Welcome to Advance Physical Therapy, Inc. Newsletter
Fall is just around the corner.  Summer is winding down and routines are beginning again.  If that routine includes work at a desk as a student, or almost anyone working in front of a monitor today, chances are you’ve experienced a pain in your neck or a headache stemming from the neck.  Why do so many people suffer from neck pain?  Silicon Valley breeds this type of behavior and this has become a very common problem that we see in our community and treat at Advance Physical Therapy.  Simply put, many of us have lost the strength to balance the 10 pound weight on top of our body as each work day hour puts more strain on our neck.

In this month’s newsletter, we’ll define the anatomy and discuss common pathological features in people who suffer from chronic neck pain and provide some simple, cost-effective solutions at your work station that minimizes neck pain from occurring.

To your health,

Advance Physical Therapy, Inc.


What is this Pain in my Neck?
Neck pain is the third leading cause of chronic pain.  The neck is comprised of the first seven vertebrae and their associated, round, flat  discs: C1 (the atlas) sits just below the skull, C2 is one more down, etc., to C7, which is even with the top of the shoulders. The discs act as shock absorbers and keep the spine flexible.  There is an outer portion to the disc and an inner core.  The disc forms the intervertebral joint which is named according to the union of the associated vertebrae that sits on top and below, such as C5-C6, or cervical vertebra 5, the disc in between, and cervical vertebra 6.

The discs degenerate with normal aging.  Various factors can affect the rate of degeneration, including genetics, poor posture, abuse of tobacco and alcohol.  Trauma, such as a motor vehicle accident, can also speed the process.  Degenerative discs can cause pain in the neck and, at times, refer pain to the shoulder or scapula.  The process also makes the disc more vulnerable to bulging or herniation.  The outer portion of the disc ruptures and the inner core can leak out, causing compression to the exiting spinal nerves, or spinal cord.  The pain can be quite severe and be accompanied by numbness or tingling in the fingers, hand or wrist. Aside from pain, one may have trouble turning their head, looking down or simply holding their head up.  More involved symptoms may include weakness of the arm, hand and grip strength.  Tension headaches can also develop from having tight or guarded neck musculature (suboccipitals, scalenes, sternocleidomastoids) and the ability to focus on tasks become difficult.

Degenerative changes or arthritis that affects the neck can also affect the cervical facet joints.  Facet joints are small, paired joints that connect adjacent vertebrae on the side of the cervical vertebral column. Inflammation and/or wearing down of these joints can also cause compression to the exiting nerve root and greatly compromise pain-free movement of the neck.

Younger people can also experience severe neck pain.  Their problem is  more often caused by overly tired and tight muscles.  In our younger patients, poor posture plays a key role in setting the stage for perpetuating a pain in the neck.

Of course, overt trauma, as from a motor vehicle accident, can cause serious and lingering neck pain. Also, lifting and prolonged carrying, as mothers do with young children, can cause problems. A poorly positioned shoulder girdle and improper positioning of the head on the neck can predispose someone for developing a chronic neck pain.

Stay tuned for next month newsletter as we discuss how to treat common cervical disorders at Advance Physical Therapy.

Independent Gym Program at APT

Advance Fitness is designed to further improve clients' conditioning beyond their rehabilitation in physical therapy.  This gym program allows our clients to improve their conditioning and focus on specific training and exercise independently at our Redwood City facility while benefitting from the direct supervision provided from our clinical staff.  Participants exercise at their own pace, use the specialized equipment that they have become familiar with, and feel confident and safe that they are implementing exercises appropriately to avoid injury.  Participants comment that this program fuels their natural desire to attain a higher level of fitness after their course of physical therapy and provides a smooth transition to independent management. 

Beyond just a work out...
  • Independent access to gym facility
  • Constant clinical staff supervision
  • Proper guidance for exercise progression
  • Safe workout environment minimizing risk of re-injury
  • Familiarity with using state of the art specialized gym equipment
  • Easy transition into an independent program after discharge from physical therapy
Ask how to sign up for Advance Fitness, our gym membership program today!
Take the Pain Out of Work
Is your job a pain in the neck?  If you are like many others who work countless hours behind a desk in Silicon Valley, then this can be a stressful issue.  This is more concerning for anyone who suffers from serious neck, shoulder, elbow, wrist and back discomfort at work.  The solution is to heed the early symptom warnings and take the initiative to prevent them from occurring.

Repetitive stress injuries hurt - both physically and financially.  Consider the following: The lifetime cost of carpal tunnel syndrome is about $30,000 per person according to the National Institute of Health.  Research also shows that individuals with a bad back  accumulate up to 60% more in medical bills than their healthier counterparts and that the average worker experiencing muscle, tendon, ligament, or bone pain loses 5.5 hours a week in productivity.  This loss in productivity can easily be as costly as missing days in the office.

You're most at risk if you often work from home.  Cornell ergonomics professor Alan Hedge found that at-home computer usage was the biggest predictor of a work-related strain injury, increasingly the likelihood by 50%.  He further noted that full-time office workers now spend an average of 6-8 hours a week working at home. 

The solutions to minimizing these problems don't have to be a costly proposition.  You don't have to spend $1000-$2000 buying the most expensive chair or computer set up to get the benefits of proper posture and ergonomics.  The first step is to recognize that it will inevitably become a repetitive strain injury if appropriate action is not taken. 

Take advantage of free fixes.
Be smarter about how you work.  To minimize neck, shoulder, wrist and back strain, stretch and walk for a minute or two every half-hour, change your posture frequently and take periodic minute-long typing breaks where you can rest or stretch your wrist and fingers.  Also, contact your Human Resource department and ask for an ergonomic assessment to address any equipment needs and adjustments to your work station.  If you have a regular work-at-home arrangement, your company may reimburse you or expense a portion of your home-office ergonomic equipment.

Purchase the correct tools that make a difference.
If your company is unable to assist in this expense or you are self-employed, then consider investing in equipment that will help keep your back, neck, shoulder, wrist and hand in the proper position.  Focus on your computer, keyboard and chair which are the root causes of most ergonomic problems.  Make sure the monitor is positioned high enough so that your eyes are in line within an inch or two from the top of the screen (where your eyes go, your head automatically follows).  A basic monitor stand is about $20.  When typing, your hands should rest at the same height as your elbows so that your wrists stay flat.  This is typically impossible if you use a laptop with an attached keyboard.  The solution is to purchase an external keyboard and mount a tray under your desk to house it (under-desk keyboard tray is $40-$100).  In addition, purchase a document holder to prevent eye and neck strain ($10-30), footrest to relieve pressure on the lower back and leg ($25-$40), phone headset to alleviate shoulder and neck strain ($10-$30), and wireless keyboard to help wrists stay flat while typing ($25-$50).

Finding a proper ergonomic chair may seem challenging especially when trying to assess the right size and fit.  You don't have to spend $1000 or more for a special ergonomic chair which may not be any better than a chair that costs a third as much.  What is important is to get a chair with adjustable height and armrests and a backrest that supports your lower back and has room to position a rolled up towel or lumbar support.  Disregard the use of wrist rests, split key-board trays and forearm supports since 90% of these ergnomic gadgets don't prove helpful.

Take advantage of a tax deduction.
If you are self-employed, you can write off work-related equipment as a home-office deduction.  To claim a tax break when working for a company, the total unreimbursed business expense must exceed 2% of your adjusted gross income to be able to deduct the portion of the ergonomic purchase above this threshold.

Seeking professional help may be the most cost-effective measure in the long run to prevent and minimize symptoms from reoccurring.  A proper assessment by a physical therapist for neck, shoulder, back, elbow, wrist and hand strain that includes a comprehensive work up for postural stability and alignment is essential.  You can use a flexible spending account (HSA) at work to fund your co-pays with pretax dollars. 

These simple solutions will help you save cash, become more mindful of your health, stress less and make your workday a lot more pleasant.
If we can answer any questions or field any topics of interest regarding  physical therapy, health and wellness or about our programs, please contact us. We'd love to hear from you.
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2944 Broadway Street                         1208 E. Arques Avenue Suite #105
Redwood City, CA 94062                     Sunnyvale, CA 94085

(W) 650.261.0330                                 (W) 408.720.8225
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