9 Things You Should Know About Pain

1. Pain is an output from the brain. While we used to believe that pain is originated within the tissues of our body, we now understand that pain does not exist until the brain determines it does. The brain uses a virtual "road map" to direct an output of the pain to tissues that it suspects may be in danger. This process acts as a means of communication between the brain and the tissues of the body, to serve as the defense against possible injury or disease. 

2. The degree of injury does not always equal the degree of pain. Research has demonstrated that we all experience pain in individual ways. While some of us experience major injuries with little pain, other experience minor injuries with a lot of pain (think of a paper cut). 

3 Despite what diagnostic imaging (MRIs, x-rays, CT scans) show us, the finding may not be the cause of your pain. A study performed on individuals 60 years or older had no symptoms of low back pain found that 36% had a herniated disc, 21% had spinal stenosis, and more than 90% had a degenerated bulging disc, upon diagnostic imaging. 

4. Psychological factors, such as depression and anxiety, can make your pain worse. Pain can be influenced by many different factors, such as psychological conditions. A recent study in the Journal of Pain showed that psychological variables that existed prior to a total knee replacement were related to a patient's experience of long-term pain following the operation. 

5. Your social environment may influence your perception of pain. Many patients state their pain increases when they are at work in a stressful situation. Pain messages can be generated when an individual is in an environment or situation that the brain interprets as unsafe. It is a fundamental form of self-protection. 

6. Understanding pain through education may reduce your need for care. A large study conducted with military personnel demonstrated that those who were given a 45-minute educational session about pain sought care for low back pain less than their counterparts. 

7. Our brains can be tricked into developing pain in prosthetic limbs. Studies have shown that our brains can be tricked into developing a "referred" sensation in a limb that has been amputated, causing a feeling of pain that seems to come from the prosthetic limb, or from the "phantom" limb. The sensation is generated by the association of the brain's perception of what the body is from birth (whole or complete) and what it currently is (post-amputation). 

8. The ability to determine left from right may be altered when you experience pain. Networks within the brain that assist you in determining left from right can be affected when you experience severe pain. If you have been experiencing pain, and have noticed your sense of direction is a bit off, it may be because a "roadmap" within your brain that details a path to each part of the body may be a bit "smudged". (This is a term we use to describe a part of the brain's virtual roadmap that isn't clear. Imagine spilling ink onto part of a roadmap and then trying to use that map to get to your destination.)

9. There is not way of knowing whether you have a high tolerance for pain or not. Science has yet to determine whether we all experience pain in the same way. While some people claim to have a "high tolerance" for pain, there is not accurate way to measure or compare pain tolerance among individuals. While some tools exist to measure how much force you can resist before experiencing pain, it can't be determined what your pain "feels like."

Read more about Pain and Chronic Pain Syndromes at MoveForwardPT.com. 

The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternatives of physical therapy for long-term pain management. 

Author: Joseph Brence, PT, DPT, FAAOMPT, COMT, DAC


Proper Warm Up for Injury Prevention

Proper Warm-Up for Injury Prevention

     In the winter months, we often find ourselves focusing on steady feet to ensure we are safe while attempting to navigate icy and snowy conditions. While safety and stability are critical elements to safe exercise in the winter months, shifting our focus to ensure proper warm-up is also key. 

     Warmup exercises are a helpful component in preventing common injuries.  In fact, improved flexibility, strength, stability and warm-up are key to decrease the risk of this knee injury along with many others. 

     A study published in The American Journal of Sports Medicine concluded that neuromuscular control exercise programs appear to reduce the risk of anterior cruciate ligament (ACL) injuries in female college soccer players.  The beneficial neuromuscular warm-up exercise programs included in the study included stretching, strengthening, plyometrics, and agilities to address potential deficits in the strength and coordination of the stabilizing muscles around the knee joint.  

Tips for Proper Warm-Up

  • Dynamic Mobility: Dynamic mobility is the body's ability to move in multiple directions safely. Dynamic mobility is closely related to flexibility and gently increases range of motion to reduce chance for injury. Try dynamic movements, such as arm circles and leg swings against a wall to ensure you are addressing both your upper and lower body. 

  • Movement-Specific Preparation: You turn on your car before heading out for a drive. By the same logic, you need to turn on the parts of your brain that control motion in preparation for a workout. For example, bodyweight squats would make sense if you are doing front barbell squats, and light band presses or push-ups for a day your doing pressing motions like the bench press. 

  • Increase Core Temperature: It's called a "warm-up" for good reason. Increasing blood flow and therefore muscle temperature makes muscles more pliable. Just like a rubber band, the more warm and pliable a muscle is, the more mobility it has. This leads to a decrease in potential muscle strain. Try walking, biking or any activity that begins to increase your heart rate to increase your core temperature. 

Our staff at Iowa City Physical Therapy are happy to assist you in learning more about these neuromuscular warm-up exercises and about physical therapy treatment of ACL injuries.

Reference:  www.MoveForwardPT.com


Enjoy the Season with a Properly Fit Bicycle!

Life Always Looks Better From A Bike … A Properly Fit Bike That Is! 

Are you ready to take your exercise routine outside to “spring” your exercise to the next level? Bicycle-related pain and injuries are commonly associated with an improper bike set up or difficulty with proper body mechanics while riding your bike.  We can help be sure you are in proper form to kick off your outdoor riding season!  

Basic Bike Tips

  • Keep a controlled, but relaxed grip of the handlebars

  • Change your hand position on the handlebars frequently for upper body comfort

  • When pedaling, your knee should be slightly bent at the bottom of the pedal stroke

  • Avoid rocking your hips while pedaling

Common Problems and Possible Solutions
Knee Pain:  Possible causes are having a saddle that is too low, pedaling at a low cadence (speed), using your quadriceps muscles too much in pedaling, misaligned bicycle cleat for those who use clipless pedals, and muscle imbalance in your legs (strong quadriceps and weak hamstrings).
Neck Pain:  Possible causes include poor handlebar or saddle position. A poorly placed handlebar might be too low, at too great a reach, or at too short a reach. A saddle with an excessive downward tilt can be a source of neck pain.
Lower Back Pain:  Possible causes include lack of flexibility in the hamstrings, low cadence, using your quadriceps muscles too much in pedaling, poor core strength, and improperly placed handlebars.

We would be happy to take a look at your bike to give you a few specific tips to improve your bike set up and/or your mechanics to keep you injury free all through your bike riding season!  

If you have any questions or if we can assist you with any of these modifications, feel free to contact us at Iowa City Physical Therapy at 319.339.4278 or visit our website at www.iowacityphysicaltherapy.com.

Snow Shoveling Tips!

Snow Shoveling is a repetitive activity that can cause muscle strain to the lower back and shoulders. Back injuries due to snow shoveling are more likely to happen to people who may not know that they are out of condition. Following these tips can help you avoid injuries: 

1) Lift smaller loads of snow, rather than heavy shovelfuls. Be sure to bend your knees and lift with your legs, rather than your back. 

2) Use a shovel with a shaft that lets you keep your back straight while lifting. A short shaft will cause you to bend more to lift the load. Using a shovel that's too long makes the weight at the end heavier.

3) Step in the direction in which you are throwing the snow to prevent the low back from twisting. This will help prevent "next-day back fatigue."

4) Avoid excessive twisting because the spine cannot tolerate twisting as well as it can tolerate other movements. Bend your knees and keep your back as straight as possible, so that you are lifting with your legs. 

5) Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back. 

6) Backward bending exercises while standing will help reverse the excessive forward bending of shoveling: stand straight and tall, place your hands toward the back of your hips, and bend backward slightly for several seconds. 

Brought to you by the APTA (American Physical Therapy Association) and MoveForwardPT.com. 

Back to School - Just Say "NO" to Backpack Aches and Pains

Increased participation in sports or exercise, poor posture with sitting, and long periods of inactivity are just a few reasons kids have increased back pain. But a new trend is arising. Healthcare providers across the nation are seeing younger populations for neck, back and shoulder pain because they are lugging around their entire locker's worth of books, school supplies, and assorted personal items all day long. 

To understand how heavy backpacks can affect our bodies, it helps to understand a few basics about the structure of our backs. The spine is made of 33 bones called vertebrae, and between the vertebrae are discs that act as natural shock absorbers. When a heavy weight, such as a backpack filled with books, is incorrectly placed on the shoulders, the weight's force can pull a child backward. To compensate for this unnatural posture, he or she may bend forward at the hips or arch the back. Individuals who wear their backpacks over just one shoulder may end up leaning to one side to offset the extra weight. These compensation patterns can cause the spine to compress unnaturally leading to development of shoulder, neck, and back pain. 


Backpack Safety Tips from the American Academy of Pediatrics (AAP) & The American Physical Therapy Association (APTA):

  1. Wear both straps to allow the weight of the backpack to be better distributed. 

  2. Wear the backpack over the strongest mid-back muscles by fitting it to rest evenly on the middle of the back. Shoulder straps should be adjusted to allow the child to put on and take off the backpack without difficulty and allow free movement of the arms. Straps should not be too loose, and the backpack should not extend below the low back. 

  3. Lighten the load by keeping the weight at 10-15% or less of the child's bodyweight. Carry only those items that are required for the day. Organize the contents of the backpack by placing the heaviest items closest to the back.

Iowa City Physical Therapy Can Help:

  1. Assistance with helping you to choose a proper backpack and fit it specifically to your child. 

  2. Education to help improve posture problems, correct muscle imbalances, and to prevent and treat pain that can result from improper backpack use.

  3. Individualize a fitness program to help children get strong and stay strong - and carry their own loads! 

Happy Halloween from Iowa City Physical Therapy

Are you excited about all the FUN of Halloween, but would like a healthier alternative for trick-or-treat?  Our friend and nutritionist Alexa Schirm from Simple Roots Wellness has a few terrific suggestions for a healthier option for this weekend's festivities.  Check out her blog at http://simplerootswellness.com/healthy-halloween-treat-ideas/ for some spooky fun ways to trick-or-treat!  

National PT Month - Debunking 7 Myths of Physical Therapy

 Move Foward (TM) - http://www.moveforwardpt.com/Myths/Infographic/Default.aspx#.VD1ZbvldWjt 

Move Foward (TM) - http://www.moveforwardpt.com/Myths/Infographic/Default.aspx#.VD1ZbvldWjt 

1. Myth: I need a referral to see a physical therapist.

Fact: A recent survey by the American Physical Therapy Association (APTA) revealed 70% of people think a referral or prescription is required for evaluation by a physical therapist. Some states and insurances providers have restrictions about the treatment a physical therapist can provide without a physician referral. Contact us today to ask any questions about physical therapy or check out APTA's direct access summary chart (pdf) to see and learn about your options for physical therapy in Iowa.  

2. Myth: Physical therapy is painful.

Fact: Physical therapists seek to minimize your pain and discomfort—including chronic or long-term pain. They work within your pain threshold to help you heal, and restore movement and function. 

3. Myth: Physical therapy is only for injuries and accidents.

Fact: Physical therapists do a lot more than just stretch or strengthen weak muscles after an injury or surgery. They are skilled at evaluating and diagnosing potential problems before they lead to more serious injuries or disabling conditions—from carpal tunnel syndrome and frozen shoulder, to chronic headaches and lower back pain, to name a few.

4. Myth: Any health care professional can perform physical therapy.

Fact: Although 42% of consumers know that physical therapy can only be performed by a licensed physical therapist, 37% still believe other health care professionals can also administer physical therapy. 

5. Myth: Physical therapy isn't covered by insurance.

Fact: Most insurance policies cover some form of physical therapy. Beyond insurance coverage, physical therapy has proven to reduce costs by helping people avoid unnecessary imaging scans, surgery, or prescription drugs. Physical therapy can also lower costs by helping patients avoid falls or by addressing conditions before they become chronic.

6. Myth: Surgery is my only option.

Fact: In many cases, physical therapy has been shown to be as effective as surgery in treating a wide range of conditions—from rotator cuff tears and degenerative disk disease, to meniscal tears and some forms of knee osteoarthritis.   In some circumstances, surgery is a necessity.  In these cases, physical therapy prior to surgery often allows for improved outcomes along with improving function postoperatively.  

7. Myth: I can do physical therapy myself.

Fact: Your participation is key to a successful treatment plan, but every patient still needs the expert care and guidance of a licensed physical therapist. Your therapist will leverage his or her specialized education, clinical expertise, and the latest available evidence to evaluate your needs and make a diagnosis before creating an individualized plan of care.  It is our goal to then provide you with the tools to progress to an independent program that allows you to not only recover from your injury, but also prevent re-occurrence.   

Thank-You "Move Forward" at www.MoveForwardPT.com for inspiring our additional thoughts to The 7 Myths of Physical Therapy.