The Benefits of Aquatic Physical Therapy

Kim Barrow, MS, PTA, CSCS

Aquatic Physical Therapy is a great adjunct to traditional land based physical therapy.  Water has hydrodynamic principles, which includes; buoyancy, viscosity, drag, and hydrostatic pressure.  The viscosity of the water adds increased resistance with movement; you can walk faster on land compared to in the water.   Drag is the pressure of the water behind an object, which can be increased by increasing the surface area, lengthening the lever arm, changing direction and/or increasing speed.  Resistance can be increased in the water using various pool equipment to help increase surface area such as: web gloves, aqua fins, upper extremity paddles, kickboards, and foam barbells to increase drag.  There are decreased gravitational forces in the pool due to buoyancy thus providing decreased stress through the weight bearing joints.  Buoyancy allows for greater ease of movement in the water.  A person who weighs 100 pounds on land only weights 30 pounds when standing in chest deep water in the pool.   Exercises such as squats, which can be challenging for some on land are much easier to do in the pool due to the buoyancy.  Water also provides hydrostatic pressure which allows for greater venous and lymph return which helps to decrease edema.  Patients with arthritis, fibromyalgia, back or hip pain, neck or shoulder pain, strained ankles or knees all find exercising in the pool easier compared to on land, but they do feel their muscles have been worked afterward without having increased pain.  As with land based PT, the goals of Aquatic PT include improvements in gait, strength, balance, endurance, coordination, flexibility, trunk/ postural stability, and agility.

Aquatic Physical Therapy is contraindicated for patients with bladder or bowel incontinence, sensitivity to chlorine, skin rash, open wounds, uncontrolled seizures, unstable angina, poor thermoregulation, and anyone on dialysis or chemotherapy. Water therapy is also used for neurological conditions such as Cerebral Palsy, Parkinsons and stroke.  Aquatic Physical Therapy is covered by most insurances and to get started a patient would first have an initial evaluation on land and the Physical Therapist would determine if aquatic therapy is a good adjunct to your treatment.  A few patients need to start with only pool therapy, but most can do a combination of water and land based PT sessions before progressing to all land based sessions.  We offer Aquatic Physical Therapy year round in an 84-88 degree pool so feel free to set up an appointment and see how water therapy can help you.

Simple Physical Therapy Rules

Alicia Fortes, BS, PTA

The snow has finally melted and the grass is beginning to get greener. The drive to get outsideand start exercises is there. To be outside, no matter if it is walking, running or anything active, it can feel good to feel the sun on your face and the wind in your hair. Don’t let yourself be held back by injury or pain.

There is a common misconception that physical therapy is for severely injured, only for after joint replacements or for the elderly populations. In reality, physical therapy can and is utilized by a wide variety of people for numerous reasons. You don’t have to be a super serious athlete going for a gold medal. All you have to do is follow these few simple rules listed below to get better and to get back to doing what you love to do pain free. This is when physical therapy will help you.

Don’t procrastinate. If something has been bothering you for a while and causing you pain get it looked at. For example, people with plantar fasciitis have much better and quicker recovery rates if caught and treated early.

Be motivated. As a patient you must take what you learn in physical therapy and apply it during your daily routine. Encorporate the home exercises into your day, everyday to be able to see and make changes. Doing exercises only when you come in for your physical therapy sessions isn’t enough. Physical therapy doesn’t just start and stop when you are with your therapist.

Finally, be positive. Positive thoughts can help produce positive outcomes and make you feel good. Look forward to getting back on your feet again and feeling the wind in your hair. Look forward to improvement!

Do you know the difference between these three billing terms

Deb Sherlock, BS

Often times insurances are confusing! Do you know the difference between a copayment, coinsurance, and a deductible?  Here is a quick breakdown to better help you under stand your insurance explanation of benefits statements (EOB's).

Deductible: A set amount for your individual insurance plan that you pay for healthcare services before your insurance begins paying

Coinsurance: Is your share of the costs of a health care service. It's usually figured as a percentage of the total charge for the service. The amount will vary depending on the services rendered.

Copayment: A copay is a fixed amount you pay for a health care service when services are rendered.

Hopefully this has helped you to better understand the insurance language!

Spring Into Your Garden Safely

by Alison Cohen, MSPT

Well folks, spring has arrived! For many of you, this means it is time get out those gardening tools, buy some seeds, and start digging in the dirt. Gardening can have a number of physical and health benefits, not to mention a great satisfaction in growing your own food. It also carries the potential risk of injury if one is not careful about their body mechanics.

The health benefits of gardening are quite numerous. Studies have shown that gardening reduces stress levels and the amount of cortisol circulating throughout the body. By lowering the amount of cortisol circulating in your body, you can boost your immune system, improve your memory, and reduce your risk of heart disease. It can also help to improve one’s mood and promote relaxation. Moderate intensity gardening can give a person a good cardiovascular workout. Since gardening is an outdoor activity, people are exposed to the sun, and thus Vitamin D. Sunlight is the best way to obtain your body’s requirements for Vitamin D, and it only takes 10-15 minutes of sun exposure to get the proper amount.  Getting enough Vitamin D can help improve the immune system and reduce risk of osteoporosis. Gardening can also help to improve one’s strength in their core, legs, upper body, arms, and hands. Finally, gardening and being exposed to the outdoors in general can help people rehabilitate from strokes, surgeries, chronic pain issues, and depression.

In order to maximize the benefits of gardening, one needs to ensure they are using proper body mechanics while gardening. Since gardening can be a repetitive, sustained activity, you are at risk for getting conditions such as tendinitis, strains, sprains, and nerve compression in various parts of the body. Examples include carpal tunnel in the wrist, tendinitis of your shoulders, bursitis in your hips, and sciatica (compression of the sciatic nerve that runs from your spine down the leg. It can cause pain, numbness, and impaired motor function in the leg). The following are some basic tips to follow that will minimize one’s risk of injuring themselves while gardening.

1. Change your position often. While gardening, it can be easy to lose track of time and find yourself having been bent over in the same crouched position for an hour working on a section of the garden. This can create excess stiffness, stress and strain on one’s knee joints and lower back. Over time, this could lead to irritation, inflammation, and decreased joint support in the knees and back. Set a timer for 20 minutes, and when it goes off, get up and stretch out of the position you were just in.
2. Use a gardening pad. Being on one’s knees for any amount of time, especially if you have arthritis, can be painful and cause added stress to them. Kneeling on a gardening pad will give extra cushion and support to your knees and alleviate potential discomfort. If you have sensitive skin, it will help to reduce risk of wearing the skin down by kneeling on the ground which is often uneven and hard.
3. Invest in raised beds. While many people get great satisfaction and joy planting their garden right in the Earth, those who have limited mobility and/or are older might benefit from using raised beds. The area needing to be tended is more controlled and is elevated from the earth anywhere from 6 to 8 inches. This can alleviate stress and strain on one’s spine, shoulders, knees, and upper back while gardening. One can more easily sit in a low gardening stool if they cannot kneel and still be able to weed, plant seeds, and harvest their crops.
4. Sit in a gardening stool. Bending straight down at your spine while gardening might make it easier to move from place to place on your feet, but can be detrimental to your spine. It is much more advisable to sit in a gardening stool and work on smaller sections. Or, if you can, get on your knees so you are not bending at your spine.
5. Take care of your hands. Your hands are used quite extensively during gardening while weeding, digging, pulling, and planting. Wearing gloves helps protect the hands from harmful microbes in the dirt, as well as cuts/scrapes on the skin. Make sure to stretch your hands, wrists, and elbows before starting to garden. This will warm up the body, lubricate your joints and loosen up the muscles. In turn, they will be less likely to become overstrained.
6. Warm up the body before gardening! This is probably the single most important thing to do. Warmed up muscles and joints have increased blood flow, are more lubricated, and are more ready to do sustained activity with reduced risk of injury. Ideas for warm ups include:
   1. Walking around the garden for a few minutes to get your heart pumping blood to the muscles and joints
   2. Stretching all major muscle groups, including your hands/wrists, shoulders, spine, and lower extremities.

Hopefully by following the above tips, you will avoid potential injury this gardening season. However, if you do find yourself injured from gardening, physical therapy is a great treatment to seek to heal yourself. At Greendale Physical Therapy, our highly educated, trained, and experienced physical therapists and physical therapists assistants can use a wide variety of manual therapy techniques, modalities for pain reduction, exercises to improve strength and mobility, and patient education tools showing you how to modify your gardening routine to allow you to participate in an activity that is fun, invigorating, and most rewarding. If you would like to set up an appointment, you can give any one of our three clinics that is most convenient to you a call, or go to our website, www.greendalept.com, and click on the link for patients to request an appointment. Here’s wishing you a most happy, healthy gardening season!