If you read my blogs and articles, then you know how I feel about maintaining proper posture if you have low back or neck pain. It is so important to make sure the everything is in correct alignment as things are healing after an injury.
Maintaining proper posture while sitting is pretty simple. Slide your hips to the back of your chair, and then place a lumbar roll behind your back at about the level of your belt. Sit up nice and tall and allow the lumbar roll to support your low back. This should also help put your neck in the proper place over your shoulders.
But what about keeping good posture while sleeping? How can you support your neck as you are sleeping?
To keep proper support of your neck as you sleep, use a cervical roll. A cervical roll is a small pillow that fits inside your pillow case and helps to keep your neck in the correct position while you sleep. You can get one on the internet at OPTP for about $20 (US).
To use your cervical roll, simply slide your it into your pillow case and make sure it supports your neck when you lie down. If you roll onto your side, the roll helps to fill the space between your head and shoulder to support your neck.
Neck pain can be a real nuisance, and it can disturb your normal sleep routine. Using a cervical roll can help you keep your neck in the correct position while you sleep.
- Related: Make Your Own Cervical Roll
One of the more frequent questions I get from patients is about what to do first when pain strikes. An important part of any physical therapy program is to make sure you are equipped with the tools necessary to help you stay healthy and the knowledge of what to do when pain first strikes.
If you have neck pain or arm pain that is coming from your neck (cervical radiculopathy) you may benefit from physical therapy to help you decrease your pain and return to your normal activities. Your physical therapist will likely prescribe exercises for your neck and instruct you in proper sitting posture. He or she may also use various treatment techniques or modalities to augment your exercise program.
Cervical traction is one treatment that is often used for people with cervical radiculopathy. Traction helps to separate joint surfaces to help take pressure off of the nerves that exit your spine and travel down your arm.
A recent study published in the Journal of Orthopaedic and Sports Physical Therapy examined the effectiveness of using various types of neck traction along with exercises during physical therapy.
The researchers randomized 86 patients with neck and arm pain into one of three groups. One group was an exercise only group performing neck exercises and scapular stability exercises. One group used mechanical traction along with the same neck and scapular exercises, and the final group used over-the-door cervical traction along with the exercises. The treatments were provided over a 4 week period for 10 sessions lasting 30-45 minutes.
The main outcome measures used in the study was changes in the Neck Disability Index (NDI) and changes in pain intensity level. Measures were taken at initial evaluation, at 4 weeks, 6 months, and 12 months after treatment began.
The data indicates that the NDI scores were lower at the 6 month point for the mechanical traction group when compared to the exercise-only group and the over-the-door traction group. At the 12 month point, the mechanical traction group showed better results when compared to the exercise only group. Thirty-two patients were lost to follow up for various reasons including receiving injections or surgery or due to crossing over between groups.
The results indicate that using mechanical neck traction along with exercise may provide better long-term results when compared to exercise with over-the-door traction or exercise alone.
If you have neck pain and cervical radiculopathy, your physical therapist may choose to use cervical traction along with exercises and postural correction to help treat your problem. This particular study shows that you may receive long-term benefits when doing exercises and using traction in the initial treatment period for cervical radiculopathy.
Recently a reader commented on a previous blog post about what to wear to physical therapy. This reader stated she is going to have surgery to repair her anterior cruciate ligament (ACL) and wanted to know what she should wear to PT during her rehab.
After ACL surgery, you may benefit from physical therapy to improve knee range of motion and strength and to get back to normal functional mobility. If you doctor has recommended you follow a post-op rehab protocol, your PT can help guide you through the process.
Often after knee surgery, your quadriceps muscle does not function properly. Your physical therapist may choose to use neuromuscular electrical stimulation (NMES) to help improve the contraction that you can make with your quadriceps. If so, your PT will need to have access to the front of your thigh where your quadriceps muscle is located. Therefore, shorts may be your best option to wear to physical therapy.
Before starting therapy, it is always a good idea to contact your PT to ask a few essential questions, and inquiring about what to wear (or what NOT to wear) should be included.
If you have fractured your ankle, you may benefit from physical therapy to help improve your range of motion, strength, and overall functional mobility. By working hard in PT, you may be able to regain your normal mobility and return to your previous activities.
Sometimes after an injury, it is helpful to connect with others who have experienced what you are going through. That's why I have set up the Ankle Fracture Rehab: Share Your Story page. You can take a look at what others are experiencing, and you can also tell others about your personal experiences with your broken ankle rehab.
I recently was evaluating a patient when a funny thing happened. He was a young child who developed neck pain while playing sports. He saw his doctor, had an x-ray, which was negative, and was referred to PT. He attended his initial appointment with his mother.
I am trained in the McKenzie Method which utilizes static positions and repeated motion testing to help determine a mechanical diagnosis for the patient. That mechanical diagnosis helps to guide treatment.
Repeated motion testing is just that-the patient repeats certain motions to load the spine in specific directions. Changes in range of motion or in subjective complaints are recorded during the evaluation.
While my patient was performing neck retraction during the initial evaluation, I was asking him questions. He performed one repetition of the motion, and I asked him what he felt.
"My neck feels a little tight," my patient said.
"OK," I replied. "Repeat that 10 times."
"My neck feels tight. My neck feels tight. My neck feels tight. My neck feels tight..." My patient kept repeating his last phrase. I wanted him to repeat the motion, not the statement.
I stopped my patient mid sentence. "Repeat the movement, not the statement!" He and his mother shared a good laugh with me about what just happened.
I made a mental note to be a little more clear with my instructions.
I live in the northeast United States, so looking out my window today is like peering into a winter wonderland. Many of my patients are canceling today due to poor weather and driving conditions, so there is quite a bit of time to play some PT games and dream. And what am I dreaming about?
With all this fresh snow falling up in the mountains, I am looking forward to the end of the storm so I can make my way up to the ski resort, strap on the skis, and hit a few runs.
Skiing and snowboarding requires good strength and endurance, good balance, and a bit of flexibility. If you are thinking about taking up alpine sports, perhaps it would be a good idea to perform some ski and snowboard preparation exercises. They can help you develop those muscle groups that are required to get up safely down the mountain with minimal chance of inury.
Last year I developed an acute onset of vertigo that seemed to come out of nowhere. Whenever I would change positions while lying down, the room would spin for about 20 to 30 seconds.
After a few episodes of the spinning room sensation, I realized quite quickly that I was suffering from benign paroxsymal positional vertigo, or BPPV. This occurs when tiny calcium crystals in your vestibular system in your inner ear move out of place and activate nerves that help control the position of your head and eyes.
I followed some simple steps to help manage my BPPV:
- I didn't panic.
- I started a few basic exercises to help reposition the calcium crystals.
- I went to see a doctor, just to be sure my vertigo wasn't caused by something more sinister.
If you have vertigo and spinning sensations when you change positions, particularly when rolling or moving from lying down to sitting up, you may have BPPV. Following some simple steps can help you quickly resolve your vertigo and get back to moving normally again.
(My vertigo lasted about 2 days or so.)
Related: The Home Epley Maneuver for BPPV
A recent study released by the American Council on Exercise (ACE) and found that youth sports coaches get a grade of "C" when it comes to overall level of knowledge.
The ACE commissioned researchers from the University of Wisconsin to survey 70 youth athletics coaches. Items on the survey examined knowledge of hydration, concussion management, strength training, and first aid. The coaches averaged a grade of "C" on the survey.
Items in which coaches scored well included questions about first aid and AED use. Seventy-four percent of the coaches were proficient in answering questions about first aid and using an AED.
The study revealed that items where 50% or fewer answered correctly were related to hydration, nutrition, acute injury management, and strength training.
If you are a student athlete or are the parent of a student athlete, it is important to ensure that your child is safe when he or she is training for their respective sports. Your child should also receive guidance in proper training techniques during the pre-season and the regular sports season.
It appears that coaches of student athletes are proficient in some areas related to coaching your child, but they may need some more training in other areas.
A physical therapist is a qualified healthcare professional who can ensure that your child is training properly for his or her respective sport. Call your local PT to set up an appointment to have a musculoskeletal screening and to help your student athlete develop an appropriate sports training program. Your PT can also speak with you about proper sports hydration and injury prevention.
If you have surgery on your knee, your doctor may recommend you wear a knee brace to help control the motion around your knee and allow things to heal properly.
If you do wear a knee brace, it is important that it is properly sized. A knee brace that is too loose will slide down and not offer much support to your joint. It could also cause a tripping hazard if it slides down too far.
A knee brace that is too tight may cause other problems like decreased circulation, numbness, or tingling in your leg.
So how do you know your knee brace is fitted properly? The "two finger" rule is a pretty simple way to be sure your brace straps are fastened just right. Here is how you do it:
- Put your brace on and fasten the straps.
- Slide two fingers under a strap. If they don't fit, the strap may be too tight. If three fingers fit, the strap may be too loose.
- Check the strap tightness for all the straps on your brace, and adjust as necessary.
While the two finger rule can help you in fitting your brace, it is always a good idea to check with your PT or doctor to ensure that you are wearing your brace properly.
Related: Do I Even Need a Brace?