Monday Memo 4/9/18

The Monday Memo

April 9, 2018                                                                           PITT DPT STUDENTS

Take A Seat 

It seems as if every day, we are warned about the potential negative effects that sitting for long durations can have on our health. Populations that endure extended amounts of sitting range from CEOs of major companies to full time students. In the physical therapy community, we know it can contribute to things such as weak core musculature, increased thoracic kyphosis, forward head posture, and much more. These impairments often lead to two of the most common referrals to physical therapy: neck and low back pain. Although it would be opportune for anyone that works a full-time job to have products such as stand up desks and stationary bicycles in replace of traditional office chairs, this is not feasible for most. Here are some simple tips in order to reduce the amount of negative impact that sitting may have on your body:

 

  • Take breaks! Even if it is only for 5 minutes every hour, make sure that you are getting up, stretching, walking or just grabbing a drink of water. This gives your body and mind a chance to reset.
  • Make sure you have adequate lumbar support. If you spend extended amounts of time sitting in a chair that does not have some kind of low back support, you can try folding a small towel or pillow to put behind your back in intervals throughout the day. It does not need to be there the whole day, but supporting your back for brief periods of time can help to maintain the natural curves of your spine.
  • Set up your desk so that your computer is at eye level. Spending an entire work day with your neck excessively flexed or extended puts unnecessary strains on it and may lead to neck pain over time. If safe and realistic, adjust your chair to position yourself directly in front of your computer screen.
  • Sit with both feet on the ground. This may seem simple, however, many of us adapt strange sitting posture over extended amounts of time. Sitting with legs crossed or propping one’s feet up on a desk can lead to low back and lower extremity problems.
  • Make time to exercise! After a long day in a relatively static position, we may feel tightness and soreness in numerous areas of the body. Exercise is an effective way to offset this. Taking a walk outside, practicing yoga, dancing, or lifting weights are all excellent ways to take advantage of your own movement system.

 

Below is a picture of a relatively healthy sitting posture. Feel free to try out as many of these suggestions as you like. Keep in mind, by no means are these a cure, but they may help you find some relief throughout your day.

Picture: http://www.sagewoodwellness.com/why-sitting-is-bad-for-your-health-tips-for-posture-and-ergonomics/

-Layne Gable, SPT

 

 

April 9, 2018 |

Monday Memo 4/2/18

The Monday Memo

April 2, 2018                                                                           PITT DPT STUDENTS

Play Ball

 

‘Tis the season for green grass, dusty diamonds, and America’s pastime… Baseball! Unfortunately, that also means there are a lot of baseball related injuries ahead of us, but that doesn’t mean we can’t do our best to prevent as many as injuries as possible. Today we will talk about some common baseball injuries (mostly in pitchers) and some ways to reduce the risk of getting hurt this season.

 

Dr. Christopher Dodson, is a board-certified Sports Medicine surgeon who works with all major Philadelphia sports, and is also a consultant for the LA Dodgers and Pittsburgh Pirates. He wrote a short piece last year regarding high rate baseball injuries in pitchers, and these are the several that made the list:

 

  1. Muscle Strain – Shockingly, some of the most common muscle strains for pitchers that finds dozens of MLB players on the bench every year are found in their abdominal muscles, specifically the obliques. The forces needed to stabilize or rotate their bodies in such a repetitive fashion can lead to severe strains.
  2. Labral Tear – This injury is when the fibrocartilaginous ring in the glenohumeral joint becomes torn. This can lead to a feeling of “catching” in the shoulder and instability, and is one of the more common shoulder injuries in baseball players.
  3. Rotator Cuff Injury – The rotator cuff is made up of four muscles (supraspinatus, infraspinatus, subscapularis, and teres minor), and can become compromised with repetitive overhead motions. The nature of pitching requires this very movement and loading often leading to damage to one of these muscles, sometimes multiple muscles.
  4. Shoulder Instability – This is what Dr. Dodson, refers to as “dead arm.” Due to instability related to fatigue of the shoulder, the muscles used in throwing can become strained with overuse leading to this sensation. With more severe instability, athletes can be at higher risk for subluxation and dislocation.
  5. UCL sprain of the Elbow – If you have heard of “Tommy John,” surgery then you have witnessed this injury in an athlete. This is damaging of the ulnar collateral ligament (UCL) that can be due to impact, or more often overuse of the ligament during something like a throwing motion. The pain is usually on the inner side of the elbow and can result in a feeling of instability.
  6. Throwers’ Elbow – Also known as, “medial epicondylitis,” this is defined as pain in the inner side of the elbow with overuse. This can often occur in pitchers who throw too hard or with incorrect form.

 

UPMC Sports Medicine reports that about 288,000 baseball related injuries occur each year. It is important to take measures while playing to reduce your risk of injury and increase your performance. Some recommendations from UPMC include:

  • Warm up properly before throwing
  • Participate in a pre-season and in-season baseball strength and conditioning program
  • Avoid year-round playing to ensure proper recovery of overused muscles
  • Promote communication between athletes and their parents and coaches about playing through pain and reporting the presence of pain

 

Finally, here is some info from UPMC Sports Medicine for reducing risk of injury in Little League baseball pitchers:

 

References:

  1. https://www.rothmaninstitute.com/stories/news-and-blog/common-baseball-injuries
  2. http://www.upmc.com/Services/sports-medicine/for-athletes/baseball/Pages/baseball.aspx
  3. http://www.upmc.com/Services/sports-medicine/Documents/young-athlete-program-sports/Baseball.pdf

 

-Jim Tersak, SPT, CSCS

April 2, 2018 |

Monday Memo 3/19/18

The Monday Memo

March 12, 2018                                                                           PITT DPT STUDENTS

A Guatemalan Spring Break

This past spring break, 13 of my fellow classmates and I had the opportunity to travel to the beautiful country of Guatemala and provide physical therapy services to those who needed it. The trip was organized through Hearts in Motion, which is an organization that provides services both domestically and internationally to people in impoverished environments by “empowering […] volunteers to change lives of people in poverty”. Our entire trip was coordinated by Hearts In Motion, including our travel arrangements within Guatemala, day-to-day itinerary, and most of our meals as well, which was very helpful!

 

After driving to the Cleveland airport, catching a flight from Cleveland to Atlanta, GA, and then taking a second flight from Atlanta to Guatemala, we finally arrived in Guatemala City on Saturday afternoon. When we landed, we were greeted by Nancy Winiecki, The Hearts in Motion representative who worked with our team for the whole week. Nancy is a physical therapist herself and works in different physical therapy clinics located near Zacapa, Guatemala in addition to coordinating all of the service teams that come to Zacapa through the Hearts in Motion organization. After meeting Nancy, we loaded our luggage onto a bus and drove about three and a half hours northeast of Guatemala City until we reached our hotel, Hotel Atlántico, in Rio Hondo. The hotel was a beautiful complex with colorful buildings each consisting of two bedrooms that slept two people each. There was also a pool, a little park in the middle of the complex, and a lobby with a bar that served beer and wine for any guests desiring a late night beverage!

 

The first night after we arrived, we settled in to our rooms and then all gathered for a group dinner and orientation meeting. Then, we went to sleep so that we would be well rested for our first day in the clinic.

 

For our first clinic day, we packed up the bus with all of the donated medical equipment that we brought down with us from the U.S. which included suitcases full of pediatric and adult AFOs, braces for multiple different joints and extremities, theraband of various resistances, and adult and children’s shoes. We also loaded the portable treatment tables and documentation materials onto the bus and then proceeded to drive about 45 minutes away to the town of Chiquimula. When we arrived, Guatemalans were already lined up outside of the building waiting to be seen, so we quickly set up our workspace, divided into groups of about 3-4 people, and then began seeing our first patients! This pop-up clinic turned out to be extremely busy, and we ended up evaluating and treating a total of 43 patients by the time we finished up for the day!

 

The next day, we set up another pop-up clinic in an old indoor basketball court in the town of Santa Cruz, and this clinic proved to be just as busy as the first pop-up clinic! We evaluated and treated just fewer than 50 patients with a large variety of orthopedic and neurologic impairments. Some patients lived close by to the clinic, but some had travelled from multiple hours away to seek our care!

 

On Tuesday, after awakening to the beautiful sunrise and getting a yummy breakfast in our stomachs, we stopped by a children’s nursery where we got to meet nine Guatemalan children (3-4 years old) and play duck, duck, goose (or as they say in Guatemala: pato, pato, gonzo) with them. It was so fun to interact with the kids and to see their endearing little smiles! For the remainder of the day, we split into two groups. One group stayed in the Teculutan clinic to treat patients, while the other group went to a nearby special needs school to paint some of the rooms. We painted the sensory room a dark blue to promote calming and relaxation, and we painted the other classroom a bright yellow so that it would be more of a stimulating environment for the children to learn in. The kids at the school were so welcoming to us, and some even hugged and kissed us as we entered. Needless to say, the students were very curious as to what we were doing in their school, and they kept checking up on our painting progress throughout the day. While it was definitely hard work to transform the original dirty grey walls into bright blue and yellow ones, it was rewarding to know that we helped to make the children’s environment more conducive to their needs, and hopefully they enjoy the new wall colors! After finishing up painting for the morning, we washed off all of the sweat and paint from our bodies as best as we could and headed over to the clinic to treat patients for the next 4 hours! When our work in the clinic was completed, we quickly changed and headed to a small restaurant right outside the hotel to get some homemade empañadas as a little appetizer before dinner!

 

On Wednesday, we worked in one of the Hearts in Motion clinic’s stationed in Zacapa for the entire day. We got to see many patients here too! The patients I treated had diagnoses and complaints ranging from cerebral palsy, to back and neck pain, to a lady with foot pain after a toe amputation, to a two-year-old child with microcephaly (possibly due to the Zika virus) and significant extensor tone. We also had the opportunity to tour the Range of Motion Program (ROMP) building that was situated right next to the physical therapy clinic and see where they make different orthotics and prosthetics. After spending about eight hours in the clinic, we headed back to the hotel and had a poolside yoga class led by our fellow student volunteer and yoga instructor, Hillary Cummings! We definitely all benefitted from a little stretching out after some long days of work!

 

Thursday, some members of our team went to a pop-up clinic, and the rest of us went to a nutrition center in Gualan. Here, we evaluated and treated patients and also participated in a large “group feed” in which we assisted over 50 children who are enrolled in a program at the nutritional center to obtain the free lunch that they are entitled to each week. The view outside of the clinic was beautiful here with mountains stretching out as far as you could see in either direction.

 

Then, after five days of hard work in the clinic, we woke up around 4:15 am Friday morning and headed for the city of Antigua, where we stayed for the last two days of the trip. Some highlights from Antigua were attending the large local market that was full of colorful Guatemalan souvenirs and accessories, making chocolate from scratch, and of course hiking the Pacaya Volcano! The volcano hike was about 7 kilometers up a very steep, narrow path consisting of rocks, gravel, and volcanic debris and was challenging to say the least. However, the view from the top definitely made the hike worthwhile! We also got to roast marshmallows over an opening in the lava field that was still hot from the most recent eruption!

 

In the end, the experience was full of memories to last a lifetime. It was so satisfying to be able to apply all of the knowledge that I have learned the past two years in PT school to help the wide variety of patients that we saw. This experience also increased my ability to think outside of the box and provide effective interventions for patients with limited time, resources, and information about their impairments available. I also loved having the opportunity to work with my fellow classmates and the three very knowledgeable clinicians that accompanied us on the trip to treat patients as a cohesive team. This strategy enabled each person to draw upon his or her individual clinical experiences and knowledge to come up with unique intervention and treatment ideas. We were then able to combine everyone’s individual ideas into a unified treatment plan for the patient, and I feel like this cooperation really helped to elevate the quality of care that we were able to provide to the patients. All in all, 9 days after we had departed from the U.S., my classmates and I returned to snowy Pittsburgh with hearts not only warmed by the Guatemalan sunshine, but also warmed with the knowledge that hopefully we were able to help at least a few people in Guatemala move better and experience less pain. To me, that definitely qualifies as a productive spring break!

-Hannah Zangara, SPT Class of 2019

March 19, 2018 |

Monday Memo 3/12/18

The Monday Memo

March 12, 2018                                                                           PITT DPT STUDENTS

Combined Sections Meeting: New Orleans

A few weeks ago over 17,000 Physical Therapists descended upon New Orleans for the annual APTA Combined Sections Meeting (CSM). I had the fortuitous opportunity to join this mass of rehab professionals and enjoy my first professional conference, both as a bright-eyed student physical therapist (SPT) and volunteer. Immediately after arriving in New Orleans with several of my classmates, we were all instantaneously met with anxious excitement for what the next few days would bring. While everyone attends CSM with different goals in mind, my list included listening and learning from some of the foremost experts in the field, as well as gaining a better idea of employment paths I could choose after graduation. While I certainly focused on these professional and academic objectives, I would be lying if indulging in a few beignets wasn’t on the list too.

As a student with an expansive series of interests within the world of PT, I attempted to sit in on a wide array of presentations. I listened to debates about post-concussive rehabilitation, absorbed new movement diagnoses appropriate for patients with neurodegenerative disorders, and was pleasantly intrigued by the possibility of combining my love for pediatrics with my interest in sports physical therapy. Even as a novice SPT, I was constantly ruminating on how I could integrate what I was hearing at CSM with what I had already learned in school. This critical thinking and assimilation of ideas is what continually moves physical therapy forward towards evidence based practice and it was reassuring that even as a student I challenged myself to do this. On top of the presentations, it was impossible to not explore the expansive and slightly overwhelming exhibit hall. Filled with hundreds of booths representing APTA sections, new and improved anti-gravity treadmills, blood flow restriction equipment, enticing travel companies, and more it was easy to spend hours meandering through it all (which is exactly what I did). However, beyond the booths and their allure of free pens, cookies, and giveaways, I found dozens of poster presentations lining the walls. This combination of new technology and ground-breaking research was riveting to peruse because it was a physical embodiment of how the profession is perpetually moving forward to try and refine our skills. Bursting with opportunities, ideas, and entertainment the exhibit hall was a lively component of CSM. Lucky for me, the vibrant city of New Orleans enveloped all of this. I aimlessly roamed the streets of the French Quarter with classmates, witnessing everything from the pop-up live music to the iconic architecture. Frenchman Street enchanted us with local art markets, jazz bands, and the best pecan pie I’ve ever tasted. Unsurprisingly, beignets, jambalaya, and gumbo became daily necessities for all of us. I think most attendees would agree that “the Big Easy” was a perfect backdrop for this year’s conference.

As I sit and reminisce about the conference, the vivacious city of New Orleans, and the balmy temperatures which were a welcomed contrast to Pittsburgh’s incessant winter, I am confident the entire experience was an impactful adjunct to my education. I am eager to apply what I took away from this year’s conference and I am already looking forward to CSM 2019 in Washington D.C.

 

-Caroline Talda, SPT Class of 2019

 

 

March 12, 2018 |

Monday Memo 2/26/18

The Monday Memo

February 26, 2018                                                                        PITT DPT STUDENTS

 

Winter Fun For Everyone

 

With the winter Olympics coming to a close, I figured now would be a great time to share what I have learned about adaptive skiing this winter. Three Rivers Adaptive Sports (TRAS) offers individuals with with disabilities the opportunity to participate in skiing and snowboarding along with other sports throughout the year. Adaptive skiing is one of their most popular events, with outings almost every weekend.

 

Adaptive skiing has equipment that allows for individuals with many disabilities and skill levels to ski the slopes just like the rest of us. Two large categories of equipment can be broken down into individuals who participate either standing or seated. Most skiers begin tethered to an instructor for their safety and the safety of others. As skiers advance their skills they may be able to independently descend the slopes but only need help for loading and off loading the chair lift.

 

Standing skiers can stand independently or with the assistance of outriggers or ski legs. These might be people with multiple sclerosis, cerebral palsy or a lower extremity prosthesis. Outriggers are essential forearm crutches with skis on the bottom allowing the skier to have better balance and control, and additional contact points with the ground.These would be used for individuals who have the ability to stand independently and move dynamically without assistance. The ski legs could be likened to a walker on skis. These allow for greater stability and trunk support. The ski instructor also can also control the ski legs with tethers or handlebars.

 

Seated skis can accommodate those who might have a higher level of disability but that is not always the case. Some of these skiers go down the slopes faster than I can. Others such as single leg amputees might opt for seated skiing because they don’t want to risk injury to their intact leg by skiing standing. Seated skiers sit in a bucket style ski on either a mono or bi ski. The mono-ski allows for greater maneuverability along with that the skier needs a greater amount of trunk control. Bi-skis allow for greater stability and are often used by many first time skiers until they can progress to a mono ski. The bucket of the ski can be unpinned while loading to allow for the skier to be lifted on the lift chair.

 

Adaptive skiing can be enjoyed by almost anyone allowing them to participate in winter sports. Next time you’re skiing you will have a better idea of what equipment other skiers are using. If you ever want to get involved TRAS is always looking for volunteers to help their skiers. Below are photos of the equipment mentioned above.

 

Photos: PSIA-E/AASI Adaptive Study Guide: https://www.psia-e.org/download/ed/adaptive-ed/AdaptiveStudyGuide.pdf

-Bobby Jesmer, SPT

 

 

February 26, 2018 |