Physical Therapy Blog | Results Physiotherapy

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Osteoarthritis: Prevalent, but not always symptomatic

Osteoarthritis (OA) of the hip and knee is among the leading causes of global disability, highlighting the need for early, targeted, and effective treatment. New research supports prevalence of asymptomatic, uninjured people, and re-confirms the importance of focused physical therapy, physical activity, and exercise. From a study published in April of this year, re-affirming the positive effects of exercise on OA. The majority of people with hip and knee OA do not meet physical activity...

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We’re Different – Here’s Why

The most important question we need to answer for physicians and healthcare professionals is Why are you different?" This new 1-page document answers that question . The answer

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When deductibles reset, don’t let patients live with pain

It’s an interesting fact that the PT industry takes a business dip in January. Why? We know there aren’t fewer people being diagnosed with issues related to musculoskeletal pain, and the amount of surgeries requiring post-operative PT may actually increase. And, with all the people trying to start the year off by getting into better shape, it’s probably peak season for nagging pain and new injuries. The typical industry response sounds logical: insurance deductibles...

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Tennis Elbow: Often Misunderstood

We have often thought of tennis elbow or lateral epicondylitis as an “inflammatory condition,” as indicated by the title. This is partially wrong. It is actually a tendinopathy ; that is, a breakdown of the common extensor tendon as it attaches to the lateral epicondyle. As a result, simple anti-inflammatory or steroid treatments will often not work and can create chronicity, preventing the patient from getting better. A tendinopathy needs a...

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How to help your patients with headaches

We know that headaches are one of the most prevalent and complicated conditions in medicine: It’s estimated that 3% of all patients in a PC waiting room suffer from some form of headache. There are different types of headaches but 60% of all headaches are appropriate for physical therapy treatment. Cervicogenic and Tension headaches respond to physical therapy treatment; specifically, treatment by a skilled manual therapist. Cervicogenic headache is actually pain referred to...

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Healthcare Cost Savings For Patients With An Incident Of Low Back Pain

Low back pain is very common, with 80% of people experiencing back pain at least once in their lifetimes.1There are a multitude of studies that have been published through the years evaluating possible treatments for low back pain. In the last decade, there have been deeper studies to show correlation between the use of physical therapy intervention for low back pain and the average health care savings. In 2004, Virginia-Mason launched an in-depth study and self evaluation of their health care spending as a result of threats made by Aetna in collaboration with other large employers in the Seattle area. Results indicated early physical therapy intervention and decreased use of imaging not only decreased health care spending in addition decreased work lost and improved productivity.2 (2 – TRYING TO FIND A SPECIFIC STUDY THAT STATES THESE STATS SPECIFICALLY!)More recently, the Alliance for Physical Therapy Quality and Innovation (APTQI) engaged The Moran Company (TMC) to begin to assess different initial treatment interventions from a cost standpoint for low back pain within the Medicare program.3 The study population consisted of 472,000 Medicare Fee for Service (FFS) beneficiaries with an incident low back pain (lumbago) diagnosis from Medicare claims data in 2014. Surprisingly, only 13% of those beneficiaries received physical therapy as their first line of treatment. While the Virginia Mason model looked more specifically at health care costs utilizing imaging, this study compares costs to those who received injections or surgeries first. The analysis shows that those who received physical therapy intervention first had an average savings of 19% as compared to those who received injections and a savings of 75% of those who received surgery first. The study further analyzed the cost savings a year following the diagnosis which showed an 18% difference with those who received injections first and a 54% difference of those who received surgery first. Table 2. Average Total A/B Medicare Spending in the Year Before and Year After Diagnosis by Initial Treatment Intervention for Incident Lumbago Beneficiaries Further studies have looked into the timeliness of physical therapy intervention with relation to cost savings, return to work, and disability. All have shown that earlier intervention have positively affected each of these categories.3,4 The APTQI and TMC collaboration determined that beneficiaries who received physical therapy intervention in the first 45 days show a 9% difference in spending while those who receive intervention within 15 days how a 27% difference in cost spending. Table 1. Average Total A/B Medicare Spending for Beneficiaries who Receive Therapy by Time to Start of Therapy, Focus Period, Year FollowingWhile many of you patients are concerned with the cost of physical therapy, there is significant research to support that early physical therapy intervention provides decreased cost savings to the consumer, including decreased spending on imaging, injections, and surgeries but also in missed days work and disability. The earlier start time further improves these costs. References: Flynn TW et al, Appropriate Use of Diagnostic Imaging in Low Back Pain: A Reminder that Unnecessary Imaging May Do as Much Harm as Good. J Orthop Sports Phys Ther 2011;41(11):838-846. Virginia Mason Model Study???? Initial Treatment Intervention and Average Total Medicare A/B Costs for FFS Beneficiaries with an Incident Low Back Pain (Lumbago) Diagnosis in CY 2014, Prepared for APTQI, May 2017, The Moran Company Julie M. Fritz, PhD, PT1; John S. Magel, PhD, PT1,2; Molly McFadden, MS1; et alCarl Asche, PhD3; Anne Thackeray, PhD, PT1,2; Whitney Meier, DPT1; Gerard Brennan, PhD, PT2. Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain: A Randomized Clinical Trial. JAMA. 2015;314(14):1459-1467.

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Management of Knee Pain in Runners

By Jordan Hicks, PT, DPT, OCSRunning is an excellent activity to improve physical fitness and reduce the risk of chronic health issues such as diabetes, high blood pressure, and heart disease. Running continues to enjoy widespread popularity, with people participating in various running events from 5k’s to ultra-marathons. Given the number of people running and the mileage logged, the frequency of injuries associated with running is also on the rise. Most runners, especially those training for longer events such as marathons, will have some type of injury during training or competition. The most common area that runners will develop pain/injury is the knee.Proactive education with these athletes is key to avoiding injuries, and then directing them to the appropriate early intervention when an injury does occur. The purpose of this commentary is to discuss a few tools to help healthcare professionals reduce risk of chronic knee injury, to help differentiate which patients need a referral to physical therapy, and to describe what physical therapy can do to manage these issues once they occur.Knee pain that develops with running is typically a result of decreased muscular control in the leg during weight bearing, either at the foot and ankle or at the hip. Patients may also have some restriction or imbalance of muscles in the thigh, or limited mobility in soft tissue structures around the knee. The problems mentioned above can cause issues with patellar tracking, which then causes stress to the surrounding tissues and the patellofemoral joint, resulting in pain. This is typically referred to as patellofemoral pain syndrome or PFPS. This term encompasses any dysfunction of this joint and its surrounding tissues. The most commonly involved structures will include patellar tendon, distal quad M-T junction, bursae, fat pad, distal IT band, and patellar ligaments. There can also be pain that is a direct result of referral from muscles in the thigh and hip.Pain usually occurs during activities such as running, walking, squatting, and is typically worse with things like going down stairs or down hill. Many times the symptoms will improve with a period of rest from the aggravating activity, but once the activity is resumed the pain returns. There is rarely a specific injury/instance, such as a fall or a pop in the knee that patients will attribute with this pain. This indicates a movement dysfunction or motor control issue, and not necessarily an inflammatory process, so the problem will not subside with rest and medication alone.At Results Physiotherapy, we provide a hands-on approach for all patients. Our examination will focus on identifying involved tissues, assessing joint mechanics, and discovering limitations in mobility and changes in motor control. Treatment provided by a Results PT will involve the application of specialized manual therapy techniques to assist with pain reduction and reduce abnormal tissue stress. Treatment techniques will include taping to help facilitate proper PF joint alignment, soft tissue and joint mobilizations to assist the healing process and increase the patient’s tolerance to specific exercises.Exercise is a key component to restoring function and reducing risk of further injury. There is significant benefit to having a PT perform a detailed movement assessment and provide an individual exercise program that fits the specific needs of each patient. This will also allow adequate time for personalized education regarding risk reduction. Results PT’s are able to give information based on current best evidence for reducing risk through proper periodization of training for current runners, as well as a structured and individual training program for new runners.

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New Post-Evaluation Email to Patients

When you refer a patient to Results, we recognize two things: You are entrusting us with the care of your patient. There is nothing more important than providing that patient with world-class treatment and service.One of the ways we do this is by creating what we call “3E Moments,” which are opportunities to Engage, Encourage and Educate your patient.This starts with receiving the referral and quickly (typically within 24 hours) getting the patient scheduled for their initial evaluation. The initial evaluation is the one of the most critical 3E moments, which is why we follow up every first visit with this email, which effectively communicates the following: A clear welcome message. It’s basic, but research confirms how important it is that patients feel welcome into our clinics. First impressions truly count. We are on a journey together. This message reinforces patient engagement and encourages them to mentally prepare for completion of their plan of care. It includes a link with more “what to expect” details and a video, all of which confirms they are in good hands and we are going to help them achieve their goals. Testimonial video links. Further reassurance and educations with the help of former patients – not just from us – which tends to be a more trusted source for consumers in general. Digital engagement. Digital/social connectivity helps solidify patient commitment – so we encourage connecting via Facebook (Check In!) and online reviews on Facebook, Google or Yelp. This in turn helps encourage other patients, creating a virtual 3E cycle.We want every referral to become a graduating patient that feels great, and feels great about their referral to Results. That’s what you’re entrusting us to deliver, and we’re dedicated to helping your patients get there.

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The word ‘doctor’ means teacher. Patients should be learning something.

Dr. Daniel Lee, one of Memphis' most prominent OB/GYN specialists, sees around 100 patients a week at his practice at MOGA in Southaven, MS. Lee has seen remarkable success in referring many postpartum patients to Results' new Mommy Bounce Back PT program.I would encourage my colleagues to realize that there's lots of different things that we can't do in the office

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Why back to normal IS the new normal

Back pain, hip pain, tailbone and pelvic pain, urinary and fecal incontinence. All just part of having a baby, right? Perhaps in the short term these issues and conditions are somewhat unavoidable, but for many women who often suffer in silence, these issues become an accepted “new normal” of pain and dysfunction. In fact, studies have shown that up to 80% of new moms won’t tell a healthcare professional all the issues they’re experiencing because it’s assumed they’ll dissipate over time or they’re too embarrassed to discuss it.As weeks become months and pain and leakage persist, or, issues become exacerbated with additional births, resignation sets in. Some turn to surgery. Some rely on pads or inserts. But very few turn to physical therapy, which in many cases has proven to be highly effective. Results Physiotherapy wants this to change.Postpartum care is primarily concerned – and rightly so – with the health of the baby. Concerns for the mother likely touch on depression, and may or may not include pain, incontinence and return to exercise and sexual activity. However, new moms often have a large number of questions or concerns that they may or may not ask at that first postpartum visit to the OB. Consider the following: Over 50% of women still experience pain during intercourse 18 months after giving birth. Urinary and fecal incontinence are common following childbirth, and when not addressed, can actually worsen over time, or with the birth of more children. About 1 in 4 women think they know how to do a Kegel, but do not. Further, Kegels can exacerbate issues when not done properly, or when performed when perineal tears are still present. Problems left untreated can lead to further complications, such as persistent low back pain or even pelvic floor prolapse – a condition that occurs when the supporting pelvic floor structures such as ligaments and connective tissue are stretched, in addition to weak muscles. The fact remains, a birth is a significant event with varying degrees of physical and emotional impact. If she were an elite athlete, it’s hard to imagine physical therapy wouldn’t be prescribed to assist in healing and a return to pre-birth health and physical activity. In France and many other developed countries, every woman who delivers a baby goes home with a prescription for 10-20 sessions of pelvic floor physical therapy as a standard course of treatment. Indeed, therapy typically begins before she returns home, so the therapist has a better idea where the new mom needs the most help. In the U.S., this approach is gaining acceptance, but can be hindered by the lack of quality pelvic therapy available or a healthcare professional’s level of comfort with PT as a course of treatment. Results is committed to providing a solution that is easily available, widely recognized for its efficacy and patient satisfaction, and highly cost effective as well.In only 6 to 8 visits, Mommy Bounce Back can identify and successfully treat issues such as: Strengthening the Pelvic Floor Incontinence Back and tailbone pain, lifting and posture Pain during intercourse Returning to exercise Scar tissue managementA mom’s new normal may include a lot more responsibility and a lot less sleep, but it doesn’t have to include pain, discomfort or embarrassment. Mommy Bounce Back – a great solution for both moms and referring HCPs.

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Opioid Use & Abuse: When Will the Tide Turn?

In 2015, more than 30,000 people died from opioid abuse. And, for the first time, heroin-related deaths surpassed gun homicides (as reported in the Washington Post in December). In high-prescription states like Tennessee, death-by-opioids has surpassed automobile-related deaths, and there are more prescriptions written each year than the total number of people who live in the state (Tennessean).The Surgeon General has initiated his Turn the Tide campaign, calling on healthcare professionals to take a pledge to help end this epidemic, and awareness of the crisis continues to rise. Today, President Trump is expected to announce a new commission – chaired by Gov. Chris Christie – to try and address the issue and help the addicted recover. Time will tell if the commission will actually do more than investigate and talk, and many feel much more is needed (Mother Jones calls announcement “Underwhelming”).Headquartered in Tennessee – one of the hardest-hit states when it comes to opioid abuse and addiction – Results Physiotherapy continues to support the fight against this killer, and remains focused on helping those living with pain. Ultimately, it’s the patient’s pain that must be addressed. Physical Therapy has been identified as an important and effective option for many, and Results and its unique form of manual-based physical therapy is at the vanguard of the fight. As a Healthcare Professional, what trends are you seeing? Have you changed your approach to prescribing opioids? What else needs to be addressed? True change will be driven by the healthcare community – we all know that – but the patient dealing with pain can’t be forgotten amidst the push to end this epidemic.#ChoosePT