Welcome to Advance Physical Therapy, Inc. Newsletter

Welcome to our May newsletter! It's hard to believe that summer is just around the corner. It's time to plan that next vacation, decompress a little and soak up some sun away from the daily work and school routine. If you have made summer plans already, then good for you! For the rest of us, let's start planning.

Continue to stay active, maintain a healthy balance between work and play and apply the following tips in this month's newsletter to keep us on the road of healthful living!

To your health,

Advance Physical Therapy, Inc.
 Manual Therapy to Resolve Knee Pain

Last month, we opened a discussion about the structures that compose the knee joint and some of the potential problems that result in the old and young alike. This month, we will describe how our therapists approach treatment for this commonly injured joint.

During the physical therapy evaluation, in short, the therapist will measure the range of motion and assess strength of the muscles that surround and affect the function of the knee. At first glance, the range of motion is quite straightforward: it bends and straightens, right? Yes. The tibiofemoral ("hinge") joint flexes and extends. But it also glides and rolls. What?!  Due to the shape and contour of the bony surfaces and meniscus, in standing with knees flexed, such as getting up from a chair, the end of the femur (thigh) rolls forward somewhat and glides backward a bit more. During walking, it gets even more bizarre. When the leg is swinging, the knee is rotating inward. When the leg is taking the weight of the body, the knee is rotating outward. That is crazy!? How come I don't see any of that going on? These are very small movements made possible by the relative laxity of the joint at different points during its motion. They are necessary for full range of motion, so your therapist will include assessment of these "accessory movements" in the exam. In this way, a skilled manual therapist is the most qualified healthcare professional to restore passive range of motion to the knee. The therapist will use clinical reasoning to decide how relevant these motion deficiencies are to the person's knee problem and treat accordingly, using many of the same techniques utilized during the examination.

The exercise training portion of the physical therapy treatment addresses muscle function of the muscles that add to the stability of the joint. These include the hamstrings, quadriceps, adductors, sartorius, gastrocnemius and tensor fascia latae. The therapist will watch everyday movements, like squatting, walking and getting up from a chair, as well as test these muscles specifically to determine where the active support system deficits are. From the information gained, the therapist has a complete picture of what factors are allowing the pain or problem to go on unresolved. Physical therapists are experts at recognizing normal and abnormal movement patterns. Each patient is unique and so are their movement patterns, so every knee patient will have a different exercise program that is designed just for them.

If you have any questions about your knee pain, feel free to give us a call.

Herbal Alternative to Treat Anxiety

Its' common to find most of us working long hours which creates more opportunity for stress and anxiety to build. This pattern then trumps our ability to rest and restore ourselves and often times, we default to medications to provide the necessary, "quick" resolution to calming our anxiety.

Benzodiazepines are a class of drug that enhances the effects of GABA to produce a calming effect. They are typically prescribed as an effective treatment for anxiety and insomnia. They are not without problems however, as they can interfere with one’s ability to work, or an individual can develop an intolerance to them, become dependent on them, and even experience withdrawal symptoms when trying to discontinue therapy.

A possible alternative to this type of medication is the herbal extract passion flower. In a small double-blind, randomized trial, the effectiveness of benzodiapenes was compared to that of passion flower. The study focused on 36 patients with generalized anxiety disorder for 28 days. Half the group took passion flower extract plus a placebo, and the other half of the group took the benzodiazepine plus placebo. By the end of the study, both groups had a 68% reduction in their anxiety levels, as measured by the Hamilton scale. The primary difference in the two treatments was that it took four days for the group taking the drug to feel a 30% reduction in anxiety, but it took the passion flower group seven days to reach that same level of success. It was only over time that both treatments had an equal effect. However, the primary benefit of the passion flower was that it did not impair one’s ability to work effectively, thereby making it a more practical treatment for the long term, without any side effects.

"Passion flower in the treatment of generalized anxiety: A pilot double-blind randomized controlled trial with oxazepam" in the June, 2012 issue of Journal of Clinical Pharmacy and Therapeutics.

How to Find A Great Physical Therapist

It's our mission to share important information that may help consumers make better choices when it comes to their health and wellness. In regards to rehabilitation, many patients have mentioned that it's difficult for them to find the appropriate physical therapist to care for their specific needs. Often times, patients wind up trying several different practitioners by trial and error only to find out that they've wasted more time searching for someone rather than spending their time resolving their pain and injury. Your health and ability to heal quickly or rebound from an injury depends very much on the level of trust you have in your health care provider.

We've had the opportunity to share some of our thoughts via a live interview with Business Journal TV on how consumers should search for a great physical therapist. We hope that our insight will help you find the right physical therapist in your area should you ever need assistance.

Physical Therapy More Effective Than Medication to Treat Osteoarthritis

Despite widespread use, the supplement chondroitin seems to have mixed benefits in helping  individuals with hip and knee pain caused by osteoarthritis. According to the April 17, 2007 edition of Annals of Internal Medicine, Stephan Reichenbach, MD and associates in Switzerland and Germany discovered that while previous meta-analyses described moderate to large benefits of chondroitin in patients with osteoarthritis, recent large-scale trials showed mixed evidence to support that theory. “Fortunately,” according to Dr. Timothy Flynn from Regis University, Denver, and board member of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT), “there are alternatives.” Dr. Flynn said that by “using an innovative treatment approach consisting of manual physical therapy and specific exercise based on recent high quality research, patients with knee arthritis frequently report a 20-40% relief in their symptoms after only two or three sessions of manual physical therapy and exercise.” He added that “these improvements are usually maintained for up to one year.” Similar results were observed in a recently published follow-on trial in patients with knee arthritis, Flynn said. “At one year, patient improvements were maintained and patients who received a combination of manual physical therapy and exercise were less likely to be taking medications for their arthritis.” “Evidence also suggests that patients with hip arthritis experience similar benefits from manual physical therapy and exercise,” he added. “The research is clear. Individuals with hip and knee arthritis should see their physical therapist first, before trying dietary supplements, prescription drugs, or surgery,” suggested Dr. Flynn. “A physical therapist can help you alleviate the pain in your knees and hips and
show you how to prevent that pain from coming back.”
For more information about the benefits of physical therapy and how it can help you alleviate knee and back pain associated with osteoarthritis, reduce your use of supplements or prescription drugs, and prevent costly and painful surgery, please feel free to contact us.

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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