Striving for Excellence in Rehabilitation Care
Prevalent Injuries & Emphasis
Age Related Injuries
Amongst older adults, falls are a major health concern. Falls amongst elders are the leading cause of injury deaths, the most prevalent cause of non-fatal injuries, and primary reason for hospital admission due to injuries. Studies have shown the rate of falls increase with aging and more than one third of 65 and older adults fall each year and cause moderate to severe injuries. The most prevalent injury by falls are hip fractures and head injuries and every hour there is one death and over 180 emergency department visits for fall-related injuries. Fortunately, falls are a public health problem that is largely preventable.
At Divine Physical Therapy & Wellness, fall preventions will be emphasized by addressing specific “risk factors” associated with falling which include, muscle weakness, spatial awareness deficit, poor balance and coordination, delayed protective mechanism, poor posture, difficulty walking, poor use of assistive devices like a cane, and general difficulty completing activities of daily living (ADLs). Additional risk factors that manifest in somatosensory deficit, vision deficit, and vestibular dysfunction such examples are loss of sensation in the feet, vision abnormalities such as double vision, nearsightedness, farsightedness and etc., hearing loss, disease that might lead to a loss of balance or drop in blood pressure. During history intake and evaluation, medications will all be acknowledged and coordinated with necessary treatment. Fall Risk Assessment and management will be essential for those with fear of falling.
Work Related Injuries
Amongst workers of all ages, some of the most usual areas of the body involved are muscle and joints in the spine, arms, hands, legs, the head/neck. According to data from the National Institute for Occupational Safety and Healthand the Bureau of Labor Statistics, an average of 200 workers are hospitalized each day. Some of most common causes of industrial injury are poor ergonomics, manual handling of heavy loads, inadequate safety training. Divine Therapy & Wellness will address work related injuries by beginning with an initial goal is to decrease the symptoms associated with an acute injury like pain, and swelling (if the injury involves a joint like the hip, knee or shoulder).
Treatment strategies will consist of education on their work related injury, therapeutic modalities, balance and core stabilization, manual therapy as in joint mobilization, stretching, and strengthening, postural training and energy conservation mechanic training. After the acute phase of injury and rehabilitation, the progression will then emphasize on more functional “work conditioning” type program which will consist of
goals that will help patients with physical tolerance for work, optimizing flexibility, mobility, endurance, cardiovascular conditioning, overall strength and learn safer work techniques and mechanics that is requires during prolonged sitting, lifting, bending and twisting. Divine Therapy & Wellness will not only help you return to work pain free with optimal physical functional mobility but will help you acknowledge and understand your injury occurrence and how to prevent a recurrence.
Rehabilitation Post Surgeries
Various surgeries require various evaluation and treatment procedures. Specificity of rehabilitation will be applied thoroughly. Divine Therapy & Wellness will acknowledge specific surgical procedure, the intraoperative findings and surgeons recommendation will be correlated with the evaluation clinical manifestation that will guide plan of care and the course of treatment for each patient. The rate of rehabilitation progression will be typically determined by the clinical assessment findings which will be monitored every physical therapy treatment and administered weekly. These findings will then be correlated with your surgeon’s specific post-operative protocol and other manifestation factors of the condition that involve health of muscles, tissues and joints and also the chronicity of the physical dysfunctions. The appreciation for proper progression of weight bearing (in the case of a hip, knee or ankle surgery), increasing range of joint motion, and strengthening progression and functional progression in activities will be addressed accordingly as a team with your surgeon and other medical doctors.
In most cases with patients that are surgical candidates, your surgeon will recommend a “pre-operative” rehabilitation program with the emphasis on the goal orientation of decreasing inflammation (swelling and edema), restoring normal pain free range of motion, muscle and joint function and normal functional mobility or gait/locomotion. A good example of this situation would be the case of a torn ligament in the knee or ankle and scheduled reconstructive surgery. The research indicates that restoring range of motion pre-operatively decreases the incidence of arthrosis or arthrofibrosis (scar tissue build up from immobility) post-operatively. Patient education is the second most important component in pre-operative program at Divine Therapy and Wellness. The education that will be provided for each patient before and after surgeries will be addressed thoroughly which will most certainly lead a patient with a much better outcome by return to full functional mobility.
Sports Activity Related Injuries in Young/Older Adults
Divine Therapy & Wellness approach to rehabilitation of sports/ physical activity injuries is quite often different than general rehabilitation. Given that specific demands of a sport often require the intervention to emphasize specificity of the sport, the rehabilitation goal will most aptly be targeted toward patient’s functional needs for the activity post their injury. The aggressive approach to athletes will conclude the return of the athlete to activity and competition as soon as is safely possible.
Divine Therapy & Wellness will appreciate the collaboration of the team physician, and the athletic trainer for maintaining optimal outcomes from physical therapy. Dr. Sarker who also has his bachelor of science in sports medicine-Athletic training, will have a thorough understanding of the etiology and pathology of musculoskeletal injuries as well as the various phases of healing.
Musculoskeletal Pathology Amongst Elders
As older adults age through out their life, loss of bone is an unavoidable fact. This is most prevalent amongst women, who tend to have less skeletal mass than men and who also lose bone more quickly. Women lose bone at an average rate of 2% to 3% per year, while men of the same age lose bone at a rate of only 0.4% per year after menopause. This provides the appreciation that many older athletes are predisposed to bone fractures and has high probability in overuse injuries.
Most common joggers’/runners' injuries amongst older adults are common over-exercise injuries including back pain, problems with the kneecap, shin splints, achilles tendonitis bursitis, stress fracture, hamstring injury, heel pain, morton's neuroma (nerve injury under the foot) calluses, and bunions that become chronic joint, bone and muscle pain injury due to lack of appropriate care management.
Flexibility deficit is another consideration amongst active elders. This is caused mainly by changes in the body's connective tissue, combined with arthritis. Muscle flexibility deficit means that our knees, hips, and other joints must bear greater stress during exercise, rather than dissipating it to surrounding tissues, such as nearby muscles. This stress can gradually destroy the joints. Pt education in appropriate work load in relation to active elders is essential in maintaining a healthy functional muscle and joint mobility.
Many types of musculoskeletal injuries are associated with particular sports. For example, the physical activities such as golf, tennis, racquetball, and even gardening performed by most active adults are prone to common overuse injuries include rotator cuff (shoulder) problems, cervical (neck) disc or osteoarthritic problems, lower back pain and epicondylitis (golfer's or tennis elbow). Also wrist pain is common because of continual extension and twisting of the wrist during swing phase in all upper extremity involved activities. Many of these problems can be avoided simply by appropriately warming up the body before starting and by doing stretching exercises. Muscle strengthening and stabilization exercises, particularly of the back and core (abdominal) muscles, are also key to preventing and treating active injuries.