Sleep and Health

Feel sluggish? Having an ache and pain that just won’t go away? Poor sleep may be to blame,as sleep is vital to health and recovery. A good night’s sleep is credited with restoring healthy brain function and physical well-being. Basically, the way you feel when you’re awake depends on how well you sleep. Disturbed sleep is often due to various stressors with the most common reported being persistent pain, depression, and/or anxiety. In fact, a recent study by the Centers for Disease Control (CDC) found more than 35% of adults are not getting enough sleep on a regular basis. The American Academy of Sleep Medicine and the Sleep Research Society recommends that adults sleep at least 7 hours each night to promote optimal health and well-being. Sleeping less than 7 hours is associated with an increased risk of developing chronic conditions such as obesity, diabetes, high blood pressure, heart disease, stroke, and frequent mental distress.

Does pain lead to poor sleep, and poor sleep leads to pain, becoming a vicious cycle? A study of sleep disturbance among chronic pain patients found greater self-reported pain intensity among those patients who rated themselves as poor sleepers (Morin 1998). It could be argued that more pain means less sleep, but the evidence points in the opposite direction. Experimental studies of healthy subjects suggest that poor sleep further exacerbates pain (Smith 2004). Sleep triggers healing and enhances tissue nutrition. Sleep helps restore balance to hormone levels, which keeps your appetite in check and strengthens the immune system. Sleep helps your brain form new pathways to learn skills and remember information, thus causing less stress. Sleep helps you make better decisions and improves your problem-solving skills. It sets the stage for improved mood and a positive outlook, so long as you wake with a good cup of coffee.

Sleep is a behavior, not an identity. Most of us have experienced some sleepless nights, but it is important not to accept disturbed sleep as the norm. Whether it’s recovery from surgery or healing from a chronic injury, sleep is a necessary element of the healing process. Once we have emerged alive and awake from the tissue trauma, the long journey ahead is far less difficult if we develop good sleep behaviors.

Looking to improve your sleep? Here are a few tips

#1: It’s tough to sleep if you’re not tired. Work up a sweat at least 10-15 minutes every day.

#2: Avoid alcohol and opiates as they are depressants. They will make you drowsy but the effect is restlessness and disturbed sleep. If you rely on any substance to sleep, consider trying some natural methods. A glass of tart juice or some chamomile tea will help relax you before bedtime. The use of aroma sticks with lavender oil has been shown to improve sleep quality in a recent study on sleep problems in cancer patients (Dyer 2016).

#3: Balanced nutrition is important to physical health and improved sleep.

Want to learn more about how sleep could be affecting your pain, lack of energy, or weight gain? Contact Travis today.

Breathing - Part 3

Breathing influences low back pain

We have all used or been told to use stabilization exercises to treat low back pain. While many people will improve with physical therapy, we too frequently experience recurrences of back pain, requiring more physical therapy or pain medications.

Several studies have demonstrated the role of respiration on postural stability. In one such study, individuals with low back pain were compared to pain-free subjects during an active straight leg raise, an exercise that requires core control. Real-time ultrasound was used to examine the activity of the diaphragm and the pelvic floor. The subjects with low back pain demonstrated an increase in respiratory rate, a greater descent of the pelvic floor, and decreased diaphragmatic excursion compared to their pain-free counterparts.

These results indicate that subjects with low back pain had to work harder to breathe during a core control activity, but they used their diaphragm less. As a result, they likely overused their accessory breathing muscles and they did not use their diaphragm for core stability. Additionally, the increase in respiratory rate indicates that sympathetic activity and stress increased as well.

This is a perfect storm for pain and decreased postural stability.

The result? Low back pain.

Similar results were found in a study that examined diaphragmatic activity during upper and lower extremity isometric activities with external resistance. Individuals with low back pain presented with smaller diaphragmatic excursion than pain-free control subjects during the resistance exercises.

Essentially, the subjects with low back pain were not using the diaphragm to its fullest potential. They were therefore more vulnerable to decreased core control and resultant low back pain. Collectively, these results highlight the role of breathing in physical therapy and call for stabilization interventions that involve the diaphragm.

In order to achieve optimal core stabilization, the diaphragm must be simultaneously involved in respiration and postural stability. Individuals who are limited in their ability to contract the diaphragm for stabilization have a higher risk of developing back pain.

Breathing dysfunction restricts mobility

Inefficient breathing patterns are often closely linked to mobility restrictions. If you present with a mobility limitation anywhere from the neck to the pelvis, we should consider the possibility of a breathing dysfunction.

Many clients who present with head, neck, and shoulder pain are likely suffering from accessory respiratory muscle overuse. We need to retrain breathing in physical therapy in order to decrease accessory muscle overload and increase activation of the diaphragm.

Inefficient breathing patterns may also restrict the rib cage or thoracic spine or decrease general flexibility. In order to improve joint mobility, range of motion and/or flexibility, we may need to calm the nervous system down with breathing in physical therapy. The parasympathetic nervous system will allow our muscles to relax, whereas the sympathetic nervous system causes them to contract. By learning how to slow down breathing, prolong exhalation, and breathe through their diaphragm, we can increase flexibility.

Breathing determines movement patterns

In order to achieve optimal movement patterns, we need a stable core from which our muscles can generate movement. Lumbar and pelvic stability depend on coordination between the diaphragm, pelvic floor, and transverse abdominis. These muscles activate prior to purposeful movements in order to establish a stable base. This allows for optimal load transference along the entire kinetic chain and minimizes stress on passive structures, such as ligaments, joint capsules, and joint surfaces.

Failure to coordinate the core stabilizers with the regulation of intra-abdominal pressure makes it difficult to efficiently transfer force from the trunk to the extremities. If we can't properly activate the diaphragm during a simple activity, like an active straight leg raise, then we are certainly not recruiting it properly when kicking a soccer ball or performing a squat. This impairs both our core stability and the resultant movement patterns. If we send our patients back to sports or complex activities without having assessed and treated their breathing in physical therapy, then we have left them vulnerable to re-injury.

Breathing changes pain perception

People with chronic pain benefit from exercises that induce relaxation. Since deep breathing calms the nervous system, it will help decrease the stress response associated with pain.

Patients with chronic pain may have an up-regulated nervous system in which there is an increase in sympathetic activity. This increases their sensitivity to touch and heightens their perception of pain. Deep breathing will mediate sympathetic arousal and increase pain thresholds. By teaching patients how to diaphragmatically breathe, we can increase parasympathetic activity, thereby inducing relaxation and decreasing the pain response.

Additionally, dysfunctional breathing may predispose individuals to faulty muscular adaptations, resulting in chronic musculoskeletal pain. For example, people who overuse their neck to breathe will be more susceptible to neck pain. Similarly, weakness in the diaphragm and pelvic floor can lead to overuse of compensatory muscles and result in chronic low back pain. By addressing breathing in physical therapy, we can restore muscle balance and decrease pain.

Assessment of breathing patterns

A breathing assessment is an often overlooked component of an orthopedic physical therapy examination. However, breathing is the foundation of stability and normal movement patterns. Therefore, a breathing assessment should be a basic starting point for all orthopedic evaluations.

When assessing breathing, we must the first rule out structural problems, such as airway obstructions or a deviated septum. For example, before posture can be addressed, we should make sure that they are not standing that way due to an anatomical obstruction. Treatment of these respiratory health problems are beyond our scope of practice and will require referral to another specialist.

After we clear anatomical obstructions, we can examine breathing pattern itself. The easiest way to do this is by lying supine and placing one hand on the stomach and the other on the chest. If you are diaphragmatically breathing, you will see more movement through the stomach and less movement in the chest. If you are an apical breather, you will see minimal movement through the abdominal wall and excess movement through the upper chest. Also take note of the rate of breathing. Is the breathing slow or rapid? Are the inhalations longer than the exhalations?

There are of course more in-depth methods of examining breathing in physical therapy, but this is all that will fit in this blog post.

Re-training breathing in physical therapy

Breathing can be an essential tool in the treatment of musculoskeletal dysfunction. However, like any intervention, breathing re-training should not be done in isolation. Breathing dysfunction may be the cause, or result of, your primary complaint. Therefore we should coordinate mobility and strength interventions with breathing in physical therapy.

When first instructing diaphragmatic breathing, it is easiest to lay supine on a mat or plinth. Place one hand on the stomach and the other on the chest in order to compare the excursion of both areas. During diaphragmatic breathing, you should feel the stomach rise and fall and the lower rib cage should expand laterally. There should be minimal movement through the chest.

While practicing diaphragmatic breathing, watch for compensation of spinal extensors (excess lumbar lordosis) as well as overuse of the rectus abdominis. Also, make sure that you do not revert to the old patterns by using accessory respiratory muscles of the chest and neck. This can happen with fatigue.

After mastering simple corrective breathing exercises, proper breathing should be incorporated into functional activities. When participating in complex activities, like running, there are increased demands for stability and respiration.

Start breathing in physical therapy today

Breathing is the root of all movement. We must therefore respect the role of breathing in physical therapy. By incorporating breathing into our assessment and treatment of musculoskeletal impairments, we can improve outcomes and increase the likelihood of lifelong recovery.

Breathing - Part 2

Breathing and the nervous system

The nervous system and the musculoskeletal system work in tandem to create movement. If we have dysfunction with one system, it may manifest in the other system. Therefore, respiratory dysfunction in the nervous system may present as a musculoskeletal problem.

The control of breathing is balanced between the central nervous system (brain and spinal cord) and the peripheral nervous system (somatic nervous system and autonomic nervous system). The autonomic division of the peripheral nervous system is of particular interest to us here. The autonomic nervous system is divided into the sympathetic nervous system, the parasympathetic nervous system, and the enteric nervous system. Here we will focus on the sympathetic and the parasympathetic divisions of the autonomic nervous system.

When we experience emotions, pain, fear, and stress, our sympathetic and parasympathetic nervous systems respond by adjusting blood pressure and heart rate (among other variables). Generally speaking, parasympathetic activity is associated with a relaxation response and sympathetic activity is associated with a heightened response.

A slow diaphragmatic breath with prolonged exhalation will increase parasympathetic activity and result in relaxation. On the other hand, rapid chest breathing with prolonged inhalation will increase sympathetic activity and result in a stress response.

When we operate mainly through the sympathetic nervous system, we are living in a state of heightened arousal. This state is known as up-regulation. Up-regulation negatively alters our breathing patterns and changes the respiratory muscles we recruit for breathing. These changes can alter motor control patterns and result in musculoskeletal pain. Therefore, we should be assessing and treating breathing in physical therapy.

Dual role of the diaphragm

In early development, the diaphragm acts primarily as a respiratory muscle. However, at 6 months, the diaphragm takes on a dual role as a respiratory muscle and postural muscle. Both of these roles must be intact in order to achieve lumbopelvic stability and optimal movement patterns.

The diaphragm initiates cores stability through its influence on intra-abdominal pressure. It works with the transverse abdominis, multifidus, and pelvic floor muscles to provide support to the spine. Proper diaphragmatic function not only allows us to breathe, but also provides us with the postural stability that is required for complex movements.

When breathing demands increase, there is competition between the two roles of the diaphragm. Breathing will always win this competition (after all, we need it to live). As a result, the diaphragm's contribution to postural stability declines.

When individuals exhibit breathing pattern dysfunction, meaning they cannot diaphragmatically breathe, or they are too dependent on accessory respiratory muscles, their bodies become hyper-focused on the demands of breathing. They will overuse other respiratory muscles and the diaphragm will be unable to perform its stabilizing role. Consequently, posture and movement patterns will suffer.

We must remember that the diaphragm is a muscle. It is critical that we involve breathing in physical therapy treatments - we have to train the diaphragm too!

In many adults, we see breathing move away from the stomach and higher into the chest. These individuals are not taking full advantage of the diaphragm. The longer they under-recruit this breathing muscle, the harder it is to normalize breathing patterns and the more likely they are to develop musculoskeletal issues.

End of part 2

Breathing - Part 1

This is Part 1 of a series about the mechanics of breathing, and how breathing relates to pain, physical therapy, and performance

Breathing

On any given day, we take anywhere from 17,000-30,000 breaths. Like blinking and swallowing, breathing is not something we have to actively think about. If you are healthy, you likely view breathing as a natural and involuntary activity. But have you ever given thought to the quality of your breathing? Conscious attention to breathing can provide insight into both your physical and emotional states.

The role of respiration in overall health should be of particular interest to physical therapists. As clinicians who pride ourselves on a whole-body approach, it is our responsibility to consider the role of breathing in physical therapy. After all, breathing is the basis for everything we do.

Why should physical therapists worry about breathing?

In our stressful and fast-paced society, many people are susceptible to developing breathing dysfunctions. These dysfunctions can feed into the functional impairments we see in the PT clinic. Breathing pattern disorders may contribute to musculoskeletal conditions by impairing motor control and compromising trunk stability.

Many athletes and patients display dysfunctional breathing patterns, limiting performance and increasing vulnerability to injury, therefore as movement experts physical therapists are the ideal experts in assessing and treating dysfunctional breathing

Mechanics of respiration

Let's briefly review the mechanics of respiration:

Inhalation, also known as inspiration, is an active process during which air enters the lungs. The diaphragm contracts and flattens and the ribs move upwards and outwards. As the dome of the diaphragm lowers, the overall size of the thoracic cavity increases. The volume of the pleural cavity increases as well. This expansion of the lungs is associated with a fall in intrapleural pressure.

Exhalation, also known as expiration, is typically a passive process, during which no muscular contractions are needed. At the end of inspiration, the respiratory muscles will relax and the chest wall and lungs elastically recoil. The dome of the diaphragm moves superiorly and the ribs depress. This results in a decrease in the volume of the thoracic cavity and a decrease in lung volume. This change in volume is associated with an increase in intrapleural pressure.

While expiration is primarily a passive process, it does become active during forceful breathing. For example, expiration is active when playing a wind instrument or during exercise. During forced expiration, the anterior abdominal muscles and internal intercostals contract, increasing the pressure in the abdominal wall and thorax.

End of Part 1..

Training Around Pain

“The pain will go away on its own”

“If I just stop going to the gym, it will get better”

“No pain, no gain” “Pain is weakness leaving the body”

At On the Go Physical Therapy, we hear statements like these from friends, family, CrossFit athletes and clients all the time. Maybe you’ve been thinking this yourself.

The Body Is Resiliant

Our bodies have an amazing ability to heal.  Have you ever had a callous rip during a workout? Within a week, it is usually all healed up, right? Does that stop you from coming into the gym and working out the next day. Nope, you just slap some tape on it, put on your grips and move on. When it comes down to it there really isn’t much difference at the cellular level between a callous and the muscles, tendons, ligaments, bones and cartilage in the rest of your body. Our bodies are continuously repairing and healing, just at different rates depending on the extent of the injury and the tissue or bone affected. 

“So you are saying the pain will go away on its own?”

Maybe yes, maybe no. The injured tissue will heal over time, but often it can be more sensitive or weakened if not properly loaded during this healing period. This could potentially lead to pain lasting even after the tissue issue has been resolved. A skilled physical therapist can help you learn how to modify your workouts, load the tissue early and progressively and prevent complications down the road when you try to jump back into CrossFit, running, or any other activity you enjoy. This means that you can come back from your injury stronger than you were prior to your injury.

“What if I just stop going to the gym or doing the activity that aggravates my injury?”

There is nothing inherently bad about the activity that is aggravating your injury. Our bodies are meant to do all kinds of activities and be in all types of postures/positions. Sure it may be helpful to pause an activity that is making symptoms worse, but only for a limited time so that you avoid overloading the injured tissue. This does not mean stop being active. It is way more important that you continue being active for your CARDIOVASCULAR HEALTH and in order to stave off chronic disease.  Not a single person is dying from low back pain or shoulder pain, but shockingly 70% of the world IS DYING FROM CHRONIC DISEASE. A skilled physical therapist can help put the fire out on your pain all while keeping you active in doing the things you love. Be wary of doctors and other medical professionals that tell you to stop doing an activity or tell you that you WILL NEVER or SHOULD NEVER do “xyz” again. That’s usually bad advice and most of us wouldn’t listen to them anyway.

“No pain, no gain” “Pain is weakness leaving the body”

Should you avoid all pain no matter what? No, current research shows that there can be some benefit to painful exercise, but when we get into these painful episodes we need to identify what is off and what got you into this predicament in the first place.  Usually it is one of two things. You are doing TOO MUCH TOO SOON and your body has not adapted to that activity. You are essentially OVERLOADING your tissues and tissues do not like that. The other factor can be your lifestyle habits are off: poor sleep, diet, high stress levels, overall body inflammation.  These things need to be discovered and addressed or you just keep adding fuel to the fire.  If a change isn’t made, you run the risk of further injury or you end up turning this acute episode of pain (short period of pain) into chronic pain (long period of pain). 

Contact Travis or call/text (781)691-4378 to learn more about how you can put out the fire on your pain and stay active through injury.

Best Hip Impingement Stretches

Hip impingement can be a difficult condition for someone to live with as it can limit his/her ability to participate in sports, perform work around the house, and complete work related tasks. At On the Go Physical Therapy we treat a lot of clients dealing with hip impingement pain (also known as femoracetabular impingement with or without labrum tears) and use these three hip impingement stretches frequently to help our patients get back to doing the activities they love.

#1 Internal Rotation Sleeper Stretch

The Internal Rotation Sleeper exercise is one of our favorite hip impingement stretches as it helps improve rotation mobility in the hip. Often this exercise can help athletes who have hip impingement symptoms perform lunges and step ups. This one is also great for individuals that feel hip pain when they’ve been stuck in a sitting position for a long time.

#2 Posterior capsule stretch

The second stretch shared in the video is a posterior capsule stretch for the hip. By stretching this tissue, many athletes will feel significant hip impingement relief with activities such as squatting or sitting for prolonged periods. This one can be great as part of a warm up prior to exercising.

#3 90/90 PAILS/RAILS stretch

The final hip impingement stretch we show is 90/90 Pails/Rails for improving hip external rotation range of motion. This stretch uses a combination of static stretching with isometric muscle contractions. This combination makes it great for creating long lasting changes in hip mobility which at the same time increasing strength of some of the deep hip muscles.

While hip impingement symptoms can be significantly disabling, stretches such as the ones above, combined with temporary activity modification and strengthening of the hip muscles can provide long term relief of hip impingement symptoms. We even regularly see the complete resolution of symptoms in people told they will have chronic hip pain unless they seek out extreme interventions such as surgery.

Please reach out to us for an appointment or a free phone call if you’d like to discuss your treatment options for hip impingement pain. Online booking is available here.

Painful squats? Look at your ankles!

The squat is an essential movement pattern that can be useful for building strength, speed, endurance, and decreasing risk for injury. Many times, athletes will complain of a tightness in the front of their hip at the bottom of the squat.

Often athletes will go and stretch their hip flexor to help to alleviate that tightness. Then, they go and squat again, but the tightness is only temporarily relieved or there has been absolutely no change whatsoever.

Then they keep trying to stretch it, squat through it, or try some other remedy.

You can also check to see if you have full hip flexion mobility. To do that, lie on your back and place one foot flat on the ground. Then bring the other knee up to your chest while keeping your back flat on the ground.

If you cannot bring your thigh to your ribs, you may be limited in your hip flexion mobility. Even if you can and you feel the pinch in your hip, tissues may be irritated.

But if you can do that test and you are still experiencing the same hip pinch, we need to look elsewhere.

It may not be the hip/lumbopelvic complex that is contributing to that pinching sensation.

So let’s take a look at the ankle.

A quick and easy test to see if you have adequate ankle mobility for squatting is the Knee to Wall Ankle Mobility Test.

Key Points:

-Start with your 1st toe 4 inches away from the wall.

-Make sure not to overpronate.

-Try to touch your knee to the wall without letting your heel come off the ground.

If you can touch the wall, you have adequate ankle mobility for squatting.

If you can’t, you may have ankle mobility issues.

The reason that ankle mobility is so important if a hip pinch is present is that if the ankle can’t go into dorsiflexion adequately, another joint in the body has to move more to descend into the squat.

Enter the hip! If there is limited ankle dorsiflexion, the hip may have to flex more in order to get to depth in the squat. The hip may have full mobility when assessed passively, but if the ankle is not moving properly, the hip may have to go into unavailable ranges of motion and in turn causing a pinch in the front of the hip.

So, if you are dealing with a hip pinch with squatting, contact me today to schedule an evaluation!

Blood Flow Restriction Training

Did you know that On the Go Physical Therapy offers Blood Flow Restriction (BFR) Training?

Blood flow restriction (BFR) utilizes the application of an inflatable pneumatic cuff (similar to a blood pressure cuff) around a limb to limit the blood flow available to the exercising muscles. The goal is to fully occlude venous flow out of the limb and to also restrict a certain percentage of arterial flow back into the limb.

Evidence supports the use of using blood flow restriction combined with low-load resistance training to enhance hypertrophic (muscle growth) and strength responses in muscles.

BFR training can be using in any situation where the goal is to increase muscle hypertrophy and strength. We are able to induce significant hypertrophy and strength gains in as little as 4 weeks, as opposed to the 8-12 weeks of traditional training. Due to the low loads used with BFR and the limited muscle damage that occurs, athletes can have a physiological stimulus for muscular adaptation while utilizing decreased training loads.

Is BFR training safe?

As long as it is used appropriately, it is completely safe. The two biggest side effects are subcutaneous hemorrhage (bruising) and numbness. Both of these side effects are transient and will go away. At On the Go PT we use a doppler to make sure we are only applying safe pressures.

Can everyone use BFR?

While BFR training can be beneficial for a wide variety of injuries and for a wide age range, there are a few contraindications to its use including:

• History of deep-vein thrombosis

• Pregnancy

• Varicose veins

• High Blood pressure

• Cardiac Disease

• Rhabdomyolysis

Have any questions? Please contact me via email/text/phone/contact form

Do I need to be in SEVERE pain to schedule an appointment?

Absolutely not! We are also experts in getting you healthier and moving better than you were before.

Notice that your shoulders are tight with overhead motion? PT can help improve range of motion and show you exercises to promote mobility and overhead stability.

Do your shoulders hurt with pull-ups or STOH? PT can help improve shoulder and upper back strength that will decrease the pain.

It is always better address something sooner, rather than let it become a chronic injury!

When is the best time to get physical therapy?

Ideally as soon as possible! The sooner we can assess and begin treating the pain and restrictions that are present, the faster you will get better! This is especially important if the pain is not only affecting your workouts but also activities performed outside of the gym.

Discomfort that is present with movement can be quite complex. With a physical therapy evaluation we assess for limitations or impairments in strength, stability, joint mobility, flexibility, coordination, and much more.

Get back to the activities that your love and schedule an appointment today!

What is Dry Needling?

What is Dry Needling (DN)?

Dry needling is a treatment technique in which small filament type needles are inserted into myofascial trigger points (known as painful knots in muscles), tendons, ligaments, or near nerves in order to stimulate a healing response with the goal of permanently reducing pain and dysfunction.  It has been shown that our bodies can develop areas of hypersensitivity and tightness as a response to various stresses i.e. postural, repetitive movements, psychological, emotional etc.  These areas are most likely to develop along tissues that are dysfunctional due to interruption of the nerves that innervate them.  This can be caused from nerve compression in a limb or in the spine from such things as disc injuries, facet joint dysfunction, vascular compression, metabolic stress or biomechanical stress.  When trigger points are present they can cause the muscles to neurologically tighten, further disrupts the normal functioning of that muscle due to increased pain and local compression of vascular structures and nerves.  Dry needling can help to effectively treat acute and chronic orthopedic and neuromusculoskeletal conditions.

Are dry needling and acupuncture the same thing? 

DN is not acupuncture or Oriental Medicine.  DN is a treatment that uses solid filament, disposable acupuncture needles, but that is where the similarity to acupuncture ends.  Dry Needling is based on Western medical research and principles, whereas acupuncture is based on Traditional Chinese Medicine in which the purpose is to alter the flow of energy ("Qi") along traditional Chinese meridians for the treatment of diseases.  The theoretical backgrounds for the two treatments are very different.  In fact, DN is a modern, science-based intervention for the treatment of pain and dysfunction in musculoskeletal conditions throughout the body. 

How does dry needling work?

• Local Mechanical Effects

  • Winding, tenting or needle grasp to deform and disrupt fibroblasts within the neighboring collagen tissue resulting in increased opioid mediated response

  • Local twitch response causing decreased muscle contraction and improved range of motion, mobilizing collagen restrictions within the muscle and fascia

• Electrophysiological Effects

  • Decreased spontaneous electrical activity (SEA) at the active trigger point, improved neuromuscular activation and timing

• Neurophysiological Effects

  • Increased pressure pain thresholds

  • Stimulation and decreased inhibition of the descending sensory pain pathways

  • Activation of central mediated systems including activation of areas in the brain involved in pain processing and the emotion of pain

• Chemical/Cellular Effects

  • Improved blood flow to nerves, tissues due to a decrease in vascular compression

  • Inflammatory and immune system responses initiated.

To schedule an appointment with Dr. Travis LeDoyt, PT, DPT, CF-L1 please go directly to https://www.onthegophysicaltherapy.com/ or click the button below. Self scheduling is easy referrals/doctors scripts are not required.

What is cupping?

Cupping is a manual therapy where small, medium, or large specialized cups (depending on the injury) are suctioned to the skin. Cupping gained public attention during the Rio Olympics due to athletes being seen with small circles on their backs and shoulders caused by the treatment. The treatment is much older than that though, and has many medical benefits. Cupping helps to address injuries by increasing blood flow to the injured area. It also loosens the myofasical layers under the skin and improves the pliability of the tissue. Increasing blood flow and pliability can help to decrease recovery time associated with repetitive injuries, overuse injuries, sprain/strains, and pain. Bringing new blood to an injured area brings vital nutrients to promote healing. The cupping treatment will usually last 2-5 minutes and is non-painful. In some cases it may cause bruising and skin discoloration associated with the new blood flow to the area. This is not considered dangerous and will usually dissipate within a couple of days

Now offering Class IV Therapeutic Laser!

On the Go Physical Therapy proudly announces the addition of Class IV therapeutic laser that delivers advanced pain relief and enhanced tissue healing. We are very excited to offer these treatments to our clients as laser therapy is an innovative drug-free and surgery-free solution for our clients. 

High-energy laser therapy with the K-Laser P4 safely penetrates deeply into the body to diminish pain and stimulate healing. Laser therapy provides a safe solution for many peoples’ pain.

 Laser therapy works by stimulating production of cellular energy in damaged cells and by enhancing the cell membrane permeability. This promotes the speed and the quality of healing, enhances the exchange of nutrients and wastes across the cell membrane and improves elasticity of injured tissues. Laser therapy also modulates pain and reduces inflammation. It can be used immediately on acute injuries, over broken skin and over metal implants. Laser therapy enhances the rate and quality of healing of acute injuries and can help with the resolution of chronic complaints such as arthritis.

 Clients interested in knowing more can contact Travis at 781-691-4378 or visit their website at www.onthegophysicaltherapy.com.  Additional information about laser therapy can be found at www.k-laser.com.

PT Can Prevent Unnecessary Surgery

Recent research is showing that surgery might not be needed as often as we think. A large review estimates that 10% to 20% of surgeries might be unnecessary and that in some specialties such as cardiology and orthopedics, that number might be higher. The reasons for so many unneeded surgeries being performed are varied, but the most common are that more conservative options aren't tried first, or lack of knowledge by the operating physician.

Physicians undergo long and rigorous training programs to become surgeons, but if they don't work hard to keep learning, their knowledge often stops growing when they leave residency. Recent research is showing that certain common surgeries aren't any better than a placebo. Two such examples are kyphoplasty - a procedure for spinal compression fractures, and partial meniscectomy - a procedure used to treat tears of the meniscus in the knee. If a surgeon hasn't continued to learn, they won't know that these surgeries often don't offer any more benefit than a non-surgical treatment and will continue to perform them.

Every surgery, even "minor" ones carry risks. These include complications from anesthesia, blood clots after surgery, delayed healing of the incision, infection, and unintended damage to nerves or other organs near the surgical site. Some of these risks cause discomfort for a period after surgery and go away, but others can result in permanent disability or even death. For some patients and conditions, surgery is a great treatment option, but with all the associated risks, when surgery can be avoided, it should be.

For musculoskeletal problems like back and joint pain, sprains, and strains, seeing your PT before a surgeon can help keep you out of the operating room and get you back to life without surgery. Studies have shown that physical therapy is just as good if not better than surgery for a multitude of conditions and carries less risk. Some examples would include rotator cuff tears, meniscal tears, spinal stenosis, low back pain, and osteoarthritis.

Physical therapy can't fix every problem, and for some patients surgery is the best choice. However, research is showing that surgery isn't a cure-all, and is sometimes just a very expensive and risky placebo. In most cases, starting with physical therapy is the right choice, and for many patients, PT is the only treatment necessary.