Direct Access to Physical therapy: Helping you and Helping Healthcare

Tags

advocacy, APTA, direct access, healthcare, injury, physical therapy, prevention, PT advocacy, rapid city, rehab, shoulder injury, south dakota

It is Thursday evening and you are playing softball. After fielding a ball you throw to first base and feel an intense pain on the front of your shoulder. This is not a new pain but it feels worse than usual. Despite your usual treatment regimen that night (Ibupfrofen and ice), you wake up with a sore, hot shoulder. It is time to get this thing fixed. Afterall you have a tournament next weekend. If you live in California there is no way you are getting started with Physical Therapy before next week. With all the state laws and insurance company hoops to jump through it becomes difficult to get started on your recovery. But in South Dakota and many other states, you can get started that day!

Direct Access: Free to use your own judgement to seek out the appropriate medical professional without being told by another one to do so.

Why is Direct Access to Physical Therapy so important?

1) When you get injured, you want to get started as soon as possible. Direct Access eliminates the wait time to get into the specialist doctor or a costly trip to urgent care.

2) Going directly to Physical Therapy may cut down on healthcare costs (unnecessary imaging, medications, extra copays). These hoops to jump through keep patients from seeking treatment or from getting better faster. Don’t worry. Physical Therapists are trained in medical screening. If you need an x-ray, medications or if Physical Therapy is not appropriate, we will refer you on. The last thing we want is to do is treat someone who has a red flag (non-musculoskeletal pathology not warranting PT).  That is why it is called a red flag. Stop!
Here are some examples of theses hoops patients must jump through in various states/insurance types:
1) You can be evaluated by a PT but can’t receive treatment utility you get a MD referral.
2) You can receive treatment by a PT for 21 days but after that you need a referral.  How often do you completely recover from an injury in 3 weeks?
3) Many states and insurance companies require a signed plan of care by an MD prior to proceeding with care.
*These examples only delay care and provide extra work from all parties. More hoops to jump through make people reluctant to use insurance at all.

Why Physical Therapy?

1) We don’t get you better. We help you get yourself better.

Sure, we are going to use modalities (fancy machines to help you feel less pain and more relaxed) and have you relax on the table for a bit (for massage, joint stretching and other passive techniques). But, this is just a jumpstart or a reset to the system. Once the system is reset we will help you re-enforce the changes. The rest of the work is done by you. We are going to educate you and train you to do what is best during your rehab and going forth.

2) We want to make sure it lasts.

Guess what? You didn’t throw your arm out JUST because your shoulder is weak. There are probably 5 other factors contributing to your recurrent shoulder pain. Ergonomics, posture, exercise habits, sleeping habits, diet, throwing technique…these are just a few things we can identify during your treatment for acute shoulder pain.  Then we can help you prevent another occurrence. We love our patients but, really, we don’t want to see you forever.

Part of “making sure it lasts” is taking you to the next level of fitness. Everyone has body image or fitness goals. We can get you started on working towards those goals during the rehab process.

3) We have an eclectic approach.

We do manual therapy. We do exercise. We use machines. We use tape and braces. We know if you don’t do your homework (home exercise program) and will make you do it in the clinic before we do the passive treatments. The benefit of being eclectic is that we do what is most important for you all the time, not just what you expect us to do.

So next time you are sidelined by a nagging reoccurring injury, get on the horn and call a PT. We will get you started on recovery immediately… IF YOUR STATE HAS DIRECT ACCESS.

*Many states have been labeled direct access but patients DO NOT have clear access (“hoops” described above).  See below in Direct Access spelled out state by state. There is lot of current advocacy related to clear direct Physical Therapy access in these states. Please help support this effort.

References and More Information

American Physical Therapy Association info on Direct Access

Direct Access Spelled out State by State

Clout for Direct Access to Physical Therapy

Golf off-season. What are you doing?

Tags

conditioning, coordination, flexibility, golf, golf fitness, physical therapist, physical therapy, power, speed development, strength training, Sundog Rehab, Sundog Rehabilitation, swing faults, Titleist Performance Institute, TPI

This is a year around sport no matter what climate you live in.  And, it is no secret that golf fitness is here to stay.  Since Tiger Woods has proven to the amateur golf community  that general fitness can lead to golf fitness, many have hit the gym as often as they hit the links.

The “what” and “when” can make or break a golf fitness program, especially if you are starting deconditioned or injured.   Will your golf fitness elevate your golf handicap?  Maybe, if you have enough golf skill.  It will DEFINITELY increase your stamina and strength for reducing fatigue or injury during your golf season.

Titleist Performance Institute recommends that 7 fitness components are addressed in a golf fitness program:  posture, balance, mobility, stability (combination of strength and balance), power, coordination, and endurance.  As a certified Titliest Golf Fitness Instructor I have gone through 5 courses to perfect the evaluation techniques of the fitness components listed above.  With the proposed program below all of these components will be addressed.

Mike Romatowski who contributes to TPI and trains at  Core Fitness in Timonium, MD suggests 3 phases of training during the year (listed below).  Periodizing your training is especially important if you live in cold weather and are unable to consistently swing a club during the winter months.

1)  OFF-SEASON

WORK ON:  Rehab, Posture, Mobility, Stability, Balance

TIME FRAME:   3-4 months from Nov – Feb – IN OTHER WORDS, RIGHT NOW!

*Before you begin any fitness program, make sure you have addressed your injuries (Rehab)

Posture is actually the first step to changing and improving your ability to enhance your golf swing.  If you don’t have good body awareness or enough flexibility to achieve good posture, club head speed or trunk separation gains decline.  This can something that takes a lot of time to improve, especially if you have ignored it.  Once you have sufficient mobility and acceptable posture, maintain it with stability exercises.  If you have sufficient mobility and stability, you can address pure strength.  The better strength base you build during off-season, the more power you can build during pre-season.

HOW?:  Yoga, Pilates, dynamic and /or static stretching for posture, body weight functional exercises (with weight if ready) for strength and balance.  Doing abdominal exercises will not necessarily give you stability.  “Finding” your stability may require the assist of a healthcare or fitness professional.

2)  PRE-SEASON

WORK ON:  Power and Coordination

TIME FRAME:  1-2 months in March and April

Power = strength x speed.  If you were able to work through your injuries and mobility deficits so that you could build a strength base, you are ready for power training.   With this type of exercise we are adding speed to our strengthening exercises.  Golfers are often concerned with getting bulky and losing their swing mobility.  If you follow a power training workout with some coordination drills, the power carryover onto the golf course will improve.

HOW?:  Olympic weight lifting with low repetition and high resistance, plyometrics for power, speed drills for speed, agility drills for speed and coordination, TPI golf posture stability drills for coordination.

*Specifically:  Crossfit, Insanity, P90X for power…but be careful not to overdo it and get injured prior to golf season.  Many of these programs are too advanced for people who do not have a strength base.

3)  IN-SEASON

WORK ON:  Mobility and Endurance

TIME FRAME:  5-6  months May – Oct

During golf season you want to focus on not getting tight or fatigued.  Since you fixed your mobility deficits during preseason, use this time to maintain it.  Light cardio will maintain your endurance.   Remember that cardio is purely raising your heart rate.  If you continue with 1 or 2 sessions / week working on low load power exercises or interval training you will not only maintain your endurance, but also maintain power.   Using the interval training as cardio will also control any weight gain.

HOW?:  Yoga, Pilates, Moderate intensity cardio (running, cycling, rowing), interval training and Olympic lifting for maintenance only.

Sundog Rehab

Still feel lost?  Have injuries you are worried about aggravating with an aggressive program?  Get into the clinic!  Get evaluated with a physical exam, video analysis and personalized program.  See info here for contacting me to get started ASAP.  There are only 3 -4 months left before the season starts.  Apppointments are conveniently located at Sundog Rehab in Rapid City.

Resources

YOGA FOR GOLF:  http://ptsportswellness.wordpress.com/2010/06/04/back-pain-keeping-you-off-the-links/ GOLF EX FOR STIFF

PEOPLE:  http://ptsportswellness.wordpress.com/2010/05/28/are-you-a-stiff-golfer/

YEAR AROUND GOLF CONDITIONING:  http://www.ajga.org/media_center/coverstories/08_Stories/11-5-08.asp

SMART Goals for your New Years Resolutions

Tags

cpmc sports wellness, goal setting, lose weight, new years eve, new years resolutions, physical therapist, physical therapy, quitting habit, SMART goals, weight loss

Happy New Year!  By now those of you who make resolutions have set some lofty goals.  If you find yourself sitting on the couch tomorrow nursing that hangover, get your pen and paper out.  New Years resolution making has been around since Babylonian times, so it would be very nontraditional if you have not set goals.  Research shows that 40-45% of US Americans make resolutions every year.  People who explicitly make resolutions are ten times more likely to attain goals than people who make general goals.

But, how many people actually keep their promises to themselves to lose weight, exercise more, or quit a nasty habit:  THE three top resolutions?  If you want to make sure you keep your promise to yourself for more than 6 months (only 46% do),  goals must be SMART.  As Physical Therapists we write goals with our patients every day in the SMART form so that they are achievable.  Here is how to do it…

S – Specific – In order to be a specific goal it must answer the question:  who? what? where? when? why?

M – Measurable – How do you know you have achieved the goal?

A – Attainable – Not necessarily easy to achieve.  You must have the right attitude, skill, and ability to achieve them.

R – Realistic – Are you motivated to continue working towards the goals?  Even though it might be difficult to attain, you have the drive to continue working for it.  If your resolutions are realistic, you are going to continue working at achieving them.

T – Timely and Tangible – Set a date.  My favorite component “Tangible” means you can see, feel, and taste it.  This is very powerful in keeping you passionate at working hard to achieve the desired outcome.  For example:  “I feel happier,”  “I feel more energetic,” “My pants feel loose.”  Too often we go by the numbers on the scale or how we look in the mirror.

Common New Year’s Resolutions:

1.  Lose weight.

–SMART alternative:  To lose 10 pounds by July 1st and feel better about my body in a bathing suit, I will visit the farmers market every week for more organic produce and walk 4 times a week to/from work.

2.  Exercise more.

–SMART alternative:  To feel better about my body and have more energy, I will run a 10K in less than 60 minutes by June 1st.  I will achieve this goal by going to the gym 3x/week to do yoga, weights, and jogging.

Other important tips when setting goals:

1.  Make them positive.  Avoid quitting something all together.  If you want to cut down on drinking, replace that glass of wine with tea.  Then you are making the habit change the addition of tea, instead of quitting alcohol.

2.  Make them public.  If you don’t tell anyone about them, you are not serious about achieving them.  They can also give you encouragement and support to help you achieve your goals.

3.  Congratulate yourself.  Look back on the previous year and list of all the things you accomplished to help motivate you for this years goals.

4.  Do not set more than 3 goals, especially if they are challenging to attain.

Now you are ready to write you goals down in the SMART format.  Good luck and Happy New Year!

AND GET OFF THE COUCH.  Start today!

Resources:

PTSportsWellnessBlog

Seth Godin Blog

Top Achievement

Stats on NY Resolutions