clinics for the last 9 months and was still incapable of doing basic things without a lot of pain in my back and shoulders. Within weeks of working with Brian and Bridgette, my pain went from a constant 7 to an intermittent 3. Today, after 3 months of treatment, my pain has virtually dispersed, and it is all thanks to this team and their knowledge in the dry needling technique. Thank you so much for helping me get back to where I was before the accident.” -Evan L.

What is Dry Needling able to treat?

· Neck pain

· Migraines and TMJ

· Back pain

· Tendonitis, shoulder and elbow pain

· Joint pain and dysfunction

· Plantar fasciitis

Benefits of Dry Needling:

· Pain relief

· Reduces muscle tension

· Restores / Increases motion and function

· Speeds up recovery

Will Dry Needling help me?

If you like the results of massage therapy but are disappointed when your discomfort returns, Dry Needling may be a great way for you to receive more long-lasting relief. Unlike other types of manual therapy, Dry Needling can treat nearly any muscle in the body, and at depths other treatments are unable to reach. Dry Needling is a great technique to complement your physical therapy treatments because it allows us to get rid of the deep knots and tension points that are unreachable during a massage.

“After trying massage for pain for 20 years, I Googled Dry Needling and Fast Track Physical Therapy came up. I was having issues with my shoulder range of motion, plus my neck and upper back. I started with Brian and moved to Bridgette when he was out of town for training. The dry needling was very helpful for my recovery, and I would highly recommend it as a tool to fixing the problem. Bridgette was very thorough in her treatments and always took the time to listen to my concerns. The techs were all very caring and always made me feel very comfortable. The office staff communicated well. They always greeted me and helped with any issue I had. I am so grateful for all the care I received from Fast Track and will miss seeing my “friends” each week.” -Kimberly C.

If you are newly injured, swollen, and have acute pain, Dry Needling is not appropriate. Additionally, patients with excessively loose joints may not be appropriate candidates for this type of treatment. An evaluation will help determine if you are a good candidate for Dry Needling.

Does the needle hurt?

The needles are very fine and solid compared to a hollow injection needle, which means they do not hurt as much. Patients report sensations of soreness, pressure, releasing, and deep aching. The needle is left in just long enough to relax your muscle, which is a short period of time. In order to return the muscle to its normal, relaxed state, the procedure is repeated in different areas. There is some discomfort because we treat sensitive areas. However, it is well worth tolerating considering the long-term relief Dry Needling treatment provides.

How will I feel after Dry Needling?

After receiving dry needle treatments your muscles may feel fatigued. Soreness can last from a few hours to 1 to 3 days, but it should not interfere with your everyday activities. We encourage you to drink lots of water and be active during this time to keep the soreness to a minimum. Applying heat to your sore muscles may help to minimize soreness. You may experience less pain and tightness after a day or so.

When used in conjunction with other physical therapy techniques, dry needling is most effective. Dry needling is another treatment tool, just like therapeutic exercise, spinal traction, other manual therapy techniques, and various modalities. It is often useful early in treatment to help break the pain cycle.

“This is a great treatment option. I have been doing Dry Needling since 2013, and Fast Track probably has the most experienced and the most certified therapists in Dry Needling in Indiana. All of our physical therapists are certified in dry needling here at Fast Track, and it has been an excellent resource to have in addition to many other certifications and techniques we use.”

–Brian Horner PT, Owner of Fast Track Physical Therapy

Practice makes perfect… but when it comes to kids’ sports, variety may be the key to great success and less injuries.

Sports are a great way to keep your kids active, fit, and is good for teaching them teamwork and discipline. Sports are great, but there could be injuries that come along with it. In physical therapy, we see many kids and young adults with sports injuries.

The American Academy of Pediatrics reports that at least 50% of athletic injuries – mostly sprains, strains, and stress fractures- are from simple overuse. It is also possible some may have more serious injuries, such as concussions, meniscus tears, or broken collar bones. Research shows kids benefit most from exposure to multiple sports and forms of activity at a young age.

In an era of specialization, traveling teams, and year-round sports, it is easy to get caught up into focusing on just one sport. Professional athletes played a variety of sports when they were younger and believe being a multi-sport athlete contributed to their success later. Lebron James played football in his youth, and Michael Jordan played baseball and golf. 90% of first round picks in a recent NFL draft were multisport athletes in high school, and 224 of the 253 total picks were multisport athletes.

When kids are 8 or 10 years old and you give them options of sports to play, their body can get exposed to several demands as they are still growing. It is not just good for them physically, but mentally as well. Once kids reach their late teen years, then they can decide which sport to more focus on.

While variety is best for growing muscles, it is also important to rest. 1-2 days off for rest each week with at least 2-3 months off of an individual sport each year is good for your health.

Focus on skills development rather than structured competition. Less injury risk, because the body is moving/training in different ways, reduces the risk for overuse injuries. Developing fundamental skills early increases success and ultimately a love for sports.

At Fast Track Physical Therapy, we encourage parents to pay close attention to your young athlete’s complaints about aches and pains. While they could be simple growing pains, they could also be precursors of those over-use injuries.