Healthy Aging Archives

Exercises to Try for a Healthy Spine

February 8, 2024 By Wendy Webb Schoenewald, PT, OCS Leave a Comment

Here are some simple exercises to maintain or improve your back flexibility and decrease back pain.

Aerobic exercise: take a short walk daily to interrupt sitting, take long strides, and keep your head and eyes up.

When you wake in the morning, do some simple spinal exercises to loosen up the joints and muscles around the spine. Repeat these throughout the day.

Try flexion: knee-to-chest exercises or child’s pose yoga stretches to open the vertebra and stretch muscles. When you stand, bend over and touch your toes slowly several times. This flexes your spine and improves the flexibility of the hamstrings and buttocks.

Try extension: Physical therapists call this exercise a press-up, or in yoga, it’s called an upward dog pose. While lying prone (on your stomach), use your arms and hands at shoulder level to press the chest up to arch the back, letting the hips sag toward the ground. Hold this for about 10 seconds, then return to lying flat. Alternately, when you stand, place your hands in the small of the back and lean backward in an arching motion, hold for 5-10 seconds, and repeat at least five times. This is good to repeat throughout the day to offset prolonged sitting.

Physical therapy is known to be valuable and effective in managing acute and chronic low back pain, and recent studies suggest that therapy could be most beneficial when used earlier in the care process. Ask your primary care provider about coming to see WWSPT’s skilled clinicians and choose physical therapy first in your care.

Lifestyle changes PTs recommend to prevent or manage Lower Back Pain

February 7, 2024 By Wendy Webb Schoenewald, PT, OCS Leave a Comment

What lifestyle changes would PTs recommend to prevent or manage Lower Back Pain (LBP)?

Physical Therapists assess lifestyle risk factors that might predispose or aggravate LBP and educate patients about better choices. The most common adjustment is to be aware of sitting with good postural alignment, avoiding slouching, and actively sitting up straight. Sitting and scrolling on our phones is a good example where slouching is common, i.e., head down, shoulders rounded, and spine flexed. Try sitting up straight and gazing down at your phone instead.

Avoid being sedentary. Prolonged sitting is common in many offices or work-from-home settings but is easily corrected with an ergonomic chair and lumbar lordosis support to create an extension of the spine as you lean back in the chair. For those at a computer, using a standing desk intermittently throughout the day is an effective way to decrease time spent sitting. When your work day ends, avoid sitting. Yes, you can lie on the couch and unload your spine!

Often, people sit slouched without pain, but when they go to get up, they have trouble straightening without pain because the tissues of the spine are overstretched into the flexed or slouched posture and are strained. When this happens, it’s good to do some backward bending and walk with long strides to balance the spine with some extension movements.

Driving long distances can cause the same symptoms, so ensuring your vehicle’s seating alignment is the best for your size and height is important. Cars often have lumbar support built into the seat, which you can adjust for comfort. Another trick is to make sure you sit straight, then align your rear-view and side mirror so when you start to slouch, you won’t be able to see your mirrors, and it will be a reminder to use good posture. Luckily, today, our cars remember these settings for us!

Use proper body mechanics when lifting objects from the floor. A straight back and bent knees are best to prevent lumbar muscle strains or spinal strains. Proper sit-to-stand movement is very helpful, and I find I need to teach this to patients with any lower leg or lumbar problem. Commonly, people round forward and stay flexed to stand; however, to stand properly, you should look up, erect, and lift with your hips and legs.

Walking is good for your back, so take a short walk before or after a meal or lunch break. Other factors that lower the risk for LBP include maintaining good health habits of aerobic exercise training, whether walking daily or getting to a gym 3-4 times a week performing strengthening and aerobic exercise. Keeping your weight in the normal range and avoiding smoking are additional factors that reduce risk.

Physical therapy involves patient education, manual therapies, and strengthening exercises that focus on trunk muscle activation and building endurance to reduce pain. Physical therapy is known to be valuable and effective in managing acute and chronic low back pain, and recent studies suggest it is most beneficial when used earlier in the care process. Ask your primary care provider about coming to see WWSPT’s skilled clinicians and choose physical therapy first in your care.

Wendy Webb Schoenewald, PT, OCS,
WWS Physical Therapy and Vestibular Rehabilitation
Doylestown, PA.
215-489-3234

Explaining Low Back Pain Beyond the Diagnosis

August 25, 2023 By Amanda Nguyen PT, DPT Leave a Comment

Low back pain, #LBP, is one of the most common injuries people experience and get treated for in Physical Therapy. According to a study published by Georgetown University, nearly 65 million Americans report a recent episode of back pain, and some 16 million adults are limited in certain everyday activities due to chronic back pain.

The most common diagnoses of low back injuries seen in physical therapy are osteoarthritis, degenerative disc disease, strains/ sprains, disc herniations, and sciatica. These diagnoses are especially prevalent among people over the age of 40. Often, an X-ray, MRI, or CT scan is needed to confirm one of these diagnoses. However, just because one of these diagnoses is present in the lower back doesn’t mean it is the root cause of pain.

Imaging does not always correlate with symptoms. In a research study published in the American Journal of Neuroradiology, researchers took MRI images and CT scans of spines in groups of people ages 20 to 80 years old without pain. They found that about 37% of the 20-year-olds and approximately 96% of the 80-year-olds had disc degeneration. Researchers also found that among the 20-year-olds, about 30% had evidence of disc bulging or disc herniation, while 85% of the 80-year-olds had it. While the imaging revealed something abnormal about the participants’ spines, they did not report any pain.

However, some people with one or both of these diagnoses have pain. So, what is the difference if two people have the same diagnosis, but one is experiencing pain, and the other is not?

Even though two people may have the same diagnoses, their presentation is never identical; no two people have the same medical histories, comorbidities, work conditions, personal activities, and habits. As a result of these factors, different muscles are being used more often than others, which leads to asymmetries of the body. If muscles are weak or inflexible, the other muscles of the body have to compensate for those imbalances, which results in improper movement patterns and pain.

If there was no traumatic event like a car accident, odds are the structural change, like the disc bulge, was there long before the pain started. The area could have been irritated with a small movement, but it was enough to cause an exacerbation of symptoms. This is often true when someone suddenly falls or shovels for the first time in the season. The pain may dissipate when this acute irritation calms down, but the same disc bulge or degeneration remains. For some, though, the pain can become chronic and persistent.

In Alie Ward’s podcast “Ologies,” the Dolorology episode, she interviews Dr. Rachel Zoffness, a pain psychologist, about chronic pain. She discusses chronic pain as “a biopsychosocial phenomenon.” Pain is influenced by biomedical (i.e., structural changes to the body), psychology (i.e., trauma, depression, mood), and social factors (i.e., environment, accessibility), and all of these factors should be considered when treating chronic pain.

Dr. Zoffness also discusses the use of opioids for chronic pain. The opioid epidemic has become a major topic because of the many overdose deaths. While these medications can block pain messages effectively, they desensitize the brain to pain and the effects of the drug. The brain gets accustomed to the medication and then demands a higher dose to decrease pain and keep it manageable. In another scenario, the pain signals can return with a vengeance if a dose is missed.

Research shows that opioids are ineffective in long-term low back pain, but exercise and activity are effective. For those who have pain with everyday tasks, their brain is very sensitive to pain because of how long pain has been present. The brain is very good about protecting the body, so it sends “danger” messages when doing tasks like unloading the dishwasher, even though they are not dangerous. So small bouts of exercise and activity lead to desensitization of the body and reteach the brain that these tasks are normal.

Addressing the mental state is also important when dealing with long-term pain. If someone is in a bad mood or stressed out, pain can be more intense due to the brain chemicals released when he or she is not feeling good. For instance, when you’re not feeling well, your body feels so much heavier and achy. Exercise can release endorphins and dopamine to boost mood and make you feel good.

So, what exercises or movements are appropriate for back pain? Physical therapists are movement experts and will be able to evaluate and assess your pain. Many of the diagnoses listed earlier are treatable with physical therapy, but at WWSPT, we don’t just treat the diagnosis; we treat the person. We will evaluate your movement, strength, and flexibility. We will take into consideration your past medical and social history. From that information, we will develop a plan for you to become pain-free and return to your prior level of function.

Dr. Amanda Nguyen. PT. DPT,
WWS Physical Therapy and Vestibular Rehabilitation
Doylestown, PA.

Got Neck Pain???

June 6, 2022 By Cassie Zanolini, PT, DPT Leave a Comment

Neck pain is one of the most common musculoskeletal disorders. Whether it’s a stiff neck after sleeping in an awkward position or a more severe injury, we’ve all dealt with neck pain in some form or another. But why does this pain occur?

One of the most common causes of neck pain is cervical osteoarthritis. Osteoarthritis is the degeneration of cartilage in the cervical spine joints. This often occurs as a result of wear and tear over time but can also be accelerated following an injury. Cartilage loss causes bone-on-bone contact and friction, which subsequently results in pain.

Pain is often localized to the cervical region and can result in stiffness, pain, and even headache. Initially, symptoms begin as stiffness in the morning, which typically eases throughout the day. In more chronic cases, degeneration in the cervical spine can cause compression of the nerve roots which give rise to the nerves that travel down our arms. Compression of the nerves can result in symptoms of pain, numbness, or weakness reaching down the arm.

Cervicogenic headaches can occur in conjunction with cervical pain as well. These headaches are a manifestation of musculoskeletal issues occurring in the cervical spine. With cervicogenic headaches, we commonly see dysfunction in the upper portion of the cervical spine, difficulty rotating, and muscle abnormalities and imbalances—all of which occur as a result of poor posture. Awareness of posture can relieve pressure in the upper cervical spine. Manual therapy and massage techniques can be helpful in reducing cervical pain and subsequent headaches. A well-tailored exercise program can help to provide relief from symptoms.

Cervicogenic dizziness can be another manifestation of neck pain. Cervical spine position and posture play a large role in our balance. Dysfunction in the upper portion of the cervical spine can lead to a sense of general disorientation and dizziness. These symptoms often worsen with neck movement or prolonged positioning. Typically, if the neck pain is able to be reduced, then the dizziness decreases as well. Manual therapy, exercise, and postural re-education are helpful to reduce symptoms.

Now that we have a better understanding of the signs and symptoms of neck pain, how can a physical therapist help you learn to manage it? Physical therapists can provide a variety of different exercise programs ranging from manual therapy to stretching, to strength, to nerve mobility—all of which help you better manage your symptoms and improve your activity tolerance.

Posture

Physical therapists are experts in posture, especially when performing functional activities. Poor posture when seated, driving, or sleeping can place increased strain on the spine, which can contribute to pain. The muscles in our neck work all day to stabilize our heads. Changes in position and posture alter our muscle position, causing muscles to be stretched too far or shortened too tight. A physical therapist can give you exercises to help correct these imbalances. Oftentimes, simple scapular retraction or shoulder-blade squeezes can help you correct upper-back posture.

Forward head posture is the most common contributor to neck pain. In this posture, our head is leaning forward out in front of our shoulders, which is exacerbated when seated while working on the computer or looking at our phones. Prolonged time in this position creates muscle imbalances that contribute to pain and even radicular symptoms reaching down the arm. Over time, these postural changes can result in loss of range of motion and degenerative changes.

Chin tucks can be an effective method for correcting this posture. With this exercise, sit upright, facing straight ahead, then pull your chin and head straight backward until a stretch is felt at the base of the skull. Chin tucks can be repeated frequently throughout the day in sets of 5 reps.

The good news is poor posture can be corrected. When working at the computer, being mindful of posture is important. Your screen should be placed approximately at eye level to ensure a neutral cervical spine position. Try setting an alarm on your phone to give you a cue to correct your posture every half hour or hour. When seated, you should be conscious of pulling your shoulder blades together and sitting up tall. Standing desks can be beneficial in helping to allow for more changes in position over the course of the day. When seated in the car, we often fall into slouched, poor posture. I recommend setting your mirrors when you’re in a position of ideal posture. This will remind you to self-correct when you slouch because you will be unable to see out of your mirrors.

Sleeping

The use of a towel roll can be beneficial in helping those with cervical pain find a more comfortable way to sleep. Tucking a cervical pillow, or rolled-up towel, into your pillow can help to support the cervical spine and maintain your normal spinal curvature while you sleep. If you sleep on your back, place the cervical pillow underneath your neck. If you sleep on your side, then place the cervical pillow in the open space between your neck and the pillow to allow for better support.

Physical Therapy

If cervical pain is interfering with your life and preventing you from doing what you love, then, schedule an appointment to see one of our experts at WWS Physical Therapy for an evaluation (215-489-3234). Physical therapists in our office will evaluate you, provide you with a program to address your needs, and help guide you in the healing process.

Dr. Cassie Zanolini, PT, DPT,
WWS Physical Therapy and Vestibular Rehabilitation
Doylestown, PA.

Chronic Conditions and Winter Weather

February 13, 2022 By Cassie Zanolini, PT, DPT Leave a Comment

Chronic Conditions can be triggered by winter weather. When cold weather comes on, some people say they can feel it in their bones. The truth is that cold weather can magnify many chronic conditions.

Arthritis and Musculoskeletal Issues

Arthritis is a condition that affects many middle-aged and older adults. The change in atmospheric pressure that comes along with winter storms can actually trigger arthritis and musculoskeletal pain. Winter weather can result in increased swelling in arthritic joints, which can contribute to elevated pain and stiffness.

Physical Therapy interventions can promote a range of motion gains to improve mobility and strength gains to better support the affected joint. Education on proper body mechanics and posture can also be beneficial in reducing pain during provoking activities.

Headaches and Migraines

Migraines are one of the most prevalent chronic medical conditions that Americans live with. Though headache is more prevalent in women, it is often highly correlated with family history.

Again, barometric pressure and temperature changes are common triggers with migraines. Episodes of migraines occur more frequently with drastic changes in the temperature, which occur commonly in the winter.

Physical therapy is often an under-utilized resource in migraine management. Through manual therapy, cervical spine management, exercise, and education, many individuals experience some level of relief from their migraines.

Diabetes

Diabetes is another of the most common chronic medical conditions, affecting over 11% of the population in the United States. Diabetes is a disease in which the individual has difficulty regulating their blood sugar. The holiday season and the seasonal changes that come with it are often difficult for those with diabetes to manage. These changes in addition to reduced activity levels due to colder weather, ice, and snow result in elevated blood glucose and HbA1c levels.

Physical therapy can help to promote increased activity levels and exercise, which can be an effective way to reduce blood sugar and HbA1c levels. Physical therapists can provide useful knowledge regarding diabetes in addition to exercise programs suited to those with diabetes.

Though these are only a few of the most commonly affected chronic medical conditions, there are many other ailments that can occur during the winter months. If you or a family member finds themselves in need of therapy to address these issues any of the therapists here at WWS PT would be happy to help.

Dr. Cassie Zanolini PT, DPT,
WWS Physical Therapy and Vestibular Rehabilitation,
Doylestown, PA.

Exercises to Try for a Healthy Spine

Lifestyle changes PTs recommend to prevent or manage Lower Back Pain

Explaining Low Back Pain Beyond the Diagnosis

Got Neck Pain???

Posture

Sleeping

Physical Therapy

Chronic Conditions and Winter Weather

Our Mission at WWSPT

WWSPT Mission 2.0

Contact WWS Physical Therapy

Ask About WWSPT Professional Associations

Posture

Sleeping

Physical Therapy

Our Mission at WWSPT

WWSPT Mission 2.0

Connect With WWSPT:

Contact WWS Physical Therapy

Ask About WWSPT Professional Associations