blog – Page 2 – Thrive Integrated Physical Therapy

COVID-19 ROAD TO RECOVERY: IMPROVING LUNG FUNCTION AND MOBILITY VIA TELEHEALTH

As a medical professional, I’ve watched with great concern as front-line medical personnel have taken the brunt of exposure to COVID-19. Recently, my physician, a man so full of life he practically sprinted down the hospital hallways, was struck down by the virus. After returning home from the hospital and a stint in the ICU, this once energetic man was unable to ambulate without the aid of a walker or take 20 steps without gasping for breath. Instead of seeing patients, his days were filled with home nursing visits, nebulizer treatments and walking exercises that were not improving his overall health. As a friend and colleague I asked myself, what techniques could I, as a physical therapist, utilize to help this patient recover? As it turns out, a lot.

When breathing becomes compromised as it does with COVID-19, patients not only have damaged lung tissue from the virus, but the muscles, diaphragm and ribs don’t operate properly making breathing even more difficult. Respiratory distress can prompt the muscular systems to overcompensate when trying to get air into the lungs. Muscles in the neck, like the scalenes, become overworked and the pectorals in the chest wall tighten, leading to poor posture. This results in a feedback loop where tight muscles then facilitate other muscle groups to weaken. Additionally, the extended period of bed rest that accompanies recovery further weakens muscles in the chest and intercostals (between your ribs). The result: stiffened, weak muscles and reduced movement of the diaphragm, which is responsible for a significant part of inspiration, or breath intake.

As a physical therapist working with a variety of cardiac and pulmonary patients, there are a number of treatment options we can deploy to help our patients recover from the severe impacts of this disease. Our treatments focus on getting the diaphragm, ribs, and the vertebrae in the spine to move better by instructing the patient on self-release techniques to gently mobilize stiff joints. We instruct patients on how to perform soft tissue releases and stretching of tight muscles, which allow the chest wall to expand and the diaphragm to move more effectively. We can then guide the patient to perform movement reeducation of the shoulder blade, thorax and core muscle recruitment. Coupling these techniques with guided breath work will then allow the patient is able to draw in and expel more air in with each breath.

Fortunately, all of this can be accomplished without the need for physical contact, limiting the spread of the disease. Working with my fallen hero via daily TeleHealth sessions I was able to guide him through self-administered rib and soft tissue stretches to release his diaphragm. Our daily exercises included diaphragmatic breathing to address stretching, strengthening and coordination of the upper neck and chest muscles. As the treatments progressed, he began to take more efficient breaths and his oxygen saturation rate improved from 89 to 96 percent at rest, with less supplemental oxygen.

Three weeks into his TeleHealth sessions, his lungs no longer “crackle” during examination. He is now able to walk the halls in his home, mostly without his walker. He can sit for hours in a chair and, with his oxygen by his side, he is doing modified yoga poses. Although he has a long road ahead, the gains he attained though physical therapy have been significant. He now says he is taking a deep breath and staying positive.

If you or someone you know is recovering from COVID-19, the team at Thrive Integrated Physical Therapy may be able to help with regaining lung function and mobility. Our Dynamic TeleHealth COVID-19 Program is available from all of our providers – please email us at info@thrivept.com for more information.

Amy McGorry, PT, DPT MTC, is a senior staff physical therapist at Thrive PT in NoHo New York. She received her Bachelor's of Science in physical therapy from SUNY Stony Brook in 1991 and earned her doctoral degree in physical therapy from the University of St. Augustine in 2011. In 2005 Amy, completed an advanced certification in Orthopedic Manual Joint Manipulation from the University of St. Augustine. In addition to her clinical skills, Dr. McGorry is a freelance news reporter for Channel 12 and contributes medical articles, short videos and slideshows to health and wellness websites.

THE UNANTICIPATED BENEFIT OF VIRTUAL PT

Hello All,

Tonight I write you from my home in Manhattan, it is 7pm and the clapping has begun. This apartment has historically been my family’s refuge. It is now also my exercise studio, my children’s school, my husband’s office. All this in 850 square feet. The disruption of normal life has made me pensive…my day to day was once large, it is now small. There is an absence of shared community, in the physical sense, and I’ve had time to reflect on it’s value. Specifically, I’ve thought much about what it means to go in to work at Thrive.

I have always loved my job at Thrive. I’ve worked there since 2014, and have been aware that I am one of the lucky who like going to work everyday. Physical therapy is a natural fit for a curious, chatty extrovert. However, I was unaware of how deeply I relied on the community fostered there until I was no longer among it. In times of strife, it has been a balm to see familiar faces of the staff, our patients, the other tenants in the building, and shop owners in our neighborhood. It made the big city feel manageable. How scary can Manhattan be if Carol at the coffee shop knows me by name? We at Thrive have grown with one another over many years, and have been a witness to one another’s healing, growth, fragility, and humor. I have realized that “job” does not describe, for me, what I do there. The work is more shared, more communal than that word implies. We, patients and staff alike, are part of a collective. It is our purpose as employees to foster and serve that community. In turn, our patients have nurtured our curiosity, propelled us towards growth, and provided comfort in human interaction. WOW!

virtual pt telehealth teletherapy So, in recognition of our loss, temporary though it may be, what is there to be gained? What can we learn about ourselves as we transition to work online? How can we continue to support one another as a community if not sharing physical space? How can we, as physical therapists, help our patients maintain their health and wellness virtually?

In a broad sense, I have been amazed at the continued support that the Thrive staff has provided and received since our physical closure. I find myself in regular communication with my patients, and am bolstered each time I hear from them. They have emailed me: recipes, educational websites for children, mindfulness apps, yoga flows to calm you down, yoga flows to pump you up, books for when you’re sad, books for when you’re happy, books for when you’re too tired to read hard books, podcasts, TED Talks, and no less than 50 assorted Netflix suggestions. They’ve emailed to talk about their medical issues, but also their musings on this weird ride we’re on. Truly, this experience is universal. As such, our need for connection is. At least for me, my connection to the Thrive community is alive still, just moved to a more virtual platform.

As an individual, what can be gained from virtual PT? Perhaps surprisingly, quite a bit. An interesting shift has happened. When conducting a virtual session, the therapist has the benefit of visual assessment, verbal feedback, movement screens, etc. That said, there is no tactile intervention. We cannot over the computer feel what muscle you are using. Nor can we help release that muscle or alter it’s function with manual intervention. Instead, we ask the patient, “What do you feel? What can you do to change this muscle tone?” Absent of the manual PT feedback , the patient becomes arbiter of success. It requires and fosters a deeper understanding of one’s own movement. A more introspective, movement aware, and in control patient emerges. This empowerment of the patient can only be good, and these tools are indefinitely theirs to own. I find myself hoping that PT’s will continue, after quarantine is long over, to use what we are learning to enable our patient’s independence and confidence. A silver lining in an anxious time…

I count the days until we are physically together, when we can charge forward in our new normal and rebuild something beautiful. Until then, our community is alive and well. We as staff are here for you, the patients. It is our pleasure to check in, to field your emails, to help you navigate TeleHealth, and to be part of your team! In turn, you have bolstered and nurtured us with your inquiries, energies, and support. We are so grateful.

Elizabeth D’Annunzio Shah, PT, DPT, OCS, MTC works with patients of all ages and abilities including recreational athletes, professional dancers and performing artists. She has a special interest in vestibular and balance disorders, movement theory and creative solutions for both neurologically and musculoskeletally impaired persons. Elizabeth is passionate about exercise as a means to maintain health, manage stress and enjoy life! She practices yoga in the Iyengar tradition, is an avid surfer, and participates in distance running events whenever possible. (more)

TELETHERAPY SERVICES: CONTINUE CARE IN THE SAFETY OF YOUR HOME

WHAT IS TELETHERAPY?

TELETHERAPY SERVICES TeleTherapy is a way for you to connect and continue to work one-on-one with your physical therapist through a secure, HIPAA compliant online platform. The evaluation and treatment sessions are similar to what you would receive in the clinic. The most noticeable difference between online and in person sessions is no hands on care from your therapist. The feedback from our patients is that TeleTherapy sessions are quite effective and meaningful.

While these visits are not a replacement for the level of hands on treatment that you have come to expect from us, they are the best way to assure that you continue to receive the professional guidance and treatment that is needed to advance your care. TeleTherapy can include a physical screen of what is truly meaningful to you, as well as “real time” feedback and guidance as to self release, exercise progression and exercise modification as needed. It allows the education component to continue in regards to tips for daily living, postural adaptations and other concerns that you may have. It is a platform that will allow us to work together to advance your rehab program and meet your goals and expectations for physical therapy during this difficult time.

WILL MY INSURANCE COVER THIS?

We know this is an uncertain time and finances are a concern for all. The team at Thrive has been hard at work staying abreast of the latest developments in patient billing for TeleHealth services. Many insurance companies are rising to the occasion and eliminating hurdles so that their members can continue to get quality care without having to incur higher than expected out of pocket expenses. As insurance policies differ from person to person, we are calling to check benefits individually for patients who are interested and advocating for coverage for everyone.

To find out what your coverage options are and for pricing on TeleTherapy sessions please email info@thrivept.com and one of our staff will be in touch with more information.

Together we will get through this.

QUARANTINE READS

Many of us find ourselves at home in efforts to flatten the curve and save lives. Instead of diving head first into the next binge-worthy streaming show, there are tons of amazing books waiting to be discovered. Here are a few of our favorite reads that you may find enjoyable as you stay at home.

The Athlete’s Book of Home Remedies: 1,001 Doctor-Approved Health Fixes and Injury-Prevention Secrets for a Leaner, Fitter, More Athletic Body! by Jordan D. Metzl, M.D. and Mike Zimmerman

You may know Dr. Jordan Metzl as one of the leading Sports Medicine physicians at The Hospital for Special Surgery. He is also an author and has provided a great resource for dealing with many common injuries in this book. What makes this book so valuable is that it explores many ailments that a patient may succumb to and breaks them down into easily understandable components and treatment methods. This creates a straightforward path for the reader to follow on the road to recovery. The book is sectioned by body region which helps you quickly hone in on your injured area. The book even has illustrations and pictures of specific exercises linked to each diagnosis. Another great feature is that each section has guidance on when home treatment is no longer appropriate and when its time to call your doctor. Readers can use this book to help manage aches and pains when they occur as well as a source of information on preventative measures to avoid these injuries in the first place.

Explain Pain by David Butler and Dr. Lorimer Moseley

Explain Pain is a great resource for patients of all ages. This book wonderfully explores the concept of pain and how our minds are so intricately connected to the experience of pain. The book is based on evidence and pain research focused on our current understanding of the subject. Butler and Moseley take difficult medical topics and use simple explanations and illustrations, making it easily accessible. This book goes over topics like the anatomy of the nervous system, current practices on pain management, how to reframe our approach to pain, and dives deeper into understanding our intimate relationships to pain. With this book, knowledge is power: the more we understand what contributes to our perceptions of pain, the better we can address it. This book is especially relevant during our current opioid epidemic and over-reliance on “quick fixes.” It helps to set a framework for a more holistic approach to pain and a pathway to recovery.

When Breath Becomes Air by Paul Kalanithi

This non-fiction autobiographical book takes us through Dr. Kalanithi’s medical journey from being a young neurosurgery resident to becoming a patient with end-stage lung cancer. Dr. Kalanithi’s love of the literary arts (even had a Master of Arts in English Literature) is clearly appreciated in his ability to eloquently link the worlds of literacy, philosophy, and medicine. He also expresses a refreshing take on the doctor-patient relationship as he experiences it from both sides. He takes us on the path of understanding how our purpose in life and sense of identity may be challenged and called into question when an illness strikes. Another great feature of this book, is that it connects with both patient and health care practitioner alike.

All of these books are available via online platforms so that you can continue to safely practice Stay at Home orders. Take a peek in to these great reads and let us know what you think!

Jari Haile, DPT, OCS, ATC, PES, is able to pinpoint faulty mechanics and movement patterns that contribute to pain. She incorporates skilled manual therapy to elongate shortened tissues, stretch tightened muscles, align the spine and decrease compression on the body’s joints. She then taps into the body’s neural pathways to “retrain the brain” how to move properly and finally break the pain-producing cycle.

RESOURCES FOR MANAGING STRESS

The COVID-19 pandemic has created a tremendous amount of stress and anxiety for all of us and now, more than ever, it’s important to take some time to check in with your mind body connection. Your mindset is the most powerful thing that you CAN control during uncertain times, and a healthy perspective will help cleanse negative thinking and strengthen your immune system. Stay safe, be well and we hope that you find these websites and apps helpful.

Below is a list of various apps and websites to help mitigate the stress caused by COVID-19

CALM: A free App for Sleep, Meditation and relaxation. Guided meditations, soothing music, mindful movement and stretching videos for better sleep, lower stress and less anxiety

HEADSPACE: Meditation has been shown to help people stress less, focus more and even sleep better. Headspace is a free app that proposes to make meditation and mindfulness simple. Their premise is to take ten minutes a day to listen in and clear your mind.

MEDITOPIA: Meditopia’s library offers over 1000+ guided meditations on topics including stress, anxiety, acceptance, happiness, motivation, focus, and breath. Free 7 day trial

MY POSSIBLE SELF: A mental health app that claims to reduce stress, anxiety and low mood. It contains self-help modules to tackle issues such as stress, anxiety, loss or major life changes. Free for the duration of the COVID-19 crisis.

Children, too, may worry about themselves, their family and friends. Children pick up cues from both parents and their caretakers. After trying some of the apps above here are a few free websites to help entertain your children during the day.

AUDIBLE: Amazon canceled the subscription costs of books and audio stories for children and students of all ages, kids everywhere can instantly stream an incredible collection of stories, including titles across six different languages, that will help them continue dreaming, learning, and just being kids. All stories are free to stream on your desktop, laptop, phone or tablet.

GO NOODLE: This free website features ways to stay active and mindful during study breaks. Utilize this website throughout the day to allow your child to have a break and move their bodies so they are able to focus better. Remember, breaks are important for little minds and bodies too.

ACTIVE KIDS DO BETTER: Active Kids Do Better equips parents with tools to get primary school children moving through play. It features a suite of free resources, for use in the classroom and at home – including videos, activity cards, and games.

MYOFASCIAL DECOMPRESSION: CUP THERAPY BY A PHYSICAL THERAPIST

You may have never heard of Myofascial Decompression (MFD), but you have probably seen it. You might recall seeing Olympic Gold Medalist Michael Phelps with bruises in perfect circles around his back and shoulders during the 2016 Olympic Games in Rio De Janeiro. Even though the art of cupping has been traced as far back as ancient Egypt, it was popularized in athletics after Michael Phelps displayed it on the world’s stage (similar to Olympic Gold medalist in Volleyball, Kerry Walsh and Kinesiotape). Oftentimes, people do not understand the difference between “Cupping” and “Myofascial Decompression” so let’s dive deeper.

	Cupping	Myofascial Decompression
Who does it?	Traditionally performed by acupuncturists	Traditionally performed by physical therapists and other rehab professionals
Goal of Treatment	Targets stagnation of blood and Qi	Targets connective tissue, trigger points, fascial adhesions, mechanoreceptors, and tight muscles
Background	Traditional Chinese Medicine : meridians, balance between Yin and Yang, Flow of Energy (Qi)	Anatomy, Physiology, Biokinesiology
Tools Used	Small glass cups with a flame	Small plastic cups with a suction pump
Treatment	Usually passive in nature: patient lays on the table for a period of time with the cups on	Active treatment: the patient is performing neuromuscular reeducation exercises, stretching, and other active movements while the cups are on

As you can see, there are differences from the traditional cupping by an acupuncturist and myofascial decompression by a Physical Therapist. Both can be effective, but have different ideologies and methodologies of its use.

One of the questions often asked is, “How does it work?” The analogy I usually give is that most massages are compressive in nature. A clinician’s hands are pressing downward into the tissue to relieve the tension. MFD is the opposite. Instead, it takes the different layers (skin, fat, muscle, bone) and separates them from each other (traction). This traction of the tissues can lead to release of tight muscles and trigger points, decrease the viscosity of the ground substance (the gel like substance that surround our cells), bring blood to the area, release endorphins and act as a distraction to assist in improved pain and function.

cupping myofascial decompression

In physical therapy since the treatment is also active we incorporate neuromuscular retraining and exercises that help to capitalize on the benefits of the cups.

I have found that this therapy has been extremely helpful for patients who have had stubborn tension/knots that are “always tight,” post surgically when scar tissue is tougher to break up, and especially with addressing areas of pain and tension that have not responded to traditional therapy.

Have more questions? Come in to Thrive Integrated Physical Therapy for a consult to see if this would be a good treatment option for you.

Currently Jari Haile DPT, OCS, ATC, PES and Tamar Amitay, MS, PT both utilize Myofascial Decompression as a form of therapy at Thrive. Schedule an appointment and find out more about this efficacious therapy.

Photograph by Alexander Mazen

IN CONVERSATION: BREATH & THE MIND BODY CONNECTION

We at Thrive are so fortune to collaborate with many types of rehabilitation, exercise, and movement specialists in the New York City area. Pilates has long been one of our staff’s preferred exercise tools, and we dearly love and appreciate the expertise of the staff at Mongoose Bodyworks, a Pilates studio that is neighbor to our clinic here in Soho.

Over the years we have found our mutual clients achieve more success in movement, return to activity, and engagement in life when we collaborate, and the conversation below is an edited version of a dialogue between Mongoose Bodyworks owner Halle Clarke and Thrive PT staffer Elizabeth D’Annunzio Shah.

breathing3

Halle: Hi! When we decided to have a conversation, we talked about many areas of professional overlap. There’s lots of crossover between what you and I do!

Elizabeth: That’s right. Ultimately, both PTs and Pilates instructors spend a fair amount of time doing movement analysis. We’re both trying to enable multi-dimensional, pain free movement.

Halle: In the spirit of that crossover, I have some questions for you that I thought might relate to both of our client populations. Specifically, let’s talk about breathing. How do you think about breathing as it relates to your patients? It’s a natural and automatic process, so is it something that you have to instruct?

Elizabeth: Good question! The short answer is “YES,” I do talk to my patients about how they breathe. There are two lenses from which I frame the discussion. The first is straight up mechanical. Breathing effects the how we engage the abdominal and pelvic muscles, and understanding the relationship between the muscles and breath is helpful in the initial stages of core training.

Halle: Can you expand on that?

Elizabeth: Absolutely. When we inhale, the diaphragm shortens and moves down into the abdominal cavity. The pelvic floor and the abdominal muscles would tend to relax and descend at this time too. Exhalation is opposite. As we blow out, the diaphragm ascends and the pelvic floor muscles lift and shorten. So, from a practical perspective, it’s easier to teach someone how to lift and contract their pelvic floor on an exhalation. I use this mechanical paradigm all the time with my post-partum moms, persons with diastasis recti, persons with back pain, etc. Basically, people who I’m teaching to re-engage their “core.” I’d imagine you have clients that fit that bill, too.

breathing1

Halle: Of course. Do you always coordinate your client’s abdominal or pelvic floor contraction with the exhalation?

Elizabeth: Not necessarily. I find it to be a great learning tool and I often start there, and then as therapy progresses we move and breathe in all different patterns.

Halle: That’s true for Pilates as well. I also find that once the client has mastered the engagement on the exhalation they can then use the breath in a variety of ways throughout the session. You mentioned that you look at breathing from two lenses. What’s the other one?

Elizabeth: I use breathing as a tool to help my patient’s quiet their nervous system down. It is common, at least in the PT world, to see patients who are in chronic pain. With that often comes anxiety and fear around making the pain worse. How do we breathe when we’re afraid?

Halle: We take short, shallow breaths.

Elizabeth: Right. We don’t breathe fully into our lungs, our respiratory rate gets faster, and we sometimes even use our neck muscles as we breathe. This type of breathing pattern signals to the body that we’re under threat, and our musculature responds to that signal. It’s flight or fight! This heightened state of arousal, sometimes called upregulation, makes sense when we are trying to score a goal or run from a bear but is not so helpful when trying to relax and rehabilitate sore and overworked musculature. This is, in part, how fear or anxiety can actually make pain worse.

Halle: Are there certain patient groups where you see this systemic upregulation?

Elizabeth: Yes…my mind starts churning in this direction any time a patient has had chronic pain (especially in the neck, pelvis, or jaw) or a lot a fear associated with movement. I cue in to people who describe their pain as worse when they’re stressed, who grind their teeth, and who use language like “clenching” to describe their muscles. In the pelvic floor world we also see this with patients with urinary urgency.

Halle: Those are great tips! I’ll keep an eye out for those symptoms. Sometimes stress isn’t on the surface and it’s good to know some signs when my clients might be internalizing their emotions.

Elizabeth: And as for Pilates clients, this is New York City! I’d imagine a lot of your clients are generally high functioning, striving, and stressed out people.

Halle: That’s true! Are you saying we should all move to the beach?

Elizabeth: (Laughs) No, but I do think there’s incredible therapeutic value to working towards nervous system downregulation. In other words, the act of quieting our bodies, slowing our exhalations, and breathing into the whole of the rib cage (instead of just into the upper ribs) dampens the flight or fight response and is a tool for muscle and mind relaxation! From a pain perspective, this is really helpful. From a movement and exercise perspective, muscles that move (as opposed to muscles held in shortened or “tensed” position) tend to be stronger and more efficient. It allows people to move with more freedom.

Halle: Mindful breathing as a mechanism to enable quality movement.

Elizabeth: Exactly.

References: Barker, V. 2016, The ‘Core Breath,’ accessed July 2019, vanessabarker.com.
Special thanks to Vanessa Barker for for allowing us to use her image “The Core Breath” in our post.

ATTN PT’S: NEW COURSE ALERT

Thrive! is hosting a University of St. Augustine continuing education course September 28-29, 2019.

Interested in learning more about cranio facial techniques? Physical Therapists please join us for CF2 – Intermediate Cranio Facial (prerequisite CF1- Basic Cranio Facial available online).

Tuition: $495

Hours: 15 Hours, 1.5 CEUs

Prerequisite: Basic Cranio Facial (available online)

Who Attends: Physical Therapists

This seminar will primarily be focused on displacement of the intra-articular disc of the TMJ, but will also cover the role of the subcranial spine in the causation of craniofacial pain and the association between detrimental oral habits (parafunctions) and craniofacial pain. Medial and lateral disc subluxations will be carefully examined, as will disc-condyle and disc-eminence subluxations. The progression of disc subluxation and other intra-articular pathology will be demonstrated by the use of clinical examples and all disorders will be illustrated by imaging. The imaging methods used in the diagnosis and management of the TMJ will be explained; this includes transcranial radiographs and tomography, as well as MRI, used for diagnosis and clinical management of intra-articular disc displacements. The lab sessions will focus on assessment of intra-articular pathology, as well as preparations of the TMJ and subcranial spine for reduction of the intra-articular disc. Finally, participants will have the chance to practice disc reduction and subsequent stabilization of the disc in the reduced position.

Learning Objectives:

At the completion of this seminar the attendee should be able to:

Explain the concept of progression of intracapsular temporomandibular joint (TMJ) disc pathology as an initial stage of dysfunction.
Discuss how a medial or lateral disc can progress to an anterior disc subluxation.
Predict the effect of oral bad habits in children and adults.
Describe the process of craniomandibular parafunction (teeth grinding) as a cause of micro repetitive trauma.
Explain the loaded gliding of the TMJ with systemic joint laxity as a cause of progressive joint disc pathology and degenerative joint disease.
Apply examination and treatment techniques to soft and hard tissues of the maxillofacial region with special emphasis on proper force and direction to avoid injury.
Explain the major cause of condylar height loss and consequential facial assymmetry.
Identify the signs and symptoms of vascular irritation for the TMJ.
Apply manual and muscular techniques for disc subluxations.
Discuss the use of removable interoclusal appliances for joint stabilization

CLICK HERE for full course information and to register.

PERSONALIZED BLOOD FLOW RESTRICTION REHABILITATION

Personalized Blood Flow Restriction (BFR) Rehabilitation is a type of Physical Therapy treatment that integrates the use of a personalized tourniquet system to restrict blood flow to an injured limb during active recovery training.

Often, after an injury or surgery, a patient does not have the ability to lift heavy weights/loads thereby slowing down their overall recovery. Studies find BFR rehabilitation allows the patient to begin strength training using lesser weights/loads that won’t stress their joints or soft tissues, while still being able to gain the muscle strength, hypertrophy and endurance comparable to that of a heavy load lifting program. (Slysz et al 2015)

While initially used in the treatment and recovery of service members who were wounded in Iraq and Afghanistan, it is now being used with the training and rehabilitation of elite athletes and in orthopedic clinical settings. Clinical trials have shown advancement in the rehabilitation of total knee replacements, wrist fractures, tendinopathies, cartilage injuries and chronic weakness after surgery.

This technique is particularly successful in assisting injured and/or post-surgical patients who are struggling with muscle mass loss and weakness. When a limb is injured, it cannot tolerate the heavy lifting necessary to prevent and reverse the loss process. BFR rehabilitation training, however, allows the patient to achieve the same benefits of heavy lifting while using light weights. BFR has also been demonstrated in the research to significantly reduce pain in the early stages of rehabilitation. (Giles 2017)

The basic process involves application of a tourniquet to the injured limb, that is then inflated (similar to a blood pressure cuff) to occlude blood flow to a limb, blocking veins but not arteries, while performing light load exercises.

While exercising with the tourniquet, the patient feels as if they are exerting a lot more force to perform what is typically considered an “easy exercise;” although it is anything but easy. During exercise with the tourniquet, the muscle fatigues and swelling occurs as fluid accumulates and lactic acid builds up. This reaction is what helps stimulate protein synthesis, stem cell proliferation and triggers hormonal responses in the body including increased growth hormone.

It is important to let your health care practitioner know your medical history prior to beginning this exercise program and discuss with your physician if you are a candidate for this rehabilitation.

If you are curious is this type of rehabilitation would be good for you, schedule an appointment and speak with your physical therapist. A thorough evaluation and medical review will be necessary before a determination can be made.

For appointments please call (212) 254-7750 or email info@thrivept.com.

Citations:

1. Sylsz, Joshua et al “Efficacy of blood flow restricted exercise: A systematic review and meta analysis,” The Journal of Science and Medicine in Sport (2015)
2. Giles L, Webster K, McClelland J, Cook J., “Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain. A double blind randomized trial,” Journal of Science and Medicine in Sport 20S (2017 e67-e105)
3. owensrecoveryscience.com

THE TAPING SOLUTION: SUPPORTING, ENHANCING & ACCELERATING TRAINING OUTCOMES

Thrive Integrated Physical Therapy, in partnership with Dominican College, is proud to announce that Mark Comerford, author of Kinetic Control: The Management of Uncontrolled Movement and a highly regarded international educator is going to teach a course at our facility this fall. This will be a course open to physicians, physical therapists and athletic trainers.

Dynamic taping was originally developed for Sports Physiotherapy, Dynamic Tape is proving extremely effective for both orthopedic , sports medicine, dance and neurologic conditions.

Dynamic Tape is highly specialized and designed to contribute genuine mechanical force into the kinetic chain. Working like a bungee cord, the unique, strongly elastic Dynamic Tape aims to absorb load, contribute to force generation, improve biomechanical efficiency and modify faulty movement patterns. Load reduction combined with powerful neurophysiological effects may provide prompt pain relief, reduce metabolic demand, facilitate recovery and improve function.

Please see below for full course description and registration information:

Dates: October 12-13, 2019
Time: 9:00am-5:00pm
Instructor: Mark Comerford
Location: Thrive Integrated Physical Therapy. 611 Broadway, Suite 503. New York, NY 10012.
Cost: $600 per person ($50 discount offered to HSS Rehabilitation Network Members & Dominican College Students)
Contact: courses@thrivept.com or call (212) 254-7750 to register or for additional information
CEU’s: Dominican College is a New York State Education Department approved provider for physical therapy continuing education. This course has been approved for 1.4 CEU’s.

MASTERCLASS

THE TAPING SOLUTION: SUPPORTING, ENHANCING & ACCELERATING TRAINING OUTCOMES

COURSE INTRODUCTION: This two-day masterclass builds both clinical and performance practitioners’ skillsets in contemporary techniques of taping alongside developing a strong rationale for the use of these strategies in the management of uncontrolled movement (UCM). Innovative taping strategies are delivered that assist in the management a wide range of presentations. The taping interventions covered are used in conjunction with movement retraining strategies that target UCM as identified by its site, direction and threshold of uncontrolled movement®.

COURSE OUTLINE: These 2 days will explore the value and potential of taping to optimize the management of uncontrolled movement based on ‘Site & Direction and Threshold®’. It will supply the rationale behind the application of techniques of taping for a biomechanical and/or a neurophysiological effect and identifies the differences (and therefore the advantages and disadvantages) between Rigid tape, Kinesio tape and Dynamic tape. It helps develop a reasoning framework to support clinicians’ and movement practitioners’ decision making of when to use Rigid tape versus Dynamic taping options.

Ultimately, the course supplies innovative taping techniques specifically matched to a classification of UCM and develops the skill of application of Rigid tape or Dynamic tape. To achieve this outcome, the course considers the value of taping to provide mechanical control of the site and direction of UCM, enhancing sensory feedback for cognitive motor control training, facilitating the efficiency of global stabiliser role synergists, inhibiting global mobiliser role synergists and helping optimize the efficiency of recruitment between stabiliser and mobiliser role synergists.

KEY FEATURES:

The course will present a variety of Rigid and Dynamic taping strategies, including:

Providing passive, biomechanical control of provocative uncontrolled movements
Increasing proprioceptive feedback for cognitive movement control training
Improving sensory-motor recruitment of inefficient stabiliser role synergists
Unloading stretch-strained synergists to decrease strain and reduce trigger point symptoms
Positively the length-recruitment relationship of synergists possessing a stabiliser role throughout their range of motion and enhance their eccentric deceleration properties
Assisting restore efficient recruitment of global mobiliser role synergists

LEARNING OUTCOMES:

At the end of this course the participants should be able to:

Display the ability to apply a range of taping approaches to a high standard
Demonstrate an understanding of the rationale for the application of differing styles of tape with respect to their influence upon aspects of biomechanics and neurophysiology
Demonstrate an understanding of the clinical advantages and disadvantages of a range of taping interventions with respect to a clinical presentations or performance deficits
Demonstrate an ability to utilize taping as an intervention strategy alongside the management of uncontrolled movement to meet a clinical or performance outcome

PROGRAMME:

Examines the principles of taping techniques, including the biomechanical and neuro-sensory uses of taping
Explores the differences between rigid tapes, dynamic tape and kinesio tapes and discusses the advantages and disadvantages of different tapes.
Identifies the goals of applying taping, including: the biomechanical control of movement for movement protection and to manage pain and issues associated to what is traditionally described as ‘joint instability,’ neuro sensory stimulation to manage pain and enhance proprioceptive feedback for movement protection and motor control retraining, facilitation of global stabiliser role synergist recruitment and inhibitory strategies for global mobiliser role synergists to recover recruitment efficiency altered in the presence of recurrent pain and injury
Develops clinical/performance reasoning processes to best match taping options to the goals of management
Practical workshops demonstrating and applying taping solutions using both rigid and dynamic taping options for a large variety of uncontrolled movements
Practical workshops using taping solutions to manage the site and direction of uncontrolled movements in the lumbar spine, thoracic spine (including specific rib impairments), sacro-iliac joint, hip, knee and foot, shoulder girdle, and cervical spine

This course offers all movement clinicians another effective tool to fast track the path to optimal Movement Health. It provides additional skills to better manage a large range of clinical presentations of uncontrolled movement. These range from acute presentations of musculo-skeletal pain, through to recurrent pain and injury, and compromised function performance deficiencies.

PROGRAMME:
DAY ONE
AM:
Introduction to Movement Control & Movement Health:
o   Diagnosis of Site & Direction and Threshold® of uncontrolled movement (UCM)
o   Global stabiliser & mobiliser recruitment synergies
o   Value of taping to accelerate movement control retraining
o   Taping augmented exercise therapy
o   Goals of Taping: taping for Rehab vs taping for Performance vs taping for Prevention (risk management)

Advantages and disadvantages of different tapes:
o   Rigid tapes
o   Dynamic tape
o   Kinesio tapes

Taping principles:
o   Biomechanical taping
o   Neuro-sensory taping
o   Mechanisms & Influences: mechanical, recruitment physiology, pain physiology, proprioception

Taping application – the basic ‘rules’

PM:
Taping for Uncontrolled Movement Workshop (practical & demonstration) using rigid & dynamic tape solutions:
o   Lumbar Uncontrolled Movements (Lumbar: flexion, extension, rotation)
o   Sacro-iliac Uncontrolled Movements
o   Thoracic Uncontrolled Movements (Thoracic: flexion, rotation)
o   Rib Uncontrolled Movements (anterior-posterior shears & upward-downward rotations)
o   Cervical Uncontrolled Movements (Low Cervical: flexion)

DAY TWO
AM:

Taping for Uncontrolled Movement Workshop (practical & demonstration) using rigid & dynamic tape solutions:
o Scapular Uncontrolled Movements (Scapular: downward rotation, forward tilt, + Cervical: rotation / sidebend)
o Gleno-humeral Uncontrolled Movements (G-H anterior glide, G-H rotation)
Hip Uncontrolled Movements (Hip: flexion, medial rotation / addiction, extension)

PM:
Taping for Uncontrolled Movement Workshop (practical & demonstration) using rigid & dynamic tape solutions:
o   Knee Uncontrolled Movements (Knee: ‘valgus’ & ITB issues; Tibial: lateral rotation)
o   Patello-femoral Uncontrolled Movements (Patellar: lateral glide / tilt, inferior glide)
o   Foot Uncontrolled Movements (Foot: pronation, inversion, dorsiflexion; Hallux: valgus) including: tendinopathy issues; ankle instabilities; plantar fascia)
Taping to facilitate global stabiliser recruitment

Taping to inhibit global mobiliser overactivity

Summary

For additional information, or to register, please contact: courses@thrivept.com or call (212) 254-7750