Tallahassee, Florida, October 20, 2008 – Neck pain is one of the top 10 reasons for a patient to visit a doctor. The lead article in the most recent issue Spine reports on the results of a randomized clinical trial which demonstrated that patients who received manual physical therapy and exercise had twice the improvement in symptoms compared to the current guideline group. The subjects in the study experienced both short and long term improvements in their neck pain. The study compared the use of manual therapy and exercise compared to the current guidelines of advice, rest, and range of motion. The results of this study are comparable to those reported by Hoving et al in 2002, which also demonstrated that manual physical therapy and exercise resulted in excellent clinical results in the treatment of neck pain while also providing a significant cost savings compared to usual physician care (Kothals-de Bos et al 2003). Manual physical therapy includes the use of hands-on techniques including joint and soft-tissue mobilization, designed to restore motion and reduce pain. Hurwitz et al (2008) concluded in a systematic review on neck pain also in the journal Spine, “Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain.”

Tim Flynn, PT, PhD, president of the American Academy of Orthopaedic Manual Physical Therapy, expressed confidence that, “This study broadens the base and depth of evidence that manual physical therapy is the first line treatment for patients suffering from neck and arm pain.” He continued, “Year after year the physical therapy profession continues to produce high quality randomized, controlled trials that demonstrate conclusively that our profession provides better outcomes for less money, while also being substantially safer than other medical interventions. Wake up America, to a new day without pain.” If you have neck or back pain or the aches and pains of musculoskeletal problems contact your local physical therapist today.

Month-long Observation Focuses on the Importance of Physical Activity
for Adults and Children

ALEXANDRIA, VA, September 18, 2007 — For the nearly 100 million Americans who are overweight or obese, physical activity must be a crucial component to weight loss and better health, which is the focus of October’s National Physical Therapy Month, the American Physical Therapy Association (APTA) announced today.

According to a recent study conducted by the Trust for America’s Health, a research group that focuses on disease prevention, obesity rates continued their climb in 31 states last year. Health officials say the latest state rankings provide evidence that the nation has a public health crisis on its hands. Last year, The Centers for Disease Control and Prevention cited evidence that found that more than 22 percent of Americans did not engage in any physical activity in the previous month.

A lack of exercise is a major contributing factor to obesity rates. “People who are overweight or obese must follow an appropriate exercise program that includes aerobic conditioning and avoids exercise that can lead to injury,” notes Terry Michel, PT, DPT, DSc, CCS, a physical therapist at Boston’s Mass General Hospital. “Physical therapists will typically recommend a low-impact form of weight training, such as exercise bands that help avoid excessive joint stress, and modified yoga stretches and Tai Chi for promoting flexibility and relaxation,” she adds.

Physical therapists develop fitness plans for both adults and children that promote the ability to move, reduce pain, restore function, and prevent disability. For those who are overweight or obese, physical therapists balance the progression of the exercise prescription with the need for joint protection and safety during exercise.

“We are no longer looking at just adults who have diseases resulting from obesity,” says physical therapist Susan S Deusinger, PhD, professor and director of the Program in Physical Therapy at Washington University School of Medicine. “Rather, physical therapists need to regard obesity as a primary concern for intervention,” she adds. Previous research** conducted by Dr Deusinger confirmed recent rising health concerns on college campuses. Her study of 300 undergrads at Washington University in St Louis found that 70 percent of the students had gained an average of 9 pounds between their freshman and sophomore years, and most were still not meeting recommended guidelines for healthy eating and exercise behavior.

“To say the least, the results of this study are cause for concern,” notes Deusinger. “People are dying from the effects of obesity, and it’s not just our parents and grandparents anymore; it’s our friends, siblings, and colleagues. No one is immune from the dual epidemics of obesity and sedentary behaviour.”

Connie Cushing, PT, MS, a 17-year-veteran physical therapist at Children’s Hospital in Birmingham, Alabama, is a member of a practice team that focuses on overweight and obese children and teens at the Hospital’s Center for Weight Management. Along with a psychologist, physician, nurse practitioner and nutritionist, Cushing evaluates each child individually (both before they enter and leave the Center). As a result, Cushing can determine whether the patient is at risk for joint and musculoskeletal problems, as well as implement what the collective team learns regarding other commonly seen issues such as diabetes or asthma. “Patients often have multiple, pre-existing medical conditions that can affect their ability to exercise and what specific exercises they are capable of doing,” notes Cushing.

“For the younger children at the Center we recommend restricting television viewing and video game playing and encourage family games that can be played both indoors and outdoors at home,” says Cushing. “It becomes a bit more complicated with teens, as we need to factor in what their interests are, both in and out of school; if they work better in groups or individually; and if they prefer being outdoors or indoors. Based on their profile, we determine a list of goals and the best ways to achieve those goals. We’ve also found that having teens keep daily logs of their physical activity provides great incentive.” She adds, “The goal of the Center is not solely weight loss. Our ultimate goal is for these kids to make lifestyle changes. Yes, we want them to lose weight, but we also want them to eat better, sleep better, and to feel better physically and emotionally.”

Consumers can find information about the fight against obesity and about National Physical Therapy Month, whose theme is “Physical Therapy: The Science of Healing. The Art of Caring,” by visiting APTA’s Consumer Web page at www.apta.org/consumer.

Physical therapists are health care professionals who diagnose and treat individuals of all ages, from newborns to the elderly, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan of care using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. Physical therapists also work with individuals to prevent the loss of mobility by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

The American Physical Therapy Association (www.apta.org) is a national organization representing 70,000 physical therapists, physical therapist assistants, and students nationwide. Its goal is to foster advancements in physical therapist education, practice, and research. Consumers can access “Find a PT” to find a physical therapist in their area, as well as physical therapy news and information at www.apta.org/consumer.
——————————————————————————–

** Racette SB, Deusinger SS, Strube MJ, Highstein GR, Deusinger RH. “Weight Changes, Exercise and Dietary Patterns During Freshman and Sophomore Years of College.” Journal of American College Health, vol. 53 (6); pp. 245-251, May/June 2005.

Most everyone has heard the saying “no pain, no gain” when it comes to exercise. This may be true in terms of a healthy individual and when it refers to the muscle burn sensation that accompanies exercise. It may also be true in terms of the two days of soreness that follows the start or progression of a strengthening exercise program, or that follows the performance of an activity that has not been performed in a while. This soreness is better known as “delayed-onset muscle soreness” and is a normal part of the adaptation process of muscle breakdown.

“No pain, no gain” is not true when one has been injured. When one is recovering from an injury it is not wise to exercise with pain. When one is performing their rehabilitation program, one should only exercise in a pain-free range. If there is always a bit of pain present, as it is true after an injury or surgery, then you should never do exercise that creates more pain or increases your pain response. The increase of pain perception is the body’s way of letting you know you are overdoing things and that some tissues are not able to handle the stress that is put on them. The soft tissues (tendons, ligaments, muscles, and fascia) involved become weak and over-stressed.

Pain is a subjective feeling that we all have experienced at one time or another. We expect that we are going to experience pain after an injury or trauma. However, if there is no presence of pain during exercise we may think that there is nothing to worry about. This may not always be the case. Pain during exercise is the body’s way of telling us whether we are exercising too hard or overstressing our bodies. But just because pain is not present, does not mean that we may not be doing harm. For instance, a sedentary or deconditioned individual may not experience a pain response during exercise. However, then one day they find they have back pain or neck pain due to a lack of muscle endurance or some other musculoskeletal problem. For this reason, many people move into pain patterns without any apparent reason or trauma.

In summary, exercise should be performed without any increase in pain. Therapeutic exercise is utilized to promote healing, increase metabolism, and introduce gentle controlled loads so that the soft tissues can adapt to normal forces. Periodic maintenance through exercise can prevent non-traumatic pain patterns from occurring. It is important to give plenty of feedback to your physical therapist or other health professional so he or she can monitor and make any adjustments to your exercise program.