Common Aches and PainsWhat You Need To Know andWhat You Need To Know and

How Physical Therapy Can Help

Gretchen Roman, PT, DPT, ,

B k dBackground

Quinnipiac University, Hamden, CTBachelor of Science in Physical Therapy, 1996New York University, New York, NYMaster of Arts in Deafness Rehabilitation, 2000

G C C QLaGuardia Community College, Queens, NYCertificate in ASL/English Interpreting, 2003M h tt G l H it l I tit t fMassachusetts General Hospital Institute of Health Professions, Boston, MADoctor of Physical Therapy 2009Doctor of Physical Therapy, 2009

Greater RochesterGreater Rochester Physical Therapy

Tobey Village Office Park140 Office Park WayPitt f d NY 14534Pittsford, NY 14534V: (585)370-7180www grpt comwww.grpt.comgroman@grpt.com

Physical Therapy Services

Orthopaedics– Shoulder

Elb

Post-Surgical RehabilitationWomen’s Health– Elbow

– Wrist– Hand

Women s HealthGeriatrics

– Finger/Thumb– Spine– Pelvis– Hip– Knee– Foot/Ankle

Sh ldShoulder

Sh ldShoulder

Rotator Cuff TendonitisShoulder ImpingementBicipitalBicipital TendonitisBursitis

Sh ldShoulder

Rotator Cuff Anatomy– SupraspinatusSupraspinatus– Infraspinatus– Teres MinorTeres Minor

– Subscapularis

Sh ldShoulder

Subacromial and Subdeltoid BursitisBursa= sac of fluid that serves as a gliding surface to reduce

f i tifriction

Sh ldShoulder

The shoulder complex is comprised of 4different joints:

1) Scapulothoracic joint2) Glenohumeral joint3) A i l i l j i t3) Acromioclavicular joint4) Sternoclavicular joint

P t S i l Sh ldPost-Surgical Shoulder

Rotator Cuff Repair

Shoulder DecompressionShoulder Decompressiondistal clavicle excision and/or acromioplasty

Sh ld E iShoulder Exercises

S iSpine

7 Cervical Vertebrae12 Thoracic Vertebrae5 Lumbar Vertebrae

24 TOTAL

S iSpine

Spinal StenosisDisc Herniation

Muscular StrainScoliosis

S iSpine

Disc BulgeDisc HerniationDegenerative Disc Disease (DDD)D ti J i tDegenerative Joint Disease (DJD)

S iSpine

Disc HerniationAnnulus Fibrosus

Disc Bulge

Tear in the annulus and the nucleus pulposus seeps out

Disc BulgeA bulging of the annulus

Nucleus Pulposus

S iSpine

S iSpine

Jelly Donut

P t S i l N k/B kPost-Surgical Neck/Back

Spinal FusionSpinal Laminectomy

N k E i & T t tNeck Exercises & Treatment

B k E i & T t tBack Exercises & Treatment

KKnee

KKnee

Knee Osteoarthritis

KKnee

Patellafemoral Syndrome

KKnee

Medial or Lateral Meniscal Injury

KKnee

SPRAINLigaments connect b t b

STRAINTendons connect

l t b bone to bone– Anterior Cruciate

Ligament (ACL)

muscle to bone

– Posterior Cruciate Ligament (PCL)

– Lateral Cruciate Ligament (LCL)

– Medical Cruciate Ligament (MCL)g ( )

KKnee

Patella Tendonitis

P t S i l KPost-Surgical Knee

Total Knee ReplacementReplacement

K E i & T t tKnee Exercises & Treatment

W ’ H lthWomen’s Health

Prenatal/PostpartumPrenatal/PostpartumOsteoporosisBreast CancerBreast Cancer– post-lumpectomy– post-mastectomy– post-mastectomy– secondary lymphedema

G i t iGeriatrics

Fall Prevention for Community yDwelling Elderly

EXERCISE!EXERCISE!Be Proactive About Managing Your Health

CardioFlexibilityFlexibilityStrengthening

Ph i l B fit f E iPhysical Benefits of Exercise

Enhances capacity to perform physical work, reducing chance of injuryImproves strength and muscle toneImproves tolerance for physical stressp p yImproves ability to sleep and the quality of sleeppHelps stabilize or maintain weight

P h l i l B fit f E iPsychological Benefits of Exercise

Serves as a powerful stress management strategyEnhances feelings of emotional well-beingIncreases feelings of self-esteemImproves body imagep y gIncreases ability to exert self-control

B d M I d (BMI) Ch tBody Mass Index (BMI) Chart

Di t ADirect Access

As of November 23, 2006, it became legal for a physical therapist with 3 years experience to treat a patient without a referral from a physicianpatient without a referral from a physician. Treatment, not including evaluation, can proceed for 10 visits or 30 days whichever comes first before a referral must be obtained to continue physicalreferral must be obtained to continue physical therapy treatment.

Regardless of this change in our practice act No faultRegardless of this change in our practice act, No-fault, Worker's compensation, and Medicare patients will continue to need a referral for payment.

R fReferencesAmerican Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00213 Accessed on January 16, 2011.htt // d / d /di i i f ti /k di dhttp://www.emedx.com/emedx/diagnosis_information/knee_disorders/knee_osteoarthritis_tka_xrays.htm Accessed on January 16, 2011.UW Medicine Orthopaedics and Sports Medicine. p phttp://www.orthop.washington.edu/totalknee Accessed on January 16, 2011.Greater Rochester Physical Therapy. www.grpt.com Accessed on January 16 2011January 16, 2011.Mayo Clinic. http://www.mayoclinic.org Accessed on January 16, 2011.University of Buffalo. http://www.ubsportsmed.buffalo.edu/education/pattend.html Accessed on January 17, 2011.

R fReferencesDynamic Rehab. http://www.dynamicrehab.com/pdf/Do%20I%20Need%20Surgery.pdf Accessed on January 16, 2011.B d Sh i TiBody Shaping Tips. http://www.bodyshapingtips.com/body_mass/bmi_chart/ Accessed on January 16, 2011.Active Edge. http://www.activedgewi.com/exercise archives.htmg p g _Accessed on January 16, 2011.Spine Universe. http://www.spineuniverse.com/conditions/herniated-disc/herniated-bulging discs Accessed on January 16 2011bulging-discs Accessed on January 16, 2011.Hoppenfeld, Stanley. Physical Examination of the Spine and Extremities, Appleton and Lange, Connecticut: 1976.

Th k !!Thank you!!