The Differences Between a Physiatrist and a Physical Therapist

2 Jun 2017 Physical Therapy , , , , ,

The road to recovery from an illness or injury often involves pain or disability, and help from a team of highly trained professionals is usually necessary. Two key players on this team are the physiatrist and the physical therapist. While their names sound similar, they have two very distinct roles.

A physiatrist is a physician who is trained in the diagnosis, treatment and management of debilitating conditions that affect the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. Some of the illnesses and conditions that they are experts in are spine problems, chronic pain, sports injuries, brain and spinal cord injuries, arthritis, work injuries and fibromyalgia. Otherwise known as physical medicine and rehabilitation physicians, their focus is to improve function and minimize pain.

Along with consulting with other physicians, a physiatrist leads a team of healthcare professionals such as physical therapists, occupational therapists, speech therapists, dieticians, and nurses, to help patients adapt to limitations and regain as much function as possible.  In this role, they may prescribe exercise, prosthetics (artificial limbs), orthotics (inserts or braces), and other equipment that help patients complete their daily tasks and live independently. They do not perform surgery, but they do perform procedures that either help in the diagnosis or the treatment of illness or injury.

Some common procedures include EMG (electromyography) to identify the source of muscle weakness, nerve conduction studies to identify nerve damage, peripheral joint injections to diagnose and treat joint disorders, trigger point injections or spinal injections for pain control, and a number of image-guided spinal procedures to reduce back pain. They also specialize in treating spasticity from neurological injuries related to illnesses such as stroke or cerebral palsy.

A physical therapist is a highly-skilled and educated, licensed health care professional that works directly with patients who are experiencing pain or debility from an illness or injury. After a thorough evaluation, they develop individual plans of care that will help patients regain as much function as possible, minimize pain, and prevent future injuries and disability. These plans may include exercise, manual therapy and manipulation, mechanical traction, education, heat or cold therapy, electrical stimulation, ultrasound, and teaching patients to work with assistive devices such as walkers or canes and artificial limbs.

They not only physically provide treatments and assist patients in performing exercises, but also teach them how to continue exercising after their treatment is complete, to stay healthy and prevent future injury. They work with patients who have experienced a wide range of illnesses and injuries, but their goal is always to help the patient live as independent and pain-free as possible. Examples of patients who will benefit from physical therapy are those who have experienced fractures or orthopedic surgery, strokes, sports injuries, accidents, neurological injuries or illnesses, pain from arthritis, and back injuries.

Patients who have experienced a long-term illness and may have grown weak also benefit from physical therapy to improve strength, balance, and endurance. Physical therapy is a proven way to decrease disability and pain, and to improve long-term health after an illness or injury.

To learn more about the services offered by both physiatrists and physical therapists, call Tucson Orthopaedic Institute at our East Tucson office at (520) 784-6200, Northwest Tucson office at (520) 382-8200, or Oro Valley office at (520) 544-9700. To request an appointment, you can call or use our secure online appointment request form.

Is Your Pain Stemming from Arthritis?

26 May 2017 Arthritis , , ,

Though pain is never pleasant, it’s an important signal our bodies use to warn there’s something wrong. Usually, what’s wrong is that you have an injury of some kind, or in some cases your body can even be misfiring pain signals.

When you have an injury – in the case of arthritis, an injury to your joints – the damaged tissues release chemicals that alert nearby sensory nerves. These nerves carry the message up your spinal cord to your brain. Your brain processes the message and sends a signal to your motor nerves to take action.

So how do you know if your symptoms are caused by arthritis or something else? While joint pain and stiffness are the most common terms used to describe arthritis, the warning signs are quite specific. Here’s what you need to know to get the right diagnosis, and the best treatment.

Symptoms of arthritis include:

  • Joint pain and tenderness
  • Inflammation in and around the joints
  • Restricted movement of the joints
  • Warm, red skin over the affected joint

Technically, pain is considered chronic when it lasts three to six months or longer, but arthritis pain can last a lifetime. The symptoms of arthritis depend on the type that you have and the location. While there are multiple types of arthritis, the two main types are rheumatoid arthritis and osteoarthritis.

Osteoarthritis is the most common type of arthritis, which often gets worse with age and is caused by wear and tear. This type of arthritis affects the smooth cartilage lining of the joint. This makes movement more difficult than usual, leading to pain and stiffness. Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder. This can cause swelling and the formation of bony spurs, called osteophytes. Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position.

Rheumatoid arthritis occurs when the body’s immune system targets affected joints, which leads to pain and swelling. The outer covering of the joint called the synovium is the first place that becomes affected. This can then spread across the joint, leading to further swelling and a change in the joint’s shape, and may cause the bone and cartilage to break down. Unfortunately, people with rheumatoid arthritis can also develop problems with other tissues and organs in their body.

Tips for relief from the painful symptoms of arthritis:

1. Exercise: Light to moderate physical activity is often one of the best things for the body. Remember to stay hydrated and don’t overdo it. You can often get a specific exercise plan catered to your specific needs or condition, made up by your healthcare professional.

2. Use hot and cold therapy: This often depends on the type of tightness or swelling involved, but it’s best to speak to a doctor or physical therapist about the proper ice or heat therapy to stick to.

3. Eat a healthy diet: Believe it or not, there is a whole list of different types of food that are known to either cause or reduce inflammation in the body.

4. Manage your weight: Simply put, the less weight and pressure put onto bones and joints, the better.

If you’re living with chronic pain due to arthritis, it may be time to take a closer look at your symptoms and explore treatment options. For more information about arthritis and other painful joint conditions, call Tucson Orthopaedic Institute at our East Tucson office at (520) 784-6200, Northwest Tucson office at (520) 382-8200, or Oro Valley office at (520) 544-9700. To request an appointment, you can call or use our secure online appointment request form.

The Cost of Being Connected: Hand Pain

19 May 2017 Hand Pain

The odds are high that you, like most everybody, has had a minor problem with a finger, hand, or wrist. The truth is, while the pain may be local to one area, they are all connected and rely upon one another for proper functioning. The hands and wrists are so commonly utilized every day, as our main tools and our first line of defense, so they are subject to a variety of problems. Some problems are the result of how you use your hands in everyday activities – for example, sprains and strains as well as fractures can occur with lifting and carrying heavy objects, operating machinery, bracing against a fall, or sports-related injuries.

If you’ve ever awakened with numb hands, had your finger lock while filling out a crossword puzzle, or tried in vain to open a jar, you know what it’s like to have your hands fail you. Hand pain can be caused by disease or injury affecting any of the structures in the hand, including the bones, muscles, joints, tendons, blood vessels, or connective tissues.

Hand pain and stiffness, often tolerated without medical attention, can be successfully treated. You don’t have to accept discomfort and disability as a consequence of aging. Fortunately, there are a host of treatments that can alleviate pain and improve function with minimal recovery time. Conditions that affect the hand and wrist include:

  • Sprains and Strains
  • Ligamentous Injuries
  • Fractures
  • Repetitive Trauma Syndrome
  • Carpal Tunnel Syndrome
  • Arthritis: Osteoarthritis, Rheumatoid
  • Ganglion Cyst
  • Trigger Finger
  • Any problem that causes pain, swelling, discoloration, numbness or a tingling sensation, or abnormal contour of the hand or wrist that persists for more than two or three days should be evaluated by your doctor as early as possible, to establish the cause and obtain the best treatment.

To learn more about hand pain, and how to treat it call Tucson Orthopaedic Institute at our East Tucson office at (520) 784-6200, Northwest Tucson office at (520) 382-8200, or Oro Valley office at (520) 544-9700. To request an appointment, you can call or use our secure online appointment request form

Don’t Be Scared of Physical Therapy Equipment

19 May 2017 Physical Therapy , ,

The main goal of physical therapy is to restore your function and mobility, and eliminate or minimize your pain so you can get back to your normally active lifestyle. In fact, as experts in the way the body moves, physical therapists help people of all ages and abilities reduce pain, improve or restore mobility, and stay active and fit throughout life. While some people might that the tasks are daunting, or the equipment difficult to use, the overwhelmingly positive results for patient recovery should soften any fears about physical therapy.

A customized physical therapy program can help individuals return to their prior level of functioning, and encourage activities and lifestyle changes that can help prevent further injury, and improve overall health and well-being. Primary care doctors often refer patients for physical therapy at the first sign of a problem, since it is considered a traditional and non-invasive approach to managing problems.

Most physical therapy uses a combination of techniques to relieve pain and boost coordination, strength, endurance, flexibility, and range of motion. Physical therapists (PTs) often ask patients to use exercise equipment like bikes and treadmills. However, other equipment like using resistance bands, medicine balls, and foam rollers can be confusing if someone doesn’t instruct you on what they are and how to use them. Here is a guide on physical therapy equipment, and why it is not scary once you know how to use it.

1. Medicine Ball: The importance of a medicine ball is that it helps with strength, coordination, and balance. The medicine ball comes in a variety of colors, sizes, and weights. It is beneficial to start with the lightest and move up in weight as you get the hang of it while doing your exercises.

2. Foam Roller: In physical therapy, foam rollers are a crucial part in relieving tension and pain. If you have sore muscles, the foam roller gets out all the tension. The foam roller comes in different sizes and colors. Most importantly, it’s important to understand that foam rolling is uncomfortable at first, essentially due to getting knots out of your body. Listen to your body, and know your limits.

3. Resistance bands: Resistance bands are lightweight and can be taken anywhere. During physical therapy, resistance bands vary in tension, color, and thickness. Whatever style and color you use in physical therapy should be the one to use at home, if instructed.

Always consult your physical therapist at Tucson Orthopaedic Institute on how to use your new equipment before using it yourself. Exercising freely whenever you want in your home can be tantalizing, but exercising improperly could set you back weeks on your path to recovery. Mastering these tools will accelerate your recovery and get you back to your old self.

To learn more about physical therapy and the equipment used, call Tucson Orthopaedic Institute at our East Tucson office at (520) 784-6200, Northwest Tucson office at (520) 382-8200, or Oro Valley office at (520) 544-9700. To request an appointment, you can call or use our secure online appointment request form.

The Benefits of Coordinated Care & Physical Therapy

5 May 2017 Physical Therapy , , ,
“Coordinated care” means that all healthcare professionals work together to help make sure patients get the right care at the right time. Coordinated care aims to make sure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. You’ll benefit when your doctor, health care provider, or hospital coordinate your care, working together to give you the right care at the right time in the right setting.

Rehabilitation is an important process after surgery or injury that involves many different healthcare professionals. Of course, the main purpose of a rehabilitation center is to prepare patients to return home. Physical and occupational therapists work together in this effort. As part of this process, the nursing staff also coordinates the details of planning services and patient care.

When everyone works together to coordinate a patient’s care, the result can be happier, healthier patients, faster recovery by those who are ill or hospitalized, and improved quality of life for those with serious and chronic conditions.

Benefits of Coordinated Care

·       Develop a plan to help achieve personal health goals

·       Family support and knowledge growth through individual visits and group seminars

·       Coordination of complex health care needs

·       Increased access to information related to medication, procedures, and diagnoses

Physical therapy has the potential to help restore independence to a homebound patient. Therapy emphasizes addressing mobility tasks and deficits in the skills that a patient has difficulty with or cannot perform without assistance. Through the incorporation of therapeutic exercise and functional training, patients will experience improvements with pain, range of motion, strength, endurance, balance, and mobility.

To learn more about coordinated care and physical therapy, call Tucson Orthopaedic Institute at our East Tucson office at (520) 784-6200, or our Northwest Tucson office at (520) 382-8200.

Common Sources of Shoulder Pain

28 Apr 2017 Shoulder Pain , , ,

The shoulder has a wide and versatile range of motion. However, when something goes wrong with your shoulder, it prevents your ability to move freely, and can cause a great deal of pain and discomfort.

The shoulder is a ball-and-socket joint that has three main bones: the humerus (long arm bone), the clavicle (collarbone), and the scapula (also known as the shoulder blade). These bones are cushioned by a layer of cartilage. There are two main joints. The acromioclavicular joint is between the highest part of the scapula and the clavicle. The glenohumeral joint is made up of the top, ball-shaped part of the humerus bone and the outer edge of the scapula. This joint is also known as the shoulder joint.

A number of factors and conditions can contribute to shoulder pain. The most prevalent cause is rotator cuff tendinitis. This is a condition characterized by inflamed tendons. Another common cause of shoulder pain is an impingement syndrome where the rotator cuff gets caught between the acromion (part of the scapula that covers the ball) and humeral head (the ball portion of the humerus).

Shoulders get their range of motion from the rotator cuff. The rotator cuff is made up of four tendons. Tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen.

You can injure your shoulder by performing manual labor, playing sports, or even by repetitive movement. Certain diseases can bring about pain that travels to the shoulder. These include diseases of the cervical spine of the neck, as well as liver, heart, or gallbladder disease. You’re more likely to have problems with your shoulder as you grow older. It is especially common after age 60. This is because the soft tissues surrounding the shoulder tend to degenerate with age.

Other causes of shoulder pain include several forms of arthritis, torn cartilage, or a torn rotator cuff. Swelling of the bursa sacs (which protect the shoulder), or tendons can also cause pain. Some people develop bone spurs, which are bony projections that develop along the edges of bones.

To learn more about shoulder pain and what could be causing it, call Tucson Orthopaedic Institute at either the East Tucson office at (520) 784-6200, or the Northwest Tucson office at (520) 382-8200,

What is Physiatry?

21 Apr 2017 General ,

A physiatrist practices in the field of physiatry, also known as physical medicine and rehabilitation (PM&R), which is a branch of medicine that specializes in the diagnosis, treatment, and management of patients who have been disabled, from a disease, condition, disorder, or injury, primarily using physical medicine, or “physical” means, including non-surgical methods, such as physical therapy and medications to treat the patient.

Essentially, physiatrists specialize in treating conditions of the musculoskeletal system (bones, muscles, joints, ligaments, tendons, and other structures), and the central/peripheral nervous system that affect a person’s ability to function. It is important to note that physiatrists do not perform surgery. A physiatrist’s treatment focuses on helping the patient become as functional and pain-free as possible in order to participate in and enjoy life as fully as possible.

Due to the broad spectrum of conditions treated and the comprehensive nature of their training, physiatrists are uniquely positioned to adapt to and design new technologies, as well as to the changing trends in healthcare. Areas of focus include:

1.       Neurorehabilitation: Some examples include Spinal Cord Injury, Traumatic Brain Injury, Stroke, Multiple Sclerosis, Amyotrophic Lateral Sclerosis, Myasthenia Gravis, Parkinson’s Disease

2.       Pain medicine: Chronic Pain Management, Complex Regional Pain Syndrome, Back Pain, Arthritis, Carpal Tunnel Syndrome, etc.

3.       Musculoskeletal care: Osteoarthritis, Osteoporosis, Rheumatoid Arthritis, Inflammatory Myopathies, Fibromyalgia, Spondyloarthropathies, Back Pain and Sacroiliac Joint Dysfunction

4.       Sports injuries: Achilles Tendonitis, Iliotibial Band Syndrome, Turf Toe, Medial & Lateral Epicondylitis, DeQuervain’s Tenosynovitis, Rotator Cuff Pathology, Acromioclavicular Separation, Biceps Tendonitis, Stress Fractures, Concussion​

5.       Post-operative care: for Joint Replacement, Organ Transplantation, Amputations, Left-Ventricular Assistive Devices, Cardiac/Pulmonary Rehabilitation

6.       Pediatric functional and developmental disorders: Such as Cerebral Palsy, Muscular Dystrophy, Spina Bifida, Down Syndrome

7.       Prosthetics and Orthotics: For Gait and Movement Disorders, Assistive Devices and Ambulation Aids, Spinal Orthoses, Neuro-prostheses

8.       Specialized rehabilitation: Concerning Fine Arts (music, dance, vocal), Cancer, Cardiac, Burns, Pulmonary, Family Training (for home care), Pelvic Pain, Alternative and Complementary Medicine, Palliative Care​

Since the spine is the locus of most of the body’s musculoskeletal system, many physiatrists focus on treating back pain. For those who specialize with treating spinal problems, their focus may be more on rehabilitation or on injections (pain management), depending upon their training and personal preference. The following is a list of back conditions commonly treated by physiatrists:

·       Back pain, sciatica

·       Muscle and ligament injuries

·       Work injuries

·       Myofacial pain

·       Fibromyalgia

·       Spinal cord injury

·       Osteoarthritis

·       Ankylosing spondylitis

·       Osteoporosis

Many physiatrists also serve to coordinate the patient’s care with a multidisciplinary team of other doctors and specialists, for example, physical therapists, spine surgeons, psychologists, chiropractors, and more.

To learn more about the field of physiatry, and how it may be able to help you, call Tucson Orthopaedic Institute at our East Tucson office at (520) 784-6200, Northwest Tucson office at (520) 382-8200, or Oro Valley office at (520) 544-9700. To request an appointment, you can call or use our secure online appointment request form.

8 Key Questions to Ask Your Physical Therapist Prior to Treatment

24 Feb 2017 Physical Therapy , , , ,

If you’ve never been to orthopedic physical therapy before or you’re starting PT at a new and unfamiliar place, there are some fundamental questions you should ask prior to your first appointment to make sure you will be comfortable at the facility and confident in the care you will be receiving.

1. Who will be providing my care?

Orthopedic physical therapy clinics may employ a number of different types of healthcare professionals, including physical therapists, physical therapist assistants, occupational therapists, occupational therapist assistants, or certified hand therapists. The type of therapist you see will typically depend on your diagnosis.

2. What qualifications and experience do your providers have?

Physical and occupational therapists have advanced degrees and typically pursue continuing education courses throughout their career. In addition, many therapists obtain additional certifications such as:

  • Orthopedic Certified Specialist (OCS)
  • Sports Certified Specialist (SCS)
  • Certified Hand Therapist (CHT)
  • Geriatric Certified Specialist (GCS)
  • Certified Lymphedema Therapist (CLT)
  • Certified Strength and Conditioning Specialist (CSCS)
  • Certified Exercise Expert for Aging Adults (CEEAA)
  • Certified Mechanical Diagnosis and Treatment (CMDT) of the Spine
  • Certified Orthopaedic Manual Therapist (COMT)

These certifications indicate the provider has taken post-graduate courses and passed an examination assuring a minimal competency level in the specific area.

At TOI, many of our therapists have these or other certifications. They also specialize in areas such as vestibular rehabilitation, balance and fall prevention, aquatic therapy, cranial sacral therapy, myofascial release, functional rehabilitation, kinesio taping, trigger point dry needling, instrumented soft tissue mobilization, movement analysis, and manual therapy.

3. Will I see the same physical or occupational therapist each time?

To build rapport and trust with your provider and ensure consistency of care, it is important for the same provider to treat you or supervise your care at each session. There may be times you are treated by a physical or occupational therapist assistant (PTA/OTA), but they are always overseen by the primary PT or OT and will follow the established treatment plan.

4. How many therapy sessions will I need and how long will they be?

This will depend on your diagnosis and compliance with your treatment plan. Your therapist will discuss a treatment plan with you in detail at the initial consultation.

5. What will a typical therapy session entail?

Your first PT visit includes a comprehensive evaluation. You will describe your medical history, your current problems and level of pain, what aggravates and eases your problem, how your pain or lack of mobility impacts or limits your daily activities, and what your goals are for physical therapy.

Your therapist will perform a physical evaluation including palpation, range of motion testing, muscle testing, neurological screening, and perhaps other tests to confirm or rule out other problems. He or she will then create a treatment plan with your input and explain what you can expect from each visit.

This typically includes therapeutic exercise (range of motion, strengthening, stretching) and functional training, as well as hands-on care, manual therapy, joint mobilization, modalities (heat, ice, ultrasound, electrical stimulation, and more), and reviewing your home exercise program.

Depending on your diagnosis, your rehab may also include aquatic therapy, vestibular therapy to treat dizziness, balance and gait training, sport-specific exercise, or other treatment to address your specific problem(s).

6. Will physical therapy be painful?

People are referred to physical therapy for pain relief or to improve mobility. Your therapist will devise a treatment plan to address your specific complaints and goals for therapy. In some cases PT may be painful, especially after surgery. If you do experience pain during your therapy sessions, it is important to communicate this to your therapist, noting the intensity, frequency, and duration of pain. Your therapist will then adjust your treatment plan to work around or through the pain.

7. Do you accept my insurance?

This will typically dictate which physical therapy facility you can visit. Be sure the facility clarifies your insurance coverage prior to scheduling your initial appointment.

8. What are your hours of operation?

Convenience is key to ensuring you attend all your therapy sessions. Make sure your PT provider offers hours that are compatible with your schedule. Many offer early morning or evening hours to accommodate working patients.

Tuscon Orthopaedic Institute offers physical and occupational therapy in two convenient locations. Collectively, our therapists have over 220 years of combined orthopaedic rehabilitation experience. Learn more about the orthopedic rehabilitation services we provide and our highly qualified therapists, then call us to schedule your appointment.

Notice of Special Hours: Walk-in Clinic OPEN this Weekend Only

12 Jan 2017 General , , , , ,

The Tucson Orthopaedic Institute After Hours Clinic will be open, this weekend only, in support of the Ft. Lowell Shootout soccer tournament. The After Hours Clinic provides specialized treatment to patients with acute orthopaedic injuries, including fractures, sports injuries, sprains, tears and other sudden bone and joint injuries – no appointment necessary!

Walk-in clinic hours are as follows:

Saturday, January 14th (10:00 am – 8:00 pm)

Sunday, January 15th (10:00 am – 2:00 pm)

East Office

1st floor of TMC’s Orthopaedic and Surgical Tower

5301 E. Grant Rd.

784-6441

Our specialists treat acute orthopaedic injuries, reducing the wait time for patients to receive care compared to an emergency room or traditional urgent care center. Patients are assured expert care with a trained orthopaedic Physician Assistant on staff, and a supervising Tucson Ortho doctor on-call. Onsite x-ray and casting services provides all the orthopaedic care patients need in one visit.

IF YOU HAVE A LIFE-THREATENING CONDITION, CALL 911 OR GO IMMEDIATELY TO A HOSPITAL EMERGENCY ROOM.

Treating Tennis Elbow

6 Jan 2017 General , , ,

Treating Elbow PainTennis elbow is another term for tendonitis that affects the elbow. Tendonitis is a repetitive stress injury, or an injury that results from overuse of tendons and muscles in a specific area. Tennis elbow is caused by overuse of arm, forearm, and hand muscles, which results in elbow pain. While it is a common injury for those who play tennis, athletes in other sports or employees who use vibrating equipment (e.g., a jackhammer) or their forearms during manual labor are also susceptible.

The medical term for tennis elbow is lateral epicondylitis, which stems from the part of the elbow that is affected: the lateral epicondyle, or the bony area on the outside of the elbow where the muscles and tendons of the forearm attach.

Most cases of tennis elbow respond to nonsurgical treatments, and resting the forearm from the activity causing the pain is the most important part of treatment. Rest allows the small tears in the tendon to heal. The length of time you need to rest depends on how severe your condition is. It might be necessary to rest for a few weeks to a few months. In addition to rest, treatments may include:

  • Ice: Apply ice to the outside of your elbow as soon as you notice pain. Use for 10 to 15 minutes at a time, several times a day.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter (OTC) medicines such as aspirin, ibuprofen, or naproxen can help relieve pain.
  • Corticosteroid medication: Your doctor may inject a corticosteroid at the outside of the elbow to relieve pain and enable you to participate in physical therapy.
  • Physical therapy: A physical therapist will prescribe specific exercises to stretch and strengthen muscles and tendons around the injured elbow. Your PT can also teach you new techniques to handle movements that aggravate your condition.
  • Counterforce brace: This is an elastic band that wraps around the forearm just below the injured elbow. It may relieve symptoms by spreading pressure throughout the arm instead of putting it all on the tendon.
  • Surgery: This is a last resort if other treatment isn’t helpful. Your doctor may recommend surgery if your elbow pain doesn’t improve after 6 to 12 months of rest and rehab, or if you have a large tear in the tendon.

If you have or think you may be experiencing tennis elbow and at-home treatment is not relieving your pain, make an appointment with one of our orthopedists at a Tucson Orthopaedic Institute office near you.

Tucson Orthopaedic Institute Expands Physical Therapy Access

5 Jan 2017 General, Media, Physical Therapy , ,

Tucson Orthopaedic Institute opens a third physical therapy location inside fitness gym, FIT at the River. Starting in January 2017, the new clinic will offer patients additional access to physical therapy treatment.

Open Monday – Friday

Monday, Wednesday (8am-5pm); Tuesday, Thursday (7:30am-3:30pm); Friday (7:30am-12:30pm)

2404 E. River Rd., Bldg. #1

Tucson, AZ 85718

At this location is physical therapist Golsa Lotfioff, PT, DPT. Lotfioff received her Doctorate of Physical Therapy in 2014 and now specializes in outpatient orthopedics, sport medicine rehabilitation, manual therapy, aquatic therapy, and pediatric rehabilitation.

Patients can now benefit from receiving physical therapy treatment in a convenient location for rehabilitation from injury or post-surgery recovery. The FIT at the River clinic provides the same quality of care and comprehensive physical therapy services as all Tucson Orthopaedic Institute physical therapy locations.

Tucson Orthopaedic Institute physical therapy locations also include the Northwest office, 6320 N. La Cholla Blvd, #200; and East office, 2424 N. Wyatt Drive, #130. For scheduling information, call (520) 784-6570 or visit www.tucsonortho.com.

Did You Know? 8 Interesting Facts about Physical Therapy

21 Dec 2016 General, Physical Therapy , , , ,

If you have a musculoskeletal injury or condition, physical therapists can help you recover by improving your mobility, reducing your pain, and restoring your function. While this is widely known, here are some interesting things you might not know about physical therapy (PT).

How did it all begin? The profession of physical therapy began during World War I in response to the need to treat injured soldiers. The benefits of PT have since been proven so great that it is now an integral part of strengthening and recovery. 8 Interesting Facts About Physical Therapy

Where do physical therapists work? Besides physician practices like Tucson Orthopaedic Institute, physical therapists can work in a number of other settings, including outpatient clinics, hospitals, inpatient rehabilitation facilities, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes.

What else do physical therapists do? Most people probably associate PT with orthopedic rehabilitation, but there are several other types of physical therapy, including neurologic rehabilitation (e.g., working with stroke patients and spinal cord injuries), acute care, post-operative care, cardiovascular and pulmonary rehab, lymphedema management, pelvic floor therapy, and burn/wound care.

Can physical therapists treat anything other than musculoskeletal disorders? Besides disorders of the bones, muscles, and joints, physical therapists can treat balance problems such as dizziness and vertigo (a dysfunction of the vestibular system in the inner ear), headaches, concussions, jaw pain (such as TMJ), lymphedema, urinary incontinence, COPD and other cardiopulmonary conditions, cerebral palsy, and multiple sclerosis and other neurological disorders.

What kind of credentials do physical therapists have? When physical therapy was first recognized as a profession, PTs only had to have a bachelor’s degree to practice. Today PTs have advanced degrees. Masters degrees became the required norm during the 1990s, while most of today’s PT graduates obtain a doctoral degree (DPT).

Do physical therapists do massage? Physical therapy is a hands-on therapeutic treatment. While PTs are trained in massage, it is not the type of massage you may have received from a massage therapist at a spa. Physical therapists use massage to reduce tightness and improve mobility of the muscle, soft tissue, or joint that is inflamed or in pain. It is typically referred to as manual therapy, manipulation, or mobilization. So massage is part of the therapy process to reduce pain and increase mobility.

How many physical therapists are there? In 2014, there were 210,900 PTs in the US. This number is expected to rise by 34% through 2024. (Source: Bureau of Labor Statistics)

Do I need a referral to receive physical therapy? It depends on where you live. Arizona and 21 other states allow unlimited direct access to PT. This means that you can see a physical therapist as often as you want for as long as you want without a referral from a doctor. However, you should check with your health insurance company first to make sure they will reimburse you for your physical therapy sessions.

For orthopedic physical therapy in Tucson, call Tucson Orthopaedic Institute today. We offer physical therapy in East Tucson [(520) 784-6570] and Northwest Tucson [(520) 382-8201]. Contact your preferred location to make an appointment.

Treating Musculoskeletal Headaches

2 Dec 2016 Headaches , ,

You know the feeling – the dull ache in your head, the tension in your shoulder, neck, and face muscles. Tension headaches, also known as musculoskeletal headaches for the accompanying muscle aches and pains, are the most common type of headache, affecting most of us at some point in our lives.

A tension headache causes mild to moderate head pain that may spread throughout your neck and shoulders. It may feel like a tight band is wrapped around your head. The muscles in your shoulders, neck, face, and head may feel sore and tender.

The most typical culprit of tension headaches is stress. Other triggers include anxiety, poor posture, lack of sleep, fatigue, eye strain, illness, hunger, or trauma, such as whiplash from an auto accident.

Besides the occasional headache, other types of tension headaches include episodic and chronic.  Episodic tension headaches are those that occur less than 15 days a month, while chronic tension headaches occur more than 15 days each month. This type may last for hours, coming and going over a long period of time.

Most tension headaches can be treated with over-the-counter pain relievers such as ibuprofen. For episodic or chronic tension headaches, you might want to try physical therapy. Physical therapists can employ hands-on techniques such as trigger point therapy or myofascial release to ease the muscular pains that contribute to tension headaches.

A trigger point is a small area in a muscle that is very sensitive to touch or pressure. It can be extremely painful. They most frequently occur in the neck, back, and shoulders. Targeting these trigger points with manual manipulation helps relax the muscle and relieve pain.

Myofascial release is a rehabilitation treatment that can relieve pain and relax muscles and tissue. Muscle tension causes both the muscles and fascia (the smooth tissue that covers muscles) to tighten. Myofascial release is a hands-on technique used by physical therapists to stretch tight and sore areas to relieve pain, restore tissue health, increase motion, and improve function.

If you have musculoskeletal tension headaches that just won’t go away, make an appointment with one of the skilled physical therapists at Tuscon Orthopaedic Institute. Call East Tucson at (520) 784-6570 or Northwest Tucson at (520) 382-8201.

The Importance of Imaging Studies in Diagnosing Orthopedic Conditions and Injuries

28 Nov 2016 General , , , , ,

The tools and techniques used to diagnose and treat orthopedic conditions are constantly evolving. Today’s orthopedic surgeons and sports medicine specialists have a bevy of imaging solutions at their disposal to help accurately diagnose disorders and injuries affecting the bones, muscles, ligaments, tendons, cartilage, and spine. Orthopedists also use these test results to create an effective treatment plan.

Two of the most common diagnostic imaging tools are X-rays (radiographs) and MRI (magnetic resonance imaging) . X-rays show bones and are always used to diagnose fractures and joint dislocations. Your orthopedist may also order an X-ray if he or she suspects that a bone or joint has been damaged from other conditions such as arthritis or osteonecrosis (bone cell death). 

Today most orthopedic practices use digital X-ray over traditional film X-rays. Digital X-rays use much less radiation and the images can be computer enhanced. Larger, clearer, color-enhanced images can result in a more accurate diagnosis.

MRI uses a magnetic field and a sophisticated computer system to give reliable and detailed images of soft tissues and bony structures. Your doctor may order an MRI to diagnose a torn muscle, ligament, tendon, or cartilage; herniated disc; hip or pelvic problems; osteoarthritis; and other conditions.

MRI can help provide information for a fast and accurate diagnosis and possibly reduce the need for exploratory surgery or other diagnostic procedures. There are different types of MRI scanners, including open MRI and closed MRI, whole-body scanners, and extremity-specific units (those that only scan arms, legs, hands, or feet).

Other imaging tests used in orthopedics include:

Arthrography: This special type of X-ray, which uses a fluoroscope and contrast iodine solution injected into the joint area, is often used to help diagnose the cause of unexplained joint pain.

CT Scan: A CT scan (computed tomography) combines X-rays with computer technology to produce a detailed, cross-sectional picture of the body part being scanned. Your doctor may order a CT scan to diagnose a bone or spinal tumor or a fracture that doesn’t appear on X-rays. CT scans can also detect trauma to the chest, abdomen, pelvis, or spinal cord. Sometimes your doctor may combine the scan with the use of a contrast dye to better visualize the area being scanned.

DEXA Bone Density Scan: DEXA, or dual-energy X-ray absorptiometry, is the most common test for measuring bone density (the amount of calcium and other bone minerals in a segment of bone) and diagnosing osteoporosis. It uses narrow X-ray beams to see how solid, or dense, the bone is and assess the risk of fracture.

Another entirely different type of bone scan may be used to identify areas where there is unusually active bone formation. It is frequently used to detect stress fractures or the presence of arthritis, infection, or cancer.

Musculoskeletal Ultrasound: Ultrasound imaging is invaluable in orthopedics. This noninvasive imaging technique is totally safe for all patients, including pregnant women, children, and those with pacemakers and metal implants. Ultrasound uses sound waves to produce pictures of muscles, tendons, ligaments, joints, and soft tissue throughout the body.

Musculoskeletal ultrasound is an excellent tool for diagnosing the cause of real-time tendon and ligament pain. As the ultrasound takes place, you can point to where you’re hurting and the orthopedist can evaluate that exact area as you’re moving and experiencing the pain. Many times, a patient’s pain seems to have no clear cause, but diagnostic ultrasound can detect tiny tears that an MRI might miss.

Ultrasound imaging is used to help diagnose numerous soft tissue injuries:

  • Sprains and strains
  • Tendon, ligament, or muscle tears
  • Tendonitis and bursitis
  • Benign and malignant soft tissue masses (lumps/bumps) and tumors
  • Inflammation and fluid collection
  • Ganglion cysts (foot, hand, wrist)
  • Hernias
  • Nerve entrapments such as carpal tunnel syndrome
  • Foreign bodies in soft tissues (such as splinters or glass)

At Tucson Orthopedic Institute, diagnostic imaging is an integral component of evaluating orthopedic injuries and conditions. Everyday our orthopedic surgeons, podiatrists, and sports medicine specialists depend on imaging studies to accurately diagnose all types of disorders and injuries in patients and plan appropriate treatment.

For the convenience of both our patients and doctors, we offer advanced imaging equipment on site. To schedule an office visit or imaging appointment, call (520) 784-6200.

5 Signs You May Have Hip Arthritis

22 Nov 2016 Doctors, General, Joint Health , , ,

Written by: Dr. Ali Dalal 

Degenerative joint disease is a very common cause of hip pain. Figuring out whether the true source of pain is the hip or the back can be a diagnostic challenge for both the doctor and the patient. Indeed, several patients have both back and hip problems. Here are 5 common signs that the pain you are experiencing is coming from your hip.

1. Do I need a different car?

It’s something we do every day and for some people, several times a day. For patients with hip arthritis, the simple act of swinging their leg to get in and out of a car can cause severe discomfort.

via GIPHY

 

2. “Honey, can you grab my flip-flops?”

Stooping forward to put on shoes and socks becomes extremely difficult and or painful due to loss of mobility. Frequently patients will report that their husband or wife assists them with this activity. In places with warmer climates, patients resort to wearing slip-on shoes.

via GIPHY

3. Get between the toes!

Frequently patients with hip arthritis experience pain when bending to wash their feet in the shower.

via GIPHY

4. Can’t stop counting sheep?

In advanced cases, patients have sleep disturbances because they cannot position their hip in a comfortable way to fall asleep. Oftentimes patients will only be able to sleep with a pillow underneath the thigh.

via GIPHY

5. It can’t be my hip; the pain is in the front.

Contrary to what many people think, the anatomic location of the hip is not the side of the upper thigh. The hip is located in the front in the crease of the groin. Groin pain and limited hip motion are the most reproducible signs of a hip problem.

via GIPHY

If any of these symptoms sound familiar, you may be suffering from hip arthritis. The diagnosis can be confirmed with a quick X-ray and treatment is usually non-operative in the early stages.  Come see Dr. Dalal at Tucson Orthopaedic Institute so you can stop living with pain and start living your life!

The Benefits of Physical Therapy after a Car Accident

18 Nov 2016 General, Physical Therapy , ,

If you’ve been in a car accident, the odds are high that you sustained some kind of injury. Depending on how serious the accident is, you might have only minor injuries such as cuts, bruises, or a sprain. More serious injuries might include broken bones, herniated discs, whiplash, brain injury, or damage to internal organs. What’s more, many people are in a state of shock after an accident, and may not notice certain muscle or joint pains right away.

Regardless of the severity of your auto accident injuries, the pain can interfere with your life and progress over time.

If you sustain any musculoskeletal-related injuries from an auto accident such as back or neck pain, arm or leg pain, pinched nerves, muscle pain, or fractures, you should see your primary care doctor or go directly to an orthopedist and request a referral for physical therapy.

Some of the benefits you’ll experience from therapy include:

Pain relief. Physical therapists can help relieve muscle, joint, ligament, tendon, and nerve pain using manual (hands-on) therapy techniques, modalities such as TENS, or therapeutic exercise.

Minimize use of pain medications. The pain relief you experience from physical therapy may help decrease your need to take pain medication or shorten the length of time you need it.

Accelerate your recovery. Physical therapy promotes healing by restoring function and mobility. Your physical therapist will work with you to improve your flexibility, strength, and range of motion.

Prevent chronic symptoms. Injury symptoms may worsen over time, even lingering for months or years after the car accident. Accident victims who do not receive physical therapy are more likely to experience chronic pain as well as degenerative disc disease later in life. That’s why it’s vitally important to begin physical therapy sooner, rather than later.

Avoid or delay the need for surgery. Depending on your injury, physical therapy can help you heal to the point that surgery is not necessary. If you do end up needing surgery, physical therapy may make it possible for the orthopedic surgeon to use a less invasive approach. Plus, therapy both before and after surgery will speed your post-op recovery.

At Tucson Orthopaedic Institute, our physical therapists are skilled in treating a spectrum of car accident injuries, and they work closely with our doctors to help relieve your pain. Call today to schedule your physical therapy appointment in East Tucson: (520) 784-6570 or Northwest Tucson: (520) 382-8201.

Proper Techniques to Stretch the Benefits of Your Workout

11 Nov 2016 General , ,
Staying strong and active has become a very important part of the lives of many people, and for good reason. It keeps our bodies younger and healthier, and it can aid in warding off illnesses and injuries as we get older.

Flexibility is also an important factor, especially if you have joint pain or arthritis. Most doctors will tell you to keep your joints moving, but sometimes this is easier said than done.

There is one very important part of any workout that should not be missed, and that is to stretch before and after your workout. Stretching promotes flexibility, increases blood flow, and reduces the chance for injury.

Stretching after your workout can be more effective than stretching beforehand, because your muscles, tendons, and ligaments are warm and pliable. This is very important if you’re dealing with an injury or arthritis. Research done at the University of Texas has shown that athletes have more flexibility if they stretch after a workout, rather than before they exercise.

There are many benefits to making stretching a regular part of your workout routine. It can decease the “day after” soreness. It can improve range of motion and increase circulation. It can even calm your mind and possibly enable you to get a better night’s sleep.

Just as there are proper ways to perform a particular exercise, there are proper ways to stretch. Here are a few important stretching do’s and don’ts:

  • Do stretch the muscle group(s) you worked on after workout is done.
  • Do hold a stretch for 15 to 30 seconds.
  • Do use an exercise band or towel to aid in getting a better stretch.
  • Don’t use quick or rapid movements, only slow and easy stretches.
  • Don’t push the stretch to the point of pain.
  • Don’t hold your breath; take a deep breath before and blow out slowly as you stretch.
  • Don’t stretch first thing in the morning. Wait an hour or two.

Proper stretching should be an important part of your daily healthy routine. Even on days you don’t work out, stretching the whole body will be beneficial in many ways. It may be worthwhile to consider developing a yoga practice. Many fitness facilities offer classes, or you can do yoga in your own home.

But even with all our good efforts to stay strong, active, and flexible, sometimes injuries just happen. Aging can also play a big role in how your body moves and responds to exercise and other activities.

At the Tucson Orthopaedic Institute, Southern Arizona’s largest and most advanced orthopedic group, we are here and ready to be of service to you. Our world-class care and reputation for successful outcomes have made us the number one choice for orthopedic care in Tucson.

Our doctors specialize in general orthopedic injuries as well as arthritis, joint replacement, sports medicine, spine care, and pediatric orthopedics.

Take a look at our website to find a location close to you, and then give us a call to schedule an appointment, or request an appointment online.

Top 10 Work-Related Injuries You Can Prevent

17 Oct 2016 General , ,

A work-related injury is an unexpected challenge that can have a devastating effect on your family and finances.  Nobody plans on getting hurt on the job, but it can happen to anyone, in any industry.

Many workplace injuries involve overexertion, slipping, tripping, falling, or repetitive movements.  These injuries can often involve the bone and joints, so an orthopedic physician is often involved in workers’ compensation cases.  Fortunately, these injuries can be avoided with a little extra care and caution on the job.

Overexertion injuries are the #1 most common workplace injury that can be prevented.  Be careful about how you pull, push, lift, or carry equipment and supplies at work.  Lift with your legs, not your back.  Take breaks, especially if you are feeling sore.

Slipping, tripping, and falling at work is the #2 most common workplace injury that can be prevented.  Watch out for slippery floors and pavement, and look where you are going at all times.  Wearing appropriate footwear for your job is also very important.

Repetitive motion injuries are also on the list at #9.  While these injuries may be harder to prevent because they are specifically related to your tasks at work, you should always give your body a break.  Our bodies were not meant to do the same activity for 8 hours every day, so try taking a 10 or 15-minute break every hour to avoid tendonitis, bursitis, carpal tunnel syndrome, and other conditions related to repetitive motion or overuse.

See the complete list of preventable workplace injuries below. Have any of these happened to you?

  1. Overexertion
  2. Slipping/tripping/falling
  3. Falling from heights, such as falling off a ladder or roof
  4. Reaction injuries, like a jerky, sudden movement in response to slipping or tripping
  5. Falling or dropped objects
  6. Accidentally hitting your toe, foot, or head on an object or wall
  7. Vehicle crashes
  8. Machine entanglement
  9. Repetitive motion injury
  10. On-the-job violence

Employer/employee training is a good way to avoid some of these injuries, by conducting training on the use of personal safety equipment such as hard hats, or the placement of wet floor signs, and guardrails around slippery and hazardous areas, and how to properly use machinery. Make it your responsibility to know and follow your employer’s safety policies.

If your life has been affected by a work related injury, come see the local worker’s comp experts at Tucson Orthopaedic Institute of Southern Arizona.  We understand your challenges and are experienced in working with Arizona’s employers to minimize time off from work. We have three locations and 32 orthopedic physicians and therapists ready to get you back to work.

Visit our website and request your first appointment today.

Focus on Continuous Improvement

16 Sep 2016 General, Media , , ,
Source: BizTucson published September 2016

Written by: Mary Minor Davis

Photo Credit: Amy Haskell

After three years of living on the road as a national healthcare consultant, Paula Register is ready to plant her roots on firmer ground in Tucson. The new CEO at Tucson Orthopaedic Institute recently got a dog. She’s planted flowers. She cooks at home more.

The North Carolina native first came to Tucson in 2010, working two years at Carondelet Health Network before her consulting job took her back on the road. Now engaged to local cardiac anesthesiologist Michael Hecht, she said she’s ready to settle down.

“Settle” isn’t a word that would normally describe Register. Look at her resume and it is easy to see why she was included in Becker’s 2011 list of Most Influential Women to Know in Healthcare. She’s held senior leadership and executive positions for most of her career. A licensed CPA, she has worked as a senior accountant and CFO for two North Carolina school districts and participated in several mergers throughout her career. In healthcare her roles include CFO and CEO for multi-specialty physician groups and CEO for a Management Services Organization, doubling its size during her tenure. She came to TOI in April of 2015.

“The opportunity at Tucson Orthopaedic came at a perfect time,” Register said. “For most of my career in healthcare I worked with supervising multi-specialty areas. This was an opportunity to focus my time and talent on one area.”

For the previous three years, Register’s consulting career took her to Oahu frequently. “I had the greatest experience working in Hawaii,” she said. “The spirit of the people, the kindness they demonstrate – it’s a good lesson for those of us who work in healthcare. I really learned the true meaning of ‘Aloha.’ ”

She’s incorporated her experience in Hawaii into the TOI philosophy – adopting “kina’ole” – the Hawaiian word for flawlessness.

“It means doing the right thing, in the right way, at the right time, in the right place, to the right person, for the right reason, with the right feeling the first time,” she said. “It embodies the whole patient experience – making them feel welcome, making them feel comfortable, being respectful of their time and hearing everything they have to say. It’s all important.”

This philosophy is what drives Register, who takes her responsibility to run a $50 million business very seriously.

“My job is to provide a good, strong business structure and clinical infrastructure to support the clinical practices, which allow (the physicians) to do what they do best. I call it the triple lane – we’re here to provide better patient experience, better patient outcomes, at a more efficient cost. It’s what we all want.”

To achieve this, Register established a culture focused on continuous improvement. “We want to make sure we get better every day.”

To this end, Register said she asks a lot of questions – especially “why?” – with respect to processes, procedures and programs that serve as patient touch points. “Why do we do it this way?” And the next questions are “How should we be doing it? Can we do it differently and achieve a better outcome?”

“We’re always going to make mistakes – it’s human nature,” she said. “But it’s how we react to that mistake that I think is important. Patients need to know that when things go wrong, we analyze what happened and what we are going to do differently so that it doesn’t happen again.”

Register said she doesn’t look to adopt change for the mere sake of change, but recognizes that there are some things that don’t need to be handled the way they were in the past because of changes in technology, information systems and other patient interactions.

One of the most noticeable examples of this is the renovated lobby space at the Grant Road location, shared in the central tower with Tucson Medical Center. Previously, check-in for TOI was behind the TMC reception area in a small office. “There were lines out the door,” she said. “When you’re in pain, the last thing you want to see is a waiting line.”

TOI re-engineered the waiting area, moving from the TMC reception area to a more open area at the west end of the tower. In addition, multiple check-in stations were added. “It opened up our availability to patients,” she said. “It’s a much better environment for our staff and our patients.”

Locating services nearer to patients is also part of Register’s strategy. There are currently four TOI clinics in greater Tucson. In the next 18 months, the TOI located on the Oro Valley Hospital campus will complete an expansion, and TOI’s newest satellite office will open next year as part of the new TMC Rincon Health Campus on the southside.

“I have this philosophy that I heard early in my career – people don’t care how much you know, until they know how much you care,” she said. “I think if people know we care, that’s what’s important. I try to show people how much I care – the team, our culture, our patients – and I hope our business owners know how much I care about how I run their business.”

Plantar Fasciitis Sufferers Can Wear Sandals

18 Jul 2016 General , ,

It is summertime. Time for the beach, the pool and backyard BBQs. Time for flip flops!  If you suffer from a condition called plantar fasciitis, you may feel limited on your choice of footwear because you’d rather avoid heel pain than wear a flimsy flip-flop.  Are there any options for supportive sandals or flip flops that won’t trigger the pain?

Plantar fasciitis is a condition of the foot that is usually brought on by over activity such as running or playing a sport. It is also caused by wearing ill-fitting, unsupportive shoes.  Everyone can suffer from plantar fasciitis but age and diabetes can predispose you to the condition.

The plantar fascia ligament does the job of a shock absorber that contracts and stretches with every step we take. This ligament can develop small micro tears which results in sharp stabbing pain in the heel or along the bottom of the foot. Treatment can range from resting, cold and heat therapy, to surgery in severe cases. Preventative measures include stretching exercises and wearing good supportive footwear, which can include sandals and flip-flops if you know what to look for.

Finding an adequate supportive sandal is not too hard to do. The internet is a great source with many retailers offering styles of sandals specially designed for plantar fasciitis. Prices range from $20 to over $100.

There are a few important features you should look for in any shoe.

  • A deep heel cup can help control pronation
  • Arch support designed to stretch the tendon
  • Cushioned foot bed for stability and shock absorption

The American Podiatric Medical Association (APMA) gives a seal of acceptance or approval to products that meet certain standards and criteria.

For more information on plantar fasciitis and heel pain, or if you would like more advice on types of shoes, the foot and ankle specialists here at Tucson Orthopaedic Institute are ready to help.  Dr. Eric Anctil and Dr. Scott Evans will see you in the East Tucson, and Dr. Geoffrey Landis will see you in Northwest Tucson or Oro Valley.

Contact Tucson Orthopaedic Institute to make an appointment at a location close to you.

Image source: https://www.sportspodiatry.co.uk/images/plantarfascia.jpg

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