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Body Shaping: How Our Habits, Environment, and Culture Influence Us

July 3, 2017/in Health & Wellness, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

While assisting in a class at a nearby Doctor of Physical Therapy program this morning, I was reminded of this fascinating article and NPR broadcast. The article talks about differences observed between our modernized civilization and some indigenous populations. For example, they found a group in rural India that almost never has complaints of back pain. Upon further exploration, they even found that their spines and inter-vertebral discs show less wear and tear. But why would this happen?

Let’s consider a few things.

Image: Visible Body Muscle Premium

A few weeks ago, Back in Step Physical Therapy shared another blog post, Tech(nology) Neck. We discussed how some of our regular, every-day activities, like using our smartphones and tablets, or working at our desk or on our laptops, can start to influence how our body is shaped, and, more importantly, how it functions. Our technology-centric population continues to see a rise in back and neck pain, thumb/wrist/elbow pain, and other complaints that can be related to our postures and activities.

We also seem to be spending more and more time sitting. Sitting during the commute to and from work or school, sitting at a desk, sitting to watch television as we relax for the evening. So imagine that our body, which is designed to have us upright, much like the spine images above, is now being asked to function in a different, seated position. It’s not a stretch to believe that this leads to a change in stresses and demands on our bodies.

Let’s now imagine even another scenario, not related to the technology that we interact with, but cultural differences. In our Western culture, we tend to sit in chairs, on stools, or on sofas. In some Eastern cultures, kneeling, squatting, or sitting cross-legged are more of the norm. Look at the pictures below to get a sense of how each of these positions could make our bodies work. Thinking about it further, how much time you spend sitting in a chair? Now imagine spending that same amount of time in one of these other positions. If you’re not used to these positions, odds are good that it would be quite uncomfortable, but, if it’s a normal position, you may use it when you’re waiting for the bus, eating, or chatting with friends.

Whether it’s our sitting position, the technology that we interact with, or the activities that we do, we are constantly influencing how our bodies move and function. It’s important that we learn more about our bodies, and ensure that they continue to operate as optimally as possible. If you want to focus on injury prevention or injury rehabilitation, or just want to learn more, please contact Back in Step Physical Therapy. We not only offer physical therapy services, but also offer wellness services, annual physical therapy assessments, and educational seminars.

The Educator’s Experience – Part 1: Patient Education

June 1, 2017/in About Physical Therapy, From Our PT, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

Teaching has always been in my blood. In fact, in the first grade, my family got called into a meeting with my teacher, Mrs. Johnson, to discuss an interesting dilemma that I was in. We would often get little in-class assignments to work on, whether it was writing, math, or reading. Apparently, I had the tendency to wander around the classroom to help the other students do their assignments, and wouldn’t work on my own until I’d helped the others. When my teacher tried to keep me in from recess as a motivator for me to do what I was supposed to be doing, it didn’t phase me a bit. She didn’t know what to do with me!

By the time I got to 4th or 5th grade, I was taking advantage of becoming a peer mentor at the school, working with younger students to resolve conflicts between one another. In middle school, I became a tutor for other students. Once high school rolled around, I became a swimming instructor and life guard. Fast forward to grad school, and I was teaching weekly dance classes over the lunch hour.

Now, I have multiple opportunities to continue in the practice of education. First, I am a clinical instructor at my alma mater, which means that I assist in lab-based courses as students are learning hands on skills. I also get the occasional chance to teach content, primarily on the topics of the integumentary system and wound care, since I have years of experience in that area. My other opportunity is a daily one – educating my patients as a physical therapist. I find that both of the avenues are incredibly important and rewarding.

Here’s why.

As a physical therapist, I have the daily opportunity to help change someone’s life. I help one person with pain management, after dealing with the same pain for four years, feeling frustrated that it’s keeping them from some of their favorite activities. I help another after a stroke or brain injury, needing to re-learn seemingly basic things, and celebrating each small victory with them, like when they can put a sock on for themselves for the first time. I help yet another person with preventative treatments, helping to stave off injury as an athlete. Many of the things that achieve these goals are things like hands-on treatments, trigger point dry needling, or exercise, to name a few.

However, I find that one of the most powerful things that I can do for a patient is to teach them something. That “something” is different for everyone. Sometimes, someone wants to know about the anatomy and physiology of what is going on in his or her body. I find that some people put more credence in the exercise program that I give them for home when they understand more about why they’re getting the exercises that I’m prescribing. If someone has been having pain for a while, or recently had surgery, that person may be fearful of movement, or afraid of re-injury. Educating this person about what to expect, talking about how it is ok to move, or introducing some gentle exercise can be a major breakthrough.

One of the more interesting things that I’ve found as an educational tool is regarding stress management, and can include things like simple meditation or mindfulness tools. I’ve had two profound cases that demonstrate this piece beautifully.

The first was a young mother who was in a car accident with her young children in the car. The kids were unharmed, but the mother had significant whiplash. During our initial session together, any time she talked about specifics of the accident, she would start to rock and shake, with obvious signs of high anxiety related to it. The next session was spent entirely on stress and anxiety management, with meditation techniques to use at home. After that, something changed in her. She was able to talk about the accident without the visceral responses, and demonstrated an overall change in her demeanor. She was able to make good progress from there after.

The second was a man who had had a massive shoulder surgery. He was having a lot of pain, and was having difficulty managing it well. At one point, between out of control pain levels and high stress at home, his body was finally rebelling, being sent to the hospital with seizures. We spent a portion of our next session going through some of the same techniques used with my other patient, and encouraged regular use of them. The next time I saw him, he reported significant improvement, and, again, continued to make good and steady progress. All of these are reasons that I believe that education on any number of topics are such an incredibly powerful tool for my patients, and regularly use them in sessions. No matter what exercises I prescribe or the hands-on treatment that I provide, I truly feel that the education piece is often the best gift that I can give to my patients.

In the next blog post, I’ll be talking more about my experiences working with Doctor of Physical Therapy students, and why it’s another area of education that I’m passionate about.

Article author, Alyssa Arms, PT, DPT, OCS holds a Doctor of Physical Therapy (DPT) degree from the University of Colorado Anschutz Medical Campus, and later obtained a Board Certification as an Orthopedic Clinical Specialist (OCS). She is also the President and Owner of Back in Step Physical Therapy in Centennial, Colorado, and is an instructor at her PT alma mater.

Why is an Annual Physical Therapy Check-Up Important?

May 30, 2017/in About Physical Therapy, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

Everyone is used to different types of regular check-ups, whether it’s for you, your family, or things that you use on a regular basis.

Most dentists recommend a check-up twice per year. They check for signs or risks of gum disease, oral cancer, or other dental problems, also knowing that some problems can indicate overall health. During your exam, they will likely do x-rays and a cleaning while you’re there.

People go to their primary care physician for an annual physical, looking at general, systemic health. Typically, an annual physical will include tests like blood work, weight, blood pressure, heart rate, and temperature. They will ask about diet and exercise. They will ask about other questions and concerns that you may have.

Here’s the question that I’d like to challenge you with: Why don’t we do regular check-ups for our bodies as a movement system – the very thing that quite literally gets us from Point A to Point B, the thing that gets us through our day, and the thing that allows us to work, play with our kids, and participate in a sport or activity? Over time, our muscles can tighten, our joints can stiffen, and our body begins to compensate for these changes. Eventually, this can contribute to other larger problems, like degenerative joint disease, knee or shoulder pain, back or neck pain, etc. Our bodies are great at determining the path of least resistance. Unfortunately, this does not necessarily mean that this is being achieved in the best, most efficient way, or in the way that our bodies are built to do it. Now again I ask, why don’t we do regular check-ups for our bodies as a movement system? It’s a great way to catch something before it becomes a bigger and more painful problem.

Another important thing to know – most states are Direct Access, meaning that you don’t have to see a physician before consulting your local physical therapist. The goal is to keep you going, pain-free, rather than becoming reliant on pain medicine, being sidelined with lost days of work, limiting interactions with your family, or seeking out surgery. Insurance may not cover this sort of preventative assessment and treatment, and not all physical therapy clinics offer this specific service of annual physical therapy screens or physicals.

At Back in Step Physical Therapy, we currently offer two kinds of annual physicals – one for the general public and one for dancers/performing artists. In either case, you’ll be seen one-on-one with a Doctor of Physical Therapy for a session to complete the evaluation. The therapist will then take some time to compile your results, and will later meet with you for an additional, shorter session on another day to give you your results. The cost covers both the evaluation session and the results session. Cost and length of sessions vary, depending upon which annual physical exam you choose.

So the next time that you’re scheduling your dental check-up, or taking your car in for it’s 3000 mile oil change, contact us at Back in Step Physical Therapy to schedule your Annual Physical Therapy Exam for your “body tune-up”!

Physical Therapists: The Movement Specialists (Part 2)

May 2, 2017/in About Physical Therapy, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

In a previous post, I discussed the overall education of a physical therapist (PT), starting from the pre-requisites with a Bachelor’s degree, all the way through taking the National Physical Therapy Exam (NPTE) and becoming licensed as a practicing physical therapist. I now want to tell you more about what happens after school, whether it’s pursuing an area of special interest, or obtaining a board certification.

Areas of Specialty or Special Interest

Now that you have a better understanding of the training to become a physical therapist, let’s talk a little bit more about where it can go from here. It’s safe to say that most people are aware that PTs can work with sports injuries, like a soccer player with an ACL tear. But did you know that PTs can also treat women during and after pregnancy, particularly for pelvic floor and incontinence problems, or perform wound care for people who aren’t healing properly?

Here are some areas for specialization, according to the American Physical Therapy Association (APTA). These may be areas for additional study or specific interest, and several have an option to obtain a board certification (more on this later).

Acute Care
- Therapists work in a hospital, and may treat those who have had a new knee replacement, who is recovering from a major accident or illness, or who is in the Intensive Care Unit (ICU), as a few examples.
- These therapists work hard to decrease length of time in the hospital, increase a patient’s independence while maintaining safety, and help prepare a patient to go home, or on to another level of care, such as a skilled nursing facility or acute rehab hospital.
Aquatics
- Therapists treat patients while in a pool. The pool is a great place to take away some body weight, but can also add resistance by pushing through the water.
- This can be great for people who maybe can’t tolerate doing as much on land.
Cardiovascular & Pulmonary
- Therapists work with patients with an array of cardiopulmonary diseases, like chronic obstructive pulmonary disorder (COPD), coronary artery disease (CAD), or congestive heart failure (CHF), to name a few.
- These therapists provide health, wellness, prevention, and rehabilitation services for those already diagnosed or for those who are at risk.
Clinical Electrophysiology and Wound Management
- Therapists use different techniques, equipment, and other resources to help treat, heal, and/or prevent wounds. These wounds typically result from pressure, trauma, surgery, vascular disorders, and diabetes.
Education
- Therapists choose to focus on the academic side of things, helping to promote the development of future therapists, as well as the progress and growth of their education. This can include education in the classroom or in the clinic.
Federal
- Therapists work with Federal medical services, either as a civilian, as a member of uniformed service, as contractors, or as tribal hires. Their work can include the entire span of services, dedicated for the military and/or other government services, like Public Health Services.
Geriatrics
- Therapists focus on the aging and geriatric population, and are well versed in the healthcare management of an older adult.
Hand and Upper Extremity
- Therapists focus on the treatment and prevention of problems related to the hand and upper limb (elbow, shoulder, and related regions).
Health Policy and Administration
- These therapists are involved in leadership, administration and management, global health, and technology in physical therapy. They also focus on professionalism and advocacy for the profession.
Home Health
- Therapists treat their patients within the home setting, rather than having the patient come in to a clinic. Patients in the home setting may have access issues to healthcare, or may have limited mobility, making a trip elsewhere much more difficult.
Neurology
- Therapists work with a variety of topics related to neurologic disorders and rehabilitation, which includes things like balance and falls, brain injury, spinal cord injury, stroke, and vestibular rehabilitation.
Oncology
- Therapists work with those currently undergoing treatment of or rehabilitating from cancer, tumors, HIV, etc., and can include lymphedema management.
Orthopedics
- These therapists focus on rehabilitation and prevention related to muscles, bones, and joints. Therapists can further specialize in imaging (like x-rays, MRIs, etc.), pain management, and occupational health (workers’ compensation), to name a few.
Pediatrics
- Therapists treat patients from birth to 21 years, including all children, people with developmental disabilities, as well as their families.
Private Practice
- Therapists are involved in owning and managing their own business as a physical therapist.
Research
- These therapists are particularly interested in doing research to improve patient care, techniques, and the profession.
Sports
- Therapists work with a spectrum of athletes, from little leaguers to Olympic athletes, from swimmers to hockey players, and everyone in between.
Women’s (and Men’s) Health
- Therapists treat pelvic floor and abdominal problems, including pregnant women, athletes with incontinence issues, or men with pelvic pain, for example.

Physical therapists may work as generalists, treating a large variety of people that require care, or may choose to specialize in what they treat. Some may treat people across several of the topics listed above. Either way, you can find a physical therapist that can provide treatment for you, regardless of age, gender, health condition, accessibility, or diagnosis!

Board Certification in a Specialty Area

Board certification is an additional step that some therapists decide to take. Typically, there is a minimum of 2,000 hours treating patients in the specific area in which you’re looking to specialize. Once that number is achieved, and an application is submitted, you’re application must be accepted. Then, you spend many hours studying for an exam that will cover around 200-250 questions over the span of 7 hours. Much like the NPTE exam to get your initial therapy license, these specialty exams can cover virtually anything that applies to your specialty area, so your breadth and depth of knowledge are thoroughly tested. This exam, however, takes about 3 months or so to get the results. If you’ve passed, you now get to use the specialty designation for your board certification. There are currently 8 areas available for certification, including Cardiovascular and Pulmonary, Clinical Electrophysiology, Geriatrics, Neurology, Oncology, Orthopaedics, Pediatrics, Sports, and Women’s Health, with over 20,000 therapists certified. There are also options to pursue residencies and fellowships, which provide additional training and mentorship in a specific area of specialty, and typically include a board certification process as described above.

Continuing Education

Aside from pursuing specific topics like those listed above, physical therapists also have a requirement to complete “continuing education”. The requirements vary state to state, and there may even be requirements for a specific job, but it’s always the same basic concept. There are frequent opportunities to continually work on our knowledge base. Such opportunities could include learning more about pilates mat exercises and how to apply them to patients in the clinic, getting the latest research on the rehabilitation of a total knee replacement, or obtaining certification to perform trigger point dry needling.

In Summary

Even beyond the physical therapy license, many physical therapists choose to pursue additional education and training. This may include residencies, fellowships, or board certifications for some. For most therapists, it’s periodically attending courses or conferences to learn skills that will ultimately help their patients. I know that, at least for myself, I’m always eager to take more classes. I’m convinced that with each class that I get to cross off of my list, I add 3-4 in its place. There is always something new and exciting to learn, and that’s just another thing that I love about my profession!

Physical Therapy: The Movement Specialists (Part 1)

April 28, 2017/in About Physical Therapy, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

When I was in college and working on my pre-med requirements, with the plans of going to medical school, someone had mentioned that being a physical therapist might be a good fit for me. At that point, I thought, “they help fix broken people, right?”. I had a very narrow understanding of what a physical therapist is, how you become one, and what exactly they do. Once I learned more, though, I completely fell in love with it, and haven’t looked back since. Everyone has different levels of exposure and understandings of the profession, so I wanted to take some time to explain more. So here goes….

History of the Physical Therapist

http://history.amedd.army.mil/corps/medical_spec/images/39.jpg

The physical therapy profession has been around for decades. Before we were ever known as “physical therapists”, we were “reconstruction aides”, where we worked with those who were affected by events like the US polio epidemic and World Wars I and II. Over the years, the demand for our profession has grown dramatically to encompass a seemingly endless list of specialties within a wide variety of settings and patient populations. We are now considered to be musculoskeletal experts and movement specialists, with many of us holding doctorate degrees.

Training to Become a Physical Therapist

The training of physical therapists (PTs) has changed over the years, including the evolution from a Bachelors degree, to a Masters, and finally, a Doctorate degree.* In 1993, the first “Doctor of Physical Therapy” program opened in the United States. In Colorado, the first Doctor of Physical Therapy (DPT) class graduated about 10 years ago. All physical therapy programs have since transitioned to the DPT degree within the past few years.

As part of the pre-requisites, DPT students have already completed a Bachelors degree with the appropriate classes to get into a DPT program, including many hours in biology, chemistry, physics, calculus, English, psychology, and more. DPT students’ education encompasses a wide variety of topics, including the basic examination and evaluation techniques, treatment options, management courses, pharmacology, radiology, differential diagnosis, and countless hours of anatomy. Specific courses include topics like orthopedics and sports, neurology, pediatrics, and cardiopulmonary diseases. Students also spend many hours learning about research methods, and how to be a good consumer of research articles. Some even get their own research published in journals.

Aside from all of the hours in the classroom and laboratory settings, DPT students also spend many months working full-time in clinics, hospitals, home health, and schools, under the supervision of a licensed physical therapist. This is the opportunity for students to apply what they’ve learned in the classroom to the patients that sit before them. DPT students complete this rigorous training, both based in the classroom and in the clinic, and finally graduate with their Doctorate of Physical Therapy degree. As much as you’d think this may be the end of the adventure of becoming a physical therapist, it’s not!

Me, at my DPT graduation in 2010

The new graduates must apply for and then take the National Physical Therapy Exam (NPTE). This exam is made up of 250 questions, with 5 hours allotted to take the exam. It covers pretty much any topic covered during PT school, from some very specific questions, to more broad questions that are used to assess your general understanding and thought processes. Upon passing this exam, you now have a physical therapy license, allowing you to actually work as a physical therapist.

*One thing that is also important to note here is that a physical therapist with a Doctorate of Physical Therapy is not necessarily a better therapist than someone with a Masters or Bachelors. Much of the degree designation is related to when you went to school, and even what degree options were available at the time. Those with Bachelors and Masters degrees have also had more experience as a therapist, which is also an invaluable breadth and depth of knowledge.

The Take-Home Message

All in all, becoming a physical therapist take a lot of training and hard work, but the final result is so incredibly rewarding. We have the opportunity to follow whatever our passion is, whether it is treating patients with cancer, new moms who are dealing with incontinence, a football player with a shoulder injury, working on research to improve the profession and the care we provide for our patients, or improving the education for future therapists.

Before working toward becoming a physical therapist myself, I had no clue about what a PT really does. I think many people share the same uncertainty, even though so many could be helped by a physical therapist at some point, or multiple points, in life. So, whether you are a high school or college student wanting to know more about a potential future profession, or a member of the general public who wanted to know more about what a physical therapist does, I hope this was helpful! Do you want to know more about what happens the degree and license are achieved? See the discussion about specialties, additional training, and continuing education in the Part 2!

Firefighters as the New Pro Athletes

January 9, 2017/in Health & Wellness, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

According to a recent article in The Denver Post, the Denver Fire Department is taking a new approach with their firefighters, which includes the use of physical therapy. They’re implementing a new health and wellness program that not only helps the injured firefighter recover from injury more quickly, but also works with them to try to prevent injuries in the first place. This new program includes working with a physical therapist, and can sometimes include daily treatment.

According to the article, the total cost of their workers’ compensation injuries has already dropped 42%, and has reduced overall costs by thousands of dollars! It’s great that there’s a new approach to health and wellness, and that they’re showing significant benefit. It is also exciting to see a large and local organization with a program like this.

Ask most physical therapists, or many others in the health and wellness community, and they’d tell you that having such a focus on prevention of injury, or reduction in the risk of injury, is an important one. Prevention can provide several benefits to the both the individual and to the business. It can reduce the long-term impact and improve quality of life for the individual, and reduce the missed days of work and money spent on treatment (whether it’s a worker’s compensation case or not).

Back in Step Physical Therapy wants to take a similar approach to preventative care. It could be from the workers’ compensation perspective. It could be someone who just wants to enjoy their day to day activities or hobbies without getting slowed down. Either way, we can help determine what could currently increase your risk of injury, and then develop an individualized program to make corrections.

Contact us to get started, or check out our services page for options and more information! If you are an employer and interested in learning what we can do for your staff, learn more about our corporate services.

Tech(nology) Neck

January 4, 2017/in Health & Wellness, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

A recent article on CNET.com gives a great description of what all of our world’s technology is doing to our bodies. While we are texting our friends about tonight’s dinner plans, typing a report on our laptops, or responding to a work email, we are providing a beating not only to our bodies physically, but also to how our brains respond to our environment. With our growing use of various technologies, we are placing more stress on our necks, thumbs, eyes, and back. Not only that, but it can contribute to things like poor quality of sleep, decreased memory, and decreased focus.

Technology use can also result in poor posture. This can impact lung capacity, which, in turn, can create many other problems. According to CNET’s article, people who spend more than 4 hours per day in front of a screen are at an increased risk of both short-term and chronic pain. And if you use a smart-phone? Depending on what position you have your head and neck, you could be adding up to an additional 60 pounds of force on your neck!

(Photo courtesy of The Washington Post and Dr. Ken Hansraj M.D.)

An article from The Washington Post provides additional information about the problems caused by working with technology. They report that the average person will spend 700 to 1,400 hours per year in these positions. If you’re a high school student, they project an additional 5,000 hours per year!

So what can you do about it, aside from just taking a break periodically? It’s important that you also do some activities or exercises to balance out these extra stressors. Make sure that you’re working on improving your posture. Do other mentally stimulating activities that don’t require screen-time. Not sure what to do, or finding that what you are doing isn’t enough? Come in and see our physical therapist at Back in Step Physical Therapy to get assessed, and we’ll create a custom program for you. Contact us here.

Millennials and High Intensity Workouts

January 4, 2017/in Health & Wellness, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

Recently, The Denver Post published an article about a rise in injuries for millennials, particularly in those that participate in things like Tough Mudder, CrossFit, other high intensity interval training (HIIT), and even things like barre classes. The reason?

People are pushing themselves to complete these activities, no matter what. They are being done with poor form, poor mechanics, pushing through fatigue, or working at a level of conditioning that the individual isn’t quite ready for. Many of these people eventually seek out care, and wind up in physical therapy. We are finding that they are often struggling with neuromuscular imbalances. In other words, certain muscles are weak, and others are overworking. The key is to focus on stability and flexibility, and then working those elements back into their routines.

Let’s talk about doing a simple squat – no weights, nothing fancy, not moving into another position. We’ll be using the image below for reference.

Image courtesy of Precisionnutrition.com.

The image at the top left is an example of good form. The others show faults in form, like having a rounded back, holding the head too far forward, or rising up on the toes. All of these are examples of poor form. Poor form can prevent the correct muscles from doing the jobs they’re made to do, and promote the use of other muscles that aren’t supposed to be as active. A squat can relate to things like getting up from a chair or sitting down, or going up and down stairs, so it’s important that you’re body is able to do it the right way. Otherwise, every time you go to get up from your chair when you’ve been training with poor form in your workouts, you’re just repeating the same improper technique.

At Back in Step Physical Therapy, we do assessments to help find out what’s contributing to your aches and pains, whether it’s poor form or muscle imbalances, and we’ll get you back on the road to conquering your workouts, whatever they may be! Contact us for an appointment, and we’ll get you back in step.

Have You Ever Experienced Low Back Pain?

October 13, 2016/in Health & Wellness, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

Have you ever felt a little twinge in your back, maybe after sleeping on the ground during a camping trip, lifting one too many boxes while moving or after a Costco run, or after sitting on the sofa watching your favorite football team play? Maybe it just feels stiff or like it needs to pop. Maybe you’ve had the deep, achy pain into the back of your hip, into the buttock, or even down your leg.

Whatever the reason or the way that you might describe it, you’re not alone. Low back pain is all too common of a complaint for people, regardless of age, fitness level, health history, occupation, and gender.

You may hear people say that “I’m just getting old”. Not true! First of all, it’s not normal to have pain, despite your age. This applies for your back, but anywhere else in the body as well. Secondly, that rationale doesn’t work for the many young teens that I’ve worked with over the years, whose muscle strength and coordination haven’t caught up to their quickly growing bodies. The why of your pain may vary a bit with age, but there is often something that can be done to help.

Low back pain also seems to be on the rise, with more time sitting at work and home, longer commutes to work and school, and increased computer time. These things that are a normal part of life can contribute, but so does a sedentary lifestyle. We may be sedentary because that’s the lifestyle that we choose, or because it’s seemingly a secondary consequence to health issues, chronic disease or injury. Again, this is an area in which we still have an influence. Individuals benefit from customized exercise programs, created by a therapist familiar with their medical condition, work requirements, or anything else that affects one’s activity level.

Our work may require extra time in the car, or many hours at a desk. On the opposite end of the occupation spectrum, our work may require hours of heavy lifting and hard labor. If you’re stuck in front of your computer all day, there are things that you can do to help counteract that. If, on the other hand, your job is very labor intensive, there are ways to make it easier on your body, or at least to make it safer.

Low back pain can affect anyone, and one of the unique populations affected are mothers – whether it’s during pregnancy or for a time after the birth of the baby. During this time, the female body is producing many different hormones, including those that will help with the birthing process. These same hormones contribute to laxity of ligaments in the pelvis and other areas, which can then lead to increased pain. Pelvic floor muscles and abdominal muscles are also particularly affected for these women, and often require some extra attention to properly recover. In many cases, these women are best served by going to a physical therapist who specializes in pelvic floor and women’s health.

When it boils down to it, the treatment of low back pain is multi-faceted, and depends upon the person having problems with it. Treatment often includes various types of muscle strengthening, learning how to move more efficiently, and getting the muscles to work correctly together. It should also include work-, sport- or lifestyle-specific training. Most importantly, it’s crucial that your physical therapist works well with and for you while developing and delivering your unique program, as well as sharing education about your pain and what you can do about it.

working together

I have suffered from back pain myself, related to two specific injuries since becoming a physical therapist. Both injuries resulted in massive amounts of pain, muscle weakness, difficulty moving, and fear of how I was going to continue doing the work that I love.

My first injury affected me for quite some time and occurred early in my career. It often made me believe that I had to limit myself to be “safe”. I stopped going out with friends as much, and backed off of my dancing. It was difficult to find a comfortable position for anything, whether it was to sleep or even just driving to work. My leg would sometimes give out when trying to walk down the driveway to check the mail, and sitting in a restaurant for dinner could bring me to tears. I worked on myself a lot, believing that I, as a physical therapist, should be able to fix myself. I almost felt guilty seeking help from someone else, because what kind of therapist was I that I needed someone?

Eventually, I learned that it did need to be a team effort and that I couldn’t do it alone. My massage therapist was an important early team member in my recovery, later joined by my personal trainer. I also had to convince myself of some of the same things I was trying to impress on my patients – this did not need to be a life-altering and life-limiting event. I began to explore ways to make improvements, but also to make modifications. I had to learn ways to improve stress-management, because that plays a huge role in pain control. I’d gotten to a pretty good place after that first injury, but then it happened again. A different injury with different problems. I quickly built my team this time, again made up of my massage therapist and my personal trainer, as well as a chiropractor, and even another physical therapist. This time, my recovery was much quicker and easier, and I’m happy to say that I no longer have daily pain, like I did for quite some time.

lessons I've learned

In the process of recovering from my own back injuries, I’ve learned a lot about back pain.

I learned that I need a good team of people to work with, and that team varied with what was going on and how I was feeling. As a physical therapist treating people with back pain, I acknowledge when we need to get other team members on board and how to work best with them for the best outcomes for our patient.
I learned that there are many options and modifications that exist to make life a little easier during recovery, and share those lessons and my story with my patients.
I learned that life does indeed move on, and that I shouldn’t let it move on without me. I use my experiences to help my patients navigate their struggles, big or small.

Back pain is no joke, whether it’s a little annoying twinge or a major injury. Despite that, I feel fortunate that I have learned so many lessons with my own struggles with back pain that I can now share with my patients on a daily basis. I believe that I have become a better therapist because of it. If you’re struggling with back pain, and want to work with someone who has”been there and done that”, please contact Back in Step PT here to make your appointment today.

Calling All Dancers!

October 13, 2016/in The Performing Arts, Uncategorized /by Dr. Alyssa Arms, PT, DPT, OCS

Are you a dancer? Do you want to know how to recover from an injury that you’ve been dealing with? Or do you want to learn ways to drastically reduce your chance of injury? What about learning how to become even better with your technique?

It doesn’t matter if you are a professional who has been dancing for years, a teacher who spends many hours on your feet, an amateur who just does it for fun, or a 5 year old who dreams of becoming a ballerina some day. It also doesn’t matter what dance style you are interested in – ballet, tap, jazz, hip hop, Irish step, West Coast Swing, ballroom, Latin, etc.

No matter what level you’re at and what discipline you’re pursuing, we can help you! I am not only a physical therapist, but also a trained dancer for most of my life. I started at the age of 3 with ballet and tap. I continued my training in these styles, with the addition jazz, until I was 18. I joined a special Performance group at my local studio when I was 9, and was then able to participate in two seasons of performances per year and audition for special roles. I took some time away from formal dance lessons while working on my undergraduate degree, but found that I was truly missing the dance life. I’m pretty sure that I drove my parents crazy with my leaping and spinning around the house, instead of taking classes. In physical therapy school, I ended up teaching lessons over the lunch hour on campus to anyone who wanted to learn. By the time that I finally began taking classes again, I was finishing my physical therapy degree. I added hip hop training, as well as some salsa. This is also when I fell in love with West Coast Swing. I continue to compete on the local and national circuits in West Coast Swing, including occasional travel to other cities for competitions.

Even as a physical therapy student, I had begun to learn how my background as a dancer could be helpful in my new profession. The most vivid memory of this took place during a clinical rotation in Washington, where I worked full-time for 8 weeks with a brilliant therapist. She had been a PT for at least 25 years, and was known to be an expert in the region. I was so fortunate to be able to train with her! We had a young dancer who had injured her hip, and had already started working with my instructor. By the time I’d arrived to the clinic, the dancer was back to “normal person” normal, but not “dancer normal”. My instructor felt like she’d hit a wall – she’d done everything she could think of, and had even made custom orthotic inserts for the girl’s pointe shoes! I timidly spoke up one day, asking if I could try something from my dance background. Within 2 weeks, I had our young dancer back to where she needed to be. I felt so proud when my instructor told me, “I probably would never have come up with the things you did. I’m glad you were here.”

That patient’s story, like so many others over the last several years, have inspired me to create a fusion of my two passions, and has led me to adding this special population to my clinic. In my many years of dance, no matter what style or venue, I have seen so many different injuries, whether it’s from one specific incident, or just from years of being tough on your body. I’ve also come to recognize certain injuries with different styles of dance, because of the demands placed on the body. My goal as a physical therapist is to now use my knowledge from both realms – dance and therapy – to get dancers back to their best, and to keep them at their best.

So if you are any sort of dancer and have any concerns, please call us at Back in Step Physical Therapy to get an appointment, and I’d love to work with you to meet your goals! Learn more about our dance specific services here.

Also check our our Dancer’s Kit!