Premier Physical Therapy

Category: Physical Therapy

4 Self Help Suggestions for Pain and/or Swelling

When to use heat?

Heat can be used for stiffness, arthritis, muscle pain, back or neck pain. Heat may be preferred for chronic or long-lasting stiffness and acute muscle soreness.

Note: Heat should NOT be used for the first 3-5 days after joint sprains such as with new knee or ankle injuries. Heat is preferred prior to activity, but can be used following physical activities as well.

Why? Heat can help relax and loosen up tense muscles and stiff joints allowing for decreased pain and improved overall movement. Heat may also increase blood flow to the area applied.

Tips for Heat: Many heating products are available for purchase. Electric heating pads, hot-packs, warm damp towels, or even warm showers/baths may be beneficial. To be most effective, apply heat 10-20 minutes.

When to use cold?

Cold can be used for new or acute injuries such as joint sprains, strains, tendinitis, and when recovering from a surgery. Cold may also be beneficial when experiencing swelling and/or bruising along with pain.

Note: Always use a barrier such as a washcloth or light towel between the skin and the cold pack/ice to prevent potential injury to the skin.

Why? Use of cold can help reduce pain by numbing the area and can help reduce swelling by decreasing the amount of blood flow to the injured area. This may help slow the inflammatory response.

Tips for Icing: The quicker cold is applied the better – cold should be used immediately following injury or surgery. Cold should be used a maximum of 20 minutes per session. Cold packs, cold compress and homemade ice-packs can be used. Frozen vegetables or frozen fruit can be substituted if you do not have an ice-pack. Cold is best used when secured to the area being treated.

When to use compression?

Compression can be used for acute injuries or conditions such as arthritis or chronic joint pain that have swelling associated with them. Some examples are joint sprains/strains, bruising, following surgery, or joints with persistent swelling with or without pain.

Note: Ensure that the compression is not too tight. Check for numbness, tingling or swelling below the area that the compression is used.

Why? Use of compression or wrapping to the injured/involved area may help decrease the overall swelling and thus improve movement and
decrease pain.

Tips for Compression: Compression wraps or compression sleeves may be used. Various types are available. Compression wraps are preferred for short-term use and compression sleeves are recommended for more long term use. If wraps are used start distally and work proximally. Comfort is key.

When should you elevate?

Elevation should be used to reduce swelling and decrease discomfort associated with swelling. Elevation can be performed with new or acute injuries as well as following surgery. Elevation can also be used to decrease “fluid retention” in chronic situations such as swelling in the legs.

Note: Compression can be used with elevation to maximize the benefit (see precautions associated with use of compression).

Why: Elevation can help decrease swelling and bruising. Elevation may limit bleeding to the injured area as well as promoting drainage of “inflammation” into the lymphatic system.

Tips for Elevation: Keep area of swelling elevated area above the heart if possible. Pillows, wedges, or rolled up towels may be helpful to prop up your arm or leg. In instances of chronic swelling in the feet and ankles, both legs may be propped at the same time.

Talk with your healthcare provider if you do not notice an improvement with your pain and/or swelling or if you feel concerned. Physical therapy may be right for you. If so, tell your doctor you want to go to Premier. We’re here to help you. Call us at 573-335-7868.
For other tips and information visit our website at sendmetopremier.com.

May 4, 2022
3 Questions We Will Ask if You Need Therapy

1. What are your limitations?

Our therapists want to know how your pain has affected how you do things in a typical day. We want to fully understand the problem and how it is impacting your quality of life. At this stage, we are focused on the root cause of the problem so we can help you get back to what you were doing previously. Other tests will also help with this, like range of motion, muscle strength and/or weakness, and joint restrictions.

2. What are your goals?

We want you to tell us the goal(s) you have in mind – like playing with your grandkids, working again, or playing sports. Being specific helps us because we may use different techniques to help you reach that specific goal.

3. Are you committed to this plan?

Your success in physical therapy partially depends on your commitment to the program. This means coming to therapy consistently and completing your home exercise program. Do you have to continue those exercises for the rest of your life? Probably not. Once you have regained your strength and gotten your pain under control, you may not need them anymore.

If you can’t commit to the plan they prescribe, simply talk with your therapist so together we can find a game plan that works for you!

It’s time to feel better NOW! Call your doctor NOW to get your script! Then, give us a call TODAY to schedule an appointment at 573-335-7868.

https://www.health.harvard.edu/blog/need-physical-therapy-3-key-questions-your-
pt-will-ask-202106072470

November 23, 2021
Ultrasound and Physical Therapy
Ultrasound or “Ultrasonography” is usually seen by many as a procedure meant for pregnancy; however, it is used for many medical procedures and can be very beneficial when used to treat musculoskeletal issues such as muscle spasms, tissue injury, and pain. In physical therapy, the ultrasound machine works by sending an electrical current through crystals found in an ultrasound probe or “wand.” This causes the wand to vibrate, causing waves to travel throughout the skin to the tissues underneath; this then causes waves to transfer energy to the tissue beneath. The machine is focused on deep tissue and does not affect the tissue close to the surface. The ultrasound frequency, duration, and intensity are adjusted per patient and ailment.

The type of Ultrasound used in physical therapy is called Thermal Ultrasound. This type of heating effect helps reduce chronic inflammation and heal muscle pain. It can also be beneficial for tissue fluid and improving movement with lymph passing through the body. Lymph helps transport white blood cells around the body, which helps fight infections and can help improve healing time.

Risks of Ultrasound

Exposure to low-intensity ultrasound for prolonged periods can cause superficial burns. Please let your therapist know if you notice any redness or bumps in the area after this procedure is performed. The risk is very low for this type of reaction, and your therapist will keep the probe moving while in contact with the skin to avoid complications. Therapeutic ultrasound is generally not used over implants, active infections, eyes, or the spine.

Benefits of Ultrasound
1. This procedure is painless, easy to do, and takes minimal time.
2. There are no known harmful effects if performed correctly by your therapist.
3. Ultrasound can reduce pain symptoms in affected areas.
4. This is a non-invasive procedure performed on the surface of the skin.
How To Prepare for Your Visit if Ultrasound is Expected
1. Wear loose-fitting clothes that can be shifted out of the affected area.
2. Ultrasound gel or cream will be used for improved gliding over the skin and may be cold.
3. The ultrasound probe will be moved in circular motions over the area and should not be felt.
*If you feel sharp pain or pinching while the Ultrasound probe is moving, please let your therapist know immediately.

Call Premier Physical Therapy at 573-335-7868 for more information on this type of modality.
August 20, 2021
Proper Sleeping Program
The average person spends 227,760 hours of their life asleep. That’s 26 years! With that being said, it is so important to spend that time in a proper sleeping position. Doing so can even help prevent back, neck, and shoulder pain! Whether you sleep on your back, side, stomach, or in a fetal position, here are some great tips to help ensure your best night’s sleep.

Back Position
- Place a pillow(s) under your knees.
- Lie down flat on your bed with no gaps visible.
  - If a gap is visible, apply a rolled towel to fill it.
- Your ears, shoulders, and hips should all be in even alignment.
Side Lying Position
- Place a pillow(s) between your knees for support and to make the knees parallel to each other.
- Fill any gaps that are visible on your side with a rolled towel.
- Ensure your head and neck are supported enough to be aligned with your spine.
- Place a pillow in between your head and your arm for support.
Stomach Position
- Place a pillow(s) under your lower abdomen.
- The preferred method for proper spine alignment is to:
  - Utilize a thick, firm pillow to place underneath your forehead to allow room for breathing.
- Alternative method:
  - Utilize a thin pillow placed for head support or no pillow at all.
Fetal Position

Note: This is best for those suffering from a herniated disc or degenerative disc disease.
- Gently roll over to your side, then bend your knees toward your chest.
- Try to switch sides to prevent imbalances.
July 1, 2021
de Quervain’s Tenosynovitis
What is de Quervain’s Tenosynovitis:

De Quervain’s Tenosynovitis is a quite painful condition that causes discomfort to the thumb side of the wrist. This happens because the two tendons that move the thumb through a pulley like system at the wrist becomes irritated. The swelling that occurs due to this irritation limits the tendons’ ability to smoothly move back and forth through this pulley, which causes pain. This is one of those conditions that if you use the saying, “No pain, no gain,” you will definitely get worse!

Symptoms:
- Pain when the thumb side of the wrist is touched, rubbed, or pain is noted when wearing a bracelet or watch.
- Pain noted when the thumb and/or wrist is moved.
- Pain when pinching or lifting when gripping, especially if you are moving the wrist down and towards your small finger side.
- Swelling, also called edema, on the thumb side of the wrist.
- Common in pregnant or new mothers.
- More common in middle-aged women between 30 and 50 years old.
Causes:
- Repetitive tasks that involve thumb/wrist motion.
- Awkward positioning of the wrist (especially moving thumb down while moving the wrist towards the small finger side).
- A direct blow to the thumb side of the wrist.
- Repetitive lifting of objects/things (including a baby).
- Hobbies like painting & carpentry, etc.
Conservative treatment (this means treating it without surgery):
- A thumb spica forearm based orthotic is the best way to treat this condition. This orthotic is recommended to be worn 23 hours a day, taking it off only to perform the prescribed treatment and shower. This orthotic MUST immobilize the thumb AND the wrist.
- Avoid tasks that aggravate the condition. Any tasks that require thumb/wrist motion can make this condition worse. Making it hurt will NOT make this diagnosis better.
- Heat/ice depending on the stage of your injury and other modalities. Ask your therapist which is best for your condition.
- Exercises: any exercises MUST be specific to your injury. Ask your therapist.
Surgery:
- Surgery is recommended only after conservative treatment has failed.
For more information, go to https://www.assh.org/handcare/condition/dequervains-tenosynovitis

Call your doctor if you are experiencing any of these symptoms, then tell them you want to go physical therapy at Premier Physical Therapy. Let us help you find relief and avoid surgery.
March 1, 2021