Telehealth: Virtual PT

Telehealth: Virtual PT 389 129 Jennifer Lane

As we continue to navigate into uncharted waters, I have been looking for ways to stay connected with existing clients and future ones too. The virtual world is where many people are turning to stay in touch with friends, family and colleagues. Kids are taking classes on-line, work outs are being broadcast so you can stay at home, and happy hours are being conducted on sites like Zoom. Netflix even has created a way for you to watch your favorite show with a group of friends at the same time, which my daughter loves!

In the world of healthcare, there is a growing category called telehealth. “Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions (Wikipedia’s definition)”.

How does this work with Physical Therapy? Well, there is much that can be accomplished via conversation with an experienced clinician. This is where my 18+ years of experience pays off for you! When I question patients about their current issues, complaints, limitations, I can formulate a good working hypothesis on what is going on. From there, the physical exam is performed to corroborate the hypothesis created during the interview. For the PT with years of experience, can then set a plan of care based on the therapy goals set.

When utilizing Telehealth for PT, the same interview process is done, and copious notes are taken. This is followed by a visual objective exam using a secure video platform that is HIPAA compliant. Both the PT and the patient can see each other via webcam from a computer or smartphone. Movement, posture, gait can all be assessed by this method. Following the evaluation, an appropriate home exercise program, as well as extensive information on how to manage the existing issue will be developed for you.  As is typical with in-person sessions, at the subsequent visits, treatment is modified according to how you are responding to the initial suggestions.

The American Physical Therapy Association (APTA) is working diligently to get policies changed so that health insurances will reimburse for this. Colorado Medicaid has already authorized that telehealth can be used for its clients. The hope is that private insurance companies like Cigna, Anthem and United Healthcare will all follow suit and pay for these services. In the meantime, my cash pay rates apply. If you are a patient of mine that is currently receiving care, there will be discounted rates for follow-up visits. Please contact me directly via email, phone call or text if interested in seeing if a Telehealth visit would work for you.

What can be treated via Telehealth? Most everything that can be treated in person: Back pain, shoulder dysfunction, knee, hip or ankle issues, vertigo and pelvic floor therapy too. Contact me today to schedule an appointment.

Over-active Bladder: What is it and do I have it?

Over-active Bladder: What is it and do I have it? 237 212 Jennifer Lane

Over-active Bladder is a catch-all diagnosis for people suffering from urinary urgency and frequency. It can sometimes be called urge incontinence, which indicates urinary incontinence due to strong sensation of urgency and inability to control it. There can be different causes of over-active bladder and in some cases, it can be treated effectively with medication. Myrbetriq, an often-prescribed medication can help reduce urinary frequency significantly but for some people it is cost-prohibitive to take it, so therefore not a good long-term solution.

So, what causes over-active bladder? As a Pelvic Floor Specialist, I have seen several issues that lead to urinary frequency and incontinence. I will look at a few of them here and discuss Holistic ways to treat it.

Pelvic Floor Weakness: The pelvic floor is made up of 3 layers of muscles with 3 specific roles. First, the muscles help support the organs in our abdominal cavity. Second, the muscles help us stay continent, both bowel and bladder. And lastly, the pelvic floor muscles have a role in sexual function and pleasure. If these muscles have become weak and we get a strong sense of urinary urgency, the muscles will not be able to hold us continent. The bladder muscle will start contracting and we will experience incontinence. This type of incontinence is called stress incontinence and is treated with Kegel exercises to improve strength, endurance and control of the pelvic floor.

Pelvic Floor Tightness: Like any other muscle in our body, pelvic floor muscles can become tight, develop trigger points and be painful. During a pelvic floor exam, muscle tone is assessed as well as strength. If there are trigger points and muscle tightness, upon palpation, urgency can be reproduced. The treatment is to reduce the muscle tightness through hands-on muscle work or with functional dry needling. Functional dry needling uses filament needles to target specific muscles to help them re-set to a normal functional state. Dry needling can help tight muscles relax and weak muscles work better.

Overactive Bladder: The bladder is wrapped in a muscle called the detrusor muscle. When our bladder fills up, our bladder signals to our brain that it is time to pee. Once we are sitting on the toilet, the detrusor muscle contracts and the pelvic floor muscles relax, and we can empty our bladder. With over-active bladder, the bladder signals the brain before it is full that it is ready to empty. We run to the bathroom urgently but then only pee for a few seconds. This can continue happening every 30 minutes to 60 minutes, depending on how bad the symptoms are. In a healthy bladder, it takes 2-4 hours to fill and it takes > 8 seconds to empty. With over-active bladder, there might also be some triggers for peeing like pulling in the driveway, putting the key in the door or entering a building. With this dysfunction, we go out of our way to always know where the bathroom is and many times, incontinence pads are worn to avoid having an accident. The Holistic approach to treatment involves behavioral modifications, mindfulness techniques, keeping a bladder diary and functional dry needling. In this case, the filament needles are applied to the abdomen and an electrical current is placed on the needles. This technique is called neuromodulation and helps “re-set” normal bladder signaling.

With all these possible causes of over-active bladder, there is a holistic way to treat them. Especially with the costliness of the drugs available to treat it, seeking out care from a trained pelvic floor specialist can allow you to re-gain control of your bladder and have a healthy pelvic floor! If you suffer from urinary incontinence or feel like you might have over-active bladder, call Holistic PT today for an evaluation!

Return to Running Protocol

Return to Running Protocol 1920 661 Jennifer Lane

It’s that season… weather is getting nicer, days are getting longer and you are motivated to get in shape, so you set a goal of doing a 1/2 marathon, marathon or triathlon. Training is off to a good start but then you develop knee pain. What now? You rest, it feels better and then you return to running again and the pain comes back. Going up and down stairs has also become painful. You don’t know what you should do because, well, you already paid the entry fee for the race and, in the past you have just been able to work through the pain. But what if something more is going on? Do you need to see an orthopedic specialist? Are you going to do permanent damage to your joints if you ignore the pain?

My suggestion is always… go see a Physical Therapist! No expensive MRI required. PT’s are able to use diagnostic testing to determine whether ligaments, meniscus, joint or soft tissue is the problem. Once the cause of the pain is determined, how fast can you get back to running, biking, training? Physical therapy is an excellent resource to help reduce pain, restore normal tissue function and help create better muscular balance. In addition to these hands-on techniques, I have used a Return to Running Protocol from Brigham and Women’s Hospital in Massachusetts for a number of years. This is for those people who are serious about resuming their running after knee pain has gotten in their way. Follow this link to see the whole protocol. Return to Running Protocol.

And call Holistic PT today to make an appointment!

Managing Long-Distance Caregiving Without Stress

Managing Long-Distance Caregiving Without Stress 1053 699 Jennifer Lane

How do you keep a parent or loved one safe when you do not live nearby? Providing care for a senior family member from afar can be a big challenge, but distance does not have to keep you from providing the security and attention your aging family member needs. Here are some tips to make the stress of long-distance caregiving a little easier.

Make Sure They Have Healthcare Coverage

When your loved one lives far away, the last thing you want to worry about is whether they have access to the care they need. Financial considerations can be a serious source of stress for caregivers and loved ones, so help your family member put together a plan to cover any care costs they may encounter. One of the best assets for keeping seniors well is Medicare, but you as a caregiver need to know all the ins and outs of your loved one’s Medicare coverage, as well as Medicare in general. Once you’ve done your homework and have the required documents, you can make an informed decision about getting your loved one the medical coverage they need.

Create a Network for Support and Help

One of the hardest parts of caring from afar is knowing what to do when emergencies arise. Creating a support network can help caregivers and seniors when an emergency comes up, whether it’s a natural disaster or other crisis. As a caregiver, you should meet with neighbors, friends, and other family members who may be able to directly assist your loved one. Talk to them about the kind of help that may be needed and exchange any essential contact information so you will be able to get speedy updates.

There are even online services you can use that will make keeping in contact much easier for members of your caregiving and support network. You may also want to go one step further and establish someone to act as a local support coordinator. Ideally, this should be a professional who can quickly act on your loved one’s behalf and coordinate any kind of care that may be needed in crisis situations, so take your time finding someone you know you can count on.

Another way to look after a senior is to hire professionals to help with jobs around the home. This can include landscaping work, lawn mowing, and cleaning. Make sure you research the best companies and their costs. For example, you can expect to pay between $99 and $233 for cleaning services in Wheat Ridge, CO.

Use Technology to Give Yourself Peace of Mind

There have been many advancements in technology over the past decades that can make caregiving easier. At the very least, seniors should have a cell phone that they are comfortable using to make staying in contact easier. Many senior-friendly phones feature simple emergency call features that can make getting help easier for your loved one if they need it, and you can even find smartphones that will keep you connected via social media or video chat. You can also look into medical alert devices (some systems cost only $19.95 a month) that can go one step further in protecting your loved one. These systems make it simple to call for help, and you can find options that have low setup costs. Some caregivers even hook up a surveillance system to help watch over an elderly family member at all times. Surveillance can be in the form of video or sensors, so you can find something that both you and your loved one are comfortable with.

Living away from an older loved one does not have to leave them without the care they need. However, you need to ensure they have access to healthcare, are surrounded by a caring network, and can reach out for help when they need it. By taking care of these essentials, you can give yourself peace of mind while giving your loved one the care they truly deserve.

Photo Credit: Unsplash

Geriatric health | Holistic Physical Therapy

Is All PT Created Equal?

Is All PT Created Equal? 2332 3504 Jennifer Lane

Is all PT the same? Well, I guess not. A client came to see me the other day, very discouraged about an experience she had with a different PT. She had surgery on her shoulder and was told by the surgeon that she could see a physical therapist in the office connected to his. She made the appointment and started treatment 2 weeks after surgery. Now, this person has had a lot of injuries through her lifetime and has received a lot of rehab. She is in her late 60’s and very active. I’m pretty sure she can ski and hike circles around my 44-year-old self! For context, there are a lot of very active and healthy older adults in the beautiful state of Colorado. It isn’t unusual to see a 70-year-old or even an 80-year-old mountain biking, hiking, skiing or participating in an advanced exercise class. I love this and my goal is to be one of these people.

I’ve veered from the original story. My client was underwhelmed by the experience she had. She was given very little time or attention, measurements were not taken of her starting point and the exercises prescribed caused extra pain. She sought me out as we have developed a relationship over the years and she was worried that the treatment she was getting was not going to help her get back to her activities, as she had hoped. She decided to come and see me, which is a bit of a drive for her and the reason she didn’t start with me in the first place. I did a standard eval, subjective report of injury and surgery and how she is feeling now. Then I took measurements of her good arm and the post-surgical arm to determine range of motion. Treatment followed which included passive treatment to the arm, joint and soft tissue and then it was wrapped up with education on how to be more comfortable at home and how to do exercises pain-free.

When we finished, she was so thankful and felt better already. I was flabbergasted by the difference in level of care that she received and was happy that she came back to me. I think there are 2 factors at play here. In some PT clinics, it’s a numbers game. Physical Therapists have to see a high volume of patients each day to hit their quotas. This may mean seeing 4 patients per hour. The other factor is that older clients are viewed as having different goals than younger folks. Listening to what my client’s goals are gives me a very good idea of how active she is. At no time do I assume that she can’t do those things just because she is in her late 60’s.

Moving forward, I plan to keep the quality high for my clients. One-hour initial evaluations, 45-minute follow up visits and I continue to keep listening to what my clients say. I can do this because I have created an environment in which it works.

What’s the take-home message? Find a PT that is going to listen to you and deliver the quality care that you deserve. Not happy where you are? Find another one. Colorado is a direct-access state which means you do not need a dr’s referral for PT. Want to learn more about direct access? Tune in for the next blog post, coming soon!

To make an appointment at Holistic PT, click here…

Causes of Headaches

Causes of Headaches 704 366 Jennifer Lane

There are several types and causes of headaches… tension headaches, migraines, sinus headaches. Physical Therapy treatment can help reduce and eliminate headaches. Like with any injury or dysfunction, it is important to first figure out what is causing the headache. After the subjective exam has been completed, a physical therapist assesses active motion of the cervical and thoracic spine to determine if there are any limitations of movement. Joint mobility and soft tissue tightness is also tested. There are a group of headaches that arise from joint dysfunction in the upper cervical spine.

Is your headache located in your forehead? This may come from limited mobility at C2 vertebrae. Does your headache wrap around your ear like a rams horn? This may indicate a restriction in the OA (atlanto-occipital) joint on the same side as the pain. Is your headache located at the top of your head? This could mean a problem at the AA (atlanto-axial) joint. Chronic, recurring headaches may be caused from poor posture placing strain on ligaments and muscles of the posterior neck. Have you suffered whiplash injuries? Repeated, high velocity injuries to the neck can set you up for headaches too.

Physical therapy is a great non-pharmaceutical way to treat and manage your headaches. Instead of treating the symptoms, a PT will help you get to the bottom of the cause! To learn more, contact Jenn Lane at Holistic PT.  Contact Jenn here… Contact Form.

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