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June National Scoliosis Awareness Month

 

June is National Scoliosis Awareness Month, which serves as a beacon to spotlight education, early detection, and public awareness about the disease. Accordingly, Spinal Dynamics has a couple of interesting updates in ways we have adopted the initiative, and are striving to help serve the cause of scoliosis beyond our excellent standard of care. 

Scoliosis affects over 7 million people in the United States, or about 1 in 40 Americans. Consequently, it is the most widely diagnosed spinal deformity nationwide. Although it can affect any age, it is typically found between the ages of 10 and 15, with females being twice as likely to be diagnosed.

Fewer than half of the schools in the U.S. provide screening, although the American Academy of Pediatrics and Orthopedics has recommended two screenings for females at the ages of 10 and 12, and one for males at the age of 13.

 

Free Screenings

We are pleased to be offering free scoliosis screenings for kids ages 10-15 on Tuesday for the rest of the month of June, walk-in or call ahead. Screenings take only about 10 minutes, and early detection is the key for successful treatment!

Wisconsin has been recognizing June as National Scoliosis Awareness Month for half a decade, but still does not provide in-school screenings for adolescents, as only half of the country does. As a result, we have decided to open up our clinic for free screenings for ages 10-15 from 12:00-1:00 for the duration of June, in support of the goals put forth nationally for this month.

Support prevention and awareness by getting your child or teen screened this month for no cost to you. We are honored and happy to provide information and resources about this disease to the public in support of the National Scoliosis Awareness Month initiative!

Schroth-Barcelona Institute 

Spinal Dynamics President Cindy Marti, has been working hard with four colleagues (Hagit Berdishevsky, Beth Janssen, Patricia Orthwein, and Amy Sbihli) to establish Schroth-Barcelona Institute, a Schroth Method teaching group sanctioned by the BSPTS based in Europe. The SBI mission, “to provide a central organization based in USA which facilitates the training and certification of physical therapists and to develop standard of education and practice standards in the Schroth Method”, fits hand in hand with the June Awareness Month goals of education and public awareness.

Though the five BSPTS certified therapists have been teaching and bringing this revolutionary treatment option to the U.S. for years through their original group, Scoliosis Education Seminars, they have recently formed this exciting new LLC to grow above and beyond their previous goals. 

One of the Schroth-Barcelona Institute continuing education teaching opportunities has already been underway with optimism and success, as the group has been teaching and increasing awareness through their 2-day  course at Beaumont Hospital in Michigan, Introduction to Scoliosis and Hyperkyphosis – Evaluation and Coordination of Care.

This course seeks to expand upon the introduction to scoliosis given in PT school, and gives therapists the tools and understanding to identify clinical signs of scoliosis/hyperkyphosis in adults and children, refer patients for x-ray diagnosis, coordinate care based upon key variables, and apply protective principles for scoliosis/hyperkyphosis in the clinical setting.

In addition to these new programs, Schroth-Barcelona Institute continues to teach their BSPTS certification courses, and Spinal Dynamics plays a supporting role in hosting and teaching some of these certification classes (pictured above). Most recently, SBI was proud to certify the March 2017 C1 level class (pictured below) featuring some of the newest group alumni, many of whom will go on to propagate the June Awareness Month initiatives and the Schroth Method teachings. 

More about Schroth-Barcelona Institute and their attempt to bridge the gap in education from PT school to specialized Scoliosis therapy using the Schroth Method can be found on their website at www.schroth-barcelonainstitute.com

 

 

Spinal Dynamics of Wisconsin - Milwaukee

Backpack Tips for Back to School

It’s almost that time again. If your child’s back to school shopping list includes a new backpack, make sure it fits correctly. A poor fitting pack can be a pain in the neck (or back).

Learn tips and tricks for making your backpack (and back to school) as pain free as possible.

  1. Fit: Make sure that it is the right size. The backpack should be centered on the torso and should not hang below the low back. A smaller child will need a smaller backpack.
  2. Straps: Backpacks allow you to distribute the weight between both shoulders. A one-strap pack or messenger bag often forces the carrier to lean or shrug to avoid slipping of the strap, which can lead to pain. Shoulder straps should be wide, comfortable and padded. Make sure they use both straps; straps should be snug enough to keep it in place, but loose enough to get the backpack on and off easily.
  3. Load: Keep the heaviest objects (e.g. textbooks) in the pockets closest to the back, rather than in the outer pockets. This helps to keep the load closer to your child’s center of gravity and makes the load easier to carry. Compression straps along the side can also help stabilize the contents.
  4. Weight: Try to keep the weight of the backpack to 15% of the child’s body weight or less. A study by Goodgold et al. found that 55% of students carry a backpack that weighs more than the recommended 15% of their body weight. Have your child clean out the backpack on a weekly basis and make sure they are only carrying the supplies they need for that day. An extra book or two adds up quickly, especially if the child needs to walk to and from home or the bus stop.
  5. Extra Credit: Use the chest and waist straps to help offload the shoulders and back.

Keep your kids healthy! If your child is complaining of back to school pain or headaches, it could be related to prolonged sitting at school or while doing homework, poor posture or their backpack. One of our physical therapists can help your son or daughter learn strategies to stretch, strengthen and adjust their posture to make back to school as pain free as possible.

Source: Goodgold S., Corcoran M., Gamache D., Gillis J., Guerin J., Coyle J. Q. Backpack use in children. Pediatric Physical Therapy. 2002;14(3):122–131. doi: 10.1097/00001577-200214030-00002.

Spinal Dynamics of Wisconsin - Milwaukee

Concussions & Physical Therapy

By: Lauren Hogan, DPT, OCS, ATC

In the past few years, there has been a lot of media attention on concussions. This has led to increased focus on diagnosis and appropriate treatment to avoid long-term consequences. Despite more knowledge and education, there are still a lot of misconceptions about the injury and proper treatment.

For example, did you know that…

  • Most people experiencing a concussion do not lose consciousness?
  • A loss of consciousness does not indicate a more severe injury?
  • A hit to the head is not required to experience a concussion? A hit to the body with force that is transmitted to to the head or a whiplash injury can also cause a concussion.

Concussion Anatomy

When a patient hits their head, the brain moves within the skull and parts of neurons (nerve cells) within the brain can get stretched. This can adversely affect the way the brain uses energy, leading to symptoms. Symptoms can vary significantly among patients with concussions, which can sometimes make diagnosis a challenge. Symptoms may include, but are not limited to:

  • Headache
  • Dizziness
  • Difficulty concentrating
  • Fatigue with cognitive, physical, or emotional activities
  • Irritability, anxiety, or depression
  • Sleep disturbances, including difficulty falling or staying asleep, or needing more sleep than usual
  • Eye symptoms, including eye fatigue, visual disturbance, difficulty watching busy environments
  • Sensitivity to light or noise
  • Neck pain
  • Impaired balance
  • Memory loss immediately before or after the injury

It is important to rule out any significant neurological symptoms that may indicate a more severe injury. If there is deteriorating consciousness, increased confusion, irritability or behavior change, severe or increasing headaches, vomiting, seizure, double vision, or weakness or tingling in the arms or legs, it is imperative to seek out emergency care immediately.

MigraineTreatment

Most people have heard that after having a concussion, the patient should avoid sports until symptoms subside, which is true. It is important to avoid too much activity to allow the brain to use its available energy to heal. Despite this, absolute rest can be detrimental as well, potentially leading to prolonged symptoms and deconditioning. An athletic trainer, physician or physical therapist trained in concussion care can assist with guiding a safe return to normal activities, including sports. The good news is that the vast majority of patients will have their symptoms fully resolve in two weeks or less with relative rest alone. But what happens with those patients that have symptoms that stick around?

Patients with symptoms that linger longer or have symptoms that increase with physical, mental or emotional exertion may have post-concussive syndrome (PCS). Certain characteristics can put people at risk of persistent symptoms, including:

  • Dizziness soon after the injury
  • Feelings of “fogginess”
  • Migraine-like symptoms – headache, nausea, sensitivity to light
  • Children or the elderly
  • Females
  • A history of depression, anxiety, learning disabilities, or ADD/ADHD
  • A history of multiple concussions

This is where physical therapy can be a vital part of recovery. A physical therapist can perform a thorough examination of the patient, determine where symptoms are coming from and address them appropriately.

  • Stiffness and muscle tightness through the neck and surrounding muscles can occur with a head injury and often influence headaches. Physical therapists can utilize manual therapy techniques to improve mobility and reduce pain. Often, strengthening postural muscles can help maintain mobility and improve posture to further reduce symptoms.
  • Eye tracking abnormalities can often cause headaches, dizziness, eye fatigue, sensitivity to busy environments or bright light. Physical therapists trained in oculomotor dysfunction can work with a patient to normalize eye movement and reduce symptoms. They can also work on restoring balance to allow for improved mobility and safety.
  • Patients with post-concussive syndrome also may have an increase in symptoms every time they try to increase their activity level. Physical therapists can also assist with a controlled, gradual and safe return to aerobic activity and sports to help reduce symptoms.

Concussions can be extremely frustrating and even life-altering, especially when patients have long-lasting symptoms. For patients with persistent headaches, dizziness, fatigue and other symptoms, physical therapy can be a crucial part of recovery. The sooner a patient can get care, typically the quicker they start to improve.

More questions about physical therapy and concussions?

Give our office a call at 414-302-0770 and ask to speak with Lauren Hogan, DPT, OCS, ATC, our concussion specialist.

Spinal Dynamics of Wisconsin - Milwaukee

What is Trigger Point Dry Needling?

Spinal Dynamics & Body Dynamics of Wisconsin has found trigger point dry needling to be a very effective treatment option for people with pain or dysfunction. In fact, our clinic was among the first physical therapy clinics in Wisconsin to provide dry needling as a treatment option. Since trigger point dry needling is a relatively new treatment option in the United States, patients often have a lot of questions. Below are a few questions we hear most frequently in the clinic.

What is a trigger point? A trigger point is an area of contracted muscle fibers that may feel like a taut band or a “knot”. When a trigger point is present, that area of muscle cannot appropriately function to contract or relax, and often causes pain and/or weakness. Trigger points may be caused by overuse, injury, or prolonged postures. They can cause pain either in the local area around the trigger point or refer symptoms to another region.

SCM

The sternocleidomastoid muscle starts just behind the ear and attaches to the clavicle (collarbone) and sternum (breastbone) of the chest. Trigger points in this muscle can cause referred pain to the areas in red. Trigger points in the sternocloidomastoid are often involved with headaches. Most muscles have a specific referral pattern, which may be close to the muscle or refer further away.

What is dry needling?  Dry needling is an treatment procedure in which a solid filament needle is inserted into the skin and muscle directly into a myofascial trigger point. Trigger point dry needling works to deactivate the trigger point to improve pain, range of motion and function.

How does trigger point dry needling work? With trigger point dry needling, the needle is inserted directly into a myofascial trigger point. By moving the needle around within the muscle, the muscle may experience a twitch response, where it contracts and relaxes. This twitch is important in deactivating the trigger point. 

Is dry needling similar to acupuncture?  Dry needling and acupuncture both use solid filament needles, but are different techniques. Typically, acupuncture is based on Chinese medicine principles, including meridians and acupuncture points. In contrast, trigger point dry needling is strictly based on Western medicine principles and research. With trigger point dry needling, the needle is typically inserted directly into the muscle to treat a trigger point. 

What type of problems can be treated with dry needling?  Dry needling can be used for a variety of musculoskeletal problems. Conditions include, but are not limited to:

  • Neck pain (with or without arm or shoulder blade pain)
  • Low back pain (with or without hip or leg pain)
  • Shoulder pain
  • Arm pain, including tennis elbow, carpal tunnel, golfer’s elbow
  • Migraines and tension headaches
  • Temporomandibular joint dysfunction (TMJ pain or jaw pain)
  • Hip or buttock pain
  • Leg pain – including sciatica, hamstring strains, calf strains, IT band pain
  • Achilles or plantar fascia pain
  • Fibromyalgia, myofascial pain syndrome

Chronic injuries, in general, may involve trigger points that may benefit from dry needling.

Is the procedure painful?  Because the needle is so thin, most patients do not feel the insertion of the needle into the skin. As the needle is relocated into the muscle, a local twitch response can elicit a quick uncomfortable or painful response as the muscle contracts, then relaxes.  Some patients describe this as a little electrical shock, while others feel it more like a cramping sensation. Once the trigger point is released, pain generally will decrease. Trigger point dry needling is generally well tolerated.

What side effects can I expect after the treatment? Patients may report being sore after the procedure.  The soreness is usually described as muscle soreness over the area treated and into the areas of referred symptoms.  Typically, the soreness lasts somewhere between a few hours to a day or two, but generally does not limit activity. In fact, some athletes undergo dry needling treatment shortly before practice or competition to assist with performance.

How long does it take for the procedure to work? Patients may notice some change in symptoms quickly, including improved range of motion or stiffness. Typically, it takes several treatment sessions for a more long-term change to take place.  Trigger point dry needling works best in conjunction with other treatment methods, such as soft tissue mobilization, strengthening exercises and stretching, so it is important to not just rely on dry needling.

Why is my doctor not familiar with this technique? Trigger point dry needling is relatively new in the United States, but is gaining significant popularity in the pain management and physical therapy fields. It has been utilized in other countries for decades.

In the past, physicians often utilized injections with lidocaine or other anesthetics to assist with deactivating trigger points. Research shows that the needle itself may be more important than the anesthetic in deactivating trigger points. Dry needling is typically less costly than an injection and more efficient, as physical therapists are able to treat multiple areas if appropriate, or treat trigger points more frequently.

Are the needles sterile?   Yes, we only use sterile disposable needles.

Do I need a referral for physical therapy and/or dry needling? Wisconsin is a direct-access state, which means that patients are allowed to see a physical therapist without a referral. Most insurance companies do not require a referral to physical therapy, but it is prudent to make sure prior to treatment. You can either call your insurance company to check or give our office a call and we can help you determine if you need to talk to a physician prior to seeing a physical therapist. Most insurance plans do cover trigger point dry needling under routine physical therapy billing, but our office can help you determine if your plan has any limitations.

All of our physical therapists are trained in dry needling. More questions? Give us a call at 414-302-0770.

Spinal Dynamics of Wisconsin - Milwaukee

5 Quick Fixes for Improving Your Desk Posture

Sitting all day can be rough. Prolonged sitting with poor posture can influence neck pain, shoulder pain, and headaches, among other conditions. In the course of history, “desk jobs” are a relatively new phenomenon and humans are really not built to sit all day long, five days a week. Unfortunately, the vast majority of jobs now involve a lot of sedentary time. 

Because of these issues, standing desks and treadmill desks are getting more common. Even if you don’t have access to a standing workstation, making small changes in your work day can help to ease the pain of prolonged sitting.

Good posture

Matt demonstrating good desk posture with feet flat, sitting on his sit bones, shoulder blades back and away from ears, and his lumbar spine supported by his chair.

1. Adjust your workstation.

Your feet should be flat. It is almost impossible to sit with good posture when your legs are crossed or tucked under you. 

You should be sitting on your “sit bones” under your bottom, not on your tailbone. 

Your chair should help to support your low back. If helpful, you can use a small towel roll at the small of your back to help you maintain the slight curve through your lower back.

Check out this article from the Mayo Clinic with specific information on adjusting different parts of your workstation.

2. Sit tall and relax your shoulder blades away from your ears. Your neck should feel long, with your ears in line with your shoulders. Avoid slumping into a rounded back and forward head position, seen in the second picture.

3. Watch your posture while you’re using the phone. Make sure that you aren’t resting your elbow on your desk or shrugging to hold the phone between your ear and shoulder. If you are on the phone frequently during the day, consider investing in a headset to assist you in maintaining good posture.

Not-so-great posture.

Rounded back + forward head = increased strain through neck, upper back and shoulder blade muscles.

4. Take frequent breaks! Try to get up and move around at least once an hour, whether you go grab a drink of water, go to the bathroom, or just take a short walk around the office.

5. Find some sort of reminder during the day to check and reset your posture during work or meetings. Find something that happens frequently during the day — whether it is an email popup alert, Googling something, or opening a specific application. Start getting in the habit of resetting your posture each time you do one of those things to help you minimize the time you spend slouched during the day.

Adjusting your posture is challenging, but small changes can add up to make a big difference. Tried these tips and still having pain or headaches during or after work? Give us a call to schedule an appointment with one of our physical therapists to help you improve your pain, posture and function.

Spinal Dynamics of Wisconsin - Milwaukee

June is National Scoliosis Awareness Month!

By: Cindy Marti, PT – Owner & President of Spinal Dynamics & Body Dynamics of Wisconsin

Last week, my fellow scoliosis physical therapist, Meg Gogin, and I attended the annual meeting of scoliosis clinicians and researchers from around the world. The Society of Scoliosis Orthopedic Rehabilitation and Treatment (SOSORT) conference was held in Banff, Canada. We learned a lot and enjoyed hikes in the mountains in our free time.

Personal Highlights:

Mountains.jpg

Visit the Canadian Rockies if you can! See Lake Louise, Moraine Lake, and hike up Sulphur Mountain in Banff. You will be mesmerized. Take the scenic route A1 from Lake Louise back to Banff to see if you can catch a view of a romping bear. We did! The Hoodoo trail is full of elk…beware! I got too close to one and had a good scare when she threatened me! People there are incredibly friendly and make it easy to be comfortable in their town.

Amy, Cindy, Meg.jpg

And, if you are wondering about Canadian beer…I recommend the Big Rock Traditional Amber, known to locals as “Trad”. If you like amber ales, you will like this!

Clinical Highlights:

Research is improving our understanding of factors that contribute to the cause and progression of adolescent scoliosis. The cause is thought to be multi-factorial–meaning that it is caused by a combination of genetic, environmental, neurological, and biomechanical variables. There was a landmark study presented at this meeting suggesting that vitamin D and calcium supplements can reduce the rate of curve progression in patients with scoliosis. This is new information and we will use it to support our patients here in the clinic by having blood work done to evaluate the possibility of adding supplements to their bracing and rehabilitation regimes.

New studies were presented that reinforced past research that BRACING WORKS and SCOLIOSIS-SPECIFIC THERAPY can help bracing. There were also interesting presentations on the treatment of adults with scoliosis, showing encouraging outcomes for these patients being treated with Physiologic Scoliosis-Specific Exercise (PSSE). When PSSE is combined with additional therapy, patients can improve their aesthetics and quality of life. We have known this to be true at Spinal Dynamics & Body Dynamics of Wisconsin for many years, but it is encouraging to see more research backing up our clinical findings.

Professional Highlights:

I was happy to be a part of the meeting, running a couple of panel discussions about the treatment of scoliosis in adolescents and adults. I am slowly getting over my nerves in being up in front of so many brilliant minds. I also just finished my two-year term on the SOSORT Board of Directors and am now co-chair of the education committee. I am happy to have made many professional friends through this group, and am continually inspired by their dedication to the treatment of scoliosis.

Cindy with SOSORT board.jpg

We also had a RECORD number of Schroth-BSPTS certified physical therapists attending the annual SOSORT meeting. I am an instructor with BSPTS (Barcelona Scoliosis Physical Therapy School) and it was inspiring to see so many of our past graduates at the conference. It feels great to be having an impact in the field.

Scoliosis is a challenging condition, that often creates confusion and anxiety in the patients themselves, in their families, and yes – even sometimes in the clinicians treating it. Scoliosis has been treated innovatively and successfully without surgery in many parts of the world for decades. In the US, we are just beginning to make strides for change in the last 5-10 years, getting more physicians on board with early detection and early intervention, and in educating more therapists to teach scoliosis-specific exercise. We still have a long way to go to get EVERY child access to the care that can help them…and get them access BEFORE their curves progress in severity. If you or someone you know is living with scoliosis, please let us know if we can help.

Thanks for reading. Meg and I are all fired up from our mountain experience, and ready to get back in the clinic! Happy June!