John Woolf's Physical Therapy Blog
Press Release: Physical therapy and exercise proven a better alternative for neck And arm pain sufferers. Tallahassee, Florida, October 20, 2008 – Neck pain is one of the top 10 reasons for a patient to visit a doctor. The lead article in the most recent issue Spine reports on the results of a randomized clinical trial which demonstrated that patients who received manual physical therapy and exercise had twice the improvement in symptoms compared to the current guideline group. The subjects in the study experienced both short and long term improvements in their neck pain. The study compared the use of manual therapy and exercise compared to the current guidelines of advice, rest, and range of motion. The results of this study are comparable to those reported by Hoving et al in 2002, which also demonstrated that manual physical therapy and exercise resulted in excellent clinical results in the treatment of neck pain while also providing a significant cost savings compared to usual physician care (Kothals-de Bos et al 2003). Manual physical therapy includes the use of hands-on techniques including joint and soft-tissue mobilization, designed to restore motion and reduce pain. Hurwitz et al (2008) concluded in a systematic review on neck pain also in the journal Spine, "Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain." John Woolf, MS PT ATC owner of ProActive Physical Therapy in Tucson, Arizona, expressed confidence that, "This study broadens the base and depth of evidence that manual physical therapy is the first line treatment for patients suffering from neck and arm pain." He continued, "Year after year the physical therapy profession continues to produce high quality randomized, controlled trials that demonstrate conclusively that our profession provides better outcomes for less money, while also being substantially safer than other medical interventions. Wake up America, to a new day without pain." If you have neck or back pain or the aches and pains of musculoskeletal problems contact your local physical therapist today. Contact: John Woolf, MS PT ATC 3945 E. Paradise Falls Drive
Suite. 109,
Tucson,Arizona
85712
Ph. 520.321.0204 Fax 520.321.0495 |
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| Written by John Woolf, MS, PT, ATC | | Saturday, 21 June 2008 | | What do I do with the Pain? This is a question asked by every athlete at some point. Truly, pain is part of the game. In 20 years of practice, I have not met an athlete who has not had pain. It’s a great topic because pain is the thing that motivates many to succeed and also creates barriers to success. Pain is a word that covers a lot of ground. There is the pain that you get in your muscles and lungs when you have been redline for 20 minutes to make your splits. (metabolic pain). There is the pain that you get when you realized that you forgot your shoes in your other bag as you unpack at the race. And the pain you get when you have missed your qualifying time by 30 seconds. (psycho-emotional pain) Then there is the pain the develops in your knee or your back or your hip after much training. (Injury pain). I will focus on this type of pain. It is useful for athletes to understand injury pain. First, pain is mostly a chemical process. You know this because how do you often treat the pain? Often with chemicals known as anti-inflammatories such as ibuprofen, voltaren or a host of other over-the-counter pharmaceuticals. When a tissue in the body is overloaded in an unhealthy way, the body creates chemistry that sends a signal to your brain that says something is wrong. A ligament, tendon, muscle, bone gets inflamed and, boom, you have pain. These are powerful little cells and molecules created by the tissue to shut the system down, and often force you to stop. You should know, however, that these chemicals create the foundational elements required for the healing process. In other words, these chemicals can be a good thing! When you have injury pain, there are two questions that you, or your healthcare provider, need to ask and then answer. The first is "what tissue is causing the pain". This is known as the structural diagnosis. It will take a good clinical exam and maybe some imaging tests to get this answer. The next is "what circumstances or conditions precipitated the pain". Also termed the functional diagnosis. Examples of functional diagnoses include weakness or muscle imbalances that prevent fast healing. If you can answer both of these questions, you will get a line on how to treat the pain and also get insight on how to prevent it in the future. Over the coming issues, we will review some of the injury pain common with endurance sports…. Stay tuned! Also - Let's make this interactive. If you have some topics you would like to cover. Log into the web site forum and let me know. Be Healthy Best Strong Be ProActive John Woolf, MS, PT, ATC ProActive Physical Therapy www.proactivept.com |
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That Pain in the Neck | Written by John M. Woolf, MS, PT, ATC | | Thursday, 24 July 2008 | Neck pain is pretty common in cyclists and triathletes. It is a pain that can be quite concerning and can range from a mild nuisance to a full-blow hindrance for riding requiring surgery. I have seen both ends of the spectrum and, although not happy about it, is currently a topic of my own concern. One can know the "seriousness" of neck pain depending on the the symptoms. If you have soreness at the base of your neck, on one side or the other toward the latter end of a long ride and it abates shortly after getting off the bike, you are normal. Hanging your head over your handlebars for 2-4 hours puts a substantial load on the muscles assigned to preventing your head from falling onto your stem. Any muscle in the body subject to this kind of prolonged strain would not be happy about it and would let you know. There are some things that you can do to minimize this occurrence, the first of which can be applied to more than just the neck. The body does not like to be in one position for too long. If you are not convinced, try this. Hold a 10 lb weight in your arm for two hours and listen to what your biceps have to say. They won't be happy. The position required for cycling on or off aero bars creates substantial and prolonged forces. To minimize the accumulation of painful chemistry in these muscles and adjacent joints, move often: minimize your static position time (SPT). Don't wait til you get sore! Just like taking steps to stay hydrated by drinking before you get thirsty, move your head and shoulders before they get painful. It does not take much, just drop your chin to your chest a couple of times and look both directions over 10-15 minutes. Also roll shoulders a few times. This allows your body to flush the chemistry and stay fresher. With practice and discipline in these proactive maneuvers, you can beat back the pain. There is more serious stuff you should be aware of. If you have any pain that radiates into or past your shoulder into your arm, or if you have prolonged numbness in a part of your hand or arm that does not go away after changing positions, you have an irritated nerve root (chemically or mechanically or both). Nerves are finicky creatures and deserve your attention! They will not tolerate much abuse for long. Get it looked at by a qualified PT who can make a referral to a specialist of necessary. Other symptoms that deserves attention include any sharp pain in your neck when you hit a bump on the road, or catching pain in your neck. Both of these symptoms can suggest a more serious issue in your neck that can likely be remedied with appropriate exercises, I currently have this affliction and have been managing it successfully by using the neck stabilizing exercises we teach in the clinic, by watching my posture on the bike, and staying proactive about my static position time. Pain in this region of the body is a real pain in the neck! Stay ProActive! If you have questions or would like to a arrange for a personal consultation, please contact John Woolf, MS, PT, ATC, COMT at ProActive Physical Therapy in Tucson, Arizona. www.proactivept.com |
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PHYSICAL THERAPISTS OFFER LOW-COST SOLUTION TO INCREASING HEALTH COSTS Spinal Manipulation, Exercise and Advice Offer Patients an Effective Alternative for Back Pain Tallahassee, Florida, Feb. 14, 2008 – Health care expenditures for patients with spinal conditions are rising without an associated increase in health status, according to a February, 2008 research report appearing in the Journal of the American Medical Association. The study suggests Americans may be wasting their money for treatments as the overall proportion of people with impaired function increased from 1997-2005, despite a 65% increase in expenditures to treat spine conditions. Physical therapists offering spinal manipulation, exercise, and education can provide an effective alternative for patients with back and neck problems, often at a lower cost. |
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