CyberPT Physical Therapy Forum

Pediatric Injuries/Conditions : preemie twins

Wed, 10 Mar 2010 09:31:29 +0000

Author: Ask a PT
Subject: preemie twins
Posted: Mar 10 2010 at 9:31am

Our user asked: "birth to preemie twins at 33 weeks. Now, at 5mos, one of them has not turned over yet. He seems to get his hands in the way or end up trying to push himself from his stomach. What can I do to help him? At what point should I have him evaluated? (if he is evaluated to early and denied services, he cannot be reevaluated for another 6 mos - in NY)"

Ask a PT Response: "My suggestion would be for you to have a more thorough discussion with your child's pediatrician and together develop a plan. The pediatrician will be able to give you much better insight for what to do, as he or she will already be familiar with your son and what his issues are. I wish you and your son the best."

Student Discussion : PT Education

Wed, 10 Mar 2010 09:29:40 +0000

Author: Ask a PT
Subject: PT Education
Posted: Mar 10 2010 at 9:29am

Our user asked: "Hi, I've recently taken an interest to becoming a physical therapist. I understand that it takes about six years to become a therapist. My plan is to first earn an Associate's degree to become a physical therapist's assitant and continue on until I've earned my Masters. Would you recommend this plan or would completing school while working as an assitant and raising kids be too complicated? Any better suggestions? Thank you for your time."

Ask a PT Response: "Obtaining a degree in physical therapy now requires a doctorate degree. From my understanding, in order to apply to a doctorate program you must first obtain an undergraduate degree. Though, having a PTA degree may be advantageous for experience once you are accepted into a DPT program, you will nevertheless still be required to obtain a bachelors degree and take various courses which are prerequisites for admission to DPT programs. Perhaps it may be a good idea for you to speak with a counselor or admissions coordinator of a PT school which you are interested in attending to obtain more detailed information. As far as your question goes about it being too complicated, I would say it would depend on the person, support available and his/her situation. When I was in PT school, I had classmates who worked part time, took care of children and attended PT school and were able to succeed. I hope this helps and I wish you the best of luck in your endeavors."

Orthopedics : Description of eversion and inversion

Tue, 09 Mar 2010 14:00:55 +0000

Author: Ask a PT
Subject: Description of eversion and inversion
Posted: Mar 09 2010 at 2:00pm

Our user asked: "Could you please explain what eversion and inversion means with respect to the ankle, with someone who has suffered a subtalor fusion?"

Ask a PT Response: "At the subtalar joint in non-weight bearing supination is the result of calcaneal inversion, plantarflexion and adduction. Pronation is the result of calcaneal eversion, dorsiflexion, and abduction.

At the subtalar joint in weight bearing supination is the result of calcaneal inversion, talar abduction and dorsiflexion. Pronation is the result of calcaneal eversion, talar adduction and plantarflexion.

When a patient undergoes an isolated subtalar fusion (arthrodesis) range of motion for both pronation and supination will be lost but not entirely as motion at the midtarsal joint can accomodate for these movements. Some studies have shown that an isolated subtalar joint arthrodesis limits talonavicular motion to about 26 percent and calcaneocuboid motion to about 56 percent. The percentage of restriction of motion obviously depends upon the position of the bones being fused. If the subtalar joint underwent fusion in supination, one would expect more restriction of the calcaneocuboid and talonavicular joints. Alternatively, if the subtalar joint underwent fusion in pronation, surgeons would expect more motion of the midtarsal complex (1). I hope this helps."

Hip, Buttock & Groin Injuries/Conditions : RA in knee put hips, back out...

Tue, 09 Mar 2010 13:57:09 +0000

Author: Ask a PT
Subject: RA in knee put hips, back out...
Posted: Mar 09 2010 at 1:57pm

Our user asked: "Three years ago my knee began going bad. X-rayed. Doc said early RA. I go up and down stairs 4-5 times a day at work 3 days a week. Knee put hips out and now my back is killing me as well. One hip in particular seems worse with less mobility. I need to know what exercises I can safely do to get that hip mobility back. I can no longer bend my left leg even near my chest. There must be exercises to help that. I have no insurance period but will do exercises you suggest. And thank you for your help."

Ask a PT Response: "It would be difficult to determine which exercises would be appropriate for you without physically evaluating you. An evaluation would allow for a therapist to have a better understanding of your posture, strength (hips, core, lower extremities), flexibility, joint play, range of motion, etc.. so that a plan of care specific to your needs can be developed. For my patients that have flexibility issues at the hip I would usually prescribe to them various stretches such as piriformis stretch, ITB stretch, hip adductor/groin stretch, knee to chest stretch, and hip flexor stretch. Sample clips of how to perform these exercises can be found on our exercise videos page http://www.cyberpt.com/cptvidlist.asp . Another website that has good instruction for exercises can also be found on http://www.exrx.net/index.html . Prior to any form of self treatment it is recommended that you seek professional and medical advise from your physical therapist or physician. Best of luck to you."

Shoulder Injuries/Conditions : Suggestion 4 Supraspinatus/tendonitis/impingement

Mon, 08 Mar 2010 13:11:41 +0000

Author: Zokambaa
Subject: Suggestion 4 Supraspinatus/tendonitis/impingement
Posted: Mar 08 2010 at 1:11pm

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Shoulder Injuries/Conditions : Suggestion 4 Supraspinatus/tendonitis/impingement

Fri, 05 Mar 2010 09:34:37 +0000

Author: Zokambaa
Subject: Suggestion 4 Supraspinatus/tendonitis/impingement
Posted: Mar 05 2010 at 9:34am

Years ago I was doing chinups I am about 5'7 so any chinup bar tends to be quite wide.. so I was doing palms forward wide grip chin ups and it felt like something popped in my shoulder... I was used to what kind of felt like the bicep tendon flicking in the groove within some ranges of motion but this was completely different and very sharp

Hurt like hell for about 2-3 weeks but then got better, with occasional flare-ups..

I couldn't tell exactly where the injury was as it felt like it was in the back in some positions and in the front in others but the pain was deep in side the joint, almost like it was the socket itself.

Laying on my left side and raising my arm out to the side in front of me as well as crossing my right hand across the body to put on the outside of my left shoulder is still painful even years later... at the time I couldn't raise it without sharp pain.

It did get better after a couple weeks though... and rotator cuff exercises and a lot of stretching helped.

about 5 years later I was doing chinups again... same as before.. wide and to the front... and again something popped... this time it was just a dull ache... not nearly as sharp as before... so laying off it and again more stretching and rotator cuff stuff helped... doctors did an x-ray and said nothing was wrong and that I should go get an MRI if I want... (8+ months wait) so I said screw it and let it go... I didn't have thousands of dolars to pay to jump the line and get a MRI within the week like the pro athletes do

About a year ago I was in a motorcycle accident... fairly minor injuries and most of it below the waist... but after being on crutches for 2-3 weeks it flared up again... this time more of a constand dull ache in the joint... it gets worse and subsides but I am pretty much feeling it all the time... but it is liveable so far..

I am doing physio for the accident and they suggested I get an ultra-sound of the shoulder... and possibly a MRI afterward...

The ultrasound shows that my Supraspinatus has some tendonitis/scar tissue and when the area is agrivated there is some minor swelling, causing impingement as well

So hopefull insurance will take care of the quick MRI otherwise I have about 8 months to wait... so hopefully physio can do something in the mean time... I don't particularily like the idea of surgery on it.

The weird thing is I did a lot of the rotator cuff injury tests and either other muscles are taking over and alowing me to do them and not throw up flags for the various rotator cuff injuries or I have an unusually high pain threshold... I guess if I went immediately when the first injury happened it would have been a whole different story..

what would likely be the best stretch and excercise to do... to assist with this... I've heard conflicting opinions as to some common rotator stretches/exercises making it worse, then then other say they are great...

also is there a way I could manually massage the area on my own?... I find it hard to do myself and get around my deltoid and trapesius muscles... I still do have a fair amount of muscle to get through.

General Discussion : Total joint center

Thu, 04 Mar 2010 18:07:41 +0000

Author: jenelpt
Subject: Total joint center
Posted: Mar 04 2010 at 6:07pm

We are trying to become a total joint center at the hospital that I work at. Just looking for information about how other joint centers are set up.

How do you schedule group sessions?

How many patients at each session, time for each group?

How many therapists work with patients in a group setting?

How do you address patients who may need 2 assist with transfers and ambulation while still attending to the other patients in the group?

Any information on how shcdueling and session are set up would be most helpful to us during this transition! Thank you!

Arm, Elbow, Wrist & Hand Injuries/Conditions : arm pain

Thu, 04 Mar 2010 15:26:40 +0000

Author: Ask a PT
Subject: arm pain
Posted: Mar 04 2010 at 3:26pm

Our user asked: "Hello, I am a bowler and have recently been concerned with some pain in my upper forearm, elbow area. I have done more lifting weights than before. Sometimes for some reason, I have pain throughout my bicep and tricep area as well as my shoulder, should I quit bowling? Or just make sure ice it"? Thanks"

Ask a PT Response: "For all my patients who experience an increase in pain with an activity in which they are performing, I usually tell them to back off from that activity to allow for the injured area to heal. In your case it may be a good idea to back off from not only the bowling but lifting of weights as well. Icing and stretching the affected area is also recommended to my patients. After a period of rest, return to the activity which was resulting in pain would usually be gradual. Good luck to you."

Hip, Buttock & Groin Injuries/Conditions : strained hip flexor

Thu, 04 Mar 2010 15:24:36 +0000

Author: Ask a PT
Subject: strained hip flexor
Posted: Mar 04 2010 at 3:24pm

Our user asked: "My hip flexor has been bothering me for about 6 months. It never had an effect on my form so I tried to train through it. It never went away. I've taken 2 weeks completely off from running and cycling. I've gone on a few short easy walks with my dog and they haven't agrivated the injury. My condition has improved but I still have some pain when I lift my right straight towards my chest. I've been doing a lot of stretch already. Is it too early to start some strenghtening exercises? If so, can you recommend some? Also, is it ok for me to use the eliptical trainer? Will that make things worse or slow my recovery?"

Ask a PT Response: "With my patients who have inuries to the hip flexor I would have them work on stretching, strengthening, manual therapy, functional/postural training and modalities to the affected area. Progression of strengthening exercises can include: standing hip AROM exercises (no weight) -> supine/sidelying/prone hip exercises -> light resistive hip exercises with tubing or ankle weights in standing -> hip strengthening on machine -> functional based hip strengthening exercises. The elliptical can be performed by my patients for a short period of time (ie. <5min) which can be increased if there isn't an exacerbation of symptoms. Since you have been experiencing problems now for about 6 months and if your condition doesn't improve, it may be a good idea to consult a PT to determine what may be contributing to your injury and what can be done to help you improve and recover. Good luck."

Pediatric Injuries/Conditions : Hamstring Lengthening

Tue, 02 Mar 2010 21:36:08 +0000

Author: stuart miller
Subject: Hamstring Lengthening
Posted: Mar 02 2010 at 9:36pm

Thanks for the suggestions. I will try these and let you know what seems to work.

Stu