Covering new ground - Washington, IL

We would like to officially announce the opening of our second central Illinois clinic, just across the river in Washington.  We're excited to be able to continue to help patients in this and surrounding communities.  If you or anyone you know in this area might need our help, please don't hesitate to give us a call!  Thank you for trusting us with your care!

This office will be led by Amy Johnson PT, OCS (formally practicing at our Peoria office), and also staffed by Kyle Cottone PT, DPT, OCS (see separate blog post for his welcome info and credentials).

Washington office phone number: (309) 444-1030

What are we Thankful for?

Greetings again!  It feels like a monthly blog-post aligns well with a "holiday theme" for these last few months of the year.  We'll try to accomplish that without being too cheesy!  First of all, with it being Thanksgiving week, we want to recognize yet again just how thankful we are for you - our patients - and the support and loyalty you have given us the past 2.5 years.  We certainly do not overlook your role in the success of our business (or the fact that we have a business at all!), and we appreciate the positive words you have shared with your friends, loved ones, and physicians.

We hope that this holiday will be a wonderful time for you and your families.  As I (Rachael) anticipate heading to my hometown of Indianapolis, IN, I'm excited about the tradition our family has started, participating in the local "Drumstick Dash" to raise money for hungry families.  It's something my sister and I started doing three years ago, and have since recruited our husbands, dad, and her children to join us.  Thinking about this got my mind spinning on traditions, and how they are formed.

We function like detectives everyday with our patients, and often times look for habits or patterns that contribute to their pain or dysfunction.  I thought about the connection between a habit and a tradition...  the definition of a habit: a settled or regular tendency or practice, especially one that is hard to give up.  And when I got thinking about it, you could say that a tradition is sort of a glorified habit, a fancy habit.  They can be anything from: going out to a certain restaurant every Sunday, to sitting around the turkey table playing cards, to braving the shopping world on Black Friday.

As we love to promote wellness and active lifestyles, I wanted to challenge you to reconsider your family "habits" this holiday.  By all means, eat until your heart's content, enjoy the company and storytelling, but also take a moment and think about the type of traditions you want to feel proud of, what it is that's meaningful to you.  Get outside and play ball (the weather's going to be great this year!), serve local people in need together, go for a walk or hike... remember all traditions started somewhere!

(WebMD has some good new habit-forming ideas for this holiday in this article on "10 Tips for a Thinner Thanksgiving.")

Happy Thanksgiving to all of you!  

Happy Halloween!

Happy Halloween from RVPT!
We hope you all have a safe and fun Halloween this week, whether it's spent tricking or treating!  Please feel free to share photos of your little ghosts, goblins, or princesses with us.  And remember, if you end up getting smashed liked a pumpkin, or stub your toe on a gravestone, come in for a free screening and we'll be glad to see if we can "spook" the pain out of you!

If our patients come in feeling like this...

We hope they leave feeling like this...

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And also, just before then end of the month:
October is National Physical Therapy Month!

We are proud to support the American Physical Therapy Association (APTA), as they work to raise awareness of our profession and all that we have to offer.  As members of this organization, we have invested time and resources into protecting, promoting, and growing physical therapy, so that we can continue to help more and more people.  National PT Month is a month dedicated to celebrating our past and our future as a profession, but more importantly celebrating our patients!  We feel so fortunate to be able to play a role in the lives of such wonderful people.

For more information on physical therapy, where we're headed, and how we may be able to help you, visit MoveForwardPT for patient-friendly resources.

Thanks again for your support & we look forward to continuing to serve you!

Vestibular Rehabilitation

Did you know that Rock Valley Physical Therapy now offers evaluation and treatment of vestibular disorders, which may cause symptoms of dizziness, imbalance, or instability?  Our staff is specially trained to assist you in identifying and treating vestibular dysfunction.  Below are some of the common complaints associated with these disorders.  If you or someone you know is experiencing any of these symptoms, we would love to help!

 
Vertigo (dizziness) can be caused by many different bodily structures being in a state of dysfunction.  The most common cause of this symptom is a condition called BPPV (Benign Positional Paroxysmal Vertigo), and involves abnormality of one or more “canals” in your inner ear that sense position change. 

Common aggravating factors involve position changes of the head, such as:

• Rolling over or sitting up/lying down in bed
• Looking up into a cupboard or down towards the floor

 

This condition can be very successfully treated in therapy with specific “repositioning” maneuvers.

Oscillopsia (a bouncing or shaking of your vision) can be a secondary complaint to BPPV or a standalone symptom of vestibular dysfunction.  It is directly caused by a weakening of your vestibular-ocular reflex which normally functions to stabilize your visual field as you do things like walk, jog, or ride in the car.

Physical therapy can help, by applying specific exercises to engage and re-train this reflex.

 

Disequilibrium (light-headedness) and imbalance (unsteadiness) are two related symptoms that can be caused by dysfunction of the vestibular system.   Common causes include: recent infection with resulting neuritis (nerve inflammation), labrynthitis (inflammation of the vestibular organs), impaired circulation, or cervical (neck) misalignment.

These symptoms may come on rapidly or gradually, but will likely come and go with:

• Position changes of the head
• Certain times of day
• General sense of “good” days and “bad” days
• Dark settings or busy environments
• Fatigue

Vestibular rehabilitation, administered by a licensed physical therapist, helps your body compensate for losses within the system, restoring comfortable & confident movement.

Welcome Rachael!

 





As a new addition to the Rock Valley family, I thought I'd better introduce myself in RVPT "blog-world" as well.  I am so excited to join this team of extraordinary professionals, and look forward to meeting and helping many new faces in the Peoria community.



I grew up in Indianapolis, IN where my interest in physical therapy was sparked; this is what drew me west to Peoria to attend Bradley University.  Although I had not intented to stay in this area after obtaining my Doctorate (DPT) degree in 2010, I was blessed to meet my husband while at Bradley, and we have decided to call Peoria "home."  With him growing up in a small town south of Springfield, IL, this is a perfect middle ground for us in many ways.

In our spare time, we enjoy spending as much time as we can outdoors with a variety of recreational activities.  We also love to travel to see friends and family as often as possible.

Professionally speaking, my background is two years practicing in a rural community north of Peoria where I treated a wide variety of diagnoses and age-groups.  I have also developed a niche interest Vestibular Rehabilitation, treating individuals with complaints of dizziness and imbalance, and have advanced training in this area.

Posterior Tibialis Tendon Dysfunction

The posterior tibialis tendon crosses the inside of the ankle joint, and works to control foot position during stance and walking.  Posterior tibialis dysfunction is the major cause of acquired flat foot deformity.^1,2

Nearly 60% of patients with a rupture of the posterior tibialis tendon had 1 or more of the following symptoms: hypertension, obesity, diabetes mellitus, previous surgery or trauma in the medial aspect of the foot, or exposure to steroids.¹

 

There are two main classifications within this disorder process:

Stage I: The tendon is of normal length, pain and swelling at medial foot
Stage II: Elongation of tendon, patient is unable to stand on toes of affected limb

What is the rehab role?

A study by Kulig et al examined the effectiveness of a 12 week program with custom -made orthotics in addition to stretching with or without an exercise program in adults with Stage I or II PTTD.  The study found that all interventions were effective in reducing pain; however the custom made orthotics along with eccentric exercises group had the most improvement in all subscales of foot functional index scores.³

A study by Alvarez et al found treating patients with Stage II PTTD with short articulating orthotics in combination with a high repetition ankle strengthening program showed significant improvements in VAS, single-support heel rise, ambulation distance, and strength.⁴

While being more expensive, custom articulating orthotics have been shown to provide best foot kinematics in gait, when compared to OTC or solid custom AFOs.⁶

Rehabilitation guidelines:^3,4

• Early stage (up to two weeks): Unload the tendon using orthotics, gastroc/soleus stretching, and build ambulation tolerance.

• Middle stage (2-8 weeks): Recruit tibialis posterior, eccentric strengthening

• Late stage (8-12 weeks): Progress toe walking to 150ft, progress ambulation distance to 2 miles, increase reps in HEP.

References:
Geideman WM, Johnson JE. Posterior Tibial Tendond Dysfunction. J Orthop Sports Phys Ther. 2000;30(2):68-77.
Trnka HJ. Dysfunction of the tendon of tibialis posterior.  J Bone Joint Surg [BR]. 2004;86-B:939-46.
Neville C et al. Choosing among 3 ankle-foot orthoses for a patient with Stage II posterior tibial tendon dysfunction. Journal of Ortho and Sports Phy Ther. 2009;39(11):816-824.

Alvarez RG et al. Stage I and II posterior tendon dysfunction treated by a structured nonoperative management protocol: an orthoses and exercises program. Foot & Ankle Internationional. 2006;27(1):2-8.

Kulig K et al. Effect of eccentric exercise program for early tibialis posterior tendinopathy. Foot & Ankle International. 2009;30(9):877-855.

Franettovich M et al. A physiological and psychological basis for anti-pronation taping from a critical review of the literature. Sports Med 2008;38(8):617-631.

ASTYM

The ASTYM system is an evidence-based rehabilitation process designed to effectively treat chronic tendon disorders, scar tissue and fibrosis.


The goal of the ASTYM treatment is to stimulate the body’s healing response, resulting in the resorption and remodeling of scar tissue and the regeneration of degenerative tendons. This effective therapy incorporates a customized program of stretching and exercise, which positively influences the alignment of the new collagen.

For some of you who may have heard of this technique, through personal experience or observation, there are some common misconceptions that we would like to clarify.  Please read-on as we unravel the myths surrounding this effective rehab process:

Myth:  All soft tissue injuries are treated equally regardless of the underlying cause.

Fact:  Chronic, long-standing repetitive injuries must be treated differently than acute injuries.  The absence of cardinal signs of inflammation should necessitate that an alternate approach should be taken.  Interventions used for a tendinosis that attempt to address inflammation where inflammation is absent will be unsuccessful.

Myth:  ASTYM is just “scrapping” people with tools.

Fact:  ASTYM tools are designed and used to promote controlled capillary leakage promoting phagocytosis of inappropriate tissue and stimulation of fibroblasts.  Although to the lay person treatments appear to be scrapping tissue, provider training and testing ensure the  proper tool pressure, direction, and angulation give the sought after effect.

 

Myth:  ASTYM is most effective when done without exercise.

Fact:  Exercise, including strength and flexibility,  in conjunction with ASTYM treatment is necessary to promote proper collagen fiber alignment and alleviate impairments caused by chronic dysfunction.

 

 

References:

Kannus P and Jozsa L. Histopathologic changes preceding spontaneous rupture of a tendon. Journal of Bone and Joint Surgery. 1991; 73-A(10):1507-1525.

Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy. 1998; 14(8):840-843.

Gehlsen GM, Ganion L, Helfst RH. Fibroblast Response to Variation in Soft Tissue Mobilization Pressure. Med Sci Sports Ex 1998; 31(4):531-535.

Wilson JK, Sevier TL, Helfst RH, Honing EW, Thomann A. Comparison of rehabilitation methods in the treatment of patellar tendinitis. J Sports Rehab, 2000;9:304-14.