When looking at wellness holistically, mental health is as central to the complete picture as weight, inflammation, energy levels, and immunity response. As part of your medical professionals team, physical therapists welcome the opportunity to help manage optimal mental health along with physical health.

In characterizing physical therapy, it’s natural to focus on the physical benefits of treatment, such as increased range of motion, strength, and stability. However, the overarching goal of physical therapy is to optimize overall health, wellness, and function. To do that, we can’t ignore the central role the brain plays in healing the body.

While a physical therapist (PT) does not replace a mental health professional (therapist, psychologist, psychiatrist), there are many ways your PT can be part of your mental health management regimen, particularly for the most common issues such as anxiety and depression. 

Help you Understand the Importance of Exercise

There are countless studies concluding the positive benefits of exercise, such as improved body image, increased energy levels, reduced stress, elevated mood, better sleep, and higher self-confidence. Exercise is also a central component of most mental health treatment plans. 

Design an Exercise Plan

Getting started with exercise is challenging. Sticking with it is even more difficult if you have physical obstacles that cause pain or limit your range of motion. This is where your PT shines as a key player in your mental health treatment strategy. At your initial visit, your PT will evaluate your physical state and identify areas that are posing challenges. From there, your PT will design a program tailored to meet your specific needs. Roping a PT into your medical team adds a layer of support to help you reach your physical, as well as mental goals. 

Cope with Stress

Stress comes from a variety of sources. Exercise helps mitigate the everyday stress we all face from life pressures and busy schedules. Dealing with physical challenges that limit your ability to exercise only adds to that stress. In addition, you may be addressing anxiety following or preceding surgery, or reeling from the shock of an accident or injury. Chronic pain commonly leads to feelings of depression and even desperation.

Your PT is an important tool in maneuvering through those feelings. He or she will meet you wherever you’re at in regards to your fitness abilities. They will create a plan that will get you moving again while considering your limitations. In short, there is an exercise plan for every ‘body’ and your PT will help identify it so you can reap the stress-reducing rewards.  

Other Mental Health Benefits of Physical Therapy

Increasing movement comes full circle with better sleep, more self-confidence, lower stress, and thus, better mental health stability (as part of an overall treatment plan). But physical therapy offers other mental health benefits beyond increasing mobility and strength. For example, consistency is another pillar of mental health. Regular appointments offer structure through face-to-face interactions and routine home exercises.

In addition, physical therapy aids in managing pain. As stated previously, chronic pain can be a deterrent to exercise, and a primary contributor to depression. Addressing the core issues of the pain can improve the ability to cope with the associated mental health aspects. 

In a more general sense, physical therapy empowers the patient with hope, a plan, and a better understanding of their condition and the requirements to reach their goals. 

Physical therapists are one piece of the mental health treatment puzzle. Inasmuch, they are skilled at communicating with other health professionals and members of your support team. For example, a PT may understand and respond to the effect of certain medications your doctor prescribes. Similarly, your PT can work with your personal trainer to identify appropriate exercises that are in alignment with your goals.  

Wherever you are on your physical and mental health journey, tapping into the resources at Encore Physical Therapy can provide you with the assessment, support, and guidance you need to keep your mental health on track.

It’s easy to fall into a bit of a slump when physical ailments keep you from spending your days the way you’d like. But healing rarely happens on our preferred timeline. So when surgery or an injury has you down, take the opportunity to try new things. Here are some ideas to get you started.

1. Read

The world is an adventure in the pages of a book. You can get into a popular fiction series or read about a subject you’re interested in from the nonfiction section. Short stories, plays, poems, and magazines are all options too. Audiobooks count as well.

2. Needlework

Make gifts or simply practice a new craft. Try out embroidery or get a counted cross-stitch kit at the craft store. Keep your hands busy with crochet or knitting. Practice sewing or quilt making. If you’re really bored, you could always work on the mending pile.

3. Take a Class

Speaking of learning new skills, when you’re laid up is the perfect time to delve into something with your full attention. Consider music, history, writing, math, interior design, or any other topic you’re interested in. There are many options online so sign up before surgery and make sure you have the materials you need.

4. Movie Marathon

Whether you’re up to date with the newest Netflix releases or you find you rarely have time to complete a show, movies and TV series help pass the time. You can watch documentaries for intellectual stimulation or delve into a list of movies you’ve always intended to see.

5. Work a Puzzle

Puzzles can be completed while sitting at a table. But if your recovery requires you to keep a leg in the air, you can still work small puzzles or work them in sections using a TV tray. Puzzle books work too so load up on word searches, Sudoku, and crossword puzzles.

6. Get Organized

Daily life is hectic. But when recovery slows things down, take advantage of the opportunity to get organized. While you might not be able to gut the pantry or reorganize your closet by yourself, you could with an extra set of hands to help. When you’re flying solo, you can clean out the recipe box and create a monthly meal plan, complete with ingredient lists. You could also use your time to put together picture albums, scrapbooks or digital frames. It’s also a good time to get your financial life in order. Pay bills, order checks, make a budget, and organize paperwork for the next tax season.

7. Papercrafts

Right along with scrapbooking, you can learn origami, make paper snowflakes with the kids, or design and put together greeting cards so you have them for every upcoming occasion.

8. Podcasts

There’s a podcast for just about every category of interest and they’re free with a smartphone app. Try a few. Look for science, history, business startup, comedy, quirky, self-help, and so much more.

9. Learn Magic

While the magic might not make you heal faster, it will help pass the time. Entertain yourself and others with some basic magic, including card tricks.

10. Wood Carving

If it’s within your restrictions, use those idol hands to create wood carvings. Start with soft balsa wood and move into pine or cedar once you master the basic technique. Try your hand at wooden toys, a keychain, or animal figurines.

11. Learn an Instrument

Again, you’ll have to see what works with your specific recovery, but if allowed, consider piano, guitar, harmonica, flute, or even the drums. There’s no time like the present.

12. Plan Ahead

Pinterest is the perfect time thief. Use it to collect ideas for future home improvement projects. Then research costs and create a timeline and budget for the projects on your wishlist. Similarly, use the time to plan out your next vacation, complete with budget and itinerary.

13. Journal

Even if your injury only has you laid up for a few days, keeping a journal will help you remember the date it happened and your state of mind during recovery. A journal after a major event can help you process emotions, keep you organized, and provide a record for medical professionals who ask about your experience.

14. Learn a New Language

Aprender español, apprends le français, or lerne Deutsch. Between podcasts, online resources, and language apps, there’s no better time to learn a second, or third, language.

15. Connect with a Community

It’s not easy to have your life turned upside down from an unexpected surgery or injury. Give yourself a break and surround yourself with others who know and understand what you’re going through. Identify online communities where you can find support. Also rely on the resources in your own community, such as your surgeon, family doctor, in-home nurse, physical therapist, mental health therapist, Doordash delivery, grocery delivery, and Uber drivers.

16. Meditate

Meditation is a learned skill. While you’re on the mend, use the time to become a student of the art. Start with short 1-5 minute guided meditations and work up to longer options. You’ll find a vast array of topics to meditate on, from stress reduction to sleep to healing. Check out Headspace or Insight Timer to get started.

17. Exercise

Once you’ve been given the green light to exercise, follow the guidance of your medical team. It might be simple movements in your chair or bed. For other injuries, exercise might mean walking short distances. Whatever it is, check with your physical therapist or doctor if you have any doubts about how or how often to perform the tasks. Also make contact if your condition worsens or you can’t keep pain under control. 

Remember each hour and every movement brings you one step closer to healing so you can get back to other activities you’ve had to shelve in the short term. 

Nearly everyone has experienced acute pain at some point in their lives. It might even be a condition that lasted days, weeks, or months. Acute pain, however, does stop at some point. Chronic pain, on the other hand, is unrelenting. It can be defined by pain that lasts longer than six months, but that’s really just a guideline.

In reality, chronic pain is a way of life for millions of people and coping with it requires a commitment to a lifestyle that encompasses more than just a treatment. Physical therapy is one component of that lifestyle that, in combination with other therapies, can add to the tool kit of coping mechanisms when dealing with chronic pain. If you or someone you love is dealing with chronic pain as a result of injury or disease, a well-rounded approach can significantly improve quality of life.

Reduce Stress

There have been many studies (such as this one) that conclude stress and chronic pain are intertwined on various levels. At the most basic level, stress contributes to tight muscles, which in turn, contributes to increased pain. Similarly, the long-term effects of chronic stress cause the body to release hormones, such as cortisol, that cause inflammation in the body. Medical professionals agree finding ways to reduce and manage stress is essential for overall health, especially when dealing with chronic pain. 

Eat Healthy

Food holds an incredible power in contributing to sickness or health. Since each body is different, there’s no right or wrong diet, but there are commonly problematic foods like dairy and gluten that can trigger inflammation in the body. Most doctors and dieticians recommend a diet high in fruits and vegetables, nuts, whole grains, and other plant-based foods and low in alcohol, sugar, fat, processed and fast foods. Talk with your medical professional about the best plan for you.

Move Often

It seems counterintuitive to move when it hurts to move, and it’s fair to say you should be careful because there are movements that can cause you more harm than good depending on the type of pain you’re dealing with. However, in general, exercise is good. You don’t have to hit the gym or spend all day doing push-ups, but a focus on being active benefits the body and the mind. Again, talk with your doctor and your physical therapist about what’s right for you.

Adjust Hobbies

Chronic pain has a way of bringing the focus towards those things we can no longer do. While it’s not ideal to have to give up the sports and other activities you love, try to embrace the opportunity to try new things. Replace problem-activities that cause flare ups with new hobbies such as painting, reading, taking classes, working puzzles, crafting, and learning a new language.

Give Yourself a Break

Dealing with chronic illness and pain takes a lot out of a person. It affects every aspect of a person’s life, from relationships to work to how you spend your leisure time. In addition to pain, you’re likely dealing with grief, depression, anxiety, guilt, and a host of other emotions. Give yourself a break. Not everyone will understand what you’re dealing with, so you’ll need to be your own best friend. Make self-care a priority and treat yourself kindly. 

Get Help

Having to constantly explain your situation is exhausting. You need support in your battle with chronic pain so make sure you keep the conversation current with family and your medical team. Set and keep appointments with the dentist, eye doctor, physician, specialists, and physical therapist. Find a reliable massage therapist. Allow friends and family to help when they offer to run the kids around or clean the house. Subscribe to a food service a few times a month. In other words, do what you need to do to reduce stress while providing care for yourself and your family. 

How Physical Therapy Can Help

Coping with chronic pain is all about finding a consistent pattern of behaviors that work for you and sticking with it. Introduce one thing at a time and within a few months you’ll be working towards a calendar with space etched out for meditation, relaxation, complete and restorative sleep, a healthy diet, regular movement, and doctor’s appointments. 

For the physical therapy component, treatment depends on your condition but can include ways to correct movement patterns, strengthen weak muscles and stretch tight ones, ice/heat, and massage. In addition, your PT can help create a plan for safe exercise and provide advice on how to best address occupational and recreational activities.

Read more about other people’s experience with chronic pain here: https://creakyjoints.org/support/things-you-only-understand-if-have-chronic-pain/

 

That feeling of your knee “giving out” or throbbing with pain are two very common patient complaints. Your knees work hard, so it’s no surprise either or both react to the workload. There are a myriad  of reasons for knee pain and many ways physical therapy (PT) can help improve or resolve it.

Types of Pain

There are three main categories of pain. Acute pain is the severe pain right after an injury. Sub-acute pain can kick in a few weeks after the injury and can last up to six months. Chronic pain is discomfort that lasts past the six-month mark.

Recommended Treatment Response

During the acute period, lean into the RICE treatment, which means rest, ice, compression, and elevation. The goal is to give your knee a chance to heal before asking it to perform movements and carry weight. 

During the sub-acute pain period, introduce gentle movement to improve mobility. 

Along the way, keep in touch with your medical professionals, who will evaluate your range of motion and pain levels, among other things. They may request imaging if there is concern over damage to muscles, ligaments, tendons, or bones. Chronic pain often persists even after the core issue has been addressed, but if you haven’t already, now is the time for a thorough evaluation and assessment from your medical professional. 

At any point along the way, your physician may recommend physical therapy to help improve mobility and rebuild strength. 

Types of Knee Injuries

From cartilage wearing down to ligament tears, the knees can suffer a host of injuries such as:

• ACL tear
• PCL injury
• MCL damage
• Osteoarthrosis
• Patellar instability
• Patellofemoral stress syndrome (PFSS)
• Iliotibial band (ITB) stress
• Hamstring strain
• Baker’s cyst
• Bursitis
• Sprains and strains

Symptoms to Watch for

In addition to pain, there are other indicators of knee injury or instability to pay attention to. Seek medical advice if you have symptoms such as locking, catching, or clicking when you bend your knee, a popping sensation when you twist or bend the knee, or an inability to straighten the knee completely.

What to Expect From Your PT Appointment

Your physical therapist will ask a range of questions regarding the initial injury, how long it’s been bothering you, if you’ve had similar issues in the past, what seems to help or exacerbate the problem, and what diagnosis and treatment you’ve already received.

He or she will then test your gait, range of motion, strength, balance, and physical structures of the knee. They will complete a comprehensive assessment of your entire lower extremity from your hips to your feet.

PT Strengthening and Exercise 

Although the movements may seem small, physical therapy exercises target the problem area, slowly strengthening muscles and increasing mobility. Your PT will work you through a variety of exercises at your appointment and send additional activities home with you. They may also offer pain-relieving therapies like electric stimulation, kinesiology taping, heat and ice application, soft tissue massage, or bracing.

Your PT can walk you through proper technique for strengthening, mobility, and balance exercises so you can improve without causing further injury. 

This might include exercises like:

• Straight leg raises to the front, side, or back
• Exercises to strengthen your hips
• Stretches for targeted muscles in the lower extremities
• Knee lifts
• Hip rotations
• Mini-squats with or without aids
• Hip flexion, extension or abduction exercises
• Hamstring curls
• Hip bridge
• Step exercises

Working with your physical therapist regarding knee pain and instability can not only improve your current pain level and mobility issues, but can help you maintain the strength and control to avoid strains and injuries in the future. Once your knee instability and pain have improved and you get the green light from your doctor or PT, try low impact activities like yoga, swimming, walking, and tai chi to keep the progress going.

To get started, give Encore a call today to see how we can help with your knee pain and instability. 

Sources:

https://www.healthline.com/health/types-of-pain

https://www.webmd.com/pain-management/knee-pain/injury-knee-pain-16/slideshow-knee-exercises

If you’ve had a nagging pain in your shoulder or can’t quite reach the top shelf lately, you may be suffering from frozen shoulder.

What is Frozen Shoulder?

Adhesive capsulitis, commonly known as frozen shoulder, is a common ailment. As the name implies, frozen shoulder presents with extreme stiffness and limited range of motion in the shoulder joint. Typically the stiffness begins gradually and then becomes more severe. During this early freezing stage, patients experience pain and their range of motion becomes more restrictive. 

In the next stage, called the frozen stage, the range of motion becomes so limited that patients may not be able to lift their arm above their head. Typically pain begins to decrease at this point, even though the range of motion becomes worse. Finally, the thawing stage will see some improvement in range of motion as the shoulder starts to relax again.

Moving through the stages is a long process. The freezing stage can last months and the frozen and thawing stages can take one to three years to completely get back to normal.

Causes

There is no single direct cause for frozen shoulder, but according to the Mayo Clinic, it is more common in diabetics, those with thyroid issues, and patients recovering from ailments that limit movement of the arm. It can also stem from a mild injury caused by something as simple as throwing a ball or catching your arm on a wall while walking. Adhesive capsulitis is more common in women than men and most commonly affects patients between the ages of 40 and 60.

Diagnosis

Your doctor can typically diagnose adhesive capsulitis with a physical exam. However, he or she may order imaging tests just to make sure there isn’t something else going on. During your exam, your doctor will ask you to move your arm in different directions to evaluate your range of motion and level of pain. He or she will likely also provide counterpressure, asking you to push against their hands in different directions. This helps identify whether the problem lies in a muscle, tendon, or ligament rather than the shoulder joint. It helps eliminate other common shoulder injuries like a torn rotator cuff.

Treatment

Your doctor may tell you to take a consistent dose of ibuprofen to help with inflammation and pain. Ice and heat can help at home too. Your doctor may also suggest a cortisone shot, which is administered into the shoulder joint capsule.

Movement

Part of the reason your doctor may recommend physical therapy is to keep your shoulder from freezing up in the first place. Doctors commonly recommend range-of-motion exercises that can help keep frozen shoulder from settling in, but if it’s already limiting you, movement is still the best treatment. 

Physical Therapy

Improving your range of motion can begin during any stage of frozen shoulder. Your physical therapist will walk you through exercises like the following to improve your range of motion. He or she may also use heat to relax the muscles before stretching and other techniques to help with pain, inflammation, and limited movement. 

Wall Walk

Standing a comfortable distance from a wall, place both hands on the wall in front of you. Use your fingers to walk up the wall as far as you can without serious pain.

Shoulder Rotation

Stabilize yourself while leaning forward 90 degrees, allowing your arms to hang naturally. Your shoulder may not allow your arm to hang straight. Regardless, move your hand in a circular motion, increasing the size of the circle as your range of motion improves. 

Door Stretch

Start facing the side of a doorway with your elbow bent at 90 degrees and the hand of your affected shoulder pressing against the inside or outside of the door jamb. Then rotate your body away from your arm for a gentle stretch.

Crossover Stretch

Sitting upright or laying on your back, use your unaffected arm to pull your affected arm across your chest. Hold for 10-15 seconds for a deep stretch and release slowly.

 

If you’re experiencing frozen shoulder, give Encore Physical Therapy a call to see how we can help.  

Sources:

Mayo Clinic, Frozen Shoulder, https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/symptoms-causes/syc-20372684

Ortho Infor, Frozen Shoulder, https://orthoinfo.aaos.org/en/diseases–conditions/frozen-shoulder/