Happy National Physical Therapy Month. Physical therapy has its roots in the 1920s and 1930s and came into high demand as rehabilitation was needed for victims of the polio epidemic and for wounded soldiers returning from World War I and World War II. Today, the field has expanded to therapists working in hospitals, outpatient clinics, care centers, schools and patients' homes. Trinity Regional Medical Center's physical therapy department treats inpatients at the hospital, outpatients at Highland Park Center, as well serving patients who are homebound and in nursing homes.
Physical therapists literally treat conditions from head to toe and many specialty areas have been established to serve patients with specific disorders. In addition to general orthopedic (bone and joint disorders) and neurological problems (such as stroke and Parkinson's disease), Trinity has therapists trained in vestibular therapy (treatment of dizziness), ergonomics (work safety) and women's health.
Physical therapists use many types of treatments depending upon the particular problem the patient is having. These can include stretching or strengthening exercises, balance exercises, gait training with a walker or cane and the use of modalities. Treatment can include using ice or heat, ultrasound, electrical stimulation and massage. These techniques are used to decrease pain and muscle spasm, and to decrease swelling.
Women's health is an area of physical therapy that has grown immensely in the past few years, but the diagnoses we treat in this area are not exclusive to women. The two programs offered at Highland Park are for urinary incontinence/pelvic muscle dysfunction and osteoporosis.
Many women (more than 50 percent), experience leakage at some time in their lives, but do not usually discuss it with their doctor. Men may also have issues with increased frequency or leakage, usually due to prostate surgery or enlargement. Symptoms include urgency, or inability to wait to use the toilet, or leakage with laughing, coughing or lifting. Treatment for these problems consists of lifestyle changes and exercise. Lifestyle changes may include decreasing caffeine intake and, believe it or not, increasing fluid intake. Pelvic muscles are just like any other muscle in the body and need exercise to stay strong. Our exercise program targets specific muscles to help control leaking and support the position of the bladder in the pelvis. The other part of the program consists of relaxation exercises (and do not we all need those!). The bladder is made up of smooth muscle, which we cannot directly control. For example, when you want to bend your elbow your brain gives signals to the nerves to make the muscles contract, and your elbow bends. With the overactive bladder, the nerves are giving it too much stimulation and urgency/leaks can result. Relaxation exercises "idle down" the stimulation to the bladder and can help with urgency, meaning fewer trips to the bathroom.
At Highland Park Center, we also use biofeedback, which is a computerized method to display muscle tone and strength. Patients can "see" muscle contractions on the screen to make sure they are contracting the proper muscle groups. Treatments for incontinence are done once per week with the patient practicing exercise and relaxation techniques at home.
This is the other area of women's health treated at Highland Park physical therapy. According to the National Osteoporosis Foundation, this condition affects over 44 million men and women in the U.S. This number represents 55 percent of those over 50 years old. Osteoporosis is often called a silent disease because many people do not know they have it until they break a bone. Risk factors for osteoporosis include being female, family history of osteoporosis, small build, and low estrogen and calcium levels, to name a few. People who take long-term steroid medications can also be at risk. Your doctor may order a bone density test (DEXA scan), which can be done at the Norma Schmoker Women's Center. This scan will give a report of bone loss in the spine and hips. Based on this information, you may benefit from physical therapy treatment.
Treatments for osteoporosis include medications, nutritional supplements, and of course, exercise. The focus of exercise is spinal muscle strengthening, but also includes balance training to prevent falls, strengthening the legs and hip girdle, and abdominals. Proper alignment of the spine is emphasized to promote weight bearing through the spine and hips, which can help maintain and improve bone density. Each patient is evaluated and a program is tailored to meet their specific needs. The goals at the end of treatment are decreased pain, improved posture, increased spinal muscle strength and improved balance. A physician's referral is needed for physical therapy services.
The field of physical therapy has changed over the years, but what has not changed is the individualized, one-to-one care that physical therapy staff provides. We have a unique opportunity to spend time with the patient and can monitor progress to work toward that patient's goals, whether it is lifting the arm overhead after shoulder surgery or getting relief from back pain. Our physical therapy staff at Trinity includes 10 physical therapists, five physical therapist assistants and six therapy aides. Many have advanced training and are dedicated to bringing the newest treatments to our patients.
From a personal standpoint, I have found physical therapy to be a rewarding career choice and am honored to work with the many patients I have had the pleasure to serve. If you have any questions about physical therapy, feel free to call Highland Park Center at 574-6900, or visit Trinity Regional Medical Center's Web site at www.trmc.org.
Joanne McEvoy is a physical therapist at Trinity Regional Medical Center.