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  • What is Pelvic Floor Physical Therapy?

    A Doctor of Physical Therapy has gone through 7 years of schooling and passed the national board examination. PT school prepares you for a little bit of everything, and after school you will take continuing education classes to learn about whatever you are interested in treating. Pelvic Floor Physical Therapists have gone through extensive extra training in order to assess and treat the pelvic floor. There is coursework through the APTA and Herman and Wallace, among many other excellent sources. I'm Dr. Caitlyn, the pelvic health specialist here at MTS, and I've completed hundreds of hours focused on pelvic floor assessment and treatment, specific coursework in pregnancy and postpartum exercise, and courses to integrate my advanced manual skills with pelvic floor treatment. At every PT session we will: Assess your symptoms and goals: Through discussion and physical examination, we will be able to understand your unique needs. Craft a personalized treatment plan: This might include targeted exercises to strengthen or relax your muscles, manual therapy techniques, biofeedback, and lots of education on your particular issue. Guide you through your journey: I will be your partner in understanding your pelvic floor and achieving your goals. What is different for a pelvic floor focused physical therapy session? I have the skills to look directly at the pelvic floor muscles. Depending on your situation, a direct pelvic floor assessment could be very helpful. An internal examination is only necessary if deemed clinically relevant and with your full consent. It involves a digital examination in the vagina or rectum (depending on your anatomy and concerns) to assess muscle strength, coordination, and tone. The physical therapist will use gloves and lubrication to ensure comfort. All sessions at Manual Therapy Specialists are done in a private room, one-on-one with the treating therapist. You can decline any part of the assessment you are not comfortable with, and your therapist will never recommend something they don't believe would be helpful. While an internal assessment is the gold standard to assess the pelvic floor, there are many other things that impact pelvic floor function that can be looked at if you are uncomfortable with internal work. The assessment results will be used to develop a personalized treatment plan to address your specific needs. It's important to be honest and open about your symptoms, even if they feel embarrassing. Remember - I have seen hundreds of people like you, and the more that I know, the better I can help! If you are ready and confident to make a change for the better, give Manual Therapy Specialists a call today to set up an appointment! Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.

  • Listen to Your Body: Common Pelvic Floor Issue Symptoms You Shouldn't Ignore

    Symptoms indicative of a pelvic floor issue are often ignored or mislabeled as “normal.” While the symptoms might be common, that doesn’t make them normal! As a pelvic health PT, all too often I hear from my postpartum clients “I have that symptom, but it’s just because I gave birth…that’s normal!” Urinary incontinence (leaking pee) for any reasons (ex: with coughing, sneezing, laughing, exercise, or urgency) and sexual dysfunction (pain with intercourse and difficulty achieving orgasm) are two very common issues that I hear from patients. Most of the time, they didn’t realize there is something to do to improve it! Here is a check list of symptoms - if you have any of them, it can be indicative of a pelvic floor issue - which means pelvic floor PT can help! Pelvic pain (genitals, perineum, pubic, bladder) Pain during pregnancy Pain after giving birth Postpartum return to exercise Pain or burning with urination Accidental loss of urine in any situation (including coughing, laughing, running, and jumping) Having to use the bathroom within a few minutes of a previous use of bathroom Getting up to urinate 2+ times per night A feeling of increased pelvic pressure Sensation of pelvic organs slipping down or falling out History of pain in low back, hip, groin, or tailbone Loss of bowel control Feeling unable to completely empty bowels or bladder Straining or pain with bowel movement Constipation or diarrhea Pain or discomfort with sexual activity or intercourse Pain with gynecological exam Don’t just live with these limiting symptoms. Give us a call today to discuss your symptoms and come up with the best solution for you. In our next post, we will outline what a pelvic floor PT session is like. Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.

  • Demystifying the Pelvic Floor - What IS the pelvic floor?

    Welcome to our 4 part series about the pelvic floor! By demystifying the pelvic floor, we can empower individuals to seek help and reclaim control over their pelvic health. Remember, you're not alone! There is a group of muscles we often forget about, and we are even encouraged to ignore or not talk about, but they are silently supporting you in numerous ways. That's your pelvic floor! This network of muscles plays a crucial role in various bodily functions, impacting your well-being more than you might realize. So, let's shine a light on this often-overlooked powerhouse… What is the Pelvic Floor? The pelvic floor muscles are at the bottom of your pelvis. There are multiple layers to the pelvic floor muscles. The ones closer to the surface are responsible for continence - if you are going to the bathroom or not. When they contract, you will not be going to the bathroom, when they relax, you can. To think about the deeper layer of muscles, you can imagine a hammock cradling your bladder, uterus/prostate, and rectum. These deeper muscles act like a sling, supporting these organs and enabling their proper function. The layers of the pelvic floor are vital for: Bladder and Bowel Control: These muscles control the release of urine and stool, preventing accidental leakage and promoting continence. When they are contracted, we are not going to the bathroom, when they relax, we can go to the bathroom. Sexual Function: Strong and coordinated pelvic floor muscles enhance sexual pleasure and erectile function in both men and women. Core Stability: They work alongside your abdominal and back muscles to support your spine and improve posture. Childbirth: During pregnancy and delivery, a healthy pelvic floor plays a crucial role in supporting the baby's weight and facilitating a smooth delivery. What makes a “healthy” pelvic floor? The pelvic floor muscles need to be able to contract AND relax, and do so at the right times. When we cough or sneeze, the pelvic floor needs to contract. When we sit down to have a bowel movement, the pelvic floor needs to relax. If you are contracting when you should be relaxing, or vice versa, that can cause issues! Throughout our series, we will cover how to know if you have a pelvic floor dysfunction, and what you can do about it! Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.

  • Don't Run on Empty: Understanding Low Energy Availability (LEA) and Relative Energy Deficiency Syndrome (RED-S)

    As a Physical Therapist with a passion for working with female athletes, and a former collegiate runner, I am well aware of the impact that fueling can have on one's recovery. For many athletes, dedication and training are second nature. But pushing for peak performance can sometimes lead down a dangerous path, one paved with inadequate energy intake and compromised health. In this post I will discuss what was previously widely described as the "Female Athlete Triad," now more accurately as Low Energy Availability (LEA) leading to Relative Energy Deficiency Syndrome (RED-S). LEA means the body simply doesn't have enough fuel to function optimally. Chronically being in this state can lead to the more serious RED-S. LEA Explained: The Cause of RED-S Think of the body as an energy bank account. When you burn more calories through exercise than you consume through food, your account goes into deficit. This is Low Energy Availability, and chronically being under-fueled leads to hallmark physiological disruptions of RED-S. Both LEA and RED-S impacts everything from your performance to your overall health. Why did they call it the "triad"? There are three major issues associated with what was previously more widely known as the Female Athlete Triad. It is now referred to as the Female and Male Athlete Triad or Relative Energy Deficiency Syndrome - as the issues associated with LEA can happen to anyone regardless of sex. The three key factors: 1. reproductive suppression (absence of period or low testosterone), 2. bone health changes, 3. low energy availability, with or without disordered eating. There are other symptoms and issues that can result, thus the switch to use of RED-S nomenclature. Risk Factors Athletes in weight-sensitive sports like gymnastics, dance, swimming, wrestling, and distance running are particularly susceptible. However, anyone prioritizing intense training over balanced nutrition can be at risk, regardless of the sport or level. Warning Signs of RED-S: -Decreased performance -Fatigue -Frequently sick (impaired immune function) -Disrupted menstrual cycle (inconsistent, or little to no period) -Increased incidence or persistence of injuries -Stress Fractures -Decreased bone mineral density -Exercising to "burn off what I ate" -Exercising while injured despite medically prescribed rest -Excessive training beyond prescribed training plan What does physical therapy have to do with this? A PT's main concern is that their patients are getting better. Without sufficient fuel, you can't repair and recover. What was a simple strain could take an excessive amount of time to heal, and your risk for injury is much higher. PT can help you adjust your programming, determine what to focus on, and how to safely build back up once you are recovered from your injury. Fueling Your Passion The good news? RED-S is preventable and treatable. Here are some key steps: -Fuel for performance: Consult a sports dietitian to create a personalized fueling plan based on your training needs and goals. -Balance is key: Prioritize nutrient-dense whole foods like fruits, vegetables, whole grains, and protein. Do not avoid carbs! -Rest and recovery: Don't underestimate the power of rest days and sleep to allow your body to refuel and rebuild. -Seek professional support: Talk to coaches, trainers, or healthcare professionals if you suspect LEA or have concerns about your nutrition and training. Physical therapists are able to help with programming and movement suggestions to ensure you can get back to your sport safely. Remember: You are not alone. By understanding LEA and RED-S, you can take proactive steps and ensure you are ready to enjoy your sports. Additional Resources and Further Reading The Female and Male Athlete Triad Coalition: https://femaleandmaleathletetriad.org/ National Eating Disorders Association (NEDA): https://www.nationaleatingdisorders.org/ Academy of Nutrition and Dietetics: https://www.eatright.org/ Relative Energy Deficiency in Sport (RED-S): Scientific, Clinical, and Practical Implications for the Female Athlete. https://pubmed.ncbi.nlm.nih.gov/36479178/ Low Energy Availability and Relative Energy Deficiency in Sport: What Coaches Should Know. https://doi.org/10.1177/17479541211054458 Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.

  • 7 Tips to Improve the Quality of Your Sleep and Healing

    Bad sleeping habits and late nights can reduce your ability to heal. If you aren’t sleeping for long periods, you aren’t getting into REM (rapid eye movement) sleep. REM sleep is when our body repairs itself. It is important to get quality sleep when you have an injury. 1. Go to bed and get up the same time every day and plan for 7-8 hours of sleep. Plan to go to bed earlier to get extra sleep. 2. Keep your bedroom dark, cool (65-70) and quiet, no blue light (No iPad, no TV at least 30 minutes before bed). Heated blankets are awesome in the winter (We fall asleep much faster). 3. Wind down for a few hours before bed, don’t exercise or do stimulating things (caffeine, a scary movie). 4. Melatonin can also help you sleep better as it helps if your body doesn’t produce enough (from stress and inflammation). Take around 1–5 mg 30–60 minutes before bed. Start with a low dose to assess your tolerance and then increase it slowly as needed. It is advised that you check with your doctor before use. 5. Make sure your mattress and pillow are supportive and not worn out. Your mattress and pillow should be comfortable and supportive. Firmness should align your spine well. This is variable per person and mattress/pillow. 6. Limit alcohol usage when trying to get quality sleep. It may help us relax but it reduces the quality of your sleep. 7. Naps should be limited to 20 minutes in the early afternoon to catch up on sleep but the better option is to go to bed early. Even implementing a few of these tips can make a huge difference int he quality of your sleep.

  • Finger Pulley Injuries in Rock Climbers

    One question to ask is why did I get injured in the first place and how can I prevent that from happening in the future. Trying to find your specific weaknesses is key. Once you find them, they are easy to train. Your fingers each have 3 joints (thumb is exception) and different muscles or parts of muscles that bend each joint. Being strong and stable at all of the finger joints and muscles is a key to preventing injury and looking at the bigger muscles of the arm, shoulder and body are other key players. Technique and training style are also worth looking at. Here are the wrist and hand muscles of importance to us. The main 3 are flexor digitorum superficialis, flexor digitorum profundus and lumbricals. The big muscles of the arm, body and core should not be overlooked as well. If they aren’t functioning well there is way more work happening at our hand and forearm than there should be. If we look at the pulling muscles: Elbow = bicep, brachioradialis exercises: bicep curls and reverse curls Shoulder = latissimus, rear deltoid and posterior rotator cuff exercises: pull downs, shoulder extension and adduction, pullovers, reverse flyes, shoulder external rotation in abduction Shoulder blade = rhomboid, mid and lower trap exercises: prone T,s and Y,s Core = abs, side abs and low back muscles exercises: planks, side planks, superman’s There are 6 basic grips in climbing: open hand, full crimp, half crimp, pinch, pocket and friction Open hand – jug + sloper, deep flexors, slight bend at all knuckles, least prone to injury Half crimp – superficial flexors, fingers bent at middle finger joint no thumb wrap Full crimp – superficial flexors, fingers bent at middle finger joint thumb wrapped, most prone to injury Pinching – lumbricals and deep flexors, fingers bent at first joint thumb on opposite edge Pocket – lumbricals, one or more fingers in a pocket hole, middle finger is strongest Friction – deep flexors, open hand palm is on wall/surface Each grip works different muscles in the system and therefore all need to be strong to be able to climb varied terrain/routes. Flexor digitorum profundus: jugs, slopers and friction – least prone to injury Lumbricals: pinching and pockets – single and double finger pockets can be dangerous Flexor digitorum superficialis: half and full crimp – most prone to injury Due to anatomy the lumbricals and flexor digitorum profundus work together when the fingers are in an extended position (open handed positions and pinching) Begin with routes that have more jugs, slopers and friction holds then progress to pinching and pocket holds and climb the least number of routes with crimp holds. Take longer breaks between climbs when on routes with a lot of crimping. The muscles in our forearms attach to long, narrow tendons as they reach into the fingers. These tendons run through sheaths and are anchored by pulleys that keep the tendons gliding flush to the bones. Pulley injuries happen when trying difficult moves when tired. Particularly crimping and during the lengthening or eccentric motion. So when you fall off and you are tired your hand slowly opens while trying to continue to hold on and tears the pulley. The most common is the A2 pulley of the ring finger. As you fatigue your elbows will tend to flare which puts more stress on the hands and pulleys. Things that increase the risk of a pulley injury Being aggressive – don’t climb way above your abilities, also don’t try big moves off of a crimp keep the movements static instead of dynamic. Not having smooth, precise and controlled motion – the more control you have and the more you use your legs and feet the less likely of injuring a pulley Being new to the sport – don’t progress too fast and be sure to take frequent and long enough breaks between climbs. Your tissues will take some time to adapt to climbing. Overtraining crimping – self explanatory, this is the grip that puts the most stress on your pulleys, train this sparingly and progressively, your tolerance will build over time as your hands, arms and tissues strengthen. Being dehydrated – tissues without water are more easily injured Being tired – if your other muscles are fatigued you will likely compensate by putting more pressure on your finger tendons as there is nothing to help stabilize How to rehab a pulley injury Step 1. Take time off from climbing and use ice or contrast baths to reduce swelling and start gentle stretching and self massage until you have full, pain-free range of motion (usually one to two weeks after injury). Tendon glide exercises can also help. Step 2. You can begin gentle re-strengthening. Putty exercises for gripping, or hand strengthening devices are gentle ways to start strengthening. Finger extension exercises are also very helpful. You can push hard enough to create mild discomfort. We want progressive loading to the tissues. Step 3. You can start to climb easy routes with lots of jugs for endurance. You can also start to use a hang board. While hang boarding, use your feet to offload or use offset handholds. Avoid crimping and painful movements for four to six weeks post-injury. H-taping can be helpful though opinions vary on effectiveness. Step 4. Full return to climbing will take six weeks for grade 1 and 2 injuries, and six to eight weeks for grade 3 injuries, with a full functional return by three to six months minimum. If you have a climbing injury and would like to learn more about how we can help please send us an email at mtsfairfield@gmail.com or call 203-557-9111. Thanks - Dave

  • Five Simple Questions You Should Ask Before Seeing a Physical Therapist

    Written by Ash Waechter Before your next appoint with your physical therapist, be sure you know the answers to these five questions that you should know before your next appointment. You will save a lot of aggravation and a lot of money. 1. “How much does it cost to see a physical therapist?” You want to see a physical therapist, but you don’t know what you should be paying, right? That’s a fair question. Actual costs According to Thervo.com, you could pay $20-$55 as your copay with insurance. If you don’t have insurance, you can expect to pay between $75-$180.* According to Healthcare Bluebook, a fair price for a physical therapy session is $176 for a first-time visit and $120 for a follow-up visit in Fairfield, Connecticut. On the high end, the rates that Health Care Blue Book posts are $264 and $180 respectively. PLEASE NOTE: While Healthcare Bluebook quotes these numbers as “fair rates,” Manual Therapy Specialists prices are fair below these values. Read on to see why physical therapy at MTS can be far cheaper than most physical therapists. Hidden costs However, you need to understand how your particular insurance works. You could end up paying more with your insurance plan. Some insurance plans will cover your copay at the time of your physical therapy appointment. However, later on, you may find that your physical therapist will bill for more. This is because your insurance company may not cover all of your physical therapists’ treatments. As stated by Becky Wesolowski of Restoration Physical Therapy: “If your plan’s deductible applies to physical therapy, you are responsible for paying the full “contracted rate” for the services provided. Your PT will send a claim for services to your insurer. Your health insurer adjusts the claim, sends it back to the PT, and your PT must then bill you for the adjusted amount.” Be very careful about paying with your insurance. What you spend on the day of your visit may not be the final payment. When paying through insurance, your physical therapist will have to send a claim to your insurance company. Afterward, you may get an additional bill. So if your physical therapist has it posted that their sessions are $125, be sure to read the fine print. At Manual Therapy Specialists here in Fairfield, Connecticut, we have one flat fee, so you ONLY pay the amount we give you. Nothing more. No bills sent at a later date for more money. Many people were caught off guard by these hidden costs of physical therapy. Here is one such story: Josh Walton said his physical therapist sent him a bill for $550.33 after he was paying $125 per session for six physical therapy sessions. When he looked at his bill, he was shocked to see that the average cost for each one-hour session at his physical therapist was actually $525 per session. Of course, the insurance was covering most of this. However, Walton was very dismayed by the games his physical therapist was playing with him and his insurance company. The physical therapist at the time of his appointment told Walton that “his cost was only $125.” That was true until six weeks later when he got a second bill from his physical therapist. See below for the actual bill: Walton said, “I didn’t understand this bill at all. At every appointment, they charged my credit card $125. I thought that’s what the actual physical therapy session costs. I knew that I had a high deductible on my insurance plan, so I knew I was going to pay out of pocket for my physical therapy sessions. But this bill is a total shock to me. I don’t understand it at all. On this bill [Patient Paid] it looks like I paid all sorts of amounts at each session. How am I supposed to comprehend this bill?” As you can see from Walton’s bill, there are many hidden costs that you don’t know when you make your appointment with your physical therapist. This is the problem when bouncing around between your physical therapist and your insurance company. It’s better to work with a physical therapist who has straight-up transparent pricing. It’s best to work with a physical therapist that gives you straight up pricing without and hidden fees with the insurance company. Manual Therapy Specialists has precisely that—total transparent pricing. Make sure you know exactly what you are paying for in advance. Manual Physical Therapy has total transparent pricing. No hidden fees or costs. The price we tell you at the beginning of your physical therapy appointment is the only price you will pay. There are no hidden fees or other costs associated with your physical therapy appointment. High costs of physical therapy Many people are surprised when they get a bill after their physical therapy session. It can come as quite a shock to you if you have experienced this yourself. Here’s another story about the high cost of physical therapy: "I had surgery ACL surgery 10/30/12. I have been upfront with the people at PT about not having insurance, and that I'm paying out of pocket, you can imagine my shock to find out I have been billed $342 a session!" As mentioned earlier, the Healthcare Bluebook puts the high price of physical therapy appointments at $264 per session, so getting a bill for $342 for a physical therapy session can be quite aggravating. We can assure you that our prices here at Manual Therapists Specialists are way below what we’ve seen so far. To get a transparent and honest cost for your next physical therapy session, click here. Ask your physical therapist what they charge Before you set up your physical therapist appointment, ask very clearly how much they charge for your appointment. Whether you are paying with your insurance or not, get a clear answer. Many doctors—not just physical therapists—are reluctant to tell patients the amount they actually bill to your insurance company. It’s your right to know. Ask them. You have to watch out what your physical therapist will charge as stated on one online forum: “I can tell you that while I was working and billing insurance, some paid the full treatment price of close to $230/hour. Yes, PT’s (and other health care prof that bill insurance) do over-charge just to see what the idiot insurance company will reimburse us for. it’s full-on highway robbery." Manual Therapist Specialists here in Fairfield, Connecticut bills out of network. Read on to see how this arrangement is actually a significant saving for you in the end. Insurance company adjustments Your physical therapist may put you at ease by telling you that your insurance company will make an adjustment to your final bill so that you are only paying what they quoted at the beginning of your physical therapy appointment. Buyer beware! On Blogging Away Debt, Kurt had this to say about the insurance company's "adjustment" for his wife's physical therapy session: “My wife went to 5 sessions, 45 minutes each, of physical therapy. When we got the bill, it was for $1,600, minus $100 adjustment per their contract with the insurance company. So that comes to $300 per session. We were a little shocked. So far they don’t seem willing to give any kind of price break, even though we have to pay that out of pocket (our insurance has a $3,000 deductible.) Wish we’d have known the price before-hand. We would have said no thanks.” When dealing with insurance and copays, be mindful of what you are precisely paying at the end of the day. You don’t want to be shocked with a bill down the line. Ask your physical therapist for all associated cost for your physical therapy appointments. Manual Therapy Specialists has total transparent pricing. The price you are given at the time of your session is the final price you will pay for your physical therapy session. As mentioned on Thervo.com, “the cost of private pay physical therapy can be 30 to 50 percent less when you pay in cash.” Therefore, paying for your physical therapy session through your insurance may cost you more in the end. Read the fine details of your agreement. Manual Therapy Specialists handles out of network patients only. As mentioned earlier, this can be a considerable saving for you. In the end, you can be sure you are the paying the right price at Manual Therapy Specialist because we have total price transparency. At larger clinics that work with insurance companies, patients will often get a bill after the fact. 2. "How long does a physical therapy session last?" This is an excellent question and needs to be clarified. If you call a physical therapists office, they will tell you that a session will last about an hour. You must be careful about this. Most times, you are in their office doing exercises. However, you are only seeing a physical therapist for about 15-20 minutes. Most of these exercises that you are doing in their facility you can do at home at no extra cost to you. So, if you add it up, you are paying full price for only 1/3 of your physical therapists time. At Manual Therapist Specialists, you will be with your physical therapist for the entire hour. You will be working with him or her the entire time of your appointment. On a cost basis, this is a better value for your money. What does this mean for you? More time with your physical therapist (i.e., one hour) equals fewer appointments, you need to make for your full recovery. Less cost for you. Many physical therapy establishments will have you doing exercises for nearly two-thirds of your total time in their facility. During the first few times, it may be necessary to learn what you are doing. However, after your first one or two sessions at your physical therapist facility, you will know how to do these exercises at home—or even at your local gym. As far as how many sessions of physical therapy you, it depends on many factors. Some of these include: · Physical activity level · Posture · Age · Diet · Medications · Smoking · Severity of injury · Duration of injury The level of recovery you can expect from physical therapy will also depend on how much you adhere to the treatment plan given to you by your physical therapist. Since our physical therapists spend a full hour with you, you are actually spending less money overall. 3. “Do you need a doctor’s referral to see a physical therapist?” No, Connecticut is a direct access state. This means you can come to a physical therapy session at Manual Therapy Specials without a referral from your doctor. The one caveat to that rule is that we just need to show improvement in 6 visits or 30 days, whatever comes first. https://runnersconnect.net/wp-content/uploads/2015/02/PT-direct-access-map-copy-LARGE-900x835.png Be on the lookout for any physical therapy clinic that asks you to see your doctor first for a referral. In Connecticut (and several other states) you don’t need to see a doctor first. However, Connecticut is one state where this rule is conditional. The condition is that you need to see improvement form your sessions during a certain amount of time. As stated earlier, that amount of time can be six visits or thirty days—whichever comes first. Sounds fair, right? This could be a sign that you may be paying more than you should. We’re not saying they are dishonest if they ask for a referral. It’s just that when you need a referral, it usually means insurance is involved. As discussed, getting your insurance company involved can be a sticky situation. It also can be more expensive. 4. “Is physical therapy painful?” Getting treated or doing some exercises that you have not done in a while may cause a little discomfort. But this is a good thing. Usually, there is good pain while you are in physical therapy. Occasionally, some people have soreness after their initial treatment. However, most people will feel looser and less painful when they leave. At Manual Therapy Specialists, we don’t believe that more pain is better, we try to use the least amount of force to create the change that we need. 5. “What does a physical therapist do?” The overall objective for the physical therapist is to help their patients manage their pain and improve their mobility and function. Some physical therapists use exercise equipment to treat their patients. These tools can be treadmills, medicine balls, weights, and more. Physical therapists can help patients who are dealing with neurological disorders and provide relief from arthritis. Physical therapists treat patients that have ongoing conditions, sports injuries, or are recovering from surgery. “Physical therapists (or PTs for short) are trained to treat muscle and joint problems, back pain, and other ailments that can make moving difficult. They also help guide exercise programs for patients undergoing cardiac rehabilitation.” –WebMD In short, physical therapists put you back to working order. But beware of overuse of modalities, such as (ultrasound and electrical stimulation). These are often used by larger clinics. This may be the reason for such high costs reported earlier. Dave uses hands-on techniques that are much better than many popular modalities or machines. He gets deep into the injury and works with it using manual stimulation with his hands. Your physical therapist at Manual Therapy Specialist uses a hands-on approach without relying on electrical stimulation machines or ultrasound. Be mindful of the fact that at many larger physical therapy clinics in Connecticut (and elsewhere for that matter), you will often times have a different therapist on follow-up visits. For some, this may not be a problem. However, many have found this arrangement to be discomforting. The therapists never really get to know you and your particular issues. At Manual Therapy Specialists, you will be seeing the same specialist each time you arrive. Dave, of Manual Therapy Specialists, uses hands-on techniques. While most larger physical therapy clinics (that charge through insurance) will have you working with the physical therapist for 12-20 minutes of your one-hour appointment. Your physical therapist at Manual Therapy Specialists works on you for 50 minutes of your one-hour session. Conclusion Going to a physical therapist can be a big deal. It’s an important decision to make. Be sure to ask the right question when you go see a physical therapist. Find out exactly what your financial obligation is throughout your physical therapy sessions. You don’t want to get a surprise bill several weeks or months after your physical therapy sessions have ended. When comparing costs to treatment, you will want to ask your physical therapist how much time you will be speeding with him or her and how much time you will be spending doing exercises in their facility. In addition to knowing how long your physical therapy session will last, you will want to know what specific exercises you are doing and if they will cause you any pain. Generally, doing exercises and getting hands-on treatment is not a painful experience. Each physical therapist facility is different. At Manual Therapy Specialists, you will be worked on by your physical therapist for an entire hour. Manual Therapy Specialists has total transparent pricing. No surprise bills later on. You will spend one hour with your physical therapist getting the hands-on treatment you need. Be sure to book, ask about costs and availability at Manual Therapy Specialists by clicking here. #physicaltherapyquestions

  • Nutrition for Quicker Healing

    Our diets can be proinflammatory or anti-inflammatory so when you have pain and inflammation, what you eat should be considered. Four areas we can look at are food allergies/sensitivities, antioxidants, omega 3’s and nutrients. Eliminate Food Allergies/Food Sensitivities Food allergies and sensitivities can cause inflammation in the body. The body reacts as if the food were a bacteria or virus and releases a bunch of cells and chemicals to attack that food. This causes inflammation levels to rise in your body making it easier to feel pain and harder to return to a pain free state. Common allergies/sensitivities include wheat and dairy, eggs and shellfish. Spicy foods and alcohol are also both irritants to your intestinal system. Getting allergy testing and/or doing an elimination diet are ways to figure out which foods are keeping your inflammation levels high. You can also keep a food journal and track symptoms such as bloating, tiredness, irritability, increased pain, etc. They are all indicators the food you just ate isn’t agreeing with you. Along with an elimination diet, probiotics can restore the balance of your microbiome which will reduce overall levels of inflammation as well. Antioxidants Cells can be damaged through oxidative stress from free radicals (has to do with electrons in oxygen). This cell damage creates inflammation. Antioxidants stop this damage which stops inflammation. One of the best naturally occurring antioxidants is in Black or Tart Cherry Juice Concentrate. It has naturally occurring chemicals that block inflammatory chemicals just like NSAIDs (Tylenol/Aleve). Take 1 ounce 45 min before bed as it also has melatonin in it which can make you sleepy. Omega-3’s The American diet is high in omega-6 and low in omega 3. Omega-6 creates inflammation, omega-3 reduces inflammation. You should learn which foods give you more inflammation and eat less of them or eliminate them. You should also eat more foods with omega-3s as this will reduce the levels of inflammation in your body. Cold water fish (salmon, cod, etc.) or fish oil tablets, walnuts or flax seed oil are all good examples of foods with high levels of omega-3s. If you buy a supplement try to buy one from the refrigerator as the good chemicals in the supplement degrade with heat and time (sitting on the shelf in the store). Magnesium, Vitamin D and Calcium Deficiencies in these nutrients can cause muscle pain / joint pain / headaches / numbness / fatigue / nerve pain / cramps / weakness and more. The important part is that these 3 are reliant on each other so they should not be taken independently or they can cause the others to be deficient. Some types of these supplements are also absorbed much less by your body (they go right through you). An example is magnesium oxide. Chelated supplements are better absorbed. Any time you can get these nutrients naturally it is preferred. Here are some examples of foods that have these nutrients in them. Magnesium – Epson Salt Baths, Halibut, Almonds, Cashews, Spinach, Oatmeal, Yogurt Vitamin D (D3) – Sun (hit the pool or beach), Salmon, Tuna, Sardines, Shrimp Calcium – Dairy, Oatmeal, Spinach Try to eat the above foods or get a supplement that has magnesium, vitamin D and calcium in it. These are 4 different areas of nutrition that will help lower your overall inflammation in your body and get you pain free faster. If you want to heal faster, find the root cause of your pain and learn how to prevent it from coming back get in touch with us. To make an appointment or find out more about our services call 203-557-9111 or email us at info@manualtherapyspecialists.com #physicaltherapy #fairfield #manualtherapyspecialists #nutritionforhealing

  • Not Your Grandma’s Physical Therapy

    What is Physical Therapy? Physical therapists (PTs) are movement experts who optimize quality of life through prescribed exercise, hands-on care, and patient education – definition straight from the American Physical Therapy Association website. What does that mean? We fix problems and pain. If you are having difficulty with a particular movement that creates pain (i.e. reaching overhead); or are unable to perform a normal activity like exercising, lifting your kids or running, then we should be your first line of defense. With Direct Access we can now see patients without you having to see your doctor or orthopedist first. We can save you time and money by getting you in the clinic and on the road to recovery as soon as possible. How is Manual Therapy Specialists different vs. traditional Physical Therapy? The lists below compare and contrast some of the differences Traditional Physical Therapy 10-15 minutes with your physical therapist One of many people in a clinic at the same time Give you exercises that you could do at home Hot/Ice packs – modalities every session Physical Therapists use Generic Protocols Can only treat one body part at a time due to insurance limitations Patients can get bills later for what insurance doesn’t pay for Manual Therapy Specialists 1-hour treatments = it takes less visits to get you better One on one treatments – just you and your therapist in private rooms Personalized exercise program based on your specific needs – to be done at home We only use modalities as needed to get you out of pain Specialized treatments – Hands-on techniques, injury and movement education We treat the whole person and use a movement-based approach Price transparency – no bills after the fact Our patients value their time and money. They see the difference in our quality of care and our ability to get people better faster with a smaller number of visits saving time and money. Our approach in unique and gets superior results. We cater to people with a more active lifestyle. Don't settle for only getting 70-80% better with traditional physical therapy. Get back to 100% with us as we have the training and tools necessary to get people to high performance function. Heal faster, find the root cause of your pain and learn how to prevent it from coming back. To make an appointment or find out more about our services call 203-557-9111 or email us at info@manualtherapyspecialists.com #PhysicalTherapy #Fairfield #ManualTherapySpecialists #HealFaster #NoPainBigGains

  • Common Deadlift Pitfalls

    We’ve all been there… heavy bar and plates on the ground. You want to lift it up badly but you sacrifice form. The next day something is hurting… Here are the 6 most common pitfalls we see with deadlift technique. Start Position – The further away from your body the bar or load is the more stress there is on your low back. Ideal position for the bar is over your midfoot. Feet should be shoulder width apart and straight ahead or with a slight turnout if comfortable. Bar position should be about one inch in front of your shins. Too far forward and the load with shift to your low back and calves. Too far back and it shifts again to your low back but you also lose balance very easily. Your shoulders should be slightly in front of the bar at the starting position, commonly they will be behind the bar if you rock back too fast. Hip height will vary depending on how long your torso and thigh bones are. Hips too high is bad for you. The low back should be in neutral not rounded position. (slight arch) Note that you can arch too much as well. Breathing/Tensioning – You want to fill your lungs with air before you lift. A can of soda is harder to crush when it is full of liquid. More tension/pressure = ability to lift more. As you set up create tension by breathing in, fire your lats and hamstrings and rock your hips down and back to create tension. Just don’t lose your balance point. Squeezing the bar firmly will also create more tension. Pulling – The easiest way to lift heavy weight is straight up. We commonly see people try to hold the bar away from their body and not drag it up their thighs or the bar path will be a squiggly line instead of a straight line. Pulling the bar into your body and engaging your lats will help with this. Lock Out – People tend to pull too far and their low back hyperextends (they arch backwards). Let’s think of this, you have a huge weight and you bend backwards creating a hinge point putting all of the weight into your low back. Not a great idea… The finish should be a stacked position with your shoulders on top of your hips, hips on top of your feet. Don’t pull into hyperextension. Head Position – The head and neck should be in a slightly tucked position to further turn on your core. If you look up you make your extensor muscle group overactive. While there may be a slight advantage for setting a PR, on a regular basis this will cause breakdown of the system and eventually injury. Lowering the Bar – People will often lose the tension that they have created when they lower the bar causing the system to crumble and the load to strain a certain area of the body. The injury will usually be due to volume and poor technique not a single lowering of the bar. There you go the 6 most common technique issues we see with deadlifting. Fix your form and go lift heavy weights! #kingofalllifts #pickthingsup #deadlift Heal faster, find the root cause of your pain and learn how to prevent it from coming back. To make an appointment or find out more about our services call 203-557-9111 or email us at info@manualtherapyspecialists.com

  • Foam Rolling makes you Feel Better and Move Better... When and How do you do it?

    What does foam rolling do? Foam rolling increases flexibility, mobility, and circulation; reduces muscle tightness and soreness; releases fascia; removes trigger points; and reduces or eliminates pain. Does foam rolling help with flexibility and mobility? Yes, it has been shown to increase both passive and active ranges of motion, albeit for a short period of time 10 min to a few days. If you do use foam rolling as intervention for increasing motion make sure to use that newly acquired moving by moving afterwards. Clinically I have seen good changes in mobility with patients that are consistent with foam rolling Does foam rolling help with recovery? Yes, there is research that shows that foam rolling can help reduce fatigue and muscles soreness. It has also been shown with helping you get back to performance levels faster than if you did not foam roll. So, foam rolling AFTER a training session is probably one of the most beneficial times to do so. It depends on your goals. Does foam rolling help release fascia? Fascia is a band or sheet of connective tissue beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs. Tightness here can limit mobility and stability. If you pull the bottom of your shirt down and raise your opposite arm up it will be limited. This is how fascia can limit movement. Foam rolling hydrates fascia (thing squeezing out a sponge and letting it fill back up with water), helps with removing metabolites, improves blood flow by stretching arteries and veins. Slow rolling helps with fluid exchange and fast rolling increases tone of muscles. Does foam rolling help remove trigger points? Foam rolling has been shown to reduce trigger points or muscle knots. We want to reduce the contracted muscle area so it can work better. Muscles need to be able to contract and RELAX fully to work at 100%. We get improvements in stability when trigger points are released. Trigger points can also cause pain. Does foam rolling help reduce pain? Pain theory – stimulus (foam rolling) to the nervous system desensitizes the system lowering levels of pain. When combined with diaphragmatic breathing can further down regulate pain. There will be less “resistance to movement”. An analogy is that if you hit your elbow and it hurts you can rub it to make it feel better. Foam rolling is the rubbing. How should I foam roll? Basically, there are two techniques fast and slow. Fast will improve tone of an area which may be good prepatory work before you do dynamic exercise like plyometrics. Generally, we like slow better as the goal is to get a release of the tissues. When people roll quickly there often won’t be a release. Think of the sponge analogy earlier in the article. Squeeze the fluid out slowly. You can also do small oscillations on the “knots” until they release. 1-2 minutes per area or until it become less sore or easier to roll through that area is good enough. When should I foam roll? Before a workout – increase tissue mobility for a better workout incorporate with a dynamic warmup, Decreases resistance to movement. If you have issues with a movement (squat, deadlift) foam roll to free up the movement so your technique will be cleaner. During a workout - foam roll the opposite muscles of the exercise, if we are doing bicep work you can roll your tricep during rest periods to free up elbow flexion. After a workout – reduced soreness and recovery time, general techniques focused on slow rolling to help improve blood flow. Below are some examples of common areas to foam roll. For more information on foam rolling or other self treatment techniques call 203-557-9111 or click here Thanks - Dave

  • Shoulder Pain: A Blueprint

    Shoulder pain can be complex because of how many parts of the body are required just to move your arm. The areas we look at are neck, shoulder blade, ribcage, shoulder and elbow/wrist/hand. If we look at all of these areas, we can fix recurring shoulder pain and can get you better faster saving you valuable time. Neck All of the muscles in your arm are controlled by the nerves that exit your neck. When you have an issue in your neck that will create a weakness in your arm. The weakest area or often the area that is working the hardest will get beat up and you will get pain. Tightness of the nerves in your neck/arm can also lead to loss of motion at your shoulder and weakness. Shoulder Blade Your entire shoulder girdle is only attached to your body through your collar bone, so an issue of your shoulder blade will affect the shoulder joint. The shoulder blade position can create impingement of the shoulder. If the shoulder blade is tipped down and the arm tries to go up it runs into the shoulder blade (acromion) and you get pinching/pain in your shoulder. Ribcage Weakness of the muscles of your ribcage creates issues with your shoulder blade motion as we just reviewed above. When you have a stiff joint in your back or a stiff rib joint you will have weakness of that area as well. Poor posture creates weakness of the shoulder blade muscles as well. Check out our posture article here. Shoulder The job of the rotator cuff is to hold the ball in the socket. (The shoulder is a ball and socket joint). When these muscles are imbalanced the ball moves around too much in the socket and the shoulder tendons get pinched and create pain. Having a strong rotator cuff keeps the ball centered in the socket. Shoulder blade position and neck involvement (nerves from the neck control the rotator cuff) also affect how strong these muscles are. Elbow/Wrist/Hand The important part about the elbow, wrist and hand is that if the muscles are weak you may compensate by overusing the next muscles up (i.e. the shoulder) leading to overuse injury. So there you go, a roadmap to fixing shoulder pain. Since everyone is different, we don’t use protocols and give out the same 5 exercises to everyone. We tailor a home program specific to YOU based on your evaluation. We will soon put out articles on the most commonly used exercises and little known exercises that are important, so check back soon for those articles. To schedule an evaluation or if you are still unsure about us a 30 minute discovery visit call 203-557-9111 or click here Thanks - Dave

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