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Camp with a Ramp 2019

Our East Mesa location, Neuro & Brain Performance Centers, is highly involved in the spinal cord injury community. They have created Neuro & Brain Community Foundation to help provide funding for therapy services & continuing research for individuals affected by neurological disorders. One of the great events they sponsor is the annual Camp with a Ramp trip for those living with spinal cord injuries.

The Camp with a Ramp provides three full days of activities that include; horseback riding, fishing, kayaking, archery, crafts, animal interaction, basketball, over-the-line, quad rugby, morning hikes on the rim, lacrosse, hand-cycling and educational discussion groups.

This year we will be hosting the trip on August 1st-4th. Please visit the Camp with a Ramp website to learn more about how to join us. We are also looking for sponsors and donations to help make this an experience of a lifetime for the campers!

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Free Fall Risk Screening

Free fall risk screening

Join us Tuesday, March 19th at our Maricopa location for our Free Fall Risk Assessment.  We utilize the newest technology in assessing balance with VirtuSense Technology.

Did you know? Falls are the number one cause of:

  • Injury and hospital visits due to trauma
  • Death from an injury among people age 65 and older.
  • It is estimated that 1 in 3 older adults falls each year!

Fill out the contact form or contact one of our Maricopa Location to schedule your Free Assessment!

Fall Risk Assessment
:
Your preferred appointment time will depend on schedule availability

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Giving Thanksgiving: Free Back Fitness Assessments

As we begin our holiday season it is time for us to reflect and be thankful.  Each year we treat hundreds of patients that have back pain.  For the rest of 2018 we are offering Free Back Fitness Assessments to all.  This free service includes a 20 minute consultation that reviews what might be causing your back pain and provide you with some guidance on how to address this.  If you aren’t currently experiencing pain this back fitness assessment will help identify if you are at higher risk of back pain based on flexibility and strength tests.  Simply contact any one of our 4 locations to schedule your appointment or fill out our contact form below.

Free Back Fitness Assessment

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Fall Risk Series Part 4: A Simple Fall Risk Prevention Exercise Program

Welcome back! We appreciate the time it took you to follow this 4 part blog series. If you are joining for the first time, please take a second to read back through the first 3 parts:

Fall Risk Series Part 1: Top 5 Fall Risk Factors Inside The Home

Fall Risk Series Part 2: Top 5 Fall Risk Factors Outside The Home

Fall Risk Series Part 3: Who Is At Risk For A Fall?

These posts lay the foundation for a couple important things. First, should you be concerned? Second, what are some practical action steps to take?

However, we would like to add some practical and pre-emptive strategies to strengthen key areas and reduce your fall risk.

Note that this blog post does not constitute medical advice. Individual needs vary widely, so it is impossible for us to diagnose your situation through blog posts! We recommend that if you have a concern, you set up a free consultation at one of our 4 locations or contact your doctor. Please consult with your doctor or get evaluated by a physical therapist before commencing with any program of exercise.

The topic this week will be:

The Top 5 Exercises To reduce Fall Risk.

What are some practical exercises I can do to reduce your fall risk? As you have seen over the past few weeks, there are plenty of fall hazards that exist in the environment, both inside the home and outside. Hopefully you have already taken a few steps to mitigate your fall risk. However, one of the most significant pieces of advice we can give has still been overlooked: What are some things you can do to improve your balance & strength to ensure that you get to live a long, happy, and independent life?

1. Sit-to-Stand

This is one of the classic balance and fall prevention exercises. If possible, it is important to include this exercise in your program. Simply sit in a sturdy chair with your legs directly in front of you, cross your arms in front of your chest, and stand up. Since you are not using your arms for balance, you will need to bring your shoulders forward as you stand. Keep the back straight as you stand up, and then sit back down. Repeat 10 times.

2. Hip Abduction

The purpose of the exercise is to strengthen the outer hip. Hold onto a sturdy chair or table for balance. Balance on one leg and move the other leg straight out to the side, keeping the toes pointed straight forward. Repeat 10 times on each leg.

3. Hip Extensions

There are two main methods of doing this exercise: with a Theraband or without one. Either way, find a sturdy table that you can hold on to, facing towards the table. While standing up straight, pull one leg straight back and stand on the other. Repeat 10 times on each leg. If the exercise is too easy, use a Theraband wrapped around the table leg on one end, and your ankle on the other.

4. Toe Raises

The following two exercises can be performed back to back, since they are very similar. This exercise will strengthen the front of your lower leg. While holding onto a sturdy table or counter (perhaps the one you used for your hip extensions), raise your toes up in the air as high as possible and hold for 1 second. Then place your toes back down on the ground. Repeat 10 times.

5. Heel Raises

This exercise is–you guessed it–the opposite of the exercise you just performed. It will strengthen your calves and the backs of your lower legs. Hold onto your sturdy table or counter, and simply raise your heels up as high in the air as you can. Hold for 1 second, and then lower your heels. Repeat 10 times.

There you have it! A simple program of exercise that can be used indefinitely. This, combined with the fall prevention techniques mentioned in parts 1-3 of this series, can ensure that you continue to live independent and healthy for many years to come.

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Patient Appreciation Day

We are celebrating National PT Month and we invite you to join us at our Tempe, Maricopa and Gilbert locations, Monday, October 29th between 8am-5pm for our Patient Appreciation Day!  We will be serving food and refreshments all day.  Also feel free to schedule a Free Injury Consultation or schedule a meeting to update to your home exercise program.  We look forward to seeing you!  Our Gilbert location will be performing Free Fall Risk Assessments using the  innovative VirtuBalance System between 11-2pm.  Feel free to drop in to get your assesment.

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Fall Risk Series Part 3: Who is At Risk For A Fall?

Welcome to Part 3 of our October Fall Risk Blog Series! If you haven’t gotten the chance yet, make sure to check out Parts 1 and Part 2 for reference. As always, if you have a concern for yourself or a loved one, please call us at your earliest convenience. We would love to help you continue to live a long, happy, and healthy life.

The topic of today’s blog post will be:

Who is a fall risk?

In this post, we will examine some common statistics and (hopefully) help you decide whether or not you should be concerned. Of course, this post does not constitute medical advice, and we strongly recommend that you consult with a medical professional before you draw any serious conclusions regarding your own level of fall risk. Without further ado, let’s jump into the post!

Who is most at risk for a fall? Here are 5 widely accepted indicators:

1. A History of Falls

By and large, the number one indicator of fall risk is that one has fallen in the past. Specifically, if someone has fallen in the past year, then they are considered to be a high fall risk in the future.

2. Being Advised to Use a Walker or Cane

Being advised to use a walker or cane by another person shows that they have observed something that makes them believe you may fall. The person may be a medical professional who has evaluated your fall risk, or simply a loved one who observes your movements on a regular basis. They may be referring to an unsteady gait or a tendency to trip or miss obstacles. There is no shame in using an implement to help you keep your balance, but this will ideally be paired with a program of easy exercise to keep you independent.

3. Using the Hands to Help With Standing Up

Often times, as we age, we will begin to compensate for decreased strength in various ways. The most common of these is to utilize the hands and arms to push off of chairs, toilets, and tables as we stand up. This, is one of the biggest indicators that a fall may be in the future.

4. Requiring Assistance From Others While Negotiating Obstacles

This can include needing help to step up stairs or onto curbs. One of the primary indicators of fall risk is needing assistance from others to perform these daily movements, since there will not always be someone around to help.

5. Taking Medicines To Help With Sleep, or Taking Medications That Cause Drowsiness/Light Headedness

Sometimes, a medication can be helping you with a significant part of your life, but it is still important to know what the side effects can be of all the medications you are taking. If you are taking a medication known to cause drowsiness, light headedness, or aid in sleep, it can affect your balance and increase your fall risk.

There you have it! If any of the above factors describe you or a loved one, please don’t hesitate to call us and get a fall risk assessment, free of charge. Stay tuned for Part 4 of our October Fall Risk Series, which will come out next Monday!

 

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Fall Risk Series Part 2: Top 5 Fall Risk Factors Outside The Home

Welcome back, everyone! This will be our second installment in our October Fall Risk series! Please read and enjoy the post, and if you have any concern for yourself or a loved one, please call and set up a free fall risk assessment at a Petersen Physical Therapy location near you.

The topic of Part 2 will be the top five environmental fall risk factors outside the house. Last week, we explored environmental factors inside the home. However, it is important to be aware of these factors wherever we go. The difference outside the home is that we have less control over them. For instance, you could straighten out the throw rug in your home, but you can’t control the size of the stairs in an office building. Being aware will be your biggest ally, but of course there are also strategies that can be employed to mitigate the chances of a fall. For instance, you can go around an area with unstable ground, instead of walking across.

Let’s get into it: the top five environmental fall risk factors outside the home are:

1. Steep/Long Stairs and Curbs

Stairs present a tricky obstacle, since no two staircases seem to be exactly the same. Sometimes steps are lower than they seem, sometimes they are steeper or deeper than they seem. Both cases can cause falls.

The solution: Be careful and be sure of your footing before placing weight on your leg. Handrails exist for a reason: use them! A common theme in this post will be awareness and taking your time, since you cannot control your outside environment as much as your home environment.

2. Sloping Driveways, Parking Lots, or Patches of Ground

While this category can include many different areas, the idea remains the same: sloping surfaces can be deceptive. Most often these are driveways or sidewalks, but they can sometimes include fields or parking lots as well. These surfaces can be deceptive, because there may not be and obvious hazard or obstruction present.

The solution: Survey the ground before moving. Be aware of a slope and balance accordingly. If possible, take a flight of stairs with a handrail instead of walking up/down a steep slope.

3. Cracked Sidewalks

Cracked sidewalks present a fall risk because slabs of concrete can move over time. Sometimes, a sidewalk looks flat, but there can be a “step” of 1-2 inches between slabs. These can often be difficult to see. Also, sometimes weeds or plants have grown in the cracks and present a further risk.

The solution: Like fall risk #2, there’s not a ton that can be done to change the environment. The best advice is to be aware of the ground you are stepping on and be careful. Use a handrail if one is present.

4. Low Light

It may seem silly to list this factor again, since it was #3 on last week’s list or the top five fall risks inside the home. The fact remains, however, that any situation can become hazardous after dark. Parking lots, yards, and even public areas can be harder to navigate once the sun goes down.

The solution: If you have to go out after dark, be careful! Bring a dedicated flashlight if you can (some people opt to use phone lights, but these can drain batteries quickly and you run the risk of losing your ability to contact someone in case of emergency). However, the most obvious solution is to do your shopping, visiting, and other errands during the day, rather than at night.

5. The Unexpected: Traffic, Dogs, Other People, etc.

This heading contains a lot of different possibilities, but the idea remains: Sometimes you are in a crowded area, or you are around others who are walking their animals, or your are crossing a road, etc. People can bump into you, and often they “came out of nowhere”. Sometimes you are crossing a street and didn’t notice the car turning right. I’m sure you can come up with a few other “unexpected” situations which could arise.

The solution: Situational awareness. Look around, be aware of who is walking behind/beside you, and how fast they are going. Anything nearby that could “bump” you, should be on your radar. This way, you can be careful as you navigate the world around you.

And there you have it! Stay tuned next week for Part 3 of our fall risk series, which will begin to explore who is at risk, and Part 4 the following week, which will discuss some easy exercise solutions you can employ to decrease your chances of falling. Please understand that these blog posts are meant to be informational, and none of it can replace medical advice. Please consult with your doctor or schedule a fall risk assessment with us in order to get specific advice for your particular situation.

 

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Fall Risk Series Part 1: Top 5 Fall Risk Factors Inside the Home

Did you know that October is National Physical Therapy Month? In honor of this time, Petersen Physical Therapy is offering free fall risk assessments for the entire month of October, in order to give back to the community. That’s it, no strings attached! If you are wondering whether you are at risk for falling, please call anyone of our four locations.  We will assess your risk level and provide you with some exercises and lifestyle suggestions to improve your balance/coordination, and decrease your risk of falling.

This will be the first in a 4 post series about fall risks, and some of the solutions you can employ to reduce the risk of falling. The articles will be posted on Mondays during the month of October. Watch this space.

The topic of today’s post will be:

What are the Top 5 Major Fall Risks in the House?

Falling has always been one of the leading causes of serious injuries in the United States, and around the world. Consider the following statistics:

One in three seniors over the age of 65 experience a fall per every year, and one in five falls causes a serious injury, such as a broken bone or head injury.

There is good reason to be concerned about this issue.

The 5 most common fall risks in the home are throw rugs and pets, so lets start there:

1. Carpets/Rugs

The edge of a carpet is an obvious place to be careful, but what about the middle? Thing about a throw rug that gets bunched up when walked on a lot. It’s true, the middle of a rug can be the most fall-causing area. The reason is simple: we’re not watching our feet around the middle of the carpet.

The solution: Make sure rugs are straightened out. Pay attention to your footing while on a carpet or rug.

2. Pets

Pets love to be the center of attention! While most of us have a soft spot in our hearts for the animals in our lives, they can also present some of the greatest fall risks. It’s important to pay attention to an animal’s movements as we enter a room, especially if you know that your pet has a tendency to dart across the room suddenly.

The solution: Since pets are always moving, there’s not a simple answer to this question. You know your animal, and you know where in the room they generally lay and walk. When you enter a room, make sure you know where your pets are.

3. Low Light

Low light is one of the factors that present the highest fall risks. We must be aware of it, especially since we ar presented with this obstacle every day, either early in the morning before the sun comes up, or walking around the house/yard at night. The obvious risk presented by low light is that it makes other fall risk factors more dangerous. The clutter in the room or the aforementioned pets become harder to see and anticipate.

The solution: Leave night lights around the house. Have a lamp next to the bed (most of us already do), and be sure of your footing before you embark on a midnight journey to the kitchen or bathroom. The key is to light areas as you move through them. Using night lights to find light switches, and then turning on the switches as they become necessary to move through the next space.

4. Low Toilet Seats, Shower Seats, Slick Shower Floors

As humans grow older, our leg muscles atrophy. One of the most common “fall areas” is the bathroom. This results from a number of factors. Low toilet seats can be a hazard area if we attempt to stand back up and lose our balance in the process. Showers present a similar problem, as well as slick shower floors.

The solution: Have grab bars installed next to toilets and in showers. Utilize rubber floor inserts for showers. These installations work wonders.

5. Old, Uneven Chairs & Tables.

We’ve all owned a set of chairs that eventually became so unstable and loose that we weren’t sure if they’d support us the next time we sat in them! Don’t let this be you! One of the ways to mitigate your fall risk is to have a stable platform to push from as you sit down or stand up. Therefore, those old creaky chairs and tables may not be the best option for your kitchen, dining room, or living room.

The solution: While it’s technically an option to repair old furniture, we recommend buying newer, more stable pieces to use. You will notice an immediate improvement in your ability to sit down and stand up.

Some closing thoughts:

There are, of course, a number of other fall risk factors not mentioned in this blog post. These include clutter around the house and power cords across walkways and rooms. If any of these are present in your home, it’s recommended to reduce your fall risk by dealing with them as soon as possible.

Of course, there is no substitute for being careful! We know you want to continue to live a full life! Don’t let a fall affect that quality!

As mentioned earlier, please call if you are questioning whether or not you are at risk for a fall. We will provide a quick assessment and some specific suggestions to mitigate your chances of a fall, allowing you to continue to live your life without the fear of falling hanging over your head!

Please join us next week for Part 2 of our October Fall Risk Series!

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Ergonomics 101: Choosing the Right Ergonomics Work Chair

Office Ergonomics

Our Top Ergonomics Work Chair Picks

Ask any architect and they will say, “The building is only as good as the foundation it is built upon”. This principle applies to the human body. As a provider of ergonomics for over 20 years, we have worked with many different companies, and many evaluating many different jobs. The work chair is the foundation for the work environment for many people that work in front of a computer for a majority of their work day. A good ergonomics work chair, that is set up properly, will support proper posture and provide a safe and comfortable work environment. A poor chair will encourage poor postures that can lead to issues in the back and neck.

What should you look for in a “good” task chair for a computer workstation?

  1. Height adjustable – Make sure the chair is able to adjust to “your” height, not necessarily the desk height. It is important that your feet are able to be placed flat on the floor with a 90 degree bend at the knees with your thighs parallel to the floor.
  2. Seat pan depth suited for your size (prefer adjustable) – Make sure the seat pans depth allows you to sit fully back in the seat with you back against the lumbar support in an upright position. You should have 2-3 fingers widths distance between the back of your legs and the seat pan. Make sure the seat pan is not too wide or too narrow for you to put your arms comfortably on the armrests.
  3. Adjustable armrests – The best armrests are adjustable up and down, but also in and out. This should provide light support on your forearms with your arms a 90 degree angle at the elbow.
  4. Adjustable lumbar support – The lumbar support should be able to adjust up and down so that it can be positioned to fit your back. It also should have the ability to lock in an upright position, so that you have proper support when you begin to fatigue and want to lean back into the lumbar support.
What chair should you choose?

The most important thing is for the chair to have the functionality to adjust to the individual. The chairs included on our list below are design primarily for people who are at least 5’2” to 6’4” and weigh less than 300lbs. If you fall outside these ranges, contact an ergonomist to help you with finding a chair to meet your needs. While we are not particular to any vendor when it comes to chairs. We have used many different chairs to meet client’s needs and there are a few that pop up as our “preferred” chairs. Below is a list based on price and the advantages/disadvantages of these selections.

$100-$200 Range Task Chairs

To be honest anything less than this price point should not even be considered as a work chair. It just won’t have the features needed. You may find a good used chair for less, but make sure it has the functionality. These chairs have limited warranties, so don’t expect them to last as long as the higher priced chairs. This price range is what you will find at many office supply stores like Staples, Officemax, and even Costco.

Staples Hyken Technical Mesh Task Chair ($129.99)

Staples Hyken

Advantages: Price, Adjustable Height, Arms, and Lumbar support, Mesh seat pan and lumbar support offers good breathability.

Disadvantages: Armrests do not adjust in and out, seat pan depth is not adjustable, mesh in chair is not as durable as foam cushions. Durability is not as good as higher priced chairs.

 

OfficeMax WorkPro 3000 Series Ergonomic Chair

WorkPro 3000

Advantages: Adjustable Height, Arms, and Lumbar support, Foam cushions offer more durability and support than mesh. Arms are width adjustable.

Disadvantages: Foam cushions not as breathable, seat pan depth is not adjustable. Durability is not as good as higher priced chairs

 

 

 

$200-$700 Range Task Chairs

This group is broad, they can be have more specialized in form and features, and differences in quality of materials. This area is the sweet spot when buying a good ergonomics chair. Chairs in this price range will have all the necessary features to adjust the chair to support a proper posture. Some of these types of chairs may be found in local office supply stores, but often they are carried by specialty office vendors or through online purchasing only. Look for companies that have a showroom or offer demos on these chairs to make sure the chair meets your needs and personal preference. Chair warranties are often extended up to 12 years. Quality vendors of these types of chairs are Steelcase, Knoll, and Herman Miller.

Steelcase Leap Chair ($350-450) (Personal all around preference)

Leap Chair

Advantages: Adjustable height, seat pan depth, armrest (in and out too), lumbar support. Seat pan tilt, Multiple fabric color choices, including leather. Very good durability

Disadvantages: No mesh option for improved breathability, cushioning is thinner than in other cushion chairs, heavier and more bulky chair than others.

 

 

Steelcase Amia Chair ($640) –

steelcase amia

Advantages: Adjustable height, seat pan depth, armrest (in and out too), lumbar support. Multiple fabric color choices, lighter than Leap and smaller platform

Disadvantages: No seat pan tilt, no mesh option for breathability

 

 

 

Herman Miller Aeron ($500-$800)

herman miller aeron

Advantages: Adjustable height, seat pan depth, armrest (in and out too), lumbar support, seat pan tilt. Mesh for increased breathability, good-looking design

Disadvantages: Few color selections, no foam cushion option, heavier chair, mesh may give over time.

 

 

 

Summary:

As you can see chair prices can range between $200 to over $1000 dollars. Finding the right chair that looks good to you and feels good for you is going to be a matter of trying it out.

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Treating Pain: Why it is different for everyone.

Why is treating pain different for everyone?  Pain is the common reason individuals seek medical care and I would suggest a primary reason people come to physical therapy. It is often an elusive phenomenon that can be disruptive to the quality of one’s life.  *The International Association for the Study of Pain‘s widely used definition states: “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” There are many classifications of pain including:**

1.”sensory-discriminative” (sense of the intensity, location, quality and duration of the pain)

2.”affective-motivational” (unpleasantness and urge to escape the unpleasantness)

3.”cognitive-evaluative” (cognitions such as appraisal, cultural values, distraction and hypnotic suggestion).

**It has been theorized that pain intensity (the sensory discriminative dimension) and unpleasantness (the affective-motivational dimension) are not simply determined by the magnitude of the painful stimulus, but “higher” cognitive activities can influence perceived intensity and unpleasantness. Cognitive activities “may affect both sensory and affective experience or they may modify primarily the affective-motivational dimension. In other words, your emotional state has a large impact on “how much pain” you feel. An individual’s framing of the painful experience can dramatically influence the intensity of that experience. As a therapist I work specifically to address physiological, biomechanical and postural factors impacting pain. In this blog I want to address other issues impacting pain.

Melzack and Casey suggest pain should not only be treated by trying to cut down the sensory input by anesthetic block, surgical intervention and physical therapy, but also by influencing the motivational-affective and cognitive factors as well. How does one accomplish this?

The first step is to get a clear picture of the physiological stimulus that is at the root of one’s pain. Different tissues will respond with different patterns of pain. Keep in mind, that though all pain is unpleasant, not all pain is of equal urgency.  It has been my observation from thirty years of experience as a physical therapist helping people in pain, that the intensity of one’s pain is most often NOT correlated with the severity of the “problem”. What I mean by that is; many conditions that are in fact life threatening, specifically certain types of cancer and auto immune diseases often offer very little pain.  Conversely conditions that are intensely painful will not threaten your life.  Examples such conditions are child-birth and sciatica.  Understand that this does not mean that one should ignore pain. The mere presence of pain is enough to alter one’s quality of life and negatively impact one’s longevity.  But, an individual experiencing pain can be helped by having a clear understanding of the cause and potential threat posed by that pain.

Another important point to consider is that all pain is mediated in the central nervous system.  It actually occurs in the brain regardless of what part of you body hurts. Take for example “phantom limb” pain, a condition in which individuals who have had a traumatic or surgical amputation of one of their limbs may continue to feel pain in that limb long after it is gone.  The pain is mediated by the brain and is by definition an unpleasant emotional experience.  Finally it is important not to judge yourself because you are experiencing pain and do not compare your pain experience to other. In our country we tend to judge pain as “bad”.  Though it is unpleasant pain is not morally bad.  Additionally, comparing one’s experience to friends and neighbors can often lead to frustration and shame.  Consider a positive emotional experience.  When my wife and I go to see a comedy, “Nacho Libre” for example, I may belly laugh through the entire movie and she may offer a polite chuckle.  Same stimulus but very different responses and neither of us is right or wrong for our response.

So what to do? If you are experience a persistent episode of pain;

  1. 1. Have your condition evaluated by an objective and qualified specialist. This will help establish a plan to handle the physiological contributors to your pain.
  2. 2. Understand your condition and its severity (you may not fully understand the pain itself and that is OK)
  3. 3. Talk to an objective third-party about how you feel. This will assist you in handling the emotional contributors to your condition.
  4. 4. Do not judge yourself, or allow others to judge you, for experiencing pain
  5. 5. Eliminate those external stressors factors that might make your experience more unpleasant.
  6. 6. Do those positive actions that will help reduce the painful stimulus and improve you tolerance to your condition

If you have questions about pain please call me at 480-833-1005.