Hamstrings & Injury Prevention

If you are an athlete, you are at a higher risk of injuring a knee when the hamstring muscles are much weaker than the quadriceps.  This is why strength and flexibility are great for preventing injury to the hamstrings and/or the knees.

 

Athletes are also at risk for hamstring and knee injuries when the gluteal muscles are not functioning properly or strongly enough. Tight hip flexor muscles are usually accompanied by weak gluts, which are responsible for shock-absorption during activity, but when not utilized, can lead to overuse of the hamstrings. Unfortunately the hamstrings are not structured to handle this type of workload, which results in injury to the hamstrings and even the knees, such as the ACL. In sum, it is also beneficial to have well stretched hip flexors prior to engaging in sports.

 

Here is a brief list of stretches and exercises to do as injury prevention.

 

Bridges – good for the gluts. Lay on your back with your knees bent, feet flat on the ground. Raise your hips off the ground so your torso and thighs make a straight line. Repeat this exercise until your feel a good burn in your buttocks. Remember you can always further challenge yourself by bridging with one leg.

 

Hip flexors stretch – Lunge forward with one leg and position the foot beyond forward knee. Straighten your hip of the rear leg by pushing hips forward. Hold this stretch for 30-60 seconds. Repeat with opposite side.

 

Walking lunges – To increase the challenge, start by bending your knees further to the ground or add dumbbells. Repeat until there is a great burn in your buns, hamstrings, and thighs.

 

If you are more experienced, other great hamstring strengthening exercises include dead lifts, good mornings, physioball hamstring curls, and many others.

 

Tyler Williams, SPT

Kristi McMahan, DPT

What’s Your Scope 5: Refer to Other Professionals

Refer immediately to the local PT, OT, or ATC any signals from your patient that are caution flags.   If operating independently, be confident with and know the health care provider you will refer this patient to.  Sometimes because we get such positive feedback from those with whom we’ve worked, we can have an “exaggerated idea of our skills.”  It is crucial to exercise caution when your higher senses flag danger, and move the patient towards the proper level of care.

 

Paul Greear

Therapy Tech

MCTMB Massage Therapist

Nampa North Outpatient Facility

 

 

 

 

Arthritis- Performing Tasks Easier without the Pain

May is National Arthritis Month.  Therefore, it is a great time to focus on fixing your arthritis pain.  Do you hurt after preparing a meal?  Do you have difficulty doing everyday things or leisure activities?  If so, it may be worth while taking time to find a simpler or easier way to do them. 

Identify – what are you having difficulty or pain doing?

Analyze – is there another way of doing it?  Do you need equipment to make it easier?

Explore – are their new products (or old ones like a buttoner) that will make the task easier or less painful?

Organize – look for ways to make what you use frequently easily available between shoulder and hip height.  “Use your head, not your back.”

I have found a few items very helpful and readily available.  Here are a few suggestions.

1. Reacher – long handled gadget for reaching.  Look in the pharmacy area of discount stores like Walmart.

2. Long handled shoehorn – I found an inexpensive one at Cabela’s in the shoe section.

3. Elastic shoe laces or curly laces – My patient told me that Payless carries these.

4. Electric jar/can opener – I saw one at Sears in the kitchen department.  It is made by Black and Decker.

 

If you have found something that has helped you let us know what it was and where you found it.

 

Susan Gordon, PT

Lead Arthritis Therapist

What’s Your Scope?:Don’t Interfere w/ or Contradict a Physician’s Recommendations or Prescriptions, and Don’t Support a Client (Patient) Who Wishes to Do So

I have had patients try to get me to badmouth doctors, or other physical therapists.  NOT GOOD.  Good medicine and effective therapy  is self evident.  So even if I might have inclinations towards different folks, or prescriptions, not only is it my job to point to them, but it is good practice to be silent on such dilemmas, and address the issues if they are significant with said therapist, or Doctor, if at all possible.  After all, the liability for such Prescriptions should lie where it falls.

Paul Greear

Therapy Tech

MCTMB Massage Therapist

Nampa North Outpatient Facility

 

What’s Your Scope?: Avoid Presenting Yourself As Having Expertise That You Don’t

-In working sports massage with the Boise Burn, I am fascinated how a team can work together to achieve a goal, each team member having just the right job.  In just the opposite way it would be catastrophic if I jumped out and tried to play referee for the game (although some of you fans would disagree based on the performance of the refs during the home game opener against the Tri-Cities Fever!). 

 

-Use your developed professional judgment to determine whether or not the issue being brought to your attention during treatment is for some other more qualified therapist (and then make sure you at least try to glean what their recommendation becomes, in order to enhance your global understanding!).

 

-Not all physical assessments need be brought to a patient’s attention; be aware and courteous of sensitivity to their own health deficiencies.

Paul Greear

Therapy Tech

MCTMB Massage Therapist

Nampa North Outpatient Facility

 

 

 

What’s Your Scope?: Tip 2

Massage therapists don’t diagnose, and officially, we don’t do “evaluations.”  But Massage Therapists MUST be able to assess and critically think through the relative condition of each patient/client that they see.  We make observations that facilitate our treatments, and sometimes these observations help illuminate the overall condition.  Communicate with the health care provider who referred the patient.

What’s Your Scope?

Recently I grazed across an article in Massage and Bodywork concerning how to best define what a body worker’s scope of practice is.  As a Massage Therapy provider with a relatively new role in the Health Care Field, it is crucial that I understand and effectively define what my scope of practice is.  After One year and almost Six months of service with SLIERS Nampa North outpatient facility, and as a team Massage Therapist with the local Arena2 football team the Boise Burn www.boiseburn.com , I have learned how to better operate as a Massage Therapist within the realm of Physical Therapists, Athletic Trainers, Chiropractors, and Occupational Therapists, each with their own unique scope.  And through these experiences I am more comfortable operating independently as a Massage Therapist while maintaining the integrity of my own scope of practice, and the scope of my colleagues. 

 

First I had to operationally define my scope of practice.  Over the next few days I will Post suggestions for other Massage Therapists working alongside an assortment of Health Care Professionals. [Some of these concepts are paraphrased from McIntosh, Nina. “What’s your scope of Practice?” Massage and Bodywork, p.130 May/June 2008.]

First off:

• Know Local and State Regulations:

-In Idaho there are no state Licensure requirements for Massage therapists.

-A Massage therapist (should) obtain a city business license if in sole proprietary business work.

-Although not regulated by our state municipality, It is a requirement that any Massage Therapist working with SLIERS have a certificate of completion in Massage therapy from an accredited school.

-It is highly recommended to obtain further credentialing through a National agency such as National Certification Board for Therapeutic Massage and Bodywork (NCTMB), Medical Massage National Certification Board, or to have legitimate training in any area of extensive bodywork modalities such as Rolfing, Myofascial Release, Lymphedema, or Cranio-Sacral work, not to mention many other valid modalities.  KNOW YOUR ETHICAL BOUNDARIES, as stated in your credentialing agency’s code of ethics, and demonstrate caution with multidimensional relationships.

-If working in a state that requires licensure (such as Oregon), a Massage Therapist must obtain Licensure from the appropriate municipal board (sometimes this could be county, or city depending on the area of the country).

-Extend your credentialing leverage through liability insurance with an accredited agency (such as AMTA or ABMP) –if working as a sole proprietor this is a must!

Paul Greear

Therapy Tech

MCTMB Massage Therapist

Nampa North Outpatient Facility

 

 

Lymphedema: Denial and Rebellion- It’s Only Human Nature

The human mind is an amazing thing.  Its ability to fool even itself to the detriment of the person is truly astounding.  I see it on a daily basis when dealing with Lymphedema patients.  The two I run into are denial and rebellion. 

• Denial #1: “I’m the exception to the rule!” Unfortunately there is no cure for lymphedema and it is a progressive condition.  Once Lymphedema has developed it does not go away.  It must be managed on a daily basis.  I can’t count how many times I have had patients report, “I tried going a day without using my compression garment and (surprise surprise) my arm/leg swelled.” 
• Denial #2:  “I haven’t had any problems for years, I’ll never develop Lymphedema!” As well, patients who have been instructed that they are at risk for developing Lymphedema at any point in time after having Lymph Nodes removed and/or undergoing radiation for cancer treatment, even 10 years or more later, come in and report they had been following the Lymphedema Prevention guidelines, but then figured they have not had any problems for years, so they won’t get it.  Now, a month or two after, they are in my office with swelling. 
• Rebellion:  “I’m fed up with dealing with this!”  I see this often as well.  A person, who has been doing well with maintaining their Lymphedema on a home program, gets fed up with having to do the self manual lymph drainage, exercises, and using the compression garments, so they just stop.  Months later they are ready to get back “on the wagon”, and come in to do the full intensive program all over again to get the Lymphedema back under control.

Don’t let human nature keep you from your success.

Sonja M. Maul PT, CLT-LANA

National Board Certified Lymphedema Therapist

Snapping Hip Syndrome

Your outfit should be snappy, not your hips.  Unfortunately with marathon season underway that is exactly what ends up happening in many recreational runners.  Robie Creek anyone?

            Many runners begin feeling a snapping, popping or sometimes a painful sensation in their hips whenever they run, squat or stand up.  This is because tendons of the hip begin to swell and become irritated.  They swell up and become painful because they are constantly rubbing against part of the leg bone (femur).  The swelling can eventually become permanent if left untreated.

            There are many reasons why this happens, but most of the time it is from too much running and/or poor running form.  Stretching, icing, resting and contacting a physical therapist for more information will help you get rid of that hitch in your giddyup and back on the trails.  Happy running.

 

Tyler Jepson, PT, DPT

Emergency Department Physical Therapist

 

 

National Occupational Therapy Month!

SLIERS would like to reccognize our wonderful Occupational Therapists!  April is National Occupational Therapy Month, and all of the hard working OTs deserve to be recognized!  If you are not a SLIERSian, or have not be an Occupational Therapy patient, you may not know what OT is.  Here is a general definition:

“ Occupational therapy is skilled treatment that helps individuals achieve independence in all facets of their lives. Occupational therapy assists people in developing the “skills for the job of living” necessary for independent and satisfying lives. ”

SLIERS OTs help treat over a thousend patients each year.  Their patients range from small children who are learning skills for living for the first time to adults regaining the skills they need to enjoy life. 

Remember to give every OT you see some EXTRA SLIERS Love this April!

For more info on Occupational Therapy, visit www.aota.org.