What is the Proper Way to Sit at Work?

This would NOT be the proper posture at work, but we see it everyday.  Many of my patients complain of pain at work and their job activities is one thing that increases their pain.  Those who sit at a desk for most of their day at work usually have multiple ergonomic flaws at their workplace and desk.  For most people when your workplace is ergonomically assessed, it may look like this:

Research has shown that the majority of complaints from working at a desk with poor ergonomics are:  eye strain, shoulder, back pain, arm, wrist, and neck pain.  Do you ever experience any of these while working at your desk?  We all do.  So what can we do about it?  A thorough ergonomic assessment and patient education has been shown to help reduce neck, shoulder, and back pain at a desk workplace.  An ergonomic station assessment can be done by assessing the workstation layout, task-work methods, and correct positioning of the video display and keyboard.  This would be an example of proper posture at a desk:

General guidelines:

1.  Task - Work Methods

One simple adjustment, away for the desk, is to avoid poor lifting technique and repetitive lifting.  This can predispose you to low  back pain.  Also try to avoid prolonged awkward postures, below the waist or overhead lifting, trunk twisting, and excessive reaching.

2.  Workstation Layout

Keep items on your desk within a close work station to avoid repetitive out-stretched reaching.  Below is a picture with a general layout of what your work station should look like.

3.  Video Display

Make sure the video screen is at eye level and within a close distance from your eyes.  The screen should also be directly in front of you so there is no need to constantly turn head.

4.  Keyboard and Mouse

The keyboard should be on a stable surface at the appropriate height allowing your wrist to be in a neutral position.  Elbows and forearms should not be in contact with a hard edged surface.  Your wrist position for the mouse should be in a neutral position.

5.  Chair

Your chair should have proper lumbar and spine suppport.  The arm rest should allow your shoulders and forearms to rest and aligned you wrist properly with your keyboard.  The seat height should be proper so the seat is not pushing into the back of your knees and your feet are resting on the ground.

6.  Phone

If you notice that your phone is on the right side of your desk and you constantly are experiencing right sided neck pain, this may be due to the phone.  To solve this problem many companies are going to a head set to avoid the awkward positions the telephone is causing.

Summary:

Having a workplace ergonomic assessment may help you get out of pain that your desk and work posture is causing you.  Ergonomic corrections, physical therapy, and patient education should resolve you pain.  Remember, you can get all of the treatment you want for your neck, should and back pain, but if the cause of it is never addressed, then your symptoms will continue to return.  Contact Pursuit Physical Therapy for an ergonomic assessment at 407-494-8835 and we can help you get out of pain and make sure it never returns.

New Pursuit Physical Therapy Website Layout!

Visit www.PursuitTherapy.com and see our new website layout.  New design, new picutres and updated information.  Don't for get to see the Top 10 Reasons to go to Pursuit Physical Therapy!  Let us know what you think?

Top 10 Reasons to go to Pursuit Physical Therapy: BONUS: Better Outcomes, Faster Results, Period!

BONUS:  Better Outcomes, Faster Results, Period!

Perhaps the most essential and significant reason for any patient to not hesitate in seeking out therapy at Pursuit Physical Therapy is quite straight forward and unpretentious—Patients see better outcomes, exponentially quicker results, and most important to the patient, Pursuit Physical Therapy adapts and customizes to each individual to ensure they get back to their activities and passions faster, pain free!  We get results!

For example, here is a case:  A patient complains of left Achilles pain after Cross Fit training.  Patient was pain free after one treatment session and home exercise program by the end of the 1st week.  After the second treatment session, the patient was pain free with exercise, and returned to Cross Fit workouts and running pain free at the end of the 2nd week.  Pain free and back to training in 2 weeks!  Visit www.PursuitTherapy.com for more information and call us at 407-494-8835 to schedule today!

  

How do you Diagnose Plantar Fasciitis?

The diagnosis of plantar fasciitis can be made with a reasonable level of certainty in the clinic by an experienced clinician after a history and examination.  Diagnostic testing (x-rays and MRI) usually do not need to be ordered to diagnose plantar fasciitis and normally should not be ordered unless the diagnosis is uncertain or the patient is not responding to treatment.

Signs and Symptoms of plantar fasciitis are:
1.   insidious onset of pain under the plantar surface of the heel upon weight bearing after a period of non-weight bearing
2.  This pain in the plantar heel region is most noticeable in the morning with the first steps after waking or after a period of inactivity
3.  In some cases, the pain is so severe that it results in an antalgic gait.
4.  Heel pain will lessen with increasing levels of activity (ie, walking, running), but will tend to worsen toward the end of the day
5.  The history usually indicates that there has been a recent change in activity level, such as increased distance with walking or running, or an employment change that requires more time standing or walking
6.   In most cases the patient will initially complain of sharp, localized pain under the medial heel as in the picture above

There are some other differential diagnoses that can be ruled out during the examination that include:  stress fractures, bone bruise, heel fat pad atrophy, nerve entrapments, and referred pain from the lumbar spine.

The good news is that >80% of plantar fasciitis symptoms resolve within a 12 month period.  But who wants to wait 12 months to be pain free!  Schedule your visit at Pursuit Physical Therapy 407-494-8835 and resolve your heel pain now!  No injections, no medication, no surgery, no problem!  We can get you back to the activities you love pain free!

What are the Risk Factors that can cause Plantar Fasciitis?

The cause of plantar fasciitis is multi-factoral and actually poorly understood, but here are some risk factors that have been proven to contribute to the cause plantar fasciits:

1.  Decreased ankle range of motion.  A decrease in ankle dorsiflexion has been shown to be a high risk factor for plantar fasciits.  This can be caused by dysfunction at the ankle joint or due to calf muscle tightness.  Many people are lacking the amount of range of motion(ROM)  needed.  The picture below shows an example of normal ROM

2.  Obesity and being overweight.  Increased body weight is a well established risk factor for plantar fasciitis because the increase weight causes and increase in stress to the plantar fascia.

3.  Work related prolonged standing.  Individuals who spend prolonged period of standing, walking, and work related weight bearing on their feet have an increased risk for plantar fasciitis.

4.  Training errors.  Overtraining, plyometrics, too rapid increase in distance, increase in intensity all can lead to the onset of plantar fasciitis.










There are many risk factors that many people believe to be the cause of plantar fasciitis but the presence of these factors to not always lead to the development of heel pain and plantar fasciitis.  Some of these factors are:

1.  Having flat feet or a high arch.  The research on this is not always consistent.  The risk of developing plantar fasciitis may increase with having a high arch or flat feet.  This is not always the cause though and this means that just because you may have flat feet does mean you will get plantar fasciitis.  Below is a picture of flat (hyperpronated) foot.  You can see how the arch is collapsed against the floor.

2.  Having a bone spur.  The presence of a heel spur is common is people without heel pain, and again, just because you have a bone spur on an x-ray does not mean that you will get heel pain or plantar fasciitis.  Bone spurs have found to be more common in older individuals, people with osteoarthritis, and those who are overweight.

Summary:

By understanding these risk factors you may be able to prevent plantar fasciitis from occurring or at least understand what factors have led you to experience your heel pain.  Remember just because you may have one of these factors doesn't mean you will get plantar fasciits.  Stay tuned to our next posts about diagnosis, prognosis, and what treatments are the best for plantar fasciitis.  If you are experiencing heel pain or plantar fasciitis symptoms contact Pursuit Physical Therapy now and get out of pain!

Here is an example of what one of our patients said who was experiencing plantar fasciitis:

Great physical therapist, I've tried EVERYTHING for my plantar fasciitis and gotten numerous injections, but Ron was the first doctor to actually look at my foot and asses the actual cause and show me how to fix it rather than just tell me to stop running and have it come back again!  I would definitely recommend him to anyone with any kind of sports injury!  He's great, PLEASE go see him!!!! He will be worth your time.  Best doctor I've seen hands down!  My foot is so much better! I'm running virtually pain free for the first time in 6 months.

Top 10 Reasons to go to Pursuit Physical Therapy: 10. No Miscellaneous Bills and Fees

#10.  No miscellaneous fees and random bills

Have you ever received a random medical bill 3 months later after you received treatment for an injury saying you owe $500 more?  I know!  You thought your insurance company was going to cover it?  One of the best reasons to not hesitate to set up your first appointment with Pursuit is you know exactly what you are paying for with each and every visit and we can guarantee the patient no miscellaneous, unexplainable fees or bills months after treatment has completed as with larger, insurance-based clinics. You will never be billed for additional specialist fees, equipment charges, or ‘complex therapy’ fees—no insurance ploys, just excellent service! We look forward to seeing you soon!  Visit www.PursuitTherapy.com today for more information or call 407-494-8835 to schedule today!

What is Plantar Fasciitis?

Have you ever experienced a sharp pain in the bottom of your heel when you step out of bed first thing in the morning?  Do you get heel pain when you run or from a long day standing at work?  Well, it is most likely a condition called plantar fasciitis and it is estimated over 2 million people experience plantar fasciitis each year.  The plantar fascia is a tight band of connective tissue that supports the arch of the foot.  Plantar fasciitis is thought to be caused by biomechanical overuse to the plantar fascia, thus creating microtears at its insertion of the heal.  Some experts have deemed this condition not an true tendinitis, implying that its etiology is a more chronic degenerative process versus acute inflammation.  Usually people will complain of a sharp pain on the bottom of their foot or pain closer towards their heel.

People state that walking, first stepping out of bed in the morning, walking after prolonged sitting, and running will cause their pain.   Usually people will report a decrease in pain after a warm-up or some stretching.   If you have a questions or concerns about plantar fasciitis feel free to visit www.PursuitTherapy.com or call 407-494-8835.  Stay tuned to see what are risk factors, diagnosis, and what is the best treatment!

Top 10 Reasons to go to Pursuit Physical Therapy: 9. Flexible Scheduling

9.  Flexible Scheduling

We offer extremely flexible hours of care for all patients. Pursuit Physical Therapy offers tailored schedules based on patients needs and their availability, first and foremost. Furthermore, our specialists can even accommodate weekend sessions if needed.

Top 10 Reasons to go to Pursuit Physical Therapy: 8. We Save You Time and Money

8.  We Will Save You Money and Time

Here at Pursuit Physical Therapy, we are dedicated to saving our patients their valuable time and money.   If you compare our private pay model vs an insurance based model, you still save money and time with our treatment approach.  Remember, there are no co-pays, unmet deductibles, and no miscellaneous bills with us.  Just one flat rate and you get better results in fewer visits.  If there is a possible way to use insurance benefits—such as flexible spending accounts—or for possible reimbursements, we will assist you to the absolute fullest ability. We can provide you with detailed paperwork for submitting claims to insurance companies. Also, there are applications available to apply your physical therapy sessions to your insurance deductible.  Call 407-494-8835 or visit www.PursuitTherapy.com to schedule today!

Why Do I Have Low Back Pain When I Golf? Can Physical Therapy Help?

This is for all of the great fathers out there for Father's Day, who are probably on the golf course right now, and who will make it home in time to watch the end of the U.S. Open!  Are you noticing that your golf scores are higher lately?  Are you starting to get low back pain (LBP) when golfing?  Have trouble beating your friends on the gold course now because of LBP?  Well, this is the blog post for you regarding golf and low back pain!  Do you know that common site of injury among professional and amateur golfers is the low back. Low back pain (LBP) is the most common injury and makes up roughly 25-50% of golf injuries.

Many of you are probably on the golf course right now with your friends, but what do we know about golfers with low back pain? Research shows that golfers with LBP have poor neuromuscular control to rotate at increased speeds. This is essential to a complex and powerful movement such as the golf swing. This is why after experiencing LBP it is essential to start physical therapy to retrain this neuromuscular control associated with the golf swing and to make sure your LBP does not return.  Not only is it about the low back when talking about golf and LBP, but what occurs at the hips and pelvis is also relevant.  Research has shown the low handicap golfers have increased pelvis rotation speed, increased hip muscle strength than high handicap golfers!  Both of these factors can be addressed with physical therapy.

The modern swing (vs the classical golf swing) is more popular with most golfers due to its increased power and distance produced. Increasing the hip to shoulder ratio with the modern swing can be problematic due to the increased stress placed on the low back, which may also predispose you to LBP. Also, the increase lateral bending and "reverse C posture" with your follow-through, as shown in the picture below, may also cause you to have LBP. 

These are factors all can be identified, treated, and be prevented from causing you to have LBP when playing golf.  Golfers with LBP have been shown to have decreased trunk and hip range of motion (ROM). What do you think happens when you perform a golf swing but you don't have enough ROM? The body will compensate at another joint causing increased and unwanted stress/load to the adjacent joint, predisposing it to injury.  For example, look at the importance of lead hip internal rotation needed for your follow through in this picture below. This could be one of many factors that is causing your LBP.

Many golfers suffer from LBP and this is something that physical therapy can help with.  Doing something as simple as warming up for 10 minutes prior to golfing can decrease your chance of injury by 50%!  Don't settle for having LBP ruin for golfing scores and the time you should be enjoying.  Call Pursuit Physical Therapy today at 407-494-8835 and be seen by our Titleist Performance Institute Certified clinician now!  We can help treat your LBP, address any biomechanical impairments that are influencing your pain, and get you back to pain free golfing! 

Visit our website at www.PursuitTherapy.com and even see what our golf specialty program has to offer.

Top 10 Reasons to go to Pursuit Physical Therapy: 7. Direct Access and No Physician Script Needed

7.  Direct Access and No Physician Script Needed

It is a misconstrued concept that a patient in pain or discomfort must first see a medical physician to be evaluated and then referred to physical therapy.   In Florida you have direct access so you can go directly to your physical therapist and there is no need to deal with waiting weeks to be seen, spending money on unnecessary diagnostic imaging, and taking another pain medication.  Patients have direct access to immediate care at Pursuit Physical Therapy—there is never a need to waste up to two weeks  or more on an ‘assumed diagnosis’ as well as the costs to cover co-payments and specialist fees. If you have an ache or ailment that is inconveniencing your normal routine, don’t settle for the pain any longer because Pursuit Physical Therapy can see you right away, no need to wait—and the only specialist you will need to see, is ours.  Call 407-494-8835 or visit www.PursuitTherapy.com today for more information

Top 10 Reasons to go to Pursuit Physical Therapy: 6. Better Outcomes in Fewer Visits

6.  Better Outcomes in Fewer Visits

It’s simple—Pursuit believes and strives for better patient outcomes with as few visits as necessary! Our therapists are standing by to begin your road to wellness!  Don’t settle for the standard 3x a week for 4 weeks.  Get out of pain now and get back to doing your favorite activities pain free.  Visit www.PursuitTherapy.com for more information.

Top 10 Reasons to go to Pursuit Physical Therapy: 5. Patient Satisfaction

5.  Passion for Patient Satisfaction

Patient care and satisfaction will always come first, guaranteed. At Pursuit Physical Therapy, each specialist is continuously passionate and apprehensive of their patients as well as their individual requirements and personal ambitions. Our specialists stay up to date with innovative techniques and most current physical therapy approaches possible; passionately, continuously, striving for optimal patient care is fundamental within this practice!  Look at what are patients are saying about their experience at Pursuit Physical Therapy on our testimonials, Yelp, Google Places, and Facebook pages.  

Top 10 Reasons People Should go to Pursuit Physical Therapy: 4. Unmatched Credentials

4.  Unmatched Credentials

Due to the credentials of our specialists, Pursuit Physical Therapy proposes a higher quality of treatment, to each and every patient. Treatment is always received by Doctors of Physical Therapy, and a board certified specialist. Within the practice we accommodate numerous athletic and rehabilitative needs, for instance, our very own Ron Miller, DPT, OCS has advantageously completed a post-doctoral residency in orthopedic physical therapy; moreover, he is Titleist Performance Institute Certified to treat golf-related injuries as well as to provide a full golf-swing analysis. Emphasizing on swing mechanics, posture, proper alignments of the body, as well as follow-through; all ultimately tailored to the individual player to optimize performance and minimize injury.  Call today to get seen by our Board Certified Specialists 407-494-8835 or visit www.PursuitTherapy.com for more information.