Fibromyalgia is a clinical condition of unknown etiology characterized by chronic generalized body pain associated with fatigue and psychological distress. It typically presents in young to middle aged women and can result in sleep disturbance and significant impairment in activities of daily living.
While medical therapy for fibromyalgia exists and may to a limited extent be beneficial in managing pain, physical therapy plays a major role in treatment and rehabilitation. The aim of physical therapy is aimed at deconditioning and muscle weakness. There are different modalities of physical therapy aimed at treating different aspects of fibromyalgia.
1. Cadiovascular Fitness Training
Patients suffering from fibromyalgia are generally inactive and often become physically inactive over time. Exercise has shown benefits in long term management of fibromyalgia, with studies even showing an improvement in pain. In recent years, exercise remains one of the most commonly recommended treatments.
Exercises are ideally low impact and could include Tai Chi, water exercise, and Qi Gong. Water based exercises seem to offer a small degree of advantage over exercises performed on land, but sometimes are not as convenient to perform. Based on patient function prior to initiating therapy, exercise programs can be tailored to the patient specifically.
2. Physical Therapy
Treatment is aimed at increasing overall muscle strength, and is aimed at reducing muscle weakness. Common advice and treatment may include:
- Avoid muscle overloading- ie lifting heavy weights
- Correcting body alignment
- Muscle conditioning and stretching
- Encouraging general activity
3. Muscle Massage
While this provides both psychological and physical relief to some extent, there is no strong evidence that it is useful as an individual treatment modality; rather it is better used in combination with other therapies.
Randomized controlled trials have shown that acupuncture can provide significant improvement in pain reduction and a reduced perception of pain. However its long term benefits have not been adequately studied, and there is no clear guidance on how often treatment should be administered. It may be more beneficial as an adjunct therapy.
5. Transcutaneous Electrical Nerve Stimulation (TENS)
TENS is an electrical based pain reliever. It is more useful for localized pain, and hence its use for fibromyalgia may be limited. However it is an easy therapy that the patient can self administer at home.
Exercise and physical therapy are mainstay treatment options for fibromyalgia. Treatment options need to be tailored to the individual. With optimal therapy, patients can experience a significant improvement in symptoms.
If you have not already noticed, we wanted to point out that we have made some updates to our website to make it more user friendly. Now no matter what device you are using to view our website you should have an easier time viewing the content.
Key changes include:
- Mobile friendly viewing
- Easy sign-up for our newsletter
- Easy access to our articles on our blog accessible off the home page
- We will continue to have the Newsletter archive on our website for our newsletters from 2008-2015, but moving forward you can access the articles easily from our blog.
- You can see any upcoming classes that we will be hosting on the right side of the screen.
We would love to hear from you on what you think of our changes. We want our website to be as helpful as possible for you, so if you want to see something different, let us know.
We are excited to start offering classes again at Legacy Physical Therapy. It has been a little while and we are glad to be back. Our first class back will be an introduction to essential oils.
We hope that you can join us for this great basic essential oils class that will help explain what an essential oil is, what determines the quality of an essential oil, how they are used and some basic essential oil protocols for health and wellness. Class is Wednesday April 6th from 6:30pm-8pm at Legacy Physical Therapy 2961 Dougherty Ferry Road Suite 105 63122. Register for this FREE event at 636-225-3649 or e-mail email@example.com
Do you have an idea for a class you would like us to host? Please let us know!
Do you want to improve your health in 2015? We at Legacy Physical Therapy want to help!
Read below for a super exciting challenge that starts SOON!!!
On January 12th, we will be launching
“The Healthy Games” 6-week Health challenge!
Whether you are wanting to lose weight, moving into your new healthy lifestyle, or maybe you’ve gotten a little off track with the holidays… this is a great way to get engaged, have a bunch of fun, and win a little money too!
Here is a link to give you a little information about the challenge.
Here’s the best part…. you can utilize your own or any meal/nutrition or exercise plan you want plus you get to have Dr. Brooke Kalisiak, owner of Legacy Physical Therapy, as your FREE health coach during the challenge! So grab a few friends, work colleagues or family members and lets get going on a healthier you!
How do you get started?
1) Click on the link below and join my team! It will only take a few minutes to get registered. You can join NOW and start the “pre-game activities”!
2) Grab a few friends and inspire them to join us. You can earn points by inviting others to the party!
3) Let’s schedule a time to talk about your health goals. Shoot me an email (firstname.lastname@example.org) or call or text me (314-494-1265). I am so excited to chat with you!
4) Here is a link to an awesome FREE e-Book that you can download. It will be a great resource to help you get started!
5) Get ready to have fun! You can start getting involved and earning points NOW and the games officially begin on 1/12/15!
The challenge runs for 6 weeks 1/12/15-2/23/15.
On Monday September 29 and Tuesday September 30, Dr. Brooke Kalisiak PT, DPT, WCS had a wonderful opportunity to represent the Private Practice Section of the American Physical Therapy Association at our Nation’s Capitol. She was among over 75 physical therapists business owners from across the country that convened in Washington, DC September 29 – 30,2014 to lobby members of Congress. As part of the second annual event hosted by the Private Practice Section (PPS) of the American Physical Therapy Association (APTA), Dr. Brooke Kalisiak met with the office of Senator Claire McCaskill, Senator Roy Blunt, and Representative Ann Wagner to discuss hard-hitting issues affecting the future of healthcare, patients, and physical therapy businesses.
Check out the full press release at: http://interact.stltoday.com/pr/local-news/PR100214120918820
If you are like us here at Legacy Physical Therapy, this warmer weather is inspiring you to get outside and get more active! We thought what better way to get active than to do it together!! Starting MONDAY MAY 5th join us for MONDAY WORKOUTS in MAY!! That’s right, instead of picking up the margarita for Cinco de Mayo come break a sweat at Legacy Physical Therapy instead. Every Monday in May (except Monday May 26th for Memorial Day) you can come train with the physical therapists at Legacy from 6:15-7:15pm.
WHAT: Workouts will vary but will involve a mix of cardiovascular and strength training. Workouts will happen rain or shine, but weather permitting we will go outside. Feel free to bring a yoga mat and your own set of small hand weights if you have them, but not necessary. All fitness levels are welcome as workouts can be tailored to the individual.
WHEN: Monday May 5th, May 12, May 19th & Tuesday May 27 (Because of Memorial Day) from 6:15-7:15pm
WHERE: Legacy Physical Therapy 2961 Dougherty Ferry Road Suite 105 63122
COST: Space is limited to 10 participants each class. To reserve a space, call us at 636-225-3649 and ask to sign up for any of the dates above. Classes are $8/person/class if you call ahead to reserve a spot. Classes are $10/person/class if you walk in without reserving a spot ahead of time (We cannot guarantee a spot). Whether you reserve a spot ahead of time or not payment is due at the time of class, CASH or CHECK only.
If this is well received we may continue the workouts throughout the summer! Please call 636-225-3649 with questions or to reserve your spot!
February was National Heart Awareness Month, so we wanted to take a moment and discuss the difference in heart attack symptoms between men and women.
MEN AND WOMEN ARE DIFFERENT!
Shocking…. I know. Heart attacks and heart disease are just another way that men and women differ. Although, both genders are susceptible to heart disease and heart attacks, a woman presents differently during a heart attack than a man does. Unfortunately, for us women, it is less clear that what is actually a serious concern is not “just nothing” like heartburn, the flu, or anxiety.
In fact, HEART DISEASE is the number ONE killer of women in America. So how do we know if we are having a heart attack?
- Uncomfortable pressure, squeezing, fullness or pain in the center of your chest
- Pain in one or both arms, back, neck, jaw, or stomach (MORE DIFFUSE THAN THE CLASSIC SIGNS OF LEFT ARM PAIN IN MEN)
- Shortness of breath (aka dyspnea)
- Cold sweats, nausea, lightheadedness, dizziness
- Extreme fatigue
ANY of these signs may indicate heart attack, therefore, if present, call 911 immediately.
Women are MORE LIKELY to present with atypical symptoms of heart attacks than men, however, chest pain is still a pretty good indicator to go to the nearest ER.
HOW can we prevent heart disease and heart attacks?
- Get Active! If you already have cardiac disease, or any other co-morbidity, your physical therapist is the best person to determine an exercise program for you!
- Eat Better! Diets lower in fat and bad cholesterol are proven to lower the risk of heart disease.
- Lose weight
- Stop smoking: this is the number one risk factor for heart disease and can cut your risk of coronary heart disease in half if you QUIT!
- Manage your blood pressure: High Blood pressures may be a sign of a more serious problem, and if managed effectively, can prevent your risk of more serious issues
So, to recap, as women we have a lot of heart! We consistently put our families and loved ones first in our lives, often brushing our own needs off. It’s especially important for us to take care of health, however, so that we can live long enough and well enough to continue to make the most of time with our families!
Karla Wente, PT, DPT, CLT
Legacy Physical Therapy
Women’s Health Clinical Resident
BONE HEALTH FOR ALL AGES:
Why does bone health matter?
Healthy bones can help you stay strong and active throughout your life. If good bone health is achieved during childhood and maintained, it can help to avoid bone loss and fracture later in life. For bones to be healthy, it is important to maintain physical activity with a healthy, balanced diet full of calcium, vitamin D, and other supplements as needed.
So what is a physical therapist’s role in bone health?
Physical Therapists are experts in the movement system. They can help patients achieve peak mobility and strength, all while keeping your individualized care in mind. The advanced knowledge of PTs is especially important for patients who already have compromised bone health or risk for fracture like: osteoporosis, female athlete triad, fad dieters, obesity, post-menopause age, long-term steroid therapy, cigarette smoking, high alcohol intake. This is not a complete list! Based on information HERE: Fracture Risk Factors!
What is osteoporosis and what does it have to do with physical therapy?
Osteoporosis is a common bone disease that affects both men and women (mostly women), usually as they age. It is associated with low bone mass and increased fragility of bones, making them more susceptible to breakage. This is typically diagnosed by a physician with a bone mineral density scan, taking into account blood levels of vitamin D, calcium, and history of prior fracture. For more information about osteoporosis in general look at: National Osteoporosis Foundation!
Physical therapists are the ideal providers to create an exercise program for those individuals who have osteoporosis, osteopenia (low bone density, but not quite osteoporosis), or those who have risk factors for fracture or falling. PTs are trained, as part of their 3 year doctoral program, to understand postural alignment, movement, gait analysis, balance, and the importance of weight bearing exercise to increase bone density and prevent injury.
So what are weight-bearing exercises and how can I do them?
First off, noone who is at risk for falls, fracture, or who has a known medical condition should start an exercise program without the consultation of a physical therapist or physician first!
Second, weight-bearing exercise includes anything the stresses the bones through their long axis. This includes:
- Walking (best results for strengthening the femoral neck, thereby decreasing risk for hip fracture)
- Yoga (Controversial: may provide whole body weight-bearing, however, can increase risk of lumbar bending which can increase compression fractures; Additionally, fall risk should be assessed before performing higher level balance exercises.) Read more here: Yoga, vertebral fractures, etc.
- Dancing (Those dancing with the stars celebrities are protecting their bone density!)
- Tai Chi (TONS of benefits, see effects on bone density HERE)
So, isn’t this just for “older” people?
NO! Starting healthy habits sooner ensures more compliance later. It is much more difficult to start an exercise program after diseases or injuries have already occurred, so better sooner than later! Additionally, your peak bone mass is about 18 in women and 20 in men…. so START NOW!
For fun activities for your loved ones who are younger check out: Best Bones FOREVER!
What does posture have to do with it?
Obviously, as a physical therapist, I am biased about good posture. However, I know how hard it is to make this a habit. The reason it is so important is that proper posture can prevent injury, pain, falls, and FRACTURE. This is critical for those high risk people! Here are some tips:
- Remember the plumb line: Keep ears in line with shoulders in line with hips in line with ankles. See PLUMB LINE!
- Use pillows when sitting or lying to support yourself in a good position.
- Bend your knees and keep your back relatively straight while you lift things. Always keep loads close to your body.
- Maintain regular fitness as staying active can prevent injuries.
Remember: By 2020, over 50% of Americans are expected to have osteoporosis. Let’s try to keep that number lower and reduce fracture risk in the future!
If you feel you are at risk or you already have osteoporosis, call us today at Legacy Physical Therapy to set up an appointment to see how physical therapy can help. 636-225-3649
Karla Wente, PT, DPT, CLT
Legacy Physical Therapy
Clinical Resident in Women’s Health Physical Therapy at Washington University in St. Louis
Did you know that there are physical therapists who focus especially on female issues? In fact, there are physical therapists here in St. Louis who are Board Certified in Women’s Health Physical Therapy (WCS).
There are multiple times in a woman’s life in which physical therapy may be appropriate. We will talk about 2 important time periods in this article: 1) during pregnancy, and 2) postpartum
Physical therapy can be a wonderful adjunct care provider during pregnancy to help with common pain complaints such as:
- Low back pain
- Sacroiliac joint dysfunction
- Carpal tunnel syndrome
- Pelvic and pubic pain
- Foot pain
- Incontinence (bladder leakage)
- Round ligament pain
Physical therapy treatment during pregnancy may include:
- Posture education to avoid injury and decrease pain
- Manual therapy to restore alignment and improve soft tissue guarding
- Therapeutic exercises for improving muscle performance and posture
- Abdominal and pelvic floor training
- Fitting for various support belts to help with stability and pain
If you are like many pregnant women, you may have concern about what exercises are appropriate during pregnancy. A physical therapist is a great resource for instruction on the do’s and don’ts of exercise during pregnancy.
The stresses of pregnancy, vaginal deliveries, and C-sections may lead to myofascial complications following the birth of the baby. Many women suffer in silence because they feel their symptoms are “Normal” after they have a baby. Fortunately, many of these symptoms can be easily treated by a physical therapist specializing in postpartum care.
Common Postpartum Complaints include:
- Low back and lower extremity pain
- Upper back and neck pain associated with breastfeeding
- Upper extremity pain or numbness associated with child care
- Diastasis recti: Separation of the abdominal muscles which commonly occurs during healthy pregnancies.
- Pain with intercourse or orgasm
- Clitoral, vaginal, rectal, pubic, or tailbone pain
- Pain and decreased mobility at scar of C-Section, episiotomy, or perineal tear
- Pelvic floor weakness
- Urinary or fecal incontinence
- Urgency and frequency
- Pelvic pain
How Physical Therapy Can Help:
- Soft tissue mobilization, myofascial release, deep tissue massage
- Therapeutic exercise for improving abdominal and pelvic floor muscle performance
- Posture, lifting techniques and biomechanics
- Home exercise program
- Abdominal binder/brace fitting
- Scar massage
- Therapeutic ultrasound to breakup clogged milk ducts
- Modalities for pain control
- Instruction in return to exercise safely
- Instruction in proper lifting/carrying of baby, stroller walking, and other activities of daily living to avoid injury
Pregnancy, childbirth and childcare are all events that result in significant physical changes and new stresses on a woman’s body. Women’s Health Physical Therapists are specifically trained to meet the special needs of women during this time of their lives and beyond.
Call us today at 636-225-3649 to set up your FREE SCREENING to see if physical therapy is right for you.
The American Physical Therapy Association (APTA) and fellow members of the Therapy Cap Coalition, a group of almost 50 associations, organizations, patient and consumer groups, are working together to make sure Congress addresses the Medicare therapy cap before December 31, 2013.
APTA representatives have been a constant presence on Capitol Hill all year long, advocating for a permanent repeal of the Medicare therapy cap, but it’s crucial that legislators hear from their constituents. Thus, the Therapy Cap Coalition has created several coordinated grassroots opportunities to maximize impact.
Already, the coalition raised awareness with a 24-hour social media and e-mail effort on November 3, 60 days ahead of the expiration of the therapy cap exceptions process. But your help is still needed!
Take Action TODAY!!!
Use e-mail and social media to flood Congress with messages on December 2, 30 days ahead of the expiration of the therapy cap exceptions process.
Ask your legislators to permanently fix the therapy cap or at the very least extend the exceptions process by December 31, 2013.
Download the APTA Action app (members and nonmembers). Search “APTA Action” in the Apple or Google Play app stores to download the app, then select the “Action Center” button to e-mail your legislators.
Urge at least one friend or family member to use the Patient Action Center to send a prewritten e-mail to their legislators.
We at Legacy Physical Therapy know how beneficial physical therapy can be for our patients. We do not want the therapy cap to limit patient’s ability to receive quality care here. Please take a minute to contact your legislator today!!