We welcome Pam De Rivero, Pediatric Physical Therapist Assistant, to our Team!

I was born in Lima, Peru. As I was about to turn five my parents decided to come to live in the United States with the American dream of a better future. From then on we have lived in Northern Virginia. I have a younger brother who calls himself my little mannequin, because going through PTA school I would always practice movement patterns and stretching techniques on him.

I was lucky enough to learn very early on in my life that Pediatric Physical Therapy was what I wanted to do. Even though I searched other possibilities of other professions I would always come back to Physical Therapy for kids.

I enrolled in the Physical Therapist Assistant program at Northern Virginia Community College. It is an outstanding program with the best instructors who cheer their students on every step of the way. I had three clinical rotations: an Outpatient Orthopedics clinic, Skilled Nursing Facility, and last but not least my favorite, School Settings.

I have worked with a wonderful family for a year and a half helping them give therapy to their two gorgeous boys. They have grown so much in this short amount of time, not only physically but in their gross and fine motor skills, speech, and best of all playing skills. I have had the honor to see these changes during this time and I have also grown to love them as part of my own family.

I believe that ALL children should have fun and be able to play. And now beginning this new journey with Fauquier Health Outpatient Rehab Pediatrics I can’t wait to incorporate that into everyday therapy, making it into a game. I am eager to meet the children and their families, and to find out what they hope to accomplish through therapy. I am also eager to meet my team and co-workers who I will be working with side-by-side to accomplish those goals.

Fauquier Health is the only local facility to offer physical, occupational & speech therapies all at one convenient, child-friendly location. If you feel your child may benefit from rehabilitation services & have questions, please feel free to give us a call at 540-316-2680, or click on the button below to submit your inquiry via email.

Does your baby tilt and hold his head to one side?

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Your baby may have a condition that is known as torticollis. Torticollis is a term that describes an abnormal neck posture. Typically, the parents or physician observe that the baby prefers to tilt or turn his/her head and neck to one side. Evidence in the literature suggests that there may be over 80 differential diagnoses that may cause a torticollis posture. The first step to determine if your baby has torticollis is to bring up your concerns to your pediatrician so he can examine your baby and perform tests as indicated. Neck x-rays are sometimes advised to rule out any abnormality of the vertebrae.

How will I know if my baby has torticollis?

You will notice that your baby prefers to hold his/her head to one side and may have limited neck movement. Torticollis is usually diagnosed within the first 2-3 months of life by the pediatrician. Torticollis is also often associated with an asymmetrical head shape (positional plagiocephaly). This often occurs when babies sleep with their head always turned to one side.

How is torticollis treated?

Conservative treatment of torticollis typically includes passive muscle stretching exercises, active range of motion activities/strengthening exercises, positioning and handling techniques for postural correction, lateral head righting/postural control and developmental exercises. Evidence based outcome measures support manual stretching with good success rates reported from 61-85%.

Should my baby be examined by a physical therapist?

If your baby has been diagnosed with torticollis, you should seek an examination by a pediatric physical therapist as soon as possible. Torticollis limits the ability for a child to move their head freely to see, hear, and interact with his/her environment. Torticollis may also lead to delayed body awareness, weakness and difficulties with balance, and asymmetrical use of their arms and legs during their developmental stages resulting in favoring one side of the body. Physical therapists will perform a thorough neuromusculoskeletal examination of your baby and develop an appropriate program for your child that specifically fits his/her needs. They will check for other conditions that can occur with children who present with torticollis including plagiocephaly, hip dysplasia, and spine problems. They will discuss the results of the examination with you and provide education for a home activity program that includes not only stretching/range of motion exercises, but also information on massage techniques, positioning ideas, and strengthening exercises to prevent any asymmetry that may be occurring. The physical therapist will also observe the patient’s gross motor skills to assure that they are meeting their motor milestones.

How do I get started?
Most cases of torticollis respond very well to physical therapy intervention. Discuss your concerns with your pediatrician and obtain a prescription for physical therapy.

At Fauquier Health Outpatient Physical Medicine and Rehabilitation, our pediatric physical therapy team has special training to treat not only torticollis, but all other congenital, orthopedic, and developmental disorders. We provide a child friendly environment with hours to accommodate school and parent work schedules.

If you feel your child may benefit from this service and would like to hear more, please call us at 540-316-2680. Or click on the button below to ask a question.

October is National Physical Therapy Month

National Physical Therapy Month, sponsored by the American Physical Therapy Association (APTA), is a nationwide observance held each October. This year’s theme, “Move Forward: Physical Therapy Brings Motion to Life” reflects the physical therapist brand, “Physical therapists help you to restore and improve motion to achieve long-term quality of life.”

Physical Therapists are highly educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility without, in many cases, the use of expensive surgery or the side effects of prescription medications. Learn more about the conditions physical therapists can treat at http://www.moveforwardpt.com/.

At Fauquier Hospital Outpatient Physical Medicine and Rehabilitation we have highly skilled, experienced clinicians who have a multitude of certifications to improve your quality of life. We have several specialized physical therapy programs that provide treatment of Pediatric, Women’s Health, Spine, Sports Therapy, Occupational Injuries, Orthopedic and Neurological conditions. Our experienced physical therapist staff has the following certifications/specializations:

• McKenzie Spine Certified Mechanical Diagnosis & Therapy (3)
• Certified Strength & Conditioning Specialist (3)
• Certified Weight Management Instructor (1)
• Certified Aquatic Therapist (1)
• Women’s Health Specialists (3)
• Certified Ergonomic Assessment Specialist (1)
• NDT Trained therapist in Adult Hemiplegia (1)
• Certified Functional Capacity Evaluators (2)

We can offer you a specialized examination and treatment in these areas of expertise.

If you feel like we may be able to help you regain your quality of life, or have questions about how we may meet your specific needs, please contact one of our physical therapists at Fauquier Health or press the button below to ask your question.

Do You Suffer from Pelvic Pain that Limits Your Daily Activities?

What is Pelvic Pain?

Pelvic Pain is described as pain in the lower abdomen, pelvis, or perineum and is considered to be chronic when symptoms have been present for more than six months. The pain may be described as aching or burning in the area of the perineum or abdomen.

What causes pelvic pain?

Pelvic pain can be caused by problems such as pelvic joint dysfunction, muscle imbalance within the muscles of the pelvic floor, trunk, and/or pelvis, incoordination in the muscles related to bowel and bladder function, tender points in the muscles of the pelvic floor, pressure in one or more nerves in the pelvis, an weakness in the muscles of the pelvis and pelvic floor. Pelvic pain can also be related to the presence of scar tissue after abdominal or pelvic surgery. There can be organic disease processes related to pelvic pain as well; therefore, it is important to consult your physician to fully determine the cause of your pain.

What are the symptoms of pelvic pain?

Symptoms of pelvic pain, in addition to pain in the lower abdomen and pelvis, may include: pain in the hip or buttock, pain in the tailbone, limited sitting tolerance, pain in the joints of the pelvis, pain with sexual intercourse, tender points in the muscles of the abdomen, reduced range of motion in the hips and lumbar spine, urinary frequency, urgency, or incontinence, painful bowel movements, constipation and/or straining with bowel movements.


How can physical therapy help?

Physical therapists are trained to evaluate and treat joint dysfunction, muscle tightness, weakness, or imbalance in muscle groups, and nerve entrapment – all potential signs of pelvic pain. Physical therapists trained specifically in the area of pelvic health can identify the possible generators of pelvic pain and develop a treatment plan specific to the patient suffering from pelvic pain. A physical therapist trained in this area my utilize hands on techniques to address muscle tightness or targeted exercises to improve muscle strength and reduce faulty patterns of muscle recruitment. Other treatment strategies may include biofeedback, retraining of incoordinated muscles, postural training, and strengthening of the abdominal core muscles.

Physical Therapy techniques for joint and soft tissue dysfunction may include:

• Exercise
• Education
• Manual techniques
• Modalities, including: ultrasound, electrical stimulation, biofeedback, and heat or cold.
  These techniques are part of a physical therapist program designed to reduce tightness, dysfunction, weakness, and pain in the pelvis.
  
  At Fauquier Health Outpatient Physical Medicine and Rehabilitation, our pelvic physical therapy team has completed extensive training in pelvic physical therapy through the American Physical Therapy Association’s section on Women’s Health. Our therapists utilize a variety of techniques as well as education to ensure each patient’s needs are addressed. All pelvic floor treatments are conducted one-on –one in a private setting.
  
  If you feel you may benefit from this service and would like to hear more, please call us at 540-316-2680. Or click on the button below to ask a question.

You're invited to make a difference in the life of an individual with an Autism Spectrum Disorder

What are Autism Action Groups?
Autism action groups are initiated, developed and supported by
Commonwealth Autism Service. Group participants include self-advocates, parents, educators, private and public service providers and other concerned individuals. Currently, there are six Autism Action Groups:

• The Central Virginia Autism Action Group
• The Greater Roanoke Valley Autism Action Group
• The Piedmont Autism Action Group
• The Cumberland Autism Action Group
• The New River Valley Autism Action Group
• Southwest Virginia Autism Action Group

The Northern Virginia Communities of Practice is joining with Commonwealth Autism Service to start a local Autism Action Group. If you are interested, or would like more information, and/or want to be part of this group, please come to our meeting:

September 2, 2009.

2 to 4 pm

Sycamore Room B

Fauquier Health

500 Hospital Drive

Warrenton, VA 20186

Drive up Carriage House Lane by the Warrenton Police Dept., turn right on Veteran's Drive, then turn left up the hill toward the main entrance. Turn right into the Bistro parking lot. Enter through the doors under the teal and gray awning at the Bistro entrance. Take the stairs or the elevator up one level. When you are looking at the "art wall" turn right and go to the end of the hallway to Sycamore Room B.

Fauquier Health hosts Pediatric Social Skills Camp

Thank you to everyone who participated in our week-long Pediatric Social Skills Camp! There were 21 participants in two groups, each participating one hour daily, Monday through Friday. The program was planned and supervised by Fauquier Health Rehabilitation Services personnel:

• Heather Smith, Speech Language Pathologist
• Alicia Lutman, Occupational Therapist
• Sherrie Beres, Occupational Therapist
• Kristine Trimble, Physical Therapist
  

Activities included:

• Introductions
• Taking turns
• Asking for what you need
• Sharing
• Measuring your feelings
• Following instructions and schedules
• Working together as a team
• Show and Tell
• Recognizing others for their accomplishments
  

The children had a great time and made new friends while learning appropriate social interaction skills. Information was shared with parents on the last day of camp to assist children in carryover of these skills at home and in the community.
Thanks again to all our participants. We hope you had fun while learning some useful new skills!

New Pediatric Occupational Therapist joins our team!

We are proud to announce Sherrie Beres, occupational therapist, will be joining our team on July 6th.

Sherrie received her Master’s degree in Occupational Therapy from Shenandoah University in 2004. Her employment history includes work in Fairfax county schools as well as the Mayo Clinic in Phoenix, Arizona. She has served as a Clinical Instructor for occupational therapy students as well as a Lead Therapist, supervising others. Until recently, she has been living in Tempe, Arizona. She is originally from our area, and is now returning to be near her family.

Sherrie’s message to children & parents…

I grew up in Centreville Virginia, where my family remains to this day. I am the youngest of four girls. My family has now expanded and I have 7 nieces and nephews who I love dearly.
I married my high school sweetheart and we have an Australian cattle dog that we enjoy running with, taking long walks with, and hiking with daily. His favorite tricks are giving high fives and rolling over.
I also enjoy cooking and spending time outside in the sunshine. I have been living in Arizona for the past 5 years and I am looking forward to making Virginia my home and being back near my family.
I went into OT in hopes of working with children. I began working with children in positions such as summer jobs in therapeutic recreation, substitute teaching, babysitting during family support groups and as an OT in the school system. Now with my new position of pediatric outpatient OT at Fauquier Health, I am truly looking forward to building a relationship with each child and family and working with my new team to teach and learn the skills needed for every child to have a more independent future. I look forward to meeting and working each one of you.

Fauquier Health is the only local facility to offer physical, occupational & speech therapies all at one convenient, child-friendly location. If you feel your child may benefit from rehabilitation services & have questions, please feel free to give us a call at 540-316-2680, or click on the button below to submit your inquiry via email.

Like poetry to our ears!

At Fauquier Health we develop close relationships with our patients as we work together to help them achieve the goals most important to them. We answer their questions and address any concerns they may have during the journey to recovery. We depend on feedback from our clients to help us guide them to their maximum potential. Occasionally, we have a client who is particularly eloquent in expressing their feelings. Such is the case of Mr. Michaele Jones, who wrote the following poem...

This question, merits time and consideration,
So, I'd like to thank the whole organization.
I've had pleasurable contact with all I contest,
Starting with the warm up smiles at the front desk.

Thanks to the ones who broke me down bending things
Making me feel child like, ready to scream.
Shouting, back straight, bend here,
Providing security, eliminating fear.

Right now I'll concentrate on Linda the most,
Who's abuse is second to none on the east coast.
Quickly, I'll point out just a thing or two,
of the many helpful things you do.

You helped me, when all I felt was down.
The many days I wore a frown,
You gave me back my hands, that's true,
Though you worked a brother, till his knuckles turn blue.

You controlled the times I would over demand
You ruled with a smile, with a gentle hand.
At home, I'd do what you told me to do
Subconsciously plotting to get back at you.

It is hard to express my appreciation,
For your Drill Sergeant commitment, dedication.
Elbows straight, fingers too.
In my nightmares, you're saying, "I'm watching you."

At the end of the day, all I can do,
Is say, Thank you, Thank you and Thank you!
(No luck with the beer dispenser?)

Interjections:
Mr. Jones thought the only way we could improve our services would be to place a beer dispenser in the reception area!
Linda Wise is Mr. Jones's occupational therapist.

Thank you, Mr. Jones! We are proud and honored to serve you!

McKenzie Spine Program at Fauquier Health Outpatient Rehabilitation Services

Karrie Giger, PT, DPT, cert. MDT explains rationale

of the McKenzie method to Kevin Turney.

Back and neck pain are very common in the general population. The annual incidence of low back pain in the general adult population is 18.6%, and the total cost of low back pain exceeds $100 billion per year in the United States according to studies. Another study reports that about 1/3 of the population will experience neck pain during a six or twelve month period, and the lifetime prevalence of neck pain is 66.7%.

The McKenize Method, also known as Mechanical Diagnosis and Therapy® (MDT) is a unique method used all over the world for examining patients with back, neck, and extremity problems and pain. It is an approach that uses a philosophy of active patient involvement and education. The McKenzie method uses a unique examination that provides the patient with a mechanical diagnosis which drives an appropriate individualized treatment plan. The McKenzie method is not merely extension exercises. It is a comprehensive, well researched approach to the spine that when followed appropriately has been found to have very successful outcomes.

This method has been found to be cost and time effective because it does not rely on expensive tests and it promotes the body’s potential to heal itself through appropriate directional movements prescribed by your physical therapist. The emphasis on active patient involvement limits the number of visits needed to the clinic. Research studies have shown that the initial McKenzie assessment procedures to be as reliable as costly diagnostic imaging (ex. X-rays, MRI) to determine the source of the problem and quickly identify those who will respond to conservative mechanical therapy. The McKenzie method is a safe, reliable, and valid method when performed by appropriately trained physical therapists.

Fauquier Health Outpatient Rehabilitation Services is the only facility in the Piedmont area to have three certified MDT physical therapists. Karrie Giger, PT, DPT, cert. MDT, Bruce Edwards III, PT, cert. MDT, and Kristen Pierce, PT, DPT, cert, MDT were credentialed by the McKenzie Institute International in August 2007 and specialize in spine physical therapy. Certification includes extensive postgraduate courses on spine assessment and treatment with successful completion of an international credentialing examination. Our outpatient department also has 5 other physical therapists currently in the process of becoming MDT certified and have received extensive training in this method. More information regarding the McKenzie method can be found at http://www.mckenziemdt.org

If you feel you may benefit from our spine service, and would like to hear more, please call us at 540-316-2680. Or click on the button below to ask your therapist a question.

May 11-17th is National Women's Health Week

What is a Women's Health PT?

Women's Health PTs are physical therapists who have advanced training and experience in assessing and treating specialized conditions including pelvic pain, pain and dysfunctions in pregnancy, incontinence and others. This training is obtained as post-graduate continuing education in specific areas.

Regina Davis, PT, Karrie Giger DPT, and Kristen Pierce, DPT, of Fauquier Health Outpatient Rehabilitation Services, are the most extensively trained physical therapists in Women's Health in the Warrenton, Virginia area. They are currently pursuing certification in Pelvic Physical Therapy through the Women's Health Section of the American Physical Therapy Association.

If you feel you may benefit from Women's Health physical therapy and would like to learn more, please call 540-316-2680 and ask to speak to Regina, Karrie or Kristen.

We understand it may be difficult or uncomfortable to discuss some Women's Health issues initially. If you would prefer to ask a question anonymously, please click on the button below. You will receive an email response within 24 business hours.

May is better Speech and Hearing Month

The Most Anticipated Moment


The most anticipated moment for a parent is the sound of a child's first words. But what if the words are delayed, jumbled, or never come at all? Speech and language problems can affect early learning and self-esteem. Give your child a chance by seeking proper treatment from a speech-language pathologist.


Reach Your Full Potential


As we strive to reach our full potential, speech and language problems can hold us back. To some it may be a delay in talking or difficulty swallowing. Others may be unable to speak clearly or comprehend because of a stroke or accident. Speech and language problems can affect anyone at any age. If you are concerned that a disorder is going untreated or are unable to find proper treatment, consult a speech-language pathologist.


Communication Disorders Do Not Discriminate

Millions of Americans have a communication or swallowing disorder. These disorders affect people of all ages, from all walks of life. For them, simple thoughts like "Thank you" and "I love you" may be impossible to convey. If you are concerned that a disorder is affecting your education, professional life, or personal relationships, consult a speech-language pathologist.

Communication for Life

Speech and language disorders can affect anyone at any age. Millions of infants, children and adults in America suffer from a communication or swallowing disorder. Whether it's a difficulty in swallowing or a disorder such as stuttering, delayed language or a voice problem, a person's ability to learn and interact with others can be affected. If you suspect you or a loved one may be experiencing a communication or swallowing disorder, consult a speech-language pathologist.




Questions? Click on the button below to ask a Speech-Language Pathologist.

If you would like to learn more about Speech-Language Pathology, visit the American Speech-Language Hearing Association website at www.asha.org

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Specialized Care for Pediatric Patients

Adults aren't the only ones who need rehabilitation therapy to maximize their physical, mental and social abilities. Some children and adolescents also need specialized services to build strength, achieve their functional potential and develop the skills they need at thome, at school and within their communities. Children may benefit from rehabilitation services if they have or are recovering from:

• Birth defects or birth injuries


• Neurological, musculoskeletal or rheumatological conditions


• Developmental delays


• Feeding problems


• Acute traumas


• Bone fractures and other orthopedic problems


• Accidents


• Injuries


• Burns


• Cancer


• Surgery


• Chronic diseases (such as sickle cell, heart or kidney diseases)
  

A Team Approach

Kids who need rehabilitation services receive care from a mulitdisciplinary team of specialists who are trained to handle the unique needs of pediatric patients. The team includes physical, occupational and speech therapists who evaluate and assess the child's functional limitations.

Rehabilitation specialists design individual treatment plans to help mazimize patients' independence and the quality of their lives. Team members use a variety of techniques and technologies that can help:

• Support patients' growth and development


• Prevent future complications and impairments


• Relieve pain


• Improve kids' cognitive abilities


• Improve strength, coordination, range of motion and fine motor skills


• Relax muscles


• Develop kids' self-care skills


• Enhance speech and language skills


• Teach kids' how to use wheelchairs, braces and other assistive devices
  

Short and Long Term Care

Some pediatric patients may need only short-term rehabilitation therapy to address certain acute injuries or issues. Rehabilitation, however, can play a major role in health care for kids with complex, lifelong conditions.

While children and adolescents undergoing therapy may be tackling difficult issues, rehabilitation professionals provide services in an age-appropriate way that keeps pediatric patients engaged. For example, therapists may use fun activities to help kids develop key coordination, motor and hand-eye skills that may improve their walking, feeding or handwriting skills. The gains children make during rehabilitation therapy often help boost their self-confidence and self-esteem, giving them a sense of accomplishment.

Developments in Pediatric Therapy

>>Kristine Trimble, Alicia Lutman and Heather Smith comprise the pediatric rehabilitation team at Fauquier Health. The pediatric office is located at 493 Blackwell Road in the Warrenton Professional Center in Warrenton, Virginia. Over the past few months, the rooms have been renovated and updated. New therapeutic tools have also been added, which the children see as "new toys".

Kristine Trimble, PT, DPT is the pediatric physical therapist who provides therapy for children with torticollis, gross motor delays, traumatic brain injuries, acquired brain injuries, cerebral palsy and dyspraxia. She also implements aquatic therapy.

Alicia Lutman, MOTR/L, ATC is the pediatric occupational therapist who works with children with fine motor delays, visual processing deficits, autism, developmental delays, traumatic brain injuries and handwriting difficulties.

Heather Smith, MS, CFY-SLP is the pediatric speech lauguage pathologist who works with children with receptive and expressive language delays, apraxia, feeding delays, autism, developmental delays, articulation/phonological processing disorders, and acquired and traumatic brain injuries.

Fauquier Health is the only local facility to offer physical, occupational and speech therapies all at one convenient, child-friendly location. If you need further information please call 540-316-2680. Or click on the button below to ask a question or request additional information. Your email will be answered within 24 business hours.

A great day for Margaret Blue!

Friday, April 10, 2009

March 12, 2009 was a proud day for Margaret Blue. She became a member of Marriott's "Quarter Century Club", marking 25 years of service as a chef. Margaret thoroughly enjoyed everyone she came in contact with during her years with Marriott. Despite a debilitating neurogenic problem that causes her to have decreased balance and weakness, this amazing woman has only missed one day of work in 25 years--because of a snowstorm!After a recent injury, Margaret came to our clinic for strengthening and to improve her walking. She has worked closely with her physical therapist, Bruce Edwards & our student from Shennandoah, Brooks Brady. Margaret credits them for helping her become strong enough to walk up to receive her 25 year service award, something she was not sure she would be able to do after her injury.Margaret has a beaming smile for everyone she meets. Her positive attitude is contagious, and the reason she has come so far. Congratulations Margaret, on your achievements!

If you would like to know more about our services, or have a general question regarding rehabilitation services, please call us at 540-316-2680, or click on the button below to submit an email inquiry.

April is Occupational Therapy Month

OCCUPATIONAL THERAPY HELPS INDIVIDUALS
LIVE LIFE TO ITS FULLEST

Occupational therapy enables people of all ages live life to its fullest by helping them promote health, prevent—or live better with—injury, illness, or disability. It is a practice deeply rooted in science and is evidence-based, meaning that the plan designed for each individual is supported by data, experience, and “best practices” that have been developed and proven over time.

Occupational therapists and occupational therapy assistants focus on “doing” whatever occupations or activities are meaningful to the individual. It is occupational therapy’s purpose to get beyond problems to the solutions that assure living life to its fullest. These solutions may be adaptations for how to do a task, changes to the surroundings, or helping individuals to alter their own behaviors.

When working with an occupational therapy practitioner, strategies and modifications are customized for each individual to resolve problems, improve function, and support everyday living activities. The goal is to maximize potential. Through these therapeutic approaches, occupational therapy helps individuals design their lives, develop needed skills, adjust their environments (e,g., home, school, or work) and build health-promoting habits and routines that will allow them to thrive.

By taking the full picture into account—a person’s psychological, physical, emotional, and social makeup as well as their environment—occupational therapy assists clients to do the following:

· Achieve goals
· Function at the highest possible level
· Concentrate on what matters most to them
· Maintain or rebuild their independence
· Participate in daily activities that they need or want to do.

Founded in 1917, the American Occupational Therapy Association (AOTA) represents the interests and concerns of more than 140,000 occupational therapists, assistants and students nationwide. The Association educates the public and advances the profession of occupational therapy by providing resources, setting standards including accreditations and serving as an advocate to improve health care. Based in Bethesda, Md., AOTA’s major programs and activities are directed toward promoting the professional development of its members and assuring consumer access to quality services so patients can maximize their individual potential. For more information, go to http://www.aota.org/.


If you feel you or someone you know may benefit from occupational therapy services please call us at (540) 316-2680 to learn more. Or click on the button below to ask a question.

Moving Day!

It has been fun while it lasted but thanks to an invitation from my physical therapist colleague Dr. Eric Robertson, I will now be doing my Physical Therapy related blog authoring at www.npathinktank.com (soon to be ptthinktank.com).  We will also be joined by fellow colleague and blogger Roderick Henderson, PT for what should be topically varied content relevant to our profession from various perspectives.

I hope you will follow and join us at this new virtual water cooler as fellow community members and stakeholders in our future as physical therapists.  I’m looking very forward to what should be an informative, enlightening and occasionally even entertaining venture with my fellow bloggers and colleagues.

Physical Therapists offer help for Incontinence

Urinary incontinence, or the complaint of involuntary leakage of urine, is not just something that happens to older people. This condition can affect men and women of all ages. The National Association for Incontinence estimates that 25 million Americans experience urinary incontinence.

Stress Incontinence is a sudden involuntary loss of urine on effort or exertion. This may occur with activities such as exercising, sneezing, coughing or laughing. Stress incontinence usually results from weakness and lack of support in the muscles of the pelvic floor. Women with stress incontinence often have “under active” pelvic floor muscles. Causes may be pregnancy or childbirth, injury or trauma, surgery in the vagina or rectum, episiotomy (during childbirth), or lack of exercise or use.

Urge Incontinence is the loss of urine that occurs as soon as you get the urge to urinate. Women with urge incontinence often have weak and “over active” pelvic floor muscles.

Mixed Incontinence is involuntary loss of urine associated with urgency and also with exertion, effort, sneezing or coughing. Mixed incontinence can include any combination of the causes of stress and urge incontinence.

Many symptoms of urinary incontinence are caused by pelvic floor muscle weakness and dysfunction. Our specially trained pelvic floor physical therapists are the ideal healthcare providers to help you gain control over your symptoms. Our therapists use their specialized medical training to evaluate your problem and design an individualized treatment program to meet your specific needs.

Physical therapy can:

• Give you control over your bladder and your life


• Save money and embarrassment by allowing less use of pads and undergarments


• Reduce use of medications for incontinence


• Possibly prevent the need for surgery

Physical therapy treatment may include:

• Education on diet and nutrition to avoid food and beverages that may irritate the bladder


• Advice on how to change behaviors that make symptoms worse


• Techniques to increase awareness of the correct use of muscles that control urinary flow


• Exercises to strengthen the muscles of the pelvic floor


• Exercises to stretch and strengthen other important muscles to help you gain control


• Techniques to decrease urinary urge and frequency


• Biofeedback to help you re-train your muscles


• Electrical stimulation to improve awareness and strengthen muscles

You should be referred to a pelvic physical therapist if:

• You leak urine during normal daily activities


• You leak urine with sneezing, coughing, or laughing


• You have difficulty starting a urine stream


• You have trouble holding urine when you feel a strong urge to go


• You urinate frequently (more than every 3-4 hours during the day, up more than once to urinate at night)


• You have difficulty getting to the bathroom because of other problems such as pain or balance.
  
  At Fauquier Health Outpatient Physical Medicine and Rehabilitation, our pelvic physical therapy team has completed extensive training in pelvic physical therapy through the American Physical Therapy Association. Our therapists use a variety of techniques as well as provide you with education to ensure your needs are addressed. All pelvic floor treatments are conducted confidentially with your therapist in a comfortable, private setting.
  
  If you feel you may benefit from this service and would like to hear more, please call us at 540-316-2680. Or click on the button below to ask a question.
  

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Do you suffer from dizziness?

You are not alone. Did you know that symptoms of dizziness are the third most frequent reason people over the age of 65 seek medical attention? Dizziness is the number one reason people over the age of 70 seek medical attention.

Fifty percent of individuals over the age of 65 who suffer from dizziness will develop a particular form of vertigo that can be alleviated with one simple physical therapy treatment. The most common form of vertigo is Benign Paroxsymal Positioning Vertigo (BPPV).

Symptoms include:

• Sudden onset
• Brief episodes of dizziness, typically lasting less than one minute
• A sense of imbalance or motion sensitivity brought on by changes in head position relative to gravity by activities such as:
  o Lying down
  o Rolling over in bed
  o Bending over
  o Looking up

BPPV is caused by tiny crystals being dislodged in the inner ear causing changes in the movement of lymph fluid, giving you the sensation you are losing your balance.

Fortunately, this problem is easily detected and can be treated with a few different repositioning techniques to move the crystals through the ear canal and “dump” them into an area that no longer causes vertigo. This treatment is usually very successful, with resolution of all symptoms within 1 or 2 therapy sessions.

A Vestibular Rehabilitation course was recently held at Fauquier Hospital and was attended by some of our therapists. They received training in these vestibular techniques and are ready to help alleviate your dizziness. If you feel you may benefit from this service and would like to hear more, please call us at 540-316-2680. Or click on the button below to ask a question.

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Congratulations Andrew!

Outpatient Rehabilitation Services is proud to announce that Andrew Mazur, physical therapist, has received certification from the Aquatic & Rehabilitation Institute. Andrew provides outpatient aquatic physical therapy for adults at our pool in the Fauquier Health Rehabilitation & Nursing Center. Andrew’s patients enjoy the skilled, individualized care he provides that helps them maximize their range of motion, strength & function after an injury, illness or surgery.

We are the only clinic in the area to offer aquatic physical therapy. Our pool is kept at an inviting 92 degrees, optimal for therapeutic exercise.

We also offer aquatic physical therapy for our pediatric patients, provided by Kristine Trimble, our pediatric physical therapist.
If you or someone you know may benefit from aquatic physical therapy, please call us at (540) 316-2680 for further information. We look forward to hearing from you!

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We've installed a new directional sign to help clients find their way to our outpatient clinic on the Fauquier Hospital campus. We are located in the Medical Office Building at 253 Veteran's Drive in Warreton, Virginia. Our clinic is on the first floor of the building, to the right of the elevator in the main lobby.

The “Socialized” Practice – Part II

With the advent of the various Internet social networking mediums on the world wide web such as Facebook, MySpace, Orkut, and a host of others combined with other communication tools such as blogs, Twitter, Friendfeed and others, the challenge for any professional or in this case physical therapists is to find a way to effectively use these tools to promote their practice and communicate with their patients and/or clients.

Scott Shreeve, who founded Medsphere Systems, coined the term “Millenial Patients” and described them as “defined by their behavior rather than their  age, sex, or demographic.  He goes on to describe how they utilize the Internet for almost every aspect of their daily lives to “meet their personal, social and professional needs.”

This group of people, the so called millenial patients, are not interested in an authoritarian, top down relationship from a professional such as a physical therapist or physician.  They are far more interested in finding a trusted partner with whom they have an ongoing relationship “based on trust, mutual respect and open communication” according to Shreeve.

My experience leads to me to strongly agree with this paradigm and therefore makes me wonder how I can best serve these patients.  I believe that the answer lies within the integration of the various communication tools available through the Internet including email, social network sites such as Facebook, Twitter, Skype, and website based discussion forums into our practices.  The challenge will be determining best practices in the integration and utilization of these amazing tools and I think perhaps the best tool currently at my disposal might just be TxXchange.  (A disclaimer: I do not have any financial involvement with TxXchange other than as a customer.)

In the third party of this series I will look at how I am envisioning the use of the aforementioned tools and particularly TxXchange in tackling some of the challenges of modern practice.

The Socialized Practice - Part I

With the advent and evolution of “the web” that part of the Internet that most people see as “The Internet”, the previously held notion that all information was proprietary and commoditized has been supplanted by the notion that information should be free and open and the normal socioeconomic barriers that determine who knew what have been shattered in the phenomenon frequently referred to the democratizing effects of information on the Internet. 

Professionals who previously held tight control on information within their domain, whether it was lawyers, physicians, physical therapists or any other profession, need to recognize that their closely held treasure trove of information is no longer their proprietary commodity to be doled out at a price they solely determine. 

Citizens can now look up medical conditions, treatments, drug trials, laws, regulations, court filings, contracts, rehabilitation regimens or practically any other information that is able to be printed or disseminated in some form of media as it all eventually ends up freely available on the web somewhere.

If we stipulate that information is not the proprietary commodity it once was and is likely never to be again, what value do professionals bring to the table that consumers will be willing to pay for?  Simply it is Expertise.  Expertise is not easily or quickly acquired.  It is an accumulation of skill, knowledge and experience.

The question then becomes how does one market expertise versus knowledge.  In my next post we will examine some tools and potential tools to address this issue.

New Blog Category: Cases!

After reading a Twitter post from a physician twitterer who commented that he has posted far more cases to his blog than he would have ever have considered submitting for publication in a more mainstream journal I had an idea.

What the heck, why not do it myself when one of those very interesting cases comes along?  So the next time one of those cases comes along, I’ll share.  Who knows?  It might just help someone else in the process.

Just When You Thought You Were Safe From Outsourcing Because You Are in Healthcare…

Apparently the safety of the notion that healthcare providers are practically immune from outsourcing overseas is being challenged if not crushed.  Note this article from medpagetoday.com have long clung to International Medical Trade Turns Big Business.

According to the article in India alone revenue from so called “Medical Tourism” rose from $264 million in 2000 to $4.07 billion (yes that is BILLION with a B) in 2005.

This will be a trend worth watching.

Physiopedia – A Challenge

I have had many conversations recently with those noting a dearth of openly available information directly related to Physical Therapy particularly when looking for information in the Physical Therapist’s voice.  Like many issues in our profession, many complain but nobody does anything.  To my relief Physiopedia is finally looking to do something about it and looks to resolve that issue.

While there is no shortage of information regarding conditions commonly treated such as ACL injury or Lower Back Pain there is a serious lack of information written in the Physical Therapists voice or that adequately demonstrates the wealth of information that comprises the unique knowledge base of Physical Therapy.  What information that is available is shielded by a legacy and in my opinion outmoded and outdated system of "by subscription only” scholarly journals.

I would urge our colleagues, particularly those who possess a unique and credible expertise in particular Physical Therapy subject matter to start or at least contribute to entries in the Physiopedia Wiki such as this entry on The Glenohumeral Joint started by Tyler Shultz, PT.

By building this open and freely available compendium of information we will demonstrate the uniqueness, credibility and value to the world, and perhaps raising the visibility of our profession just a notch higher.

My thanks to all involved with the Physiopedia project.  It is a project deserving of our time and contributions.

WSJ Story Pulls Back the Veil of Woo Surrounding Complementary Alternative Medicine (CAM)

Steve Salerno does an excellent job in his Wall Street Journal (WSJ) article The Touch That Doesn’t Heal.  In this article he points out some of the myths surrounding treatments that are not grounded in science and exposes them to the skeptical treatment they so deserve.

He also exposes how these pseudoscientific treatments are then passed on to insurers using rather dubious and self serving interpretations of the Current Procedural Terminology codes used to bill third parties for medical services.

This is an article well worth reading and should serve as a wake up call to the third party payer community who should be far more concerned with reducing true fraud and abuse rather than arbitrarily reducing reimbursement to all providers across the spectrum.

Well done Mr. Salerno and let’s hope that policy makers now endeavoring to clean up the mess that our healthcare system has become take notice.

New Kid/Journal on the Block

Friday January 2nd, 2008 I received what has turned out to be a pleasant surprise in the mail in the form of a free copy of a newly published journal Sports Health.  They must have known my birthday was coming up the following day.

This particular journal is published with an emphasis on “A Multidisciplinary Approach” and is a collaborative publication of the American Orthopaedic Society for Sports Medicine, North American Society for Sports Medicine, National Athletic Trainer’s Association and the Sports Physical Therapy Section of the American Physical Therapy Association.

The Table of Contents is divided up based up the discipline.  The Sports Physical Therapy articles were solidly written and similar in quality and content as what is typically found in the Journal of Orthopedic and Sports Physical Therapy.  The focus on this particular discipline content was on ACL treatment including the article I found most interesting by Hurd, Axe, Snyder-Mackler describing Management of the Athlete with Acute Anterior Cruciate Ligament Deficiency (ACL-D).  This article goes into excellent detail in the use of a treatment algorithm developed at the University of Delaware. 

I find this publication interesting in the multidisciplinary approach and frankly I think that this will further enhance the collaborative and collegial relationship that should exist between physicians and physical therapists.  Perhaps it will help to shine a light on the significant contribution of physical therapists to the body of knowledge in the management of orthopedic conditions for physicians.

So thank you the thoughtful person who sent me this early birthday gift and I think it will even be worth the dues to join the Sports Physical Therapy Section of APTA.