Welcome to Advance Physical Therapy, Inc. Newsletter
Happy Thanksgiving!

Fall turns to winter, and even here in sunny California, we seem to hear of people who complain about their aching joints more with the advent of the crisper temperatures. It's been suggested that the barometric pressure exerted by the air around a joint can cause the tissues around a joint to swell. Also, that nerves that innervate the joint are more sensitive to the air pressure. In fact, despite the fact that your Great Aunt Millie could forecast the weather with uncanny precision by how her right knee was feeling, there have been very few scientific studies looking at correlation between winter weather changes and joint symptoms. The studies that do exist are not conclusive as a whole.

In the meantime, our current issue explores the ways in which physical therapy, and in particular, manual therapy and exercise, can help with the pain of arthritis. At this time of year, we're often overextended with home, school and family commitments, so we'll also explore the seven best energy boosters.

We hope you have a wonderful holiday, sharing good company, good times and good food with your friends and loved ones.

To Your Health,

Advance Physical Therapy, Inc.
 Physical Therapy Treatment for
Degenerative Joint Disease

The signs and symptoms of osteoarthritis are well known to millions of Americans. They include stiffness, soreness, aching or swelling in or near a joint either after overuse or after a period of inactivity, such as the first hours of the morning. Many times, a joint which is chronically stiff and sore will hurt for no reason at all.

The common treatments for osteoarthritis include acetaminophen (tylenol) for mildly painful cases, and non-steroidal anti-inflammatories (NSAIDs, like advil), for moderate to severe pain. Alternatively, for severe pain, your physician may prescribe narcotics and opiate analgesics or inject your joint with corticosteroids, a powerful anti-inflammatory drug. Of course, surgery is another option, depending on the joint involved, your age, and the chronicity of the problem. Many people are surprised to learn that the degree of joint degeneration shown on an X-ray does not correlate with the level of pain or disability experienced. 

Along with pain-relieving medication, physicians will advise their patients to exercise. Studies show again and again that regular exercise, including cardiovascular exercise, strength training, and flexibility programs have a significant effect on the pain, function and disability of people who suffer from arthritis. We can assume that for those with mild pain, starting up an exercise program that includes these elements may be all that is needed. For many more who find themselves caught in a downward spiral of moderate to severe pain and stiffness, moving the joint just makes the pain worse, so they move less and the stiffness and pain worsens, as the cycle is repeated. This is where the training of a physical therapist skilled in a particular method called "manual therapy" can help.

At Advance Physical Therapy, our therapists have advanced training in the application of manual therapy methods to decrease the stiffness in the joints using soft tissue and specialized joint mobilization techniques. During an examination, our therapists will complement the medical diagnosis given by your physician, with a thorough passive, "hands-on" diagnosis to determine what the joint's motion restrictions are. Once we know which passive motions have been restricted by the degenerative process of arthritis, we can gently restore the joint to an optimal range over the course of several sessions, which allows the joint more freedom of movement. Additionally, an examination of your muscle strength and patterns of activation allow us to prescribe the proper exercises to build strength around the arthritic joint and to minimize abnormal stresses through the joint. Besides the powerful combination of manual therapy and therapeutic exercise, your therapist may make other suggestions to help with your pain and minimize joint loading, including guidance on posture correction, ergonomic adjustments, sleep positioning or footwear and orthotics.

All Californians now have direct access to the care of a physical therapist. Beginning in January 2014, you will no longer need to see a physician first for a new problem that affects your movement. Call us today to find out how we can help you with your arthritis pain.
Benefits of Medical Exercise Therapy to Improve Degenerative Joint Pain

The first line of defense is not to neglect or ignore joint pain that doesn't resolve on its own after a week or two. Usually, minor aches and pains do subside with rest but if joints persist to have pain that is sharp, dull or throbbing with or without movement, with weight bearing or non-weight bearing activities (walking, squatting, transitioning between positions), and/or if there is presence of swelling, it is important that you consult with your physician and physical therapist for a thorough assessment to identify the specific cause(s) of the joint pain. If joint pain is left untreated, persistent inflammation can result in further deterioration of the cartilage around the joint surface which can lead to increased pain, inflammation, and immobility. Pain and immobility leads to muscle guarding, poor muscle contraction and coordination, muscle weakness and fatigue which then can perpetuate a vicious cycle of pain, stiffness and further cartilage breakdown.

And while degenerative joint pain may be a result of genetics, overuse, trauma, or from sedentary living, it is important to understand what we can do to slow down joint and cartilage degeneration that is within our control. Physical therapy provides the resources necessary to effectively treat and improve bone, muscle and joint health. A thorough physical therapy evaluation will determine the causes of joint pain and identify the specific areas of cartilage breakdown, muscle weakness and poor postural alignment. Next, joint mobilization techniques help improve joint alignment and spacing to minimize friction between joint surfaces while soft tissue mobilization help resolve muscle imbalance and asymmetrical tension. Following these techniques, dosed medical exercises provide the necessary light resistance to allow proper joint lubrication to occur in a pain free range of movement. A prescribed exercise program may consist of 3-4 sets of 30 repetitions performed 4 times/day to promote the proper synovial lubrication to the joint surfaces. These exercises are specifically set up by the therapist to ensure that the joint surfaces are properly aligned and that the correct muscles are being recruited.  Next, the resistance level changes for a series of exercises at 3 sets of 15-20 repetitions that may be necessary to establish proper muscle contraction, coordination and endurance for completing pain free movements.  Each exercise phase is carefully assessed by the therapist to ensure that the joints and muscles develop the proper control, stability, balance, and coordination necessary to progress towards more functional exercises. Joint pain is avoided in order to optimize joint restoration and further degeneration.

The key to treating degenerative joint pain is to address the symptoms early on and seek professional assistance to determine the extent of the injury. Early intervention is the best way to preserving joint health and function.

Please contact us if you have any questions regarding how physical therapy can help you treat degenerative joint pain.
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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The 7 Best Energy Boosters

Are you tired all the time? About 10 million doctor visits each year are attributed to fatigue. And large consumption of coffee won't help. Too much caffeine actually saps energy and makes fatigue worse. The best way to beat fatigue is to create conditions that bring more energy into your days and remove the obstacles that drain it away.

Most of us know that exercise is a great way to boost energy by increasing blood flow and circulates oxygen to the brain and other tissues. It also increases brain-derived neurotrophic factor (BDNF), a protein that improves alertness and focus, along with physical energy. Other energy-boosters that work include the following.

1) Green drinks.  Drinking more greens can be a better choice than just eating them when your energy is low. Liquid greens and juices made from wheat grass, barley and other vegetable extracts are alkalizing. They increase pH and shift the body's balance to a less acidic state. Too much acidity - a consequence of all the meat and grains in the American diet - impairs energy as well as health. The grasses used in green drinks contain chlorophyll that remove energy-depleting toxins from the body.

2) Whole eggs.  We need plenty of protein to satisfy our appetite, keep energy levels humming and prevent post-meal slumps. Whole eggs are better than egg white omelets because the yolks are high in choline, a B vitamin that reduces inflammation and the fatigue that accompanies it. Don't worry about the saturated fat in egg yolks since it's not the enemy that people once thought. Include a source of protein with every meal - eggs, nuts, fish, grass-fed meat, beans or tofu.

3) Coenzyme Q10 (CoQ10).  This is likely the most essential energy-producing nutrient that most people don't get enough of. CoQ10 increases mitochondria activity which are the energy boosting structures of cells, The body naturally produces CoQ10 buts it's a complicated process that involves at least 7 vitamins. Since many people don't get enough of these nutrients - including Vitamin C and B vitamins - levels of CoQ10 tend to be too low to boost energy. Supplement with 100-200 mg of CoQ10 daily.

4) High-glycemic foods occasionally.  It's known that the best carbohydrates for long-term energy have low-glycemic load such as lentils, peanuts, carrots, chickpeas. But if you are trying to lose weight and still keep your energy high, having an occasional serving of high-glycemic foods every 4-7 days help the body overcome its tendency to burn fewer calories. Having a meal once or twice a week that contain faster-burning carbohydrates like pasta, white rice or white potatoes may cause a jump in insulin which overcomes the slowing of your metabolism that comes along with dieting.

5) Replenish your bacteria.  The action inside your intestines greatly affects how you feel. A study published in Journal of Psychiatric Research found that probiotics (live, beneficial bacteria) may have anti-depressant effects. The same organisms improve immunity and make it easier to fight off the fatiguing effects of viruses and bacteria. Eat one or more daily servings of live-culture yogurt.

6) Lights out.  Nothing zaps your energy more than a poor night's sleep. People don't realize that even dim lights such as small LEDs on the computer, cell phone and clocks can make it difficult to get a decent night's rest. Sleep scientists have found that traces of ambient light inhibit the production of melatonin, a sleep-promoting hormone. If you don't get enough sleep, take a nap which improves memory, lowers stress and improves energy. Studies by NASA show that a short 26 minute nap can increase performance by 34% and alertness by 54%. Limit your naps to 25 minutes or less later in the morning or early in the afternoon.

7) Breathe deeply and well.  Many people don't breathe the way we are naturally suppose to breathe. We live in a fast-paced society, hunched over desks and staring at computer screens. Both stress and poor posture tighten muscles in the upper body and make it harder for the lungs to expand. We have become shallow breathers which decrease oxygen and causes mental and physical fatigue. Take a breathing break every few hours and learn to breathe from your diaphragm. Remind yourself to relax and breathe in more fully during the day.
Simple Steps to Better Bone Health

The bones perform some of the most important functions in your body, including keeping you standing upright, carrying your body weight and acting as the largest reservoir of calcium. Calcium is a critical mineral used in many bodily functions, including muscle contractions – yes, your bones even help keep your heart pumping.

Did you know that your bones are continually changing over your lifetime? Your body is constantly making new bone and breaking down the old bone. However, as you age, your bones become thinner and you are more susceptible to diseases such as osteoporosis. So what can you do to ensure you keep strong and healthy bones, no matter your age? Read these quick tips for maintaining bone health below to find out.

1. Get Active.
We all know that regular exercise can help ward off a variety of health issues, but it also helps to keep bones healthy and strong. People who are physically inactive have a higher risk of osteoporosis than people who get regular exercise. The Surgeon General recommends at least 30 minutes a day of weight bearing or strengthening physical activity for adults. Walking, hiking, jogging, climbing stairs, tennis, and dancing are all great ways to get moving and build your bones. Be sure to talk with your doctor before you begin any exercise regimen.

2. Get Enough Calcium.
The recommended dietary allowance (RDA) for calcium is 1,000 milligrams (mg) a day for adults ages 19 to 50 and men ages 51 to 70. You can get calcium in a variety of ways. You can take a calcium supplement, there are many over the-counter varieties available. You can also add calcium to your diet through a variety of foods such as milk, yogurt, spinach, almonds, canned salmon, sardines, broccoli, kale and soy products. Remember that your calcium needs can change as you age. Make sure to check with your physician to see what dosage of calcium is right for you.

3. Don’t Forget the D.
Make sure you take your calcium with vitamin D. Vitamin D helps the body to absorb calcium. The sun is a great source of vitamin D. 10-15 minutes a day, three times a week is enough. However, many of us are deprived of our sun time during the winter months so taking a vitamin D supplement may be in order.

4. Stop Smoking
Research suggests that smoking contributes to weak bones by reducing the body’s ability to absorb calcium and therefore reducing bone mass.

5. Watch your Weight.
Being underweight is a high risk factor for osteoporosis. Underweight people tend to have lower bone mass than heavier people at a similar height.

6.  Protein – Not all are created equal.
While we all know the value of protein for muscle mass and keeping us healthy, protein is one of the key components of bone tissue know as matrix.  The bone tissue or matrix is made up of special triple-helix proteins known as collagen.  This protein provides the framework for calcium and other critical minerals to bind and create strong healthy bones.  A new breakthrough in molecular nutrition, known as Cyplexinol®, is a specialized protein which activates key cells to grow this critical bone tissue. Cyplexinol® is rapidly changing the landscape of natural bone nutritional supplements.

2944 Broadway Street                         1208 E. Arques Avenue Suite #105
Redwood City, CA 94062                     Sunnyvale, CA 94085

(W) 650.261.0330                                 (W) 408.720.8225
(F) 650.261.0331                                   (F) 408.720.8755

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