There are many choices in health care. Here’s why you should see a physical therapist first:

If you or a family member are dealing with pain and aren’t quite sure who you should go see, a physical therapist might not be the first person you think of. Hopefully after reading this, it’ll help you understand why a physical therapist should be who you see first.

Physical therapists are specialists in musculoskeletal issues. Whether you are having trouble getting out of bed, picking up your kids, having difficulty reaching into the cupboards, or any other daily tasks that you’re having trouble doing, a PT can help. A physical therapist will do an extensive evaluation and give you a game plan that will help you get back to what you want to do, which is the whole point, right? A physical therapist can help facilitate your recovery by giving you the tools to be healthy for the long run, without relying on medications, injections, or surgery.

Many people know physical therapists treat backs, knees, shoulders and all orthopedic issues, but did you know a PT can also treat migraines, TMJ/TMD and vertigo? If you choose PT first, you’ll feel better faster and could potentially save money in the process! Who doesn’t like to save money? Also, in the state on Indiana, a law was passed that does not require a referral to see a physical therapist. Most people don’t know that, so we’re trying to make sure people understand they have a choice in where they want to go to get better.

I like to compare physical therapy to when something goes wrong with your car. If you need to invest in parts or get work done to keep your car running properly, why wouldn’t you do the same thing in regards to your health? There are many places you can go for an injury. Hopefully, you know now that you can choose physical therapy first!

Posture Talk…

For many years, there was the thought that “bad posture” may be the reason behind an individual’s back pain. Sitting improperly, lifting heavy objects for work or exercise, or maintaining awkward positions were attributed to be the sinister source of back pain. However, there has been a shift in this thought process. A systematic review could not find a causal relationship between physical activities which include bending/twisting, awkward postures, sitting, standing/walking, carrying, pushing/pulling, lifting, and manual handling/assisting patients with low back pain. With all these conflicting thoughts and evidence, it can be confusing to figure out the best way to maintain your spinal health and prevent future or recurring back pain.

Here are some recommendations moving forward that could help those who experience back pain:

Try finding a more comfortable position: We all have variations within our spines that make certain positions more painful or pain-free compared to our peers. Finding a more relaxed posture is associated with more symptom relief. If you find certain positions in your daily life that are provoking your back pain symptoms, try to alter your position slightly to see if you can make the position more comfortable or relaxing. Your spine is strong! Your spine is built to withstand the forces and motions that we do every day.

Movement is healthy for the spine and even encouraged if you are experiencing back pain. Try to move into positions that you may have avoided in the past due to their association with pain. Pain doesn’t always mean you are harming the spine. Furthermore, learn to trust the strength of your spine.

Reflect on the other areas of your life. Poor diet, sleep, and stress can all contribute to low back pain. Back pain is a multi-factorial problem that can be caused by different areas in your life. Before attributing “bad posture” to your back pain, think of the whole picture and other possible culprits that could be improved for your overall health and wellness.

Even though “bad posture” may not be the cause of your back pain, always pay close attention to your body mechanics, especially if heavy lifting has provoked your back in the past. As mentioned before, try to take a holistic approach to the multi-faceted problem of back pain. If you find yourself or a loved one experiencing acute or recurring back pain, it may be time to see a physical therapist. Is your back bothering you? Contact us for a free injury or screening so we can evaluate your posture and get to the bottom of your back pain!

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.