Staff Spotlight Get to know one of our Doctors of Physical Therapy!

Science Behind PT Follow a case study about how PT helpS knee recovery

Healthy Recipe! Try this healhy, protein- packed recipe!


Lift Properly. You pick things up constantly. Even if you’re lifting something light, make sure you’re facing the object. Squat, keeping your spine straight. Lift with your leg muscles, as this will reduce the pressure placed on your spine. Use Good Posture. When you’re standing, imagine a string is attached to the top of your head—lifting you up. This will keep your hips, spine, shoulders and neck aligned. If you’re sitting, don’t slouch. Use Strength Training. Your body has hundreds of muscles. These muscles protect and control your spine. By lifting weights, running and swimming, you can keep them strong. Training your core and hip muscles will help distributing lifting power to your hips and legs rather than your back, allowing you to easily control quick, lifting movements. It never hurts to visit a physical therapist, either. Get regular check-ups, and make sure your body is in good condition. If you have a history of back injuries, pain or minor aches, don’t hesitate to talk to a professional. You deserve a pain-free life, and your back will thank you.

Back pain can hinder your day-to-day activities. Left untreated, it can even lead to long-term joint, spine and nerve damage. As one of themost common physical complaints, over 80 percent of the U.S. population will suffer from it at some point in their lifetime. The pain itself can hinder your ability to reach, lean, kneel, lift or bend. It can also hinder your time spent with friends and family. Direct pain aside, minor aches and cramps associatedwith a back painproblemcanmake you irritable—ruining your good time.

Unfortunately, a lot of people don’t seek treatment when back pain arises. Before they know it, they have a big problem. They might assume nothing— except for medication—can solve their back pain problem. Medication might mask the pain, but it won’t cure the problem’s root cause. PHYSICAL THERAPY IS CATERED TOWARD YOUR NEEDS & GOALS! You’re in luck: Back pain is treatable! The National Institute of Neurological Disorders and Stroke covers a number of back pain remedies. These include the use of strength exercise, physical therapy and medication. Where medication is considered, anti- inflammatory drugs, analgesic medications and counter-irritants are the most popular. Before you can treat your back pain, however, you need to know why it started. Whether you’ve tweaked a muscle or have a deeper injury, a spine specialist can help. BACK PAIN PREVENTION A little prevention goes a long way. If you want to avoid future back pain, you can make sure you’re being good to your back.


A few things cause back pain. The American Physical Therapy Association covers each of these, but the following are leading causes: • Spinal and core muscle weaknesses • Bad posture • Spinal muscle and tissue damage • Improper lifting form • Limited hip, spine and thigh muscle flexibility • Bad abdominal, pelvic and back muscle coordination

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Staff Spotlight


in an Out-Patient Orthopedic clinic, and my interest in that aspect of Physical Therapy began to blossom at that time. The curriculum at Texas State University placed a big emphasis on Orthopedics, and after the first several classes, I knew that was what I wanted to pursue. One of the biggest factors that intrigued me about becoming a Physical Therapist was that we have the opportunity to be “lifetime learners,” and continually hone our skills and further our understanding and knowledge. As a result, I am currently enrolled with the Manual Therapy Institute, and am pursuing my specialization in Orthopedic Manual Therapy. My favorite aspect of the job is getting the chance to be a part of my patients’ lives and help them pursue and achieve their goals. When not helping patients get better, I really enjoy playing recreational sports such as golf, soccer, and softball, spending time with my family, and exercising.”

“Physical Therapy became my passion after working with a

Physical Therapist about 15 years ago when my younger brother was undergoing post- surgical rehab after hip surgery. My younger brother has Down Syndrome and is non- verbal, and I took notice of the patience, kindness, and compassion that the Therapist showed my younger brother. It was during that rehabilitation process where I observed that Physical Therapist work with my brother that I knew what I wanted to do for my career. I obtained both my Bachelors Degree in Exercise and Sports Science, and my Doctorate of Physical Therapy from Texas State University, and I am very proud to be a Bobcat! Prior to Physical Therapy School, I worked as a Physical Therapy Technician

“Thank you AMT! When I first walked hesitantly down the hallway towards AMT it seemed another typical office setting. But when I entered your office, I felt I had stepped into a forest full of life. The full length of windows looking into a stand of wild trees stunned me, and continued to offer me hope that the natural energy of the trees would become a part of my healing. Your engagement with me and others is a great gift you offer, your enjoyment with each other is healing in the way your energy infuses the workspace, and your dedication to all of us and the skills that are used have helped me heal an injury I thought earlier might live on for a long time. Thank you for your care and the way you inspire an understanding–that work, pleasure, and dedication can all come together as a major force in healing. I’ve been greatly helped by Roli, James, and importantly, all the folks at AMT who are energized by working in the forest, as well as being the forest, a true ecosystem of kindness, skill, and dedication to helping.” PATIENT SUCCESS SPOTLIGHT

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HAND TO HEEL ROCKS Start off on your hands and knees in a tabletop position. Push yourself away with your hands, moving lower body towards your heels. Try and keep your back as straight as your can. Move back to the starting position. Repeat. Try 3 rounds of 15 repetitions.

~ Rich A

SWAN DIVE Lay on stomach with your arms overhead. Press your chest upwards, keeping themuscles in your trunk and legs relaxed. Repeat 6 times.

Always consult your physical therapist or physician before starting exercises you are unsure of doing.

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Case Study For Physical Therapy The Effect of Early Surgery vs. Physical Therapy on Knee Function Among Patients with Non-Obstructive Meniscal Tears

Despite recent studies suggesting arthroscopic partial meniscectomy (APM) is no more effective than physical therapy (PT), the procedure is still frequently performed in patients with meniscal tears. Methods: Noninferiority, multicenter, randomized clinical trial conducted in 9 hospitals in the Netherlands. Participants were aged 45 to 70 years with nonobstructive meniscal tears (ie, no locking of the knee joint). Patients with knee instability, severe osteoarthritis, and body mass index greater than 35 were excluded. Recruitment took place between July 17, 2013, and November 4, 2015. Participants were followed up for 24 months (final participant follow-up, October 11, 2017). Three hundred twenty-one participants were randomly assigned to APM (n = 159) or a predefined PT protocol (n = 162). The PT protocol consisted of 16 sessions of exercise therapy over 8weeks focused on coordination and closed kinetic chain strength exercises. Results: Over a 24-month follow-up period, knee function improved in the APM group by 26.2 points (from 44.8 to 71.5) and in the PT group by 20.4 points (from 46.5 to 67.7). The overall between-group difference was 3.6 points (97.5% CI, -∞ to 6.5; P value for noninferiority = .001). Repeat surgery (3 in the APM group and 1 in the PT group) and additional outpatient visits for knee pain (6 in the APM group and 2 in the PT group) were the most frequent adverse events. Conclusions: Among patients with nonobstructive meniscal tears, PT was noninferior to APM for improving patient- reported knee function over a 24-month follow-up period. Based on these results, PT may be considered an alternative to surgery for patientswithnonobstructivemeniscal tears. Subjective: 35 y.o. FwithRmedial knee diffuse

pain that she noticed was worse with box jumps and squats. Denies any distal signs and symptoms currently, mild crepitus with closed kinetic chain flexion/extension, aching worse after workouts and knee is stiff in themornings. Pt. also reported feeling as if her knee would swell after her work outs but goes away after application of ice at night. Objective: Current pain level 5/10, Least: 2/10, Worst: 8/10 ROM: Right knee AROM: 0deg extension to 135 deg flexion with reports of endrange, medial joint line knee pain Strength: Iliopsoas 5/5, TFL: 5/5, GluteMax: 4/5, PGM: 3/5, Quads: 4/5, HS: 5/5, Gastrocnemius: 5/5, Soleus: 5/5 Movement Analysis: Noted R hip anterior glide andmedial rotationwith squatting (both single leg and bilateral). Pt. also reports reproduction of her signs and symptoms with both jumping and landing. Joint Mobility: Noted decrease in R tibiofemoral posterior glides with internal rotation Intervention: Manual Therapy included posterior tibiofemoral joint glides with internal rotation gd III for increasing flexion. Therapuetic exercises included single leg squats with resisted hip abduction, AAROM knee flexion and vigor gymsquatswith resisted hip abduction. Outcome: Post treatment patient reported feeling better in her knee and stating that her left just really felt tired rather than her original signs and symptoms. Pt. was issued a detailed home exercise program that included single leg squats with hip abduction resist to fatigue only, several times a day, modified air squats to fatigue and use of an upright or recumbent bicycle for both repetitive, low load compression and cardiovascular benefits. • The load of the tissue must be monitored and controlled. • Training should also only causeminimal to no fatigue. • Proximal hipmuscular performance and control of compensatory movement at the hip is important todecrease adverse effect at the distal tibiofemoral joint.

HEALTHY RECIPE Cilantro Lime Chicken & Avocado Salsa

• 1.5 lb. boneless chicken breast • 1/4 cup lime juice • 2 tbsp olive oil • 1/4 cup fresh cilantro • 1/2 tsp ground cumin • 1/4 tsp salt INGREDIENTS

For Avocado Salsa: • 4 avocados, diced • 1/2 cup fresh cilantro • 3 tbsp lime juice • 1/2 tbsp red wine vinegar • 1/2 tsp red pepper flakes • 1 garlic clove, minced

DIRECTIONS Add 1/4 cup of lime juice, olive oil, 1/4 cup of fresh cilantro, ground cumin, and 1/4 tsp of salt to a small bowl. Whisk until mixed. Add chicken and marinade to a large ziplock bag. Let chicken marinate for at least 15 minutes. Preheat grill to medium-high heat (about 400°F). Place chicken on grill and grill each side for 4-6 min, until chicken is no longer pink. Remove and let sit. For avocado salsa: add avocado, 1/2 cup fresh cilantro, 3 tbsp lime juice, red wine vinegar, red pepper flakes, garlic clove, and salt to a small bowl. Gently toss to mix. Top the cilantro lime chicken with the avocado salsa and serve.


• Signs of Cartilage Overload clinically could include: an increase in joint stiffness, swelling, loss of ROM and dull aches in the knee. • Cartilage is trainable. Repetitive and symptom free compression/ decompression in weight bearing situations is the stimulus.

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