Posted on 12/1/2020

In today’s “new normal,” day-to-day life, personal health and wellness is at the forefront of all of our minds. We are protecting ourselves, cleaning more often and trying our best to live fit and healthy lives. One of the most important factors in determining our long-term health and wellness is the food that we put into our body. Especially during this time of year, when sweets and rich foods are easily in reach, it’s more important than ever to make sure our diet is full of nourishing foods to fuel our immune system and fight off illness.

While a healthy, balanced and colorful diet is extremely important, there are a few key vitamins and minerals that help build our immunity more than others. They all act on different parts of our body’s reaction to illness, allowing the body to fight longer and harder against these intruders. These particular vitamins, and some of their function in the immune system, include:

• Vitamin C – Protects your cells against free radicals, and absorb/store iron
• Vitamin B6 – Makes antibodies to fight disease
• Vitamin E  – Defends your cells against free radicals

Luckily for us, these vitamins are found in many of the foods that we eat on a daily basis. Some common foods that contain these nutrients include:

• Vitamin C – Oranges, strawberries, bell peppers, spinach, broccoli, and kale.
• Vitamin B6 – Tuna, salmon, chicken, chickpeas, bananas
• Vitamin E – Vegetable oil, peanuts, sunflower seeds, almonds, spinach, broccoli

The above is by no means an all-inclusive, but definitely a good starting point to begin making changes to help strengthen your immune system. Although these vitamins can easily be found in the health and wellness aisle at your local grocery store or pharmacy, it is not the best way for our body to absorb and take in these nutrients. Including foods that contain high amounts of each of these vitamins into our diet is a much easier, and healthier, way to get our body’s fill.

Another important aspect of strengthening our immune systems that comes in handy during the current times is daily physical activity. This could include walking, running, hiking, yoga and strength training. Any time you are getting your heart rate up and blood pumping, you are stimulating your body to build stronger muscles, flushing out the lungs and heart as well as boosting your immune system. Exercise helps recruit specific cells that find pathogens and wipes them out, as well as increases the amount of these cells that flow through the body on a regular basis.

If you have questions, a nagging injury that is limiting your ability to perform daily tasks or are unsure about the right path to take for your personal wellness journey, please reach out to your health care provider to discuss the best plan for you.

By: Erica R. Konopka, P.T., DPT. Erica is a physical therapist and multi-site center manager for Select Physical Therapy in North Carolina. 

KORT is part of the Select Medical Outpatient Division family of brands.

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Posted on 11/10/2020

Did you know that exercise is one of the most under-utilized tools for managing many aspects of your health? It is well known that exercise can help with weight loss by boosting your metabolism and burning calories, but there are so many more benefits, especially as we age.

Individuals naturally lose bone density and muscle mass as they age. Studies show that after the age of 50, bone breakdown occurs more than bone strength. Women particularly see an acceleration in bone loss around menopause, which puts them at a higher risk for osteoporosis. While there are supplements to help with this, regular weight-bearing exercise reduces the risk for osteoporosis.

At age 30, we naturally begin to lose muscle mass; physically inactive individuals can lose between three-to-five percent muscle mass each decade after 30. These factors lead to an increase in frailty, which in turn increases the likelihood of falls and fractures. The good news is that you can offset these problematic changes by sticking to a regular exercise program.
Here are some other great and important benefits of regular exercise:

• Exercise helps to reduce the risk of chronic disease. According to The National Institute of Health, lack of regular exercise is the primary cause of chronic disease in the United States. Getting into a fitness routine can increase insulin sensitivity, which in decreases blood sugar, blood pressure, fat levels in blood and cholesterol. It also improves cardiovascular health.
• Do you have a high stress job? Do you easily allow anxiety to interfere with life? Regular exercise can help with that. Exercise triggers your brain to release endorphins in your body which are mood enhancers and natural pain killers. They create a feeling of well-being. Along with being a mood enhancer, exercise also helps to increase energy levels. Exercise has been shown to begin to help elevate moods in as little as 10 minutes into the activity.
• Improving brain health and memory. Exercise increases your heart rate, blood flow and oxygen to your brain. According to a study by the Proceedings of the National Academy of Sciences of the United States of America, regular aerobic exercise increases the size of the hippocampus, the part of your brain that is involved in verbal memory and learning. Exercise also stimulates the release of growth factors chemicals in the brain that affect brain cell health, the growth of new blood vessels in the brain and even the survival of brain cells. Reduce your risk factors by beginning an exercise program today.

You don’t need to exercise for hours at a time to see results in your general well-being. By setting aside 30 to 45 minutes most days of the week for moderate physical activity (brisk walking, swimming, strength training), you can reap the rewards of enhanced health and wellness.

Now that you are aware of all of the great benefits from regular exercise, why not jump in? You don’t have to be a seasoned athlete to exercise. If you are nervous about beginning a program, a physical therapist is a great resource to help design a safe and effective program for you. Physical therapists are movement specialists who are more than qualified to set up an appropriate program to fit your needs.

In most states, you can choose to see a physical therapist without a referral from a physician. If you do need a referral, most primary care doctors will gladly provide you with a prescription for physical therapy so that you can begin your journey to a better, healthier you.

Make time for your wellness before you are forced to make time for your illness. Your physical therapist can help.

By: Colony A. Hopkins, P.T., DPT, COMT, AIB - VR/CON. Colony is a physical therapist with NovaCare Rehabilitation in Uniontown, Pennsylvania.

KORT and NovaCare are part of the Select Medical Outpatient Division family of brands. 

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Posted on 10/21/2020

As recently as five years ago, if you had Googled ‘esports athletes,’ you may very well have come across many sarcastic comments about how they aren’t real athletes. In 2020, you will find items about their tremendous hand-eye coordination, work ethic and the degree to which they work to hone their craft.

You’ll also find the following: esports are growing at a tremendous rate, for both participants and in terms of viewership. Nearly 100 million people watched the League of Legends World Championships in 2018. There are more than 1.2 billion players of esports worldwide. It is expected that there will be $1.1 billion dollars of revenue generated by worldwide esports in 2020.

Much like their colleagues in traditional sports, esports athletes place a demand on their bodies that can sometimes be detrimental to their physical health. Unlike traditional athletes, these negative effects rarely start with one-time injuries and are not often obvious. I have had the privilege to work as a physical therapist with the Harrisburg University Storm esports program and have seen problems ranging from carpal tunnel syndrome, to tennis elbow (lateral epicondylitis), to nerve entrapments and neck and upper back pain.

For the gamers at Harrisburg U, we take a comprehensive approach. They often train many hours a day, so things like load management, which is often discussed in regard to the National Basketball Association and National Football League, is a very real thing that our physical therapists advise for gamers. The gamers at Harrisburg U workout with a personal trainer multiple times every week. We help coordinate with their personal trainer what they should be doing with upper extremities during these sessions so they aren’t overloading muscles in the arms and hands.

As with many problems that physical therapists address, a problem in one area can be rooted elsewhere, such that an unnoticed postural problem an lead to pain in the wrist or hand. Positioning is very important for gamers and maintaining proper posture is key, so targeted exercises for their postural muscles are a must. Sometimes correcting this can be the difference to the pain in their hands. Basic sports medicine principles like stretching, warming up and using ice after practice and competition are also vital.

Esports is a burgeoning field both as a profession and as an avocation. Much like their counterparts in traditional sports, they place high demand on key muscle groups and face the risk of injury or pain. This is true for professional and collegiate players and weekend warriors. Just as we do with any athletes, physical therapists play an important role in prevention, management and recovery from injury for the esports athlete.

By: Bryan Hoyt, MSPT, CEAS. Bryan is a physical therapist and regional director of operations for Select Physical Therapy in central Pennsylvania. 

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Posted on 10/12/2020

For the management of some types of pain, prescription opioids can certainly help. However, there is not enough evidence to support prolonged opioid use for chronic pain. We sat down with Katie McBee, P.T., DPT, OCS, M.S., CEAS II, PYT-C, regional director of our WorkStrategies Program, to ask her a few questions regarding opioid use, chronic pain and the benefits of physical therapy as a safe alternative to prescription medication. 

1. In your opinion, what are the main reasons for the opioid epidemic in the United States?

There is no simple explanation as to what caused the opioid epidemic in the United States. Opiates are not a new drug and have been abused at other time periods in American history, but not nearly to the extent that is happening now. For example, with health care access issues due to COVID-19, opioid prescription rates are on the rise with death rates up 30% since the pandemic’s onset.

Initial research on opiate medications said they were effective and safe and addiction was rare when used for short-term pain.¹ The development of FDA approved OxyContin in 1995 had labeling that stated iatrogenic addiction was “very rare,” and a widespread marketing campaign to physicians started to build medical providers’ confidence in prescribing these medications to decrease pain-related suffering.² Add to that the 2001 standards implemented by the Joint Commission on Accreditation of Healthcare Organizations for organizations to improve their care of patients with pain medication and this is probably what catalyzed the beginning of our current opioid epidemic.  

With medical providers focused on pain as a vital sign, pain quickly became the enemy and had to be eradicated to show successful management for many conditions with an increased focus on post-operative pain management. As drugs became more widely available, aggressively advertised and culturally acceptable, a three-fold increase in prescription rates for these medications ensued. With the increase in opioid prescription rates, death rates from side effects also increased by three-fold to more 16,000 in 2011. 

2. What is the difference between chronic pain versus pain suffered as a result of an injury? 

Pain is a mechanism designed to protect us from harm. Pain is not the enemy. A common misconception about pain is that it is not a simple cause/effect relationship. The amount of injury does not equal the amount of pain we experience. Pain is a complex process based on many areas of the nervous system and the brain communicating together to let us know what we need to prioritize and protect. The more threatening the brain perceives something, the more we potentially feel pain. 

Acute pain or pain suffered immediately after an injury or surgery to the body’s tissues is a protection mechanism from the brain to remind you to protect the area so that no further harm is done. As the tissue heals and time passes, there is less threat of injury so the brain stops signaling, the pain eases and you slowly get back to normal activities. 

In chronic pain, the tissues are not signaling danger to the brain as much as they are in acute pain. When the brain perceives threat for extended periods, it starts to change the nervous system to become a pain-producing machine. It creates new nerve junctions to make things hurt that wouldn’t normally hurt, like light touch on the skin. It can decrease the amount of pressure needed to create a pain signal. It creates more chemicals along the nervous system so it can create greater pain experiences with fewer stimuli. Research is still trying to figure out why some individuals have pain that goes away as the tissues heal and others have pain that persists despite the fact that the tissue has healed.

Individuals can be at risk of developing chronic or persistent pain for a number of reasons, including unhelpful coping strategies, stress, chronic illness and poor sleep habits. It appears the more emotional or physical stress going on at the time of the injury and/or during the healing process, the more at risk you can be of developing a persistent pain issue. A holistic approach to address some of these drivers of persistent pain is showing promise in being able to reduce the pain and get people with chronic pain back into their normal lives again.

3. Why is physical therapy important and what are some of the benefits to patients? 

Physical therapy is an ideal treatment for many types of acute and chronic pain and should be a part of any single or multidisciplinary treatment plan for pain. The goal of physical therapy is to increase function and keep people in their meaningful life activities while they are healing. Physical therapists are trained to address many of the drivers of chronic pain and can perform testing and screening to see if your pain system is sensitized and adjust treatment to desensitize the pain system as well as address the functional limitations many people often experience when they are in pain.  

Physical therapists have many tools they can use to decrease pain and desensitize the pain system. These tools include education on pain to discover what could be driving pain issues. Once the pain drivers are discovered, a physical therapist will develop a holistic plan to address these drivers, including increased activity, sleep hygiene, stress management skills and pacing techniques. 

The best thing about physical therapy for pain is that the outcomes for some of the techniques are better than many medications and procedures available; plus, there are no negative side effects. If you or someone you know has an issue with pain, please request an appointment today to begin physical therapy treatment. 
References

1. Porter J, Jick H.  Addiction rare in patients treated with narcotics. N Engl J Med. 1980;302:123.
2. Van Zee A. The promotion and marketing of OxyContin: commercial triumph, public health tragedy. Am J Public Health. 20:99 (2):221-227.

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