Hello all,
Here
is a picture of knee flexion, as I talked about last week. Roger began
treatment at the 90 degrees position, and is now around the 125 degrees
position.
I’d
like to use this week to explain the evaluation process at Synergy. When new
patients come in, we must first perform an evaluation that analyzes the state
of their condition, from which Vincent can determine the best path of
treatment.
The
evaluation starts with asking the patient about the injury, such as when it
happened, the history of the patient, and any surgeries they underwent. This
gives us a general idea. Then we ask about their pain levels. This determines
how aggressive we should be in treatment. Additionally, if the patient has
constant pain, the injury is most likely in the bones, whereas temporary
periods of pain usually signify muscle or tendon injuries. Next, we measure the
range by getting the patient to actively move the joint in all directions
possible. If the injury is muscle or tendon related, the patient will have the
normal passive range, but will be unable to actively move their joints to
normal limits. If the injury is bone related, they most likely will have pain
for both passive and active motions.
The
beginning of treatment involves learning the necessary stretches to start to
loosen the muscles and joints. This makes the therapy more effective and
ensures long-term health. So when the patient first comes in, we teach specific
stretches designed for their injury, making sure they learn every detail of the
stretch. The patients are expected to do the stretches at least 5 times a day,
every day. Most patients that do follow this regiment have much quicker
recoveries. Since the patients only come into the clinic for a couple hours a
week, it is vital that they incorporate the therapy into their daily schedule.
Synergy is unique in the emphasis of being proactive and giving the patients
the tools to stay healthy on their own.
This definitely all makes sense and sounds reasonable. Do you guys have patients fill out a questions form at all, prior to taking them in? Or do you just talk to them about it?
ReplyDeleteWe have the sheet of questions that we need to fill out, but we like to first explain it to them then ask them what their response is. This allows for a more uniform scale across all patients.
DeleteHey Zach! I loved hearing about the process you guys go thorough. About how many patients do you see in one day? Also, any examples of common stretches? I'd imagine you have to be very specific when explaining them to patients to make sure they do them correctly.
ReplyDeleteWe have about 5 patients at a time, each staying for around an hour each. But I couldn't give you an accurate number for the total amount.
DeleteAn example would be a calf stretch, which only requires that they put their foot against a door frame and push their hips forward using the back foot.
Zach....as one who has never really had a problem, I find this process not only logical but very fascinating. I did not realize that movement restrictions/pain are different if the injury is bone related as opposed to muscle or tendon injuries. Your blog is informative in addition to relating what you are attempting to achieve SRP-wise.
ReplyDeleteHey Zachary! If a patient has severe pain is the treatment more aggressive or less? And what defines an aggressive approach?
ReplyDeleteIt would be less until the pain lessens. And being aggressive is pushing very hard into the muscles to tear the tissues apart. It often brings patients to tears.
DeleteZachary, If you only had time to do four stretches a day, what stretches do you find more beneficial for an active person?
ReplyDeleteWell since legs bear our weight all day, I would probably say the calf, hamstring, and quad stretches are very important. Then I would move up to the pec/shoulder stretches on the doorframe
DeleteWow, that's a lot of angles. So do you guys judge how far a patient's progress is based on how far they can stretch without experiencing pain? And what happens is the pain suddenly pops up at an earlier angle even after they passed that point during that stretch already?
ReplyDeleteHi, I am Nathan from Lutheran High School. This is an interesting topic. It is confusing how some people respond so well to physical therapy while others see little to no improvement. In your week three post you mentioned how critical it is for the patient to do their stretches at home, do you believe that a physical therapy patient gets out what they put in? In other word is there a correlation between how much better a patient gets and how dedicated they are to doing the stretching and routines at home? Also you mentioned at the beginning that you were considering changing your thesis, have you decided to do so or are you still using your original thesis?
ReplyDeleteHi, I am Nathan from Lutheran High School. This is an interesting topic. It is confusing how some people respond so well to physical therapy while others see little to no improvement. In your week three post you mentioned how critical it is for the patient to do their stretches at home, do you believe that a physical therapy patient gets out what they put in? In other word is there a correlation between how much better a patient gets and how dedicated they are to doing the stretching and routines at home? Also you mentioned at the beginning that you were considering changing your thesis, have you decided to do so or are you still using your original thesis?
ReplyDeleteHey Nathan! Thanks for the interest.
DeleteIt is definitely dependent on the patient putting in work. We see many patients come in tight and sore, and their progress is slowed down.
I have decided to change my thesis. It will now center on Vincent's methods rather than the effects on physical therapy.
Hey Zach! I am also doing my SRP at a physical therapy site and I can see the similarities and differences between the two centers. Are the patients at Synergy older or younger and do most come in for rehabilitation purposes after a surgery? Also, what is Roger's goal for knee flexion? I know that at Spooner PT, it can vary a little depending on the patient.
ReplyDeleteHey Rachael! Thats awesome. They are usually older, but that's also because I work during school hours. They usually are in for post-surgery rehab. Roger is fine at 130 degrees, he just wants to return to that point after his upcoming surgery. Also, he is working to remove his limp. I heard that you are also working at the JCC! Is that where you are doing some PT work?
DeleteHey Zach!! It sounds like the physical therapy is really helping Roger improve his lifestyle. I am working at the JCC with Max Gregory, the fitness director. He is helping me create a program for patients with Marfan Syndrome and he is showing me the daily actions of a personal trainer. I am doing all my PT work at Spooner Physical Therapy!
DeleteOh ok that sounds awesome! Tell him I said "Hi!"
Delete