Billerica, Mass. —
Physical therapy for patients who have undergone mastectomies can make all the difference as they return to their old lives.
At New England Rehabilitation, which has outpatient offices in Billerica, therapists combines strengthening exercise with more advanced techniques to help patients who have had mastectomies regain their full range of motion following surgery. Joana Ingram, a physical therapist at New England Rehabilitation in Billerica, said therapy is something patients should be thinking about even before the surgery begins.
“Most people wait,” Ingram said. “Most people don’t wind up coming here. They think the cancer is gone and they end up developing scar tissue, or worse-case scenario, they get lymphodema.”
Ingram said the level of therapy, as well as how long it lasts, depends on the patient. Age, physical condition, and the complexity of the surgery all play a role in determining how long therapy lasts. Regardless, she said patients should get it done as soon as possible.
The physical therapy following mastectomies ranges from strength-training exercise to more complex procedures. Dr. Deniz Ozel, medical director for New England Rehabilitation, said a weakness or swelling in the arms is the main after-effect of mastectomies or lumpectomies.
“There are problems that occur can lead to functional problems, like not being able to do daily activities,” Ozel said. “They reduce quality of life.”
Range of motion and strengthening exercises are the first step of the post-surgery therapy, with gentle stretching and exercises to strengthen the muscles around the shoulder and elbow, as well as endurance exercises. Ozel said patients are shown how to compensate for limitations in motion in order to maintain their independence.
Lymphodema, a condition of fluid retention and tissue swelling caused by a compromised lymphatic system, is another potential effect caused by mastectomies. Should this occur, therapists use a four-step process called complex decongestive therapy. The first part is massaging the skin, followed by manual lymph drainage. Elastic bandages can be used to keep fluid from building up, and a variety of exercises comprise the final step.
“This could be done over a the course of a few weeks to four weeks,” Ozel said. “Usually if it’s caught early it doesn’t take very long.”
Ingram, who is certified in lymphodema treatment, said taking measurements of the patient’s arms prior to surgery can help determine if lymphodema occurs. Should it happen, patients need to take care to observe their skin condition, and try and avoid insect bites or injections on the affected area. If a patient with lymphodema develops folds in their skin, they need to examine the areas between the folds.
Effects on the patient
For patients who do not undergo post-operational therapy, the effects can be significant. Patients who undergo mastectomies or lumpectomies and don’t exercise following surgery can develop a condition called frozen shoulder, where they lose all motion in one or both arms.
Ozel said this therapy has come to the forefront in recent years, as more patients survive cancer.
“They want to return to their old lives,” said Ozel. “People are not satisfied with having limited movement.”
Ozel said this therapy is especially important if the patient leads a very inactive lifestyle. Though the therapy does eventually end, therapists always recommend their patients to maintain the exercise and continue to build strength.
Ingram said there is often a psychological side to this work. Some patients, in pain following the surgery, may be unwilling to attend therapy sessions. Others can become depressed by the scarring or other effects of the surgery.
“We’re supposed to just treat the body, but a lot of time we wind up treating the mind of the patient,” Ingram said. “Not everybody who’s here wants to be here.”
Copyright 2010 Billerica Minuteman. Some rights reserved
Asheville, NC (CompNewsNetwork) – Typically, wellness programs are associated with efforts to reduce health care costs and to increase productivity. Yet, the benefits of healthy workers transcend reduced health care costs, including Workers’ Compensation and lower absenteeism. Healthy workers are less prone to injury and when injured, recover quicker than unhealthy workers. Conversely, out-of-shape workers are at a higher risk for injury and healing is often delayed and complicated by other health factors. If workers are able to change and modify their lifestyle and reduce their health risks, medical costs will decline.
While this may seem intuitive, the connection between wellness and Workers’ Compensation has been slow to take root. Separate risk management departments overseeing Workers’ Comp and Group Health, concerns about expanding the employers’ liability for work-related injuries, a focus on workplace safety rather than workers’ health and a number of small companies with high Workers’ Comp costs that do not offer health insurance have all been contributing factors.
A recent University of Michigan study of a Midwest utility company’s workplace wellness program found that over nine years, the utility company spent $7.3 million for the program and reaped $12.1 million in savings. Medical and pharmacy costs, time off and Worker’s Compensation factored into the savings. The study, which took into account a number of costs, including indirect costs of implementing wellness programs, such as recruitment and the cost of changing menus, showed that wellness programs work long-term even though employees aged during the course of the study.
Overall, the program cost the employer $100 per employee. The cost of lost work time, Workers’ Compensation, and pharmacy and medical expenses among employees who participated each year increased by $96, compared with a $355 increase among employees who did not participate.
This is good news for employers. Amid heightened cost pressures and leaner staffs brought about by the prolonged economic downturn, employers need to reduce all types of absences and maintain productivity. While employers tend to focus their energies on controlling health care costs since the dollars are highly visible and more easily shifted, there are significant opportunities to control other costs with wellness programs.
On average, employers can see a 30% reduction in Workers’ Compensation and disability claim costs according to a review of 42 published studies involving the economic returns of wellness programs. Moreover, wellness programs will reduce the costs of absences that, according to the 2010 Kronos/Mercer Survey on the Total Financial Impact of Employee Absences add up to 8.7% of payroll costs, more than half the cost of health care.
Of course budget and company size will dictate the type of program a company can undertake. However, there are five steps that all companies should take before launching a wellness program:
Know your cost drivers. Analyze Workers’ Compensation, health care and absenteeism data to identify common issues and trends. Understand the legal regulations governing wellness programs.
2.Do a workplace assessment
Examine the physical and cultural framework in which the wellness program will operate. Consider opportunities for on site physical activity, partnerships with community wellness providers, local gyms or health and nutrition classes, on-site vending machines and cafeteria, etc.
Identify the interests and motivation of employees as well as barriers to employee participation through surveys, wellness committees as well as analysis of past efforts
For several years, businesses have been shifting more of the costs of health insurance to workers through premiums and higher deductibles. Since 2005 workers’ contributions to premiums have gone up 47%, while wages have increased only 18%. Employees are feeling the pinch. Show them how usage affects premiums and how wellness efforts can reduce usage.
4.Support from management
A wellness program will not succeed without the ongoing support of management. Communicate the goals of the program and assess the commitment of supervisors and management.
5.Identify goals and metrics for measuring success
When implementing a wellness initiative, senior management will want to see a return on investment. Establishing a consensus on the goals or metrics upon which to measure the success of the program will help shape the program and ensure its success.
This material is provided as general information and is not a substitute for legal or other professional advice.
October is recognized as Physical Therapy Month, and the American Physical Therapy Association offers tips to stay healthy.
Teresa Schuemann, of Colorado Physical Therapy Specialists in Fort Collins, said families should be at the forefront of establishing physical activity habits.
“It’s much easier for children to adopt healthy lifestyles if they see their parents making physical activity a priority,” she said in the release. “Parents should emphasize a healthy lifestyle instead of focusing solely on weight and support the family’s healthy choices rather than pounds lost.”
The association contends that physical therapists can help families balance the many priorities they have for their children and help them find ways to incorporate physical activity into children’s play, leisure time and daily family routines.
For obese children and adults, promoting movement, reducing pain when it is present, maintaining or restoring function, and preventing disability are the goals of a physical therapist-designed exercise program, according to the release.
“Physical therapists address how obesity affects the way the body moves and functions,” Susan Deusinger, professor of physical therapy and neurology at the Washington University School of Medicine in St. Louis, Mo., said in the release. “This is accomplished through individual and group exercises to restore flexibility, increase strength and cardiovascular endurance, reduce pain, and address postural stability and balance. These help the individual to better perform activities of daily living while decreasing disability associated with long-term obesity.”
Physical therapists also incorporate behavior modification into weight loss programs, according to the release. For instance, treatment may include identifying causes of unhealthy behaviors, learning how an individual’s readiness to begin or continue positive behaviors impacts progress, and recognizing any barriers that may compromise healthy habits.
Physical therapists help the individual set goals and monitor his or her behavior, according to the release. Frequent contact, feedback and continuous motivation and support are all components of behavioral programs that physical therapists provide in individual and group settings.
Obesity is a risk factor for type 2 diabetes, a chronic disease marked by high levels of sugar in the blood that is associated with numerous health complications, according to the release. Improving capacity for physical activity and increasing muscular strength are crucial to preventing loss of physical function and independence, the association reports.
An individualized program developed by a physical therapist can help reduce the need for medications, lower risk of heart disease and stroke, and help manage glucose levels. For people with complications associated with diabetes, physical therapists can help restore quality of life through the use of special tests to check foot sensation; decrease cramping pain during walking; evaluate and care for skin ulcers and sores that are slow to heal; improve walking ability by adapting shoes or orthotics; instruct on how to protect the feet if they have lost sensation, and recommend shoe wear or assistive devices, according to the release.
According to the association, the guidance and encouragement of a physical therapist who understands individual needs, priorities, and challenges and who is able to closely support and monitor progress can be the determining factor in helping an individual to achieve his or her goals.
GREENWICH, CT- On Tuesday, October 12, from 7-9 p.m., the ONS Foundation for Clinical Research and Education will present a free workshop on girls sports injuries with a focus on ACL injury and stress fractures at the OGRCC, Eastern Greenwich Civic Center, 90 Harding Road, Old Greenwich.
Primary care sports medicine physician Gloria Cohen, MD and orthopedic surgeon and sports medicine specialist Katherine Vadasdi, MD will discuss why girls have certain risks for potentially serious sports injuries. The hands-on workshop is open to girls, ages 11 to 19, parents, youth sports coaches and athletic trainers. Physical therapists from ONS Physical Therapy will work with participants in small groups on effective conditioning techniques for injury prevention.
The workshop is a collaboration between the OGRCC (Old Greenwich-Riverside Community Center) and the ONS Foundation for Clinical Research and Education. The seminar is free, however registration is required. Call (203) 637 3659 or email email@example.com.
ONS Foundation for Clinical Research and Education, Inc. is a registered not-for-profit, 501(c)3 organization devoted to understanding the causes and optimal treatments of orthopedic injuries and musculoskeletal conditions. The ONS Foundation, in alliance with Greenwich Hospital, strives to improve standards of excellence for the treatment of musculoskeletal disorders through clinical research, physician and patient education, and community outreach programs. The Foundation is located at 6 Greenwich Office Park, 10 Valley Drive, Greenwich, CT.
An Illinois state trooper who killed two teenage sisters in a high-speed collision, driving 126 mph while sending e-mails and speaking to his girlfriend on his cell phone, has filed a workers’ compensation claim for injuries he says he sustained in the fatal crash.
Matt Mitchell, who pleaded guilty to reckless homicide and reckless driving, could have thousands of taxpayer dollars coming to him, angering the family of Kelli and Jessica Uhl, who were 18 and 13, respectively, when their vehicle was struck head-on by Mitchell’s patrol car the day after Thanksgiving 2007.
“At least at the beginning, he was a disgrace to his uniform, now I believe he is a disgrace to the human race,” said Thomas Q. Keefe, the attorney representing the girls’ parents, Kimberly Schlau and Brian Uhl.
Two other girls, passengers in the car, were also injured.
For two years after the accident, Mitchell was placed on paid leave, continuing to earn his $68,000 annual salary. Mitchell pleaded guilty last year as part of a deal with prosecutors and served 90 days probation, never seeing any jail time.
On the day of the accident, Mitchell was responding at triple-digit speeds to the scene of an incident at which troopers were already present. He was simultaneously e-mailing colleagues and on the phone with his girlfriend, when his car jumped the median and struck the car in which the girls were riding.
Days after he pleaded guilty in a criminal trial, Mitchell resigned from the force and denied any responsibility for the girls’ death in a civil suit brought by the family against the state.
“This man has no shame,” Keefe told ABCNews.com. “He had no shame when he changed his story and insisted he was not responsible for that crash, and he continues to have no shame now. That’s gall.”
Keefe said that because Mitchell was a state employee on the job at the time of the crash, the family’s civil case is tied up in a special court of claims, and a jury will never hear the case.
The same conditions, being a state employee and on the clock, also qualify Mitchell for disability insurance.
Workers’ compensation insurance is purchased by employers for the coverage of employment-related injuries and illnesses. Update — Illinois ex-trooper denied workers’ comp in deadly crash
New York Jets cornerback Darrelle Revis watched the second half of their game against the New England Patriots from the sidelines after a hamstring injury caused him to leave the game.
Revis originally sustained the injury last week against the Ravens, but he apparently reaggravated the injury with 53 seconds left in the first half, while covering Randy Moss.
Moss made a touchdown catch on that play.”I pulled up,” Revis said. “Usually I rely on my speed … but it wouldn’t let me speed up to make a play.After the game, Revis made it clear that he did not believe that there was a tear, but that he just felt tightness in his hamstring.
He will have an MRI on his injured hamstring on Monday. During the offseason, Revis was involved in a contract dispute that was not finalized until just before the first week of the season.Next week, the Jets will face the Miami Dolphins.
To seek treatment for a sports injury like the one above, make an appointment with one of these sports medicine doctors in New York / New Jersey. CLICK HERE or Call:
Chronic Musculoskeletal Complaints
NEW YORK (Reuters Health) – A large, population-based study conducted in Norway shows that physical exercise is associated with a lower prevalence of chronic musculoskeletal complaints more than a decade later.
Physical inactivity and chronic musculoskeletal complaints share “several negative determinants of health,” Dr. Helene Sulutvedt Holth of the Norwegian University of Science and Technology in Trondheim and colleagues point out in the December 1 issue of the online journal BMC Musculoskeletal Disorders.
The team evaluated results of two public health studies in which 39,520 participants responded to questions about physical activity patterns between 1984 and 1986 and to questions about chronic musculoskeletal complaints eleven years later between 1995 and 1997.
Chronic musculoskeletal complaints (MSCs) were defined as MSCs lasting three months or more during the year previous to the questionnaire. Chronic widespread MSCs were defined as pain in the axial region, above the waist or below the waist for 15 days or more during the previous month.
At the follow-up questionnaire, Dr. Holth and associates found that 51% of respondents reported chronic MSCs and 5.9% reported chronic widespread MSCs.
Participants who exercised at baseline were less likely to report chronic MSCs, with an odds ratio (OR) of 0.91 compared with inactive individuals. Those who exercised three or more times a week had an OR of 0.72 for chronic widespread MSCs.
“In the present study, a participant’s physical activity level is based on leisure time exercise only,” Dr. Holth and colleagues caution, noting that “the impact of occupational physical workload might also have contributed to the results.”
The study results may lead to a better understanding of the processes leading to musculoskeletal complaints, the researchers say. “Future studies should try to clarify whether chronic MSCs are a cause or a consequence of inactivity.”
BMC Musculoskelet Disord 2008;9.
Three main causes of chronic musculoskeletal pain:
Colyer, who recently joined UC Health after completing her residency at the University of Kentucky Medical Center, is licensed to practice acupuncture. Based at Drake Center, she sees both inpatients and outpatients at the rehabilitative care center in Hartwell.
“What really interested me when I chose PM&R were the chances for complementary medicines such as acupuncture,” says Colyer. “It’s another way of helping injured people get back into the community with more function and a better quality of life.”
Acupuncture has been practiced in China and other Asian countries for thousands of years. The term refers to a variety of procedures and techniques involving the stimulation of anatomical points of the body, but it’s most often associated with needles manipulated by the hands or by electrical stimulation.
According to the National Institutes of Health’s National Center for Complementary and Alternative Medicine, (NIH) the 2007 National Health Interview Survey found that an estimated 3.1 million U.S. adults and 150,000 children had used acupuncture in the previous year, an increase of about 1 million people over the 2002 survey.
Acupuncture practitioners in the U.S. must be licensed (Colyer, who also specializes in stroke rehabilitation at Drake, took intensive course work in acupuncture outside of her regular medical training), and acupuncture needles are regulated by the U.S. Food and Drug Administration to meet requirements that they be sterile, nontoxic and labeled for single use by qualified practitioners only.
“There are a lot of uses for acupuncture, but the treatment I’ve learned is exclusively for pain management,” says Colyer. “So if muscles are tight, or having spasms, when we insert needles into the muscles it loosens them up and people feel a lot more relaxed and more comfortable.”
Numerous studies of exactly how acupuncture works have been inconclusive, but the Western view is that it likely works by stimulating the central nervous system to release chemicals that dull pain, in addition to stimulating blood flow and tissue repair at the site itself.
Treatment techniques can also include electrical stimulation, using two needles at a time so the impulse passes from one needle to the other.
“People want to see clinical trials, but it’s hard to do that because you can’t get a good control group,” says Colyer. “For example, how do you fake acupuncture well?”
Treatment regimens vary depending on the patient, and some insurance carriers may cover acupuncture while others may not. The National Center for Complementary and Alternative Medicine recommends that prospective patients check with their insurer before they start treatment.
Provided by University of Cincinnati (news : web)
Acupuncture is a suggested relieves pain:
- Low-Back Pain
- Neck Pain
- Osteoarthritis/Knee Pain
- Other Conditions
Chronic pain in the muscles and joints can make life miserable. Standard treatments like ice and heat, anti-inflammatory medications, physical therapy, and appropriate exercises can often ease the pain. But when they don’t, acupuncture is an option with a good track record that’s worth considering.
MusculoSkeletal Resources New York Pain and Injury Care
Pain Management Clinics in New York / New Jersey now on twitter.
MusculoSkeletal Resources New York Pain Care is one of the leading medical doctor networks specialized in the diagnosis and treatment of pain related conditions. Patients receive compassionate care and a multidisciplinary approach to the treatment of pain from injury. catch us @injurydoctornyc
A new study in The Journal of Pain, published by the American Pain Society, has found that those who suffer from chronic musculoskeletal pain (CMP) may fell an increase in pain with acute exercise, but over the long-term, exercise has the opposite outcome and reduces pain.
Researchers from the University of Wisconsin tested levels of experimental pain sensitivity in Gulf War veterans that suffered from CMP similar to fibromyalgia and compared the results with healthy soldiers.
Although the vets reported greater, more intense leg pain during initial exercise sessions, regular exercise over the long-term appeared to reduce the pain threshold. In addition, regular exercise is critical for reducing the risk of long-term disability and mood disorders.
Remember Exercise is Medicine! Exercise is also a valuable method along with physical therapy when managing chronic pain. Exercise increases strength and flexibility, reduces joint pain, and helps combat fatigue. Breathe deep and find a pain management specialist nearest you to start your pain management wellness program.