• Lower Extremity Amputee and Prosthetic

    Posted on 2/7/2019 by Diane Jagelavicius, C.P.

     

    An amputation, whether planned or not, is a physical, mental and emotional loss, one that requires time to adjust.  A wide range of emotions occur while undergoing the process of amputation and are completely normal as you begin to process and adjust to this life-changing event. Understanding what you are feeling and why will help you to process the situation and overcome negativity and hurdles.

    No matter what circumstances have brought you here, NovaCare Prosthetics & Orthotics can help and is devoted to meeting the special needs of those with all levels of amputation. As you embark on this unique journey, keep these seven tips in mind:

    You are not alone.
    The Amputee Coalition estimates there are two million amputees in America and 185,000 leg amputations each year. This leads to a challenging period of physical recovery and complex psychological, emotional and social issues. While everyone’s path in life is unique, you should not feel as if you are alone.

    Support groups, peer mentors and online forums are all available if you are looking to connect with others in a similar situation as you. In your physical rehabilitation program, you have the potential to form strong bonds with your peers through shared challenges and successes. Your friends, family and caregivers can also provide a tremendous amount of support.

    If using a prosthesis will improve your function, then you are considered a candidate for a prosthesis.
    At a minimum, you must be able to tolerate standing. It is OK if you need help to stand. A strong desire to walk with a prosthesis will help you overcome any physical challenges along the way. No matter what your physical condition, motivation is the single biggest factor to your prosthetic success.

    Your previous lifestyle and abilities are the best indicators of success with a prosthesis.
    For below knee amputees, it is expected you will be able to return to all the activities you were participating in prior to the amputation. If you were dealing with sores and infection prior to your amputation, your quality of life will likely improve as an amputee.

    Many factors also affect success, like general health and the length of your amputated limb. If you have multiple conditions or injuries, they may limit your potential. Generally, the higher the amputation level, the more energy is required to walk. If your amputated limb is short or above the knee, you can expect to be able to participate in most of the activities you were participating in before your amputation.

    Take ownership of your care.
    Rehabilitation is a team effort, and your participation is essential to your success. At the core, no one is more invested in the quality of your life than you. Physicians, therapists, prosthetists, patients, family members, friends and caregivers are all part of your team. Spend time picking the right people for your team. It never hurts to do a little research, or seek a second opinion.

    Be honest with your team members about your rehabilitation goals. They will work with you to set up small, achievable goals to help you gain momentum, stay motivated and get you back to your best.

    Follow instructions and guidelines, and ask plenty of questions. Seek out solutions rather than making excuses. The more informed and proactive you are the better patient you will be, and the better choices you will make about your future care.

    It’s OK to smile and have a little fun.
    Sometimes life can get too serious, especially when it takes unexpected turns. It’s OK to have fun and let some joy into your life. Laughter is great medicine, too!

    Some patients take it a bit further and get creative with the design of their prosthetics. Prints and fun fabrics can be laminated in the socket; patients have chosen designs like butterflies, camouflage, tie-die, lightning and American flag patterns.

    Your prosthesis will be custom designed for you. The socket is the most important part.
    Each prosthesis is unique and tailored to meet your lifestyle and abilities. Your prosthetist will spend time with you to understand your needs and goals and use that information to design your prosthesis. Many different styles and componentry options are available.

    The most important part of your prosthesis is the socket, the portion that interfaces with your body. The socket is the part that translates your body movement to the componentry. To provide the most benefit, the socket must be snug and supportive. Your prosthetist will work with you to come up with the fit for you.

    Receiving your prosthesis is a really big milestone, but it is not the end goal.
    Learning how to walk or function with your prosthesis, returning to your lifestyle, work, family, home, sports, etc., are all the end goals.

    After amputation surgery there is a lot of emphasis placed on receiving the prosthesis. So much so it is easy to mistake the prosthesis itself as the end goal. But really, much of the work begins after you receive the prosthesis.

    Participation in a formal gait training program after you receive your prosthesis is an investment in the quality of your life. It takes time and practice to adapt to your new lifestyle and be confident with the prosthesis.

    Keep up the hard work and, before you know it, you will reach your goals in no time!

    At NovaCare Prosthetics & Orthotics, we consider it part of our job to be your advocate. If you have questions, concerns or would like more information specific to prosthetic devices and/or other organizations and resources that can help you, please contact a NovaCare Prosthetics & Orthotics center near you today. We’re here to be your partner for life.

    By: Diane Jagelavicius, C.P., prosthetist for NovaCare Prosthetics & Orthotics. Diane earned a bachelor’s degree in exercise physiology from Rutgers University and post-bachelorette certificate in prosthetics at Northwestern University. She completed residency at POSI prior to becoming an ABC certified prosthetist. Diane is passionate about patient outcomes and specializes in lower limb prosthetics with an emphasis on socket fit. She has extensive experience with microprocessor knees and ankles, suction/ elevated vacuum suspension and various socket designs. NovaCare Prosthetics & Orthotics is part of the Select Medical Outpatient Division family of brands. 

  • skeletal heat image of neck

    Posted on 7/10/2018 by Nicole Tombers, P.T., DPT

     

    In a culture dominated by cell phones, table stand computers, neck pain and headaches are becoming more and more common. Studies show that up to 45 percent of today’s workforce will experience problematic neck pain at some point.1, 2 As a physical therapist, I often find that these problems are associated with muscle tightness and weakness brought on by poor posture. It can be difficult to maintain perfectly straight posture all day, especially when your thoughts are focused on other things, such as the work project you need to finish this week, the heavy traffic on the roads around you or the emails you are answering from your tablet in the evening.

    Here are a few tips and tricks that will set you up for success when it comes to maintaining good posture and reducing the strain on your neck in everyday situations.

    Set your car mirror
    Many people spend up to an hour or more in their car every day – driving to and from work, running errands and shuttling the kids to their many activities. Having poor posture in the car can place extra stress on the joints and muscles of your back and neck. Leave yourself a little reminder to keep good posture by adjusting your rearview mirror.

    When you first get in your car, sit in a tall but comfortable posture; not leaning on the door or console, and not slouched low in your seat. Once you are in a good position, adjust your rearview mirror appropriately. Then, as you are driving, if you look in your mirror and realize you do not have the full view, it will be a reminder that you need to adjust your posture back to that good starting position.

    Adjust your workspace
    If you are one of the millions of people who spend their work day sitting at a desk, it can be a major source of strain on your neck and back. Modifying your workspace may help keep you in a good posture while you work. Here are a few key things to pay attention to:

    When sitting, your hips and knees should be at 90 degree angle with your feet flat on the floor or stool.
    Your arms should be comfortably supported on armrests with shoulders relaxed and elbows at a 90 degree angle. The keyboard and mouse should be positioned comfortably under your hands; you should not be reaching forward for the keyboard, nor should you be actively holding your shoulders up near your ears.
    The monitor should be directly in front of you (if you work with more than one monitor, try to keep them centralized in your field of vision as much as possible) and the top of the monitor should be at your eye level.
    Keep work off of your lap
    Sitting on a couch or chair with your laptop, tablet or other papers on your lap tends to lead to a hunchbacked posture. Ideally, you should bring your work up to eye level (as discussed above) to reduce strain on your neck. If you must work from the sofa, try to raise it up a little by placing a pillow or folded blanket on your lap and working from that elevated surface.

    Set a posture timer
    If you know you are going to be focused on a project for a long period of time, try setting a timer on your computer or cell phone to go off every 20 to 30 minutes as a reminder to be conscious of your posture and readjust as needed.

    Use a pillow roll
    Ideally, you want to have a neutral spine while you sleep so that you can wake up feeling refreshed rather than cramped and stiff. Stomach sleeping is not good for your neck as it requires you to have your head turned to one side for a prolonged period. Back or side sleeping is preferred.

    You want to have your head in line with your body and your neck fully supported. You can accomplish this by rolling a hand towel lengthwise and placing it inside your pillow case so that when you lay down it fills and supports the curve of your neck.

    Do some self−massage
    Place two tennis balls or racquet balls about one inch apart in a tube sock or nylon. You can hold the ends and place one ball on either side of your spine to give the muscles at the base or your head a nice massage.

    Take stretch breaks
    When you sit at a desk all day, your body grows stiff and your mind grows tired. Take a short break every hour or so. Stand up, look around, go for a short walk, take some nice deep breaths and do a few stretches. Here are a few options that can easily be done at your workstation:

    Segmental rolling: Start with a nice tall posture (either sitting or standing) and focus on slowly bringing your chin to your chest one vertebra at a time until your neck and upper back are rounded forward. Hold at the bottom for a few seconds, then slowly return to upright posture one vertebra at a time.
    Segmental rolling

    Cat stretch: This is a popular yoga-style stretch that can be done sitting, standin, or on hands and knees. With arms stretched out in front of you, gently round your back, tuck your chin and pull your shoulder blades apart. Hold this pose for five to 10 seconds.
    Cat stretch

    Upper trapezius stretch: Sitting up tall with hands resting in your lap, gently tip your head to one side and turn chin into shoulder until a stretch is felt in your neck. Hold this pose for 30 seconds and repeat on the other side.
    Upper trap stretch

    Chin tuck: With ears directly over your shoulders, gently tuck your chin as if trying to make a double chin. You should feel a gentle stretch at the base of your skull.
    Chintuck

    Scapular squeeze: sitting or standing tall with ears directly over your shoulders, gently squeeze your shoulder blades together without pushing your chin forward or raising your shoulders up. Hold this pose for five seconds, relax and repeat five to 10 times.
    Scapular squeez

    For persistent neck pain, please consult with your physician or contact one of our outpatient physical therapy centers conveniently located near you to speak with a licensed clinician today. Our highly trained physical therapists will help to alleviate your pain and get you back to work, athletics and daily life! 

    Resources:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489448/
    http://www.123chiropractors.com/articles/the-statistics-regarding-neck-pain/
    By: Nicole Tombers, P.T., DPT. Nicole is a physical therapist for Select Physical Therapy in Eagle River, AK. She treats a variety of conditions, but specializes in post-surgical rehabilitation and treatment of dizziness and vertigo. Nicole loves helping people improve and providing them with the education they need to have power over their circumstances.

  • Snow Shoveling

    Posted on 1/17/2019 by Sarah Donley, MSOT, CHT

     

    Mother Nature has yet to truly make her presence known in 2019, but that all could change this weekend. Many in the Midwest and Northeast will feel the effects of a storm that’s slated to bring dangerous amounts of snow, wind, ice and rain. With that in mind, we've provided a few snow shoveling and snow blowing tips to practice if your area turns into a winter wonderland!

    Remember to wear appropriate layers of light, loose and water resistant clothing for warmth and protection when you go outside in these low temperatures. Layering allows you to accommodate your body’s constantly changing temperature. Switch to mittens if your hands are becoming cold quickly. Mittens trap body heat by keeping your fingers together and reducing evaporative heat loss.

    Snow Shoveling

    Before you begin to clear snow from your driveway or walkway, remember that snow shoveling is a cardiovascular and weight-lifting exercise. It should be treated like a day in the gym – stretch before exercising and take it slow if you’re not in shape.
    Move smaller amounts of snow and tackle the job by dividing it into thirds, with one-hour rest breaks.
    Keep your back straight and your knees bent to decrease the pressure to your lower back when lifting. When moving the snow, turn your whole body by pivoting your legs, not just your upper body.
    Use an ergonomically correct shovel, one where the rod of the shovel bends in an elbow shape, not the straight line shovel. These shovels help you to keep your back straighter reducing spinal stress.
    Sometimes, however, there will be a storm when a snow shovel simply isn't enough. And while a snow blower can certainly help, hand injuries such as burns, lacerations, crushed bones, fractures and even amputations can also occur if proper techniques aren't practiced. Here are some tips on how you can keep your hands safe during these snowy months.

    Snow Blower

    While it sounds simple, never put your hands down the chute or around the blades of a snow blower. Use a broom handle, clearing stick or another tool to clear any clogs. Wait 10 seconds after the engine has been turned before you attempt to unclog the chute; blades could still be spinning even though the machine has been turned off. Generally, keep your hands and feet away from all moving parts.
    Avoid wearing scarves and loose fitting clothing which could become tangled in the moving parts and pull you into the machine.
    Never direct the discharge chute toward you, other people or areas where any damage can occur. The blower can also discharge hard objects, such as salt, sticks and ice further and faster than snow.
    Use proper hearing protection for your ears, and wear glasses or snow goggles for your eyes.
    If the ground is icy or slick after you’ve finished shoveling or snow blowing, spread sand or salt over the area to help create foot traction. Be aware of areas that may be uneven which could cause you to slip, trip or fall.

    Finally, think spring! Punxsutawney Phil saw his shadow and predicted six more weeks of winter ahead, but here’s to hoping the furry seasonal prognosticator is wrong this year.

    By: Sarah Donley, MSOT, CHT. Sarah is an occupational therapist at NovaCare Rehabilitation in Swedesboro, NJ. She focuses on fractures, tendonitis and compression injuries. She is Graston- certified, providing her with an advanced method of soft tissue mobilization.

  • Snow Shoveling

    Posted on 3/21/2018 by Dorothy Lehr, DPT, OCS, Cert. MDT

     

    Major snowstorms have already hit many parts of the country this winter, and the fourth nor'easter in three weeks is currently battering the East Coast, drowning out any hopes of spring. There is lots of fun to be had with the fluffy white powder, but removing snow from sidewalks and driveways is an unenviable chore and one that can cause a plethora of physical problems.

    With that in mind, below are a few tips and stretches to keep you safe and healthy while out in the winter wonderland:

    Choose an ergonomically correct shovel, one which has a curved handle and an adjustable handle length. As opposed to a straight line shovel, a shovel which is small, lightweight and curved will allow you to carry a manageable load of snow and keep your back straighter, reducing spinal stress.
    Proper shoveling technique is just as important as the correct shovel. Keep your back straight and bend at your hips and knees. When moving the snow to a new location, avoid twisting your body. Instead, turn your whole body by pivoting your legs.
    Avoid slipping on slick areas or black ice by wearing shoes or boots with good tread. Applying pet-friendly salt, sand or kitty litter will also increase traction and decrease the risk of slipping.
    Snow shoveling can be as physically demanding as a gym workout and should be treated like a day in the gym. Don’t overexert yourself, especially when the snow is wet and heavy. In deep snow, take a few inches off the top and tackle the job by dividing it into thirds, with one-hour rest breaks.
    Snow shoveling is a cardiovascular and weight-lifting exercise, and just like you would stretch before working out at the gym, performing the stretches described below before, after and even during snow shoveling can help in preventing an injury.
    Lumbar Extension – This stretch will help in balancing any forward bending that may occur during shoveling. While standing or lying on your stomach, bend back as far as is comfortable and hold for three to five seconds. Perform 10-15 repetitions.

    Lumbar Extension - Step 1  Lumbar Extension - Step 2

    Quadriceps Stretch – While standing, use your right arm to pull your right leg up toward your buttocks. Make sure to keep your trunk straight and use your other arm to hold onto a sturdy object to maintain your balance. Hold each stretch for 20 seconds and perform five reps on each leg. This will help stretch out your quad muscles that you’ll be using to lift while shoveling.

     Quad Stretch

    Hip Flexor Stretch – In a half-kneeling position and while maintaining an upright trunk, lunge forward until you feel a stretch in the front of your hip. Hold this position for 20 seconds and perform five repetitions on each leg. This stretch will help to stretch the muscles you’ll be using while moving snow and helps to keep your spine in a neutral position.

     Hip Stretch

    Sometimes, there will be a winter storm where a snow shovel simply isn’t enough. While a snow blower can certainly help with snow removal, hand injuries such as burns, lacerations, fractures and even amputations can occur if proper techniques aren’t practiced. Here are a few tips to keep you safe while operating a snow blower:

    While it sounds simple, never put your hands down the chute or around the blades of a snow blower.
    Use a broom handle, clearing stick or another tool to clear any clogs. Wait 10 seconds after the engine has been turned before you attempt to unclog the chute; blades could still be spinning even though the machine has been turned off.
    Generally, keep your hands and feet away from all moving parts of a snow blower.Avoid wearing scarves and loose fitting clothing which could become tangled in the moving parts and pull you into the machine.
    Never direct the discharge chute toward you, other people or areas where any damage can occur. The blower can also discharge hard objects, such as salt, sticks and ice further and faster than snow.
    If you are feeling some unwanted aches and pains or suffered an injury during your clean-up efforts, we’re here for you. Contact the center nearest you to schedule a complimentary consultation. Stay safe and keep thinking spring – it’s coming!

    By: Dorothy Lehr, DPT, OCS, Cert. MDT. Dot is a physical therapist and center manager with NovaCare Rehabilitation in Willingboro, NJ. A treating clinician for 12 years, Dot is a board certified orthopaedic specialist and McKenzie credentialed therapist, specializing in spine treatment.