Tag Archives: spinal stenosis

Elite PT Newsletter September 2017 – Back Pain Workshop + Meet our new PT!

In this month’s edition you’ll meet our newest addition to Elite Physical Therapy: Allie Hoyt DPT, ATC and learn about our first ever Back Pain and Sciatica Workshop.  Here we go:

 

I can’t believe another month has flown by. It’s an exciting time of the year with kids going back to school (although my son would disagree) and high school sports getting started again.

Meet our new Physical Therapist

We are extremely blessed to be able to bring on a new PT and to find one as bright as Allie Hoyt.

Allie, DPT, ATC, graduated from Grand Valley State University’s doctorate of physical therapy program in 2017 where she completed clinical rotations with EXOS and The Ohio State University’s Performing Arts Medicine program. She graduated from Hope College’s athletic training program in 2014, where she gained experience working with men’s soccer and lacrosse, women’s basketball and volleyball, as well as cross-country and tennis.

Since 2014, she has been working as an athletic trainer and was one of the primary athletic trainers for the professional company members of the Grand Rapids Ballet. Through this, she continues to have a special interest in the performing arts, and more specifically with dancers. Her passion for movement started at a young age when she began dance classes that continued through high school and college.

Allie believes that everyone has the right to optimize their ability to move and she is happy to be able to help individuals reach their specific movement goals. She is extremely excited to join the Elite family!

Q: So how did you become interested in athletic training and physical therapy?

A: I started dancing at a young age and it was through dance that I first learned to love movement. I also ran cross country and track throughout middle school and high school. I was definitely NOT the star athlete, but because of my dance background everyone knew if they needed a muscle stretched I would be able to help. One day I was stretching my friend Liz’s hamstring and she bluntly said “Allie, you should be a physical therapist”. I laughed and thanked her, but I had no idea what a physical therapist was or did. I turned to Google that night and realized physical therapy sounded like a really cool profession. That summer I found myself shadowing a pediatric physical therapist and fell in love with rehabilitation.

Q: What excites you most about being a physical therapist?

A: I love the human body. It is amazing what our bodies are capable of and how they work! Being able to help others realize their body’s potential and reach their movement goals is why I enjoy this profession. I get to love and serve others through physical therapy and that is what excites me most.

Q: What types of things do you like to do outside of work?

A: I love to be outdoors, so hiking, biking, kayaking, and other modes of adventuring bring me joy. I also love good coffee and like to try out new coffee shops as well as brew my own cup of coffee using different methods. I have a dance background so you might find me trying out a dance class here and there as well.
Q: Who is your favorite college football team?

A: Notre Dame (I had to ask and no we didn’t hire her because she is a Notre Dame fan)

Allie has been through clinical internships at some pretty elite facilities around the country so she’s ready to take on the world of orthopedics and sports medicine. She’ll be seeing all types of cases from lower back pain, neck pain, sports injuries, shoulder pain, hip pain, and more. She has quite a background in dance medicine as well which is a very under served population in this area. She has a special interest in working with dancers to recover from injuries as well as prevent them. She’ll be putting together some special programs for dancers in the near future.

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Back Pain and Sciatica Workshop

We will be hosting our first workshop on back pain and sciatica on Saturday September 30th from 10 – 11am. If you know someone who has been suffering from back pain and/or sciatica then be sure to let them know about this workshop!

Lower back pain is a huge problem in the medical field and in this country. In fact we see more folks with lower back pain (and the resulting leg pain) more than any other diagnosis.

Unfortunately many people feel like there is no ‘cure’ and they just have to live with it. Check out this short video for more information on the workshop and to listen to how this is one of the biggest ‘myths’ in the health care industry.

The workshop is technically for those who have not been clients of ours in the past. Past clients receiving this newsletter are welcome to call us with questions ANYTIME! We are more than happy to answer any questions you may have and set up a time to get you in for a free screen if that is what is necessary.

In other words, we don’t want you to wait! If its not going away after a couple weeks it may not go away at all without some sort of treatment. The sooner we get you pointed in the right direction, the sooner you get better!

Like I said, call us anytime! 231 421-5805

Have a great month of September!

Joe Heiler PT

Elite PT July 2017 Newsletter: Lower Back Pain, Employee Spotlight – Jesie Bott, Exercise Tips and more…

Hope you’re having a great summer and surviving the craziness that is northern Michigan in July.

This months newsletter features:

  • Employee Spotlight – Jesie Bott
  • Lower Back Pain – 80% of us are going to have it!
  • Exercise Tip of the Month

Employee Spotlight
Jessica “Jesie” Bott was our very first employee starting back in 2012.  She took a bit of a hiatus after giving birth to her daughter but she’s been back a couple years now and we love having her around as much as possible.  Jesie home schools her two children and works Fridays during the school year but in the summer we’re blessed to have her 2.5 days per week.  She’s got a ton of energy and really loves to get to know her patients and clients.  She does a great job for us here at Elite Physical Therapy so we wanted to tell her story.

Jesie is an Athletic Trainer and licensed massage therapist, graduating from Grand Valley State University in 2005.  Jesie has worked in the outpatient orthopedic setting since graduation, and also worked as the athletic trainer at Kingsley High School for 5 years.  Jesie is a Graston Technique Certified Clinician, and trained through Functional Movement Systems giving her the ability to critically analyze a person’s movement ability and develop exercise programs that really work!

Why did you become an ATC/LMT?
“I had an inclination toward sports and health and wanted a career that kept me physically active and challenged me mentally.  Athletic training was a perfect fit!”

What do you enjoy most about the job?
“What I truly like best about my job is helping people feel better. I’m passionate about it.  I want to see people get results and I’m happy to be a part of that.  At Elite, I enjoy the one on one experience with each patient as well as having the freedom and ability to use my knowledge and creativity to problem solve and do everything I can to help someone feel better.”

What do you do for fun?
“Other than working at Elite….:)  I enjoy spending quality time with my family.  We love to be outdoors, camping, playing in the water and playing with our sweet puppy.”

Jesie has been married to David Bott for 13 years and have two great kids – Chase and Clare.  Jesie also owns Freedom Massage Therapy and currently sees clients at Elite PT on Tuesdays and Fridays. You can call her at 231 357-0151 for more details.

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Did you know that lower back pain will affect at least 80% of us at least once in our lifetimes.  Depending on the research article, once you’ve had a back pain episode, chances are between 60-80% that you’ll have recurring episodes beyond that.  Not great odds at all.

Here at Elite PT, lower back pain is the most common diagnosis that we treat.  There are numerous causes of lower back pain – some easier to fix than others, but it’s our job to figure that out.

One of the more common causes is Spinal Stenosis.  Stenosis literally means ‘narrowing’ and in this case the narrowing can cause compression and irritation to the nerves that leave the spinal cord and go out to the lower back, hips, and legs.  This causes pain across the lower back and can also produce symptoms into one or both legs.

spinal stenosis

How do you know that you may have Spinal Stenosis?

  • 50+ years old
  • Standing and walking increase symptoms
  • Sitting and lying down relieve symptoms
  • Leaning on the cart at the grocery store allows you to walk with less back pain

Spinal stenosis, like most types of lower back pain, is something that can absolutely be treated in physical therapy.  Certain muscles being ‘tight’ can create more compression and narrowing and therefore must be address using soft tissue techniques like massage, Graston Technique and dry needling.  Exercises must also be incorporated to stretch those tight muscles and improve how our joints move around the back and hips.

Other muscles tend to be ‘weak’, specifically the abdominals and glutes.  When strong and working with the right timing these muscles can reduce damaging forces across the spine.

A comprehensive physical therapy program that addresses all these factors can be extremely beneficial.

Here is what one of our former clients with spinal stenosis had to say:

Patient Testimonial
“I came to Elite taking medication to numb the pain in my back and legs so I could make it through the day.  Thanks to Jesie I have no more pain and know how to strengthen the muscles to help prevent the pain from returning.  She is a great therapist and I will use her again in the future if the need arises.”
– D.B. from Traverse City

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Exercise Tip of the Week

Child’s Pose is a common yoga pose that produces flexion through the hips and spine.  For someone with spinal stenosis this movement frequently decreases or eliminates the person’s symptoms.  If it relieves your pain, then do it whenever you need relief!

Child's Pose

Try to sit back on your heels – unfortunately my knees don’t bend that far!

In the bottom position, take 4 breaths in through the nose and out through the mouth.  Breathing in this manner decreases tone through the back muscles and also calms the nervous system bringing further relief.

For those with knee pain who can’t perform this exercise, try the seated floor press below.  It’s basically the same movement but with more body weight (usually fine but can be too much if you’re really sore).  Use the same breathing technique but be sure to put your hands on your knees to push yourself back up when you’re done.  This just takes some extra pressure off your back.
Seated Floor Press

You may find these simple exercises can make a huge difference in how you feel and how long you can be on your feet throughout the day.  If so, just keep doing them and you may just be able to keep yourself out of pain.

If you have all the signs and can only get temporary relief with the exercises then you probably would benefit from physical therapy.  Call us if you have questions (231 421-5805) and we could tell you if PT is for you.
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Have a great month of July with hopefully more warm weather to come.

We can be reached at 231 421-5805 or through email:  Joe@elitepttc.com if you have questions or if you just want to let us know how you’re doing.

Back Pain and Sciatica – Part 2

Last month I posted a case study showing how we treat back pain and associated ‘sciatica’ like symptoms here at Elite Physical Therapy in Traverse City.  You can find that article here:  http://www.elitepttc.com/back-pain-and-sciatica-physical-therapy-treatments/

This month’s case study is a little different in that the presentation and location of the pain were quite different but it still comes down to playing detective to determine where the patient’s symptoms are really coming from.  Before we get started here, I’m re-posting the picture of the dermatomes of the body (basically the sensory distribution of the nerves from the spine) so be sure to check that out.  Pretty cool how we were created for sure!Dermatomes

Case Study #2

The patient in this case presented to our clinic with pain shooting into the front of his hip and groin as well as down the front and side of his thigh.  He also reported minor back pain but it was nothing compared to the pain in his leg.  The patient reported having this pain on and off over the past couple years especially when exercising but recently it was much more constant and severe.  In the past he had been diagnosed with IT Band syndrome (pain laterally in the hip and thigh might make you think that), and more recently with a hip flexor strain (could also make sense now that he was having more pain into the front of the hip and groin).

Exam

  • minimal tenderness to the ‘hip flexor’ muscles anteriorly, slight weakness with manual muscle testing but no pain (probably not a hip flexor strain).
  • moderate tenderness and active trigger points in the lateral hip musculature that referred pain down the lateral thigh to the knee (could be part of IT Band syndrome).
  • springing of the lumbar vertebrae at L2 and L3 reproduced the typical symptoms  he felt into his anterior hip/groin as well as lateral thigh (Bingo!)

Treatment

Dry needling was performed at the levels of L2 and L3 along with electric stimulation for 10 minutes, and followed up with Graston Technique (GT) to decrease tone and improve mobility of the superficial fascia and muscles of the mid and lower back.

A couple exercises were given to maintain, and hopefully even improve, the mobility gained through the spine and hips as a result of the dry needling and GT.

Results

The patient reported a significant decrease in the anterior hip and groin symptoms as well as a moderate improvement in lateral hip and thigh symptoms.

During the second treatment session I decided to treat the muscles of the lateral hip as well since they also referred pain into the lateral thigh.  This was done with by dry needling + e-stim just like we had done in the low back.

By the third treatment session a few days later the patient was reporting a significant reduction in lateral hip and thigh symptoms as well.

Final Thoughts

It took a few more treatments to completely resolve this patient’s symptoms but it’s nice to see an immediate decrease in symptoms to know that you are treating the right areas.  With a thorough evaluation process it wasn’t hard to figure out that the patient’s symptoms were primarily coming from his spine which was quite a different diagnosis than what was previously thought.

A little detective work plus effective treatment tools like dry needling and Graston Technique can make a huge difference in patient outcomes especially in these ‘sciatica’ cases.  If you have similar types of symptoms or pain that just doesn’t ever seem to get better then give us a call!  If you have any questions feel free to email me:  joe@elitepttc.com

The Bird Dog – A Core Stability Classic

The ‘bird dog‘ exercise is a core stability classic in the physical therapy world, and is certainly a favorite of ours here at Elite Physical Therapy.

That being said I see this exercise done incorrectly more often than not.

The whole idea behind core stability is to resist unwanted movement through the pelvis and spine when moving through the hips and shoulders.  Watching most therapists, and even yoga and pilates instructors, teach this exercise you would think just the opposite.  Check out the video below to see the exercise performed incorrectly (first 3 reps) and then done correctly (next 3 reps).

When performed incorrectly you can see how much movement is occurring through the lumbar spine.  Many folks are stuck in excessive lumbar lordosis (too much inward curvature) which can become painful especially with prolonged standing and walking.  A majority of the athletes I work with, including the dancers and gymnasts, would fall in this category as well.  Going into even more lordosis is only going exacerbate the issue.

As you can see when performed correctly, nothing moves through the pelvis and spine.  It’s only my shoulders and hips.  Performing a bit of a posterior pelvic tilt (think tucking the tailbone) will bring the person out of the excessive lordosis and help to stabilize the trunk.  Also notice there is much less excursion with the upper and lower extremities.  There is no way you can lift the arms and legs as high as in the first example and maintain any type of stability.

There are times however that a bit of lumbar lordosis (arch) may be necessary to maintain throughout the exercise.  Sometimes this is just the more comfortable position to be in.  If that’s the case then that is going to be the appropriate position for your body.

To learn to stabilize in this position, using a water bottle either across or along the spine is a nice trick (the latter being the more challenging).  Focusing on keeping the water bottle from rolling off your back will reflexively fire more muscles and with the correct timing to keep your spine and pelvis stable.

Adding a resistance band would be a higher level challenge. Do not attempt to add resistance until you are able to control your body weight.

Give the bird dog a try yourself and see how much more challenging it can be when you actually stabilize the core!

If you have any questions, contact me at joe@elitepttc.com or at 231 421-5805.

 

Functional Dry Needling for Low Back Pain

Functional Dry Needling has been a great addition to my manual therapy ‘tool box’ especially for those with low back pain.  Recently, Nelson Min PT from Kinetacore (the group that trained me) wrote a short article on using dry needling for patients with spinal stenosis.

Spinal stenosis is one of the most common causes of low back pain in folks 50+ years of age.  The most common presentation is pain with standing and walking that is relieved with sitting down, forward bending, or lying down.

So here is Nelson’s article on Functional Dry Needling and the treatment of Spinal Stenosis:

“I listen for several things when evaluating a new patient with low back pain.  I take particular interest when my patient informs me that their pain increases with prolonged standing or walking versus pain that increases with prolonged sitting.  An older patient that tells me that their back pain increases with prolonged standing and walking, and is then relieved immediately with sitting, makes me suspect stenosis.  For someone younger, I am suspicious of spondylosis or some other instability.  I would confirm this with my biomechanical exam but this little detail in the patient’s history often steers me in the right direction.”

Listen to your patient — he is telling you the diagnosis.  – William Osler MD

To continue reading, head on over to Kinetacore.com

If you have questions on Functional Dry Needling or the treatment of back pain, feel free to email joe@elitepttc.com or call me at 231 421-5805231 421-5805