Blog – Page 3 – Kinetic Edge Physical Therapy
Thursday August 8, 2019

Are You A Passive Patient or an Active Consumer of Healthcare?

Think about the last time you made a big purchase, say $1,000 or more. Did youhealthcare go out and buy the first thing you saw? Take one recommendation from somebody? Or did you research it, learn some things, compare it to other options, and select something that was right for you? Most people tend to be educated and research large purchases like cars, televisions, or the newest iphone. So why do we so often fail to do this with healthcare? By becoming more educated healthcare consumers we can go from passive patients who take the first recommendation that comes from a practitioner to an active consumer who weighs options and makes choices. Here are some questions to talk through with your practitioner the next time a healthcare decision comes up.

What are the benefits or expected results?

When a treatment or procedure is recommended, the patient often assumes that it will make them “better.” But what the patient expects and what the healthcare provider expects are often two different things. For example, a patient having back surgery expects to be pain free after surgery. The surgeon probably doesn’t expect that to happen. Outcomes from back surgeries are terrible. A large study of 1450 patients in the Ohio worker’s comp system showed that after 2 years 26% of patients who had surgery returned to work. Compare that to 67% of patients who didn’t have surgery. There was also a 41% increase in the use of painkillers in the surgical group.

What are the risks and downsides?

Patients want to hear about the benefits of a treatment, but they often don’t ask or care about the risks. To be an educated consumer, you need to. If one treatment has a 3% edge over another, but has a high risk of making you itchy or causing frequent headaches, do you want it? Going back to the back surgery study from before, the researchers found a 1 in 4 chance of a repeat surgery and a 1 in 3 chance of a major complication. With surgery you risk infection, blood clots, complications with anesthesia, and a whole host of other things. These risks need compared with other treatments. In the case of back pain, physical therapy is a valid alternative with a much lower risk profile. You might have some soreness with physical therapy, you might sweat some and be challenged with exercise, but the risks of PT compared to surgery are minimal.

What are the alternatives?

Don’t feel bad asking about alternative treatments. If you were looking at a certain car you wouldn’t go out and just buy it. You’d at least consider the competitors and probably even test drive them. You should at least look at the other options in healthcare too. Maybe the first recommendation that your practitioner makes is the right one for you, but if you don’t consider the alternatives you’ll never really know.

Why this treatment over the other ones?

This is the question where the rubber meets the road. You’ve learned about all the options, now you can see if your practitioner is balancing the risks and benefits to make the right choice for you. Staying with the back pain example, research shows that more than 40% of people who seek care for back pain will not receive a treatment of known effectiveness. Back pain is also the #1 reason for opioid prescriptions, despite a 2016 recommendation from the CDC to avoid prescribing opioids for back pain, and opt for non-drug treatments like physical therapy. By asking for the rationale and carefully weighing options, you can avoid being one of the people who gets an ineffective treatment.

What’s it cost?

This last question is becoming more important as patients bear an increasing share of the cost of healthcare. Even if you don’t have a high deductible plan or hefty co-pays, by being financially responsible today, you’ll probably see smaller price increases in your premiums down the road. That back surgery that we’ve been talking about? It’ll likely cost between $60,000 and $80,000. So if we put the whole picture together, a patient who takes the first recommendation for surgery will have a $60,000 procedure that leads to a higher risk of disability, and a higher risk of long term painkiller use, while risking infection, and blood clots. Don’t forget the 25% chance that you’ll get to do it all again in a repeat surgery. Seems like a bad deal. An educated consumer would learn that physical therapy is a viable alternative to surgery with comparable outcomes, much less risk and lower cost. In fact, a large study of 122,723 subjects showed that people with back pain who got physical therapy in the first 14 days lowered their healthcare costs by 60%. It’s easy to see why bargain shoppers love PT!

Thursday August 8, 2019

What is the Key to Growth

What is the Key to Growth?

August 2019

By Troy Vander Molen, PT, DPT

As I sit in a beautiful condominium just a few minutes’ walk from the Atlantic Ocean in Hilton Head Island, SC, I can’t help but feel conflicted. I am grateful for this time away with my family. These moments come infrequently, and our three kids – all teenagers – will be out of the house before my wife and I know it. We are blessed beyond measure!

However, there is still a small part of me that feels guilty for not being back home contributing to the Kinetic Edge team’s mission of transforming lives and restoring hope through movement. It is my life’s mission to help people grow in their ability to move and function using my unique, God-given gifts, talents, and passions, and for a few moments this week I’m stepping away from that mission.

As I sit here and contemplate the meaning of this inner conflict, I am reminded of a book that I read last year: Peak Performance: Elevate Your Game, Avoid Burnout, and Thrive with the New Science of Success. Written by Brad Stulberg and Steve Magness, the authors highlighted how the world’s best performers – in sport, art, and business – follow a common pathway to growth by taking on challenges that make themselves uncomfortable (stress) and then follow up with recovery and reflection (rest).

Stress + Rest = Growth

The best performers in the world will crash and burn if they get out of balance. Too much stress and not enough rest leads to injury, illness, or burnout, but too much rest and not enough stress leads to complacency.

In order to grow, we need to step out of our comfort zones. We need to seek out stress. We need to get comfortable with being uncomfortable. This path to personal development is active and counter to complacency.

In today’s culture of accomplishment, it seems counter-intuitive to rest. But rest is also essential.

Brad Stulberg states it well:

There is real magic in stepping away. Though it may seem paradoxical, after a certain point, it’s not hard work that is the key to improvement. It’s rest. It’s only when we step away – nothing more power than when we sleep – that both our bodies and brains rebuild and strengthen.

When we rest, hormones like testosterone and HGH are released, and these chemicals make us more resilient to future challenges. But the benefits of rest are beneficial for more than just our bodies. When we daydream, let our minds wander, and relax, our subconscious minds go to work, and when we sleep – really sleep – our brains process, consolidate, connect, and store all the information we were exposed to during the day. Cut that process short, and you will limit your growth and development.

This sounds like physical rehabilitation

I often explain my career as a physical therapist in the following simplistic way:Troy I stress the body. If someone comes to me with a pain or dysfunction, I have a variety of treatments at my disposal that can reduce the pain. These are important, but the physical issue isn’t truly resolved until we get to the root of the problem, and that requires me to find the right stress to the right tissue at the right time to generate the right response.

Our bodies are made to adapt. Apply a stress – the right stress at the right time to the right tissue – and the body will accommodate and get better at handling new and greater stresses.

But, here’s the tricky part. Most of the body parts that are hurting are likely experiencing an overload. For some reason or another, that part is getting too much stress and not enough rest, so the growth equation is out of balance. To take the load off the over-stressed body part, we need to find the root problem and make sure that this area is taking care of business in the way it was designed.

That’s physical rehabilitation. It’s about finding the right balance between stress and rest.

Maybe that’s the problem…

If you’ve been dealing with a physical problem for some time, think about it through the lens of the stress/rest equation.

If you’ve had treatments that simply attempt to eliminate the pain, you probably haven’t gotten to the root of the problem. Medications, injections, electrical stimulation, and ultrasound treat the site of the pain but not the root cause of the pain. Though they can be an important part of the rehab process, they don’t provide stress or rest. They simply mask the pain and the root problem.

If you have pursued treatment that simply looked at the site of the pain but not the entire movement environment, you’ve probably had incomplete care. Incomplete care leads to temporary results. Like growth in any area, your body needs a balance of stress and rest, and a physical therapist or occupational therapist with knowledge of how to stress the right tissues in order to eliminate stress (or provide rest) to the sore tissue is a great resource that can lead to a physical transformation.

So, if you want to find out how get to the root of the problem and grow out of your physical problem by finding the right balance to the stress/rest equation, just give us a call at 866-588-0230 and schedule a free screen. Our friendly movement experts will spend 20 minutes with you and let you know how you can solve your problem for good by applying the right stress to the right tissue at the right time.

Is that out of your comfort zone? Well, that may be necessary for you to find success. And one lucky client who takes us up on our offer in the month of August will win a free copy of the Peak Performance book by Stulberg and Magness. Call today!

Now, back to the beach!

Wednesday July 10, 2019

Katie Gosewisch’s Top Wedding Memories

At Kinetic Edge, we’re celebrating the marriage of our occupational therapy Katie 1assistant Katie Williams to Sean Gosewisch. Katie and Sean were married on the Iowa State Fairgrounds on May 18.

The two met through mutual friends in Oskaloosa right after Katie graduated from William Penn. However, other relationships kept them from dating until they ran into each other about a year later and found out they were both single. So they went out for a simple date in Oskaloosa and ended up singing a ton of mutually loved songs in his car to end the night. Katie says even now that their shared love of singing is one of the things she loves most about him.

Sean proposed to Katie under the stars in the mountains while the two were visiting a friend in Aspen. Katie says he compared their love to the infinite number of stars and then completely surprised her with his proposal. Talk about a romantic!

We asked Katie to share some of the best parts of their big day, and this is what she had to say:

  1. My wedding dress: I am not a shopper, and I actually dreaded wedding dress shopping so much. I had been in the shop once before and was scheduled to go back with friends and family to make sure it was the one. It happened to be Black Friday so the lady informed us that their clearance dresses were even cheaper with it being Black Friday. I was pretty set on my previous dress I had picked out but figured it wouldn’t hurt to look. I tried a couple on and nothing was doing it for me, but there was one more that my sister-in-law found for me to try on. In my mind “the one” wasn’t really a thing… It’s a dress; they all look nice. However, this dress was “the one”! It fit like a glove, and it was a STEAL!
  2. My dancing dress: Yes, I know I said my wedding dress was “the one” and it was.Katie 2 But it was not going to allow be to me to dance at my wedding like I wanted to with it being a “mermaid” style dress. I was going to make it work anyway, but I ended up finding a place called New Hope in Oskaloosa. They had new wedding dresses for super cheap, and I fell in love with one that was 8 sizes too big for me. My amazing aunt reluctantly (at first) agreed to see if she could make it work for me. She also made my prom dresses so having her alter my dancing dress was very special for me. She did an AMAZING job, making it exactly what I wanted. She even voiced having fun with problem solving how to make it work.
  3. Our first look as I walked down the aisle: I remember being so nervous and excited to see Sean. When I actually did see him as I turned the corner down the aisle, that’s when it all became so real, and I had to fight tears of joy for most of the ceremony.
  4. Special music: I have some very vocally talented cousins in my family so one of them sang a song during our unity candle lighting. He and another cousin also sang our first dance song. It was so special having that extra special touch to both of those intimate moments of our wedding.
  5. Getting ready in the hotel room with my bridal party before the wedding: Katie 3One of my bridesmaids is a hair dresser so she and her co-worker, who is also a friend, did our hair. Her sister did all of our makeup. It was so nice knowing the people doing my hair and makeup because it was such a laid-back environment and everyone was really able to just be ourselves an relax. Plus, they did an amazing job!
  6. Setting up the venue: We spent Thursday and Friday setting up, and I loved seeing everything we’d prepared come to life.
  7. Our flowers furnished by family friends: It was so special to have my cousin and family friends make our gorgeous flowers. It wasn’t planned, but the family friend that made Katie 4my bouquet was actually the same person that made all of my prom flowers so having her do my wedding made for an extra special touch.
  1. Our wedding cake: A completely different cousin made our wedding cake. I am truly blessed with talented family and friends and loved having them share their talents to make our big day perfect.
  2. THE DANCE: Sean and I love dancing and even though we didn’t get to do as much as we’d have liked to, it was still a blast when we did dance as well as seeing everyone else have a good time.
  3. Reflecting on our day: Sean and I both loved getting to the hotel and Katie 6reminiscing of the day. We felt so blessed to have such wonderful family and friends that showed up to help celebrate such a monumental day for us!

 

Wednesday July 10, 2019

Is Tingling in My Arm a Pinched Nerve or Carpal Tunnel Syndrome?

Dr. Troy Vander Molen, PT, DPT

In our May newsletter and blog post, I asked the question, “Is the kink in my neck a July Newsletter 1pinched nerve?” If you were paying attention, you will remember that the answer essentially was, “Probably not.” While a kink in the neck is always accompanied by localized stiffness, soreness, and difficulty moving the neck, a pinched nerve typically involves symptoms – numbness, tingling, and/or pain – that travel down the arm.

The natural follow-up questions, then, are these:

If I have numbness, tingling, and/or pain down the arm, does that mean that I have a pinched nerve? Or is it carpal tunnel syndrome?

Good questions!

Technically, the answer to the first question is “yes.” Because nerves carry motor information from the brain to the body and sensory information from the body to the brain, symptoms of numbness and tingling in the arm are likely due to compression of nerve somewhere.

So, the ultimate questions are: What things can compress a nerve? And where does that compression occur?

Back in May, I included this statement in my blog post:

Nerves can potentially be compressed either centrally as they exit from the spine or peripherally by structures like tight muscles that exist external to the spine. Spine-related issues that can put pressure on a nerve as it exits the spine (i.e. central causes) include herniated disks and other arthritis-related changes like narrowing of the disk space, disk degeneration, and bone spurring.

Numbness and tingling in the arm can be caused by compression on a nerve in multitude of areas and from a multitude of sources. The compressive force is not necessarily coming from the neck and may, in fact, be coming from multiple areas.

What structures external to the spine can compress a nerve and cause numbness and tingling?

There are many structures that can compress a nerve as it travels from the brain to the terminal body part. Compression from one or more of the structures along the pathway of the nerve can contribute to a variety of arm symptoms.

There is a condition called double crush syndrome. With this condition, there is increased nerve symptom intensity due to distinct compressive forces along the pathway of the nerve at two or more locations. Double crush syndrome can lead to diagnoses like carpal tunnel syndrome (CTS) or thoracic outlet syndrome (TOS), which don’t fully explain the root cause of the problem and can lead to expensive and often ineffective treatments.

Because of double crush syndrome, treatment of arm numbness and tingling must be comprehensive. If you have been told that you have carpal tunnel syndrome, you may have been led to believe that you have pressure on your nerve at the carpal tunnel of the wrist. You may even have gone through a diagnostic test of nerve conduction velocity (i.e. NCV or EMG) that “proved” that you have pressure on the nerve at the wrist.

But, in the words of ESPN football analyst Lee Corso, “Not so fast, my friend!”

The key to successfully treating any condition that is causing numbness and tingling in the arm is to assess and correct any of the structures that can place a compressive force on the nerve throughout its entire pathway.

Here are the primary culprits that must be cleared to ensure that you eliminate peripheral nerve compression and numbness/tingling in the arm.

July Newsletter 2SCALENE MUSCLES

As the nerves pass from the neck to the fingers, they pass through many structures. At the origin of the nerves, this bundle of nerves (known as the brachial plexus) passes through the scalene, which are muscles that run from the upper part of your neck to the first rib. Tightness of this muscle group will compress the nerve bundle, which can manifest as numbness and tingling down the arm.

COLLAR BONE

When the scalene muscles are tight, the first rib may elevate, which further compresses the nerve bundle. Furthermore, a forward head/rounded shoulders posture (see pec muscle information below) and weight gain can further increase the mechanical compressive forces in this area.

PECTORAL MUSCLES

Our chest muscles are comprised of the more superficial (and visible) pec major and the underlying pec minor. These muscles travel from the sternum and the front of your rib cage and connect on a bone that projects forward from your shoulder blade (the coracoid process).

As the nerve bundle and accompanied blood vessels travel distally down the shoulder into the arm, branches of these nerves are positioned beneath the pec minor. You will typically know that the pec minor is tight because you will see that the shoulder is rounded, or hunched. This problem, by the way, can also cause shoulder problems because of increased compressive forces on the rotator cuff tendons and a bursa in that region

For a great summary of how to manage this issue, check out this article by Daniel Stern and Shannon McKenna of Cirque Physio.

If you are concerned about numbness and tingling in the arm and have wondered whether you have carpal tunnel syndrome or thoracic outlet syndrome, I encourage you to take advantage of our free injury screens. Take a test drive for FREE by scheduling a brief and complimentary 20-minute consultation with one of Kinetic Edge’s movement experts, and you can get simple answers to your musculoskeletal problems. Call 866-588-0230 today to claim one of our few open slots.

Saturday June 1, 2019

YOUNG GIRL WITH AUTISM BENEFITS FROM OCCUPATIONAL THERAPY

by Marketing Specialist Lindsey Klyn

Vivian Turner Occupational TherapyOn July 6, 2015, Jack and Megan Turner welcomed their fourth child, a little girl named Vivian, into the world. For the first year of her life, Vivian seemed to be hitting all her milestones and growing right along. But once her first birthday came and went, her parents began to notice that she wasn’t behaving like other one-year-old kids.

The differences were small. Vivian wasn’t saying words or babbling. She didn’t make eye contact and didn’t seem to be playing with toys like she should. After they continued to notice these small differences, the Turners sought out their family doctor. Their doctor recommended bringing Vivian to be evaluated at the University of Iowa’s developmental department, so the Turners did.

The evaluation lasted for most of the day, ending with a sit down with a specialist. That was the moment the Turners learned that Vivian was diagnosed on the autism spectrum, along with a speech and developmental delay.

“Truthfully, I don’t think I heard much after that,” shared Vivian’s mom Megan. “We left and when I got in the car, I sat and cried thinking, ‘What in the world do I do for autism?’ Knowing there isn’t a ‘cure’ for autism was the scariest thing to me.”

The Turners faced a lot of fear and unknown after this diagnosis. They wondered if Vivian might grow out of this or if there would be medicine that could help. Their world looked bleak, and they feared how this diagnosis would impact their sweet little girl.

Despite how they felt, the Turners were committed to doing all they could to help Vivian. The doctors suggested starting speech therapy and occupational therapy. After hearing about the occupational therapy team at Kinetic Edge Physical Therapy from a few people, the Turners called to set up an evaluation for Vivian.

Occupational Therapist Elise Spronk performed Vivian’s initial evaluation. She discovered that Vivian was struggling with her fine motor skills, as well as not really playing with toys. Vivian preferred to line toys up rather than play with them. In addition, Spronk noticed Vivian’s social interaction, her ability to dress herself, and her ability to eat with utensils could all use work.

“At the start of therapy, our goal was to just have Vivian attend long enough to an activity to participate in play without quickly going from one activity to the next,” shared Occupational Therapist Elise Spronk. “As this improved, we were able to focus more directly on her skills so that she’d be able to participate in other play and self-care skills.”

After a year of weekly occupational therapy, the Turners notice a drastic change in their almost four-year-old daughter. Vivian used to hate the feeling of any wet texture and now plays with items like wet sand and shaving cream, an indication of improved sensitivity to stimuli.

Pella Sensory Play at Kinetic Edge“This little girl who couldn’t even put a finger in something like that is now putting whole hands and arms in,” Megan exclaimed. “After seeing these changes happen week after week, I started telling myself this is happening and is real. It has been a huge life changer! Kinetic Edge has been nothing short of a God-send really.”

Life now looks a lot different for the Turners than it did three years ago when they got Vivian’s diagnosis. Thanks to help from therapies, school, and home life, Vivian now says words and babbles all the time. She even enjoys getting into messy things. While Vivian still show signs of delay, the Turners outlook on this diagnosis completely changed as they’ve been filled with hope.

“I believe Vivian will live a full, self-functioning life when she gets older,” said Megan. “We have a cheerful and happy-go-lucky daughter who shines light on our lives every day! I wouldn’t change anything for the world.”

Kinetic Edge’s mission is to transform lives and restore hope through movement. Vivian is another one of the stories that attribute how they’re bringing hope to individuals of all ages in Iowa. A  child with delays in developmental milestones, abnormal sensory preferences, trouble with reflex integration, or difficulty with visual perception can benefit from pediatric occupational therapy. These symptoms sometimes occur for no apparent reason and other times can be the result of a specific diagnosis. To find out more about occupational therapy at Kinetic Edge, call 866-588-0230.