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Winston Salem Health – Physical Therapy, also known as physiotherapy, was introduced to the United States following WWI (1914) to rehabilitate soldiers returning from the war. The profession has grown to include many subspecialties such as orthopaedic, sports, chronic pain syndrome, ergonomic modification, and industrial rehabilitation for injured workers.

What is physical therapy?

Physical Therapy combines passive modalities with therapeutic exercise to rehabilitate the spine and other parts of the body. Passive modalities include heat/cold therapy, ultrasound, electrical stimulation, massage, and joint mobilization. These modalities are not the sole treatment, but supplement therapeutic exercise. Active therapy, or therapeutic exercise includes stretching, strengthening, and postural modification to rehabilitate the spine and prevent re-injury.

What is the purpose of Physical Therapy?

The purpose of physical therapy is to help the patient return to active life as quickly as possible. Therapy strives to reduce pain, increase flexibility, range of motion, and function, build strength, and correct posture.

Physical therapy is often prescribed for patients following spine surgery, to treat soft tissue trauma, nerve inflammation/injury, muscle spasms, fractures, arthritis, and many other problems.

Patient education is an important component in physical therapy. Patients learn how their spine works, proper body mechanics, common disorders and their causes, benefits of good posture, importance of physical fitness and its relationship to injury and disease prevention.

Who are Physical Therapists?

Physical Therapists are licensed health care professionals. Prior to practicing they must obtain either a Bachelor’s or Master’s Degree in Physical Therapy and pass an examination to be licensed. Their didactic and clinical training includes (but is not limited to) anatomy, Kinesiology (study of movement), study of disease and injury, healing and recovery, and a myriad of therapeutic treatment techniques. Therapists practice in hospitals, outpatient clinics, rehab centers, home healthcare agencies (serving homebound patients), and private practice.

What does the Physical Therapist do?

The physical therapist talks to the patient and evaluates their condition by testing joint motion, muscle strength, cardiovascular function, reflexes, and functional skills. If a physician referred the patient, the therapist will review the prescription along with the patient’s records. After necessary information has been gathered, the physical therapist designs a treatment plan to fit the patient’s needs and goals. The therapist and patient will work together as a team toward wellness.

Is physical therapy painful?

Sometimes Physical Therapy is uncomfortable or painful. However, the therapist has treatments available that can help minimize pain. As muscles are stretched and exercised, it is only natural to experience some soreness. As therapy progresses, range of motion increases as does strength and soreness diminishes. In general, patients feel better following therapy and look forward to the next session.

How long does a therapy session last?

The amount of time needed depends on the type of therapy involved. For example, it may take one patient longer to complete their therapeutic exercises than another. Also, as a patient makes progress, their treatment plan is adjusted.

Winston Salem Health Physical Therapy Information Source: Dana L. Davis, MPT and Spine Universe

Winston Salem Health: The Physical Therapy Initial Evaluation

When you go for an initial evaluation with a physical therapist, you can expect the physical therapist to ask a number of questions during the interview component of your evaluation. Most likely, he or she will ask questions about:

* how your back pain developed,
* how long you’ve had it and if you have had episodes in the past,
* what activities aggravate it or make the pain better, and
* any medical history that may impact your treatment.

Then, the therapist will conduct a musculoskeletal exam that may include an assessment of your:

* lumbar spine movements and muscular flexibility,
* sitting and standing posture, and
* strength testing of your legs and trunk muscles.

The therapist may examine “repeated movements” and the response of your back pain to several repetitions of a particular movement in a variety of directions. Additionally, the physical therapist may test your reflexes or sensation if indicated. A “plan of care” will then be established by your physical therapist, which may incorporate some of the treatments described in the next section, as indicated by your symptoms and your goals.

Use of Movements, Postures, and Positions to Reduce and Stabilize Pain

In the physical therapy examination of low back pain, the physical therapist can often identify particular movements and positions that actually lessen or control the pain. Once identified, the physical therapist may instruct you in those postures and movements that help to alleviate the pain. These can then be applied to the activities in which you are involved on a daily basis.

A physical therapy treatment program that is active in nature and geared toward instructing the patient in self care techniques and back injury prevention are key ingredients in returning a person to a pain-free, active and healthy lifestyle.

Winston Salem Health Physical Therapy Information Source: Kimberly Wallace, MS, PT, Cert. MDT and Spine Universe

Sore throat is usually caused by a viral or bacterial infection of the throat and/or tonsils. The common cold frequently starts with a mild sore throat. Both viruses and bacteria (especially the Streptococcus bacteria) may cause severe sore throat with pus on the tonsils. A lab test called a throat culture and certain blood tests can help identify the cause so that specific treatment may be given, when appropriate.

An infection of the throat is frequently accompanied by swollen, tender glands in the neck. A fever may also be present.

What should you do about it?

1. Increase your fluid intake.
2. Get plenty of rest and eat as well as possible.
3. Gargle with salt water (1 teaspoon table salt to 1 glass of warm water) or use over-the-counter gargles, sprays, or lozenges.
4. Take acetaminophen or ibuprofen in the usual doses recommended over the counter — usually 1000 mg. of acetaminophen or 400 mg. of ibuprofen every 4 hours for an adult. This will decrease throat pain and reduce any fever you may have.

Remember…

1. A throat infection may be present by itself or accompany an infection elsewhere in the repiratory system.
2. It is important to differentiate between a viral or bacterial cause before antibiotics are prescribed.
3. Infectious mononucleosis is a common cause of sore throat in young people. A specific test is available for this. Certain antibiotics can aggravate this condition.

Winston Salem Health: Physical Therapists focus on the musculoskeletal needs of their patients. As team players, the spine specialist, physical therapist, and occupational therapist all work together with the patient and family members to aid in the patient’s recovery process. The spine specialist determines the patient’s injury and type of surgery needed when necessary.

Based on the medical evaluation, the spine specialist recommends physical therapy and occupational therapy when indicated. The physician provides the therapist with a prescription including a diagnosis and recommendation of duration, frequency, and treatment. A rehabilitation program is devised based upon the therapist’s initial evaluation. A treatment plan is then designed to meet the patient’s specific goals and the patient is progressed per their treatment protocols.

The physical therapist designs a personalized exercise program to treat the patient’s injury or surgical procedure. The role of the therapist is to evaluate and manage a program, which is designed to accomplish the goals set by both the patient and their therapist. Based on the patient’s evaluation and objective measurement, the type of treatment may include a muscle strengthening program, a flexibility and general conditioning program, and pain management program.

Treatment may include a specific exercise or rehabilitation program and modalities such as moist heat, paraffin, ultrasound, electrical stimulation, iontophoresis, ice, a home exercise program, and “hands on” consisting of myofascial release, soft tissue massage, passive range of motion, and joint mobilization, as needed.

The goals of physical therapy depend on the patient’s type and level of activity to which the patient would like to return regarding their particular activities such as golf and tennis. The goals of a patient’s treatment plan is to restore joint function and joint mobility, increase muscle strength, decrease pain and inflammation, improve flexibility, resume normal activities, and return to sports as tolerated.

All of these goals can be achieved by working together as a team to help the patient recover from an injury or surgical procedure, helping to pave their road to recovery.

Winston Salem Health Physical Therapy Information Source: Shari Herschenhorn, RPT, CPT and Spine Universe

Sexual harassment can occur in a variety of circumstances, including but not limited to the following:

* The victim as well as the harasser may be a woman or a man. The victim does not have to be of the opposite sex.
* The harasser can be the victim’s supervisor, an agent of the employer, a supervisor in another area, a co-worker, or a non-employee.
* The victim does not have to be the person harassed but could be anyone affected by the offensive conduct.
* Unlawful sexual harassment may occur without economic injury to or discharge of the victim.
* The harasser’s conduct must be unwelcome.

It is helpful for the victim to directly inform the harasser that the conduct is unwelcome and must stop. The victim should use any employer complaint mechanism or grievance system available.

When investigating allegations of sexual harassment, EEOC looks at the whole record: the circumstances, such as the nature of the sexual advances, and the context in which the alleged incidents occurred. A determination on the allegations is made from the facts on a case-by-case basis.

Prevention is the best tool to eliminate sexual harassment in the workplace. Employers are encouraged to take steps necessary to prevent sexual harassment from occurring. They should clearly communicate to employees that sexual harassment will not be tolerated. They can do so by establishing an effective complaint or grievance process and taking immediate and appropriate action when an employee complains.

Winston Salem Health: Who are Physical Therapists and What Do They Do?

Physical Therapists are licensed health care professionals who diagnose and oversee the management of patients in order to improve the physical and functional abilities of people of all ages. Physical Therapists also play a role in helping individuals maintain optimal health and fitness, and prevent the onset or progression of impairments, functional limitations, and disabilities related to disease, disorders, and other conditions.

Where Do Practice Physical Therapists Practice?

Physical therapists practice in a wide variety of settings, including private practices, emergency rooms, hospital inpatient and outpatient rehabilitation centers, skilled nursing facilities, sub-acute facilities, patients’ homes, higher educational settings, research settings, schools, fitness centers, office and industrial workplaces, and sports training centers.

Physical Therapist Education and Licensure

In order to practice as a “Physical Therapist,” one must have graduated from an accredited physical therapy program, pass the National Physical Therapy Examination (NPTE), and be licensed in his/her given state(s). Physical therapists often pursue professional development opportunities, including post-professional degrees such as

• Doctor of Philosophy (PhD),
• Doctor of Science (DSc),
• Master of Science (MS),
• Master of Arts (MA),
• Master of Business Administration (MBA), or
• Master of Public Health (MPH).

Clinical specialization opportunities, such as clinical residencies, are also available to Physical Therapists. Examples include:

• Orthopedic (OCS),
• Neurologic (NCS),
• Pediatric (PCS),
• Sports (SCS),
• Geriatric (GCS),
• Cardiovascular and Pulmonary (CCS), and
• Clinical Electrophysiologic (ECS) clinical specialties.

What should you do about them?

1. Clean the area gently with mild soap and water. An antibacterial soap is fine, but any mild soap will do.
2. Apply pressure with a clean cloth or gauze pad if bleeding until the bleeding stops.
3. Continue cleaning as above 2 to 3 times a day.
4. After cleaning, apply an over-the-counter antibiotic ointment such as Polysporin or Bacitracin. Ask the pharmacist for a suggestion if you don’t find what you need.
5. Cover the scrap or cut with a Band-aid or non-stick gauze paid if it is moist or oozing or irritated by clothing.
6. Check the last time you had a tetanus shot. You should have had one within the past 5 to 10 years.

Typical responses to violent/traumatic events

• Shock and disbelief: immediately after experiencing or learning about violent or traumatic events, many people may feel numb, or feel like such events can’t quite be real.
• Speculation about what happened, and seeking more information, such as listening to or watching the news, checking the web for possible updates, talking to others about what each know or have heard.
• Physical reactions including fatigue, nightmares, exhaustion, and health problems.
• Cognitive reactions including difficulty concentrating, making decisions, or memory problems.
• Emotional reactions including fear, guilt, anxiety, depression, feelings of helplessness, and anger.
• Wanting to check in with loved ones, even if they are not close by or in any immediate danger. It is normal to want to touch base with someone you care about.
• In the hours and days following such events, the shock begins to wear off, and more feelings may emerge. It is important to share these feelings with people that you trust.

Coping suggestions

• Do activities to de-stress and help yourself to feel safe.
• Structure your time – keep busy.
• Give yourself permission to have feelings and to share those feelings w/others.
• Help your fellow students by checking out how they’re doing.
• Talk to others – this is the most healing medicine.
• Listen to others – reassure them that they are safe, don’t take their feelings personally.
• Don’t scapegoat.
• Don’t turn to alcohol or drugs.
• Keep your life as normal as possible.
• Keep a journal.
• Reassure yourself that a wide range of reactions and feelings are normal.
• Remind yourself that DU takes your safety seriously and is doing everything possible to keep you safe.

Circumstances or signs that may lead you to seek additional counseling support

• Memories of previous loss, trauma, or crisis that you have faced
• Experiencing heightened feelings of anxiety, fear for your safety, or rage
• Crying more than usual in response to sadness

• Throw out all cigarettes by breaking them in half and wetting them down. Clean out all ashtrays in your home, office, or car and throw them away. Discard matches; hide lighters.
• When the urge to smoke hits, take a deep breath. Hold it for ten seconds, then release it slowly. Taking deep, rhythmic breaths is similar to smoking, but you inhale clean air, not poisonous gases.
• Exercise to help relieve tension. Climb stairs rather than take the elevator, park the car a block or two from your destination and walk the rest of the way. At home, practice touching your toes, jog in place, do jumping jacks.
• When tempted to reach for a cigarette, think of a negative image about smoking. Select your worst memory connected with the habit—the time when you burned a hole in your suit or when you were left completely breathless after running for a bus that pulled away. Imagine this experience for 15 seconds whenever an urge occurs.
• Reward yourself with oral substitutes in the same way you may have used cigarettes. Good examples: sugarless gum, lemon drops, pumpkin or sunflower seeds, apple slices, carrot sticks, unbuttered popcorn.
• Eat three meals. This maintains constant blood sugar levels, thus preventing urges to smoke. Avoid sugar-laden foods and spicy items that can trigger a desire for cigarettes.
• Scramble up your day and change habits connected with smoking. Drive a different route to work; eat lunch in a new place; leave the “scene of an urge.” At home avoid your “smoking chair” after dinner, reach for gum rather than a cigarette when answering the phone.
• Cleanse your body of nicotine. Drink liquids—lots of them. Water (6 – 8 glasses), herbal teas, fruit juices, and caffeine-free soft drinks all are beneficial. Coffee, caffeinated soft drinks and alcohol increase your urge to smoke, so avoid them.
• Keep your hands—and mind—busy. Work on a crossword puzzle, knit a sweater, balance your checkbook, fix something around the house, shampoo the dog.
• Spend your day with friends who don’t smoke. Visit places where smoking is prohibited; a library, theater, department store, or museum. Travel in the “no smoking” car of your train.
• Get rid of smoker’s breath by brushing your teeth several times.
• Go public with your plans to quit. Ask friends to help keep you from back sliding. Ask family and co-workers who smoke not to do so around you.
• Pat yourself on the back. Quitting smoking is hard and you deserve credit for your efforts.
• Treat your body and soul with kindness: indulge in a bath, massage, nap. Listen to your favorite music. Realize you don’t need a cigarette to have a good time.