Welcome to Health News

Ed Deboo, PT, along with two other Bellingham Physical Therapists were profiled in the “Northwest Health” magazine.

“Ed Deboo, PT, doesn’t want to fix people. He wants them to fix themselves. ‘I don’t want you to come in and watch you ride my bike,’ he says.‘I help to facilitate the healing process and remove roadblocks, but you own your own health.’

To read the entire article and view the pictures, please click here to download the NW Health PDF

What’s new in the literature?

I will often come across an article that I think my patients would be interested in. I have included a short summary and then cited the source if someone was interested in the entire article. Enjoy!

Teenage athletes, poor sleep, and sugary drinks: recipe for disaster

Nice lefty finish, but jumping off wrong leg ;)

Nice lefty finish, but jumping off wrong leg 😉

Being the basketball junkie that I am, I was reading an article that was trying to explain why so many young, first round draft picks in last years draft where injured: 7 of the top 11 picks where injured and lost significant time during the season (if not the whole season!). But why?

Although the article was about young NBA players, the authors detailed 4 risk factors that all of our young athletes can learn from:
1. Sleep deprived teens: Not only do our schools start way too early for their natural wake/sleep cycle, our kids make it worse with “blue light” emission from devices,like phones, ipads, TV’s etc. right before bed. The exposure to blue light blocks the brains production of Melatonin that is responsible for making us drowsy at night. Athletes who sleep less than 8 hours per night are almost 2 x more likely to suffer an injury than counterparts who sleep > 8 hours per night.

2. Put down the Gatorade and pick up the Chocolate milk. Too many sugary drinks, not enough milk and calcium, leading to decrease in bone density. The lack of dairy often also leads to low levels of vitamin D.

3. Early specialization in sports, often year round players by the 5th grade, often leads to repetitive stress injuries.

4. Too much fluff in the weight room. I’m a HUGE advocate of the weight room for all of us, especially teenage athletes. Unfortunately, not many are going to lift and if they do, they are too heavy in to “core work” or “bands”. You need to lift and move heavy things, plain and simple, to help strengthen bone density, tendon strength, muscle size, ligaments, and to protect from injury. (Anyone seen Geoffrey lately???? Hello biceps, how you doin’)

Parents, good luck with adding more battles to our daily life, but the research is out there, Good luck!

Myofascial Trigger Points

An Introduction to the Self Treatment of Myofascial Trigger Points
Learn simple, cost effective techniques to help alleviate
chronic muscle pain

Myofascial Trigger Points (TrP’s) are very common and are responsible for many of our common, daily, complaints of “muscle-type” pain.

As a Physical Therapist, I have successfully added TrP therapy to my practice and have found it most useful for clients’ home exercise program, to compliment their stretching and strengthening exercises.

The classes is 1-day, from 9am -4pm and covers the most common TrP’s that I work with, starting from neck and headache pain, down to Achilles and foot issues. The class is step up with both lecture and lab time. TrP work will be taught with foam rollers, tennis and lacrosse balls, wooden dowels, and with Thera-canes. Participants will leave with a much greater understanding of how TrP’s work, aggravating factors, and how to help treat them.

The class is open to everyone. Healthcare professionals will benefit from gaining a deeper understanding of TrP work to help their clients improve overall function at a faster rate.

Lecture objectives
1. Define a myofascial TrP
2. Discuss the “science” of TrP’s
3. Explain the difference between a “latent” and “active” TrP
4. Understand the aggravating factors for TrP’s
5. Learn why “self–massage” may be the best treatment for TrP’s
6. Should I stretch or not? The science of stretching
7. Beyond the Basics: what to do if you are still in pain
8. Reference material and professional help

Lab objectives:
Learn how to locate and self-treat the most common TrP’s for the following conditions:
1. Headache and neck pain: scalenes, suboccipitals, SCM, upper trapezius, and masseter
2. Shoulder pain: subscapularis, infraspinatus, pectoralis, levator scapula
3. Elbow and wrist pain: extensor and flexor digitorum
4. Back pain: quadratus lumborum (T12 region), psoas, gluteals
5. Hip, ITB, and leg pain: gluteals, psoas, quadriceps, TFL
6. Shin “splints”: anterior tibialis
7. Achilles tendonitis: soleus

Comments from previous classes can be found here:

Please contact me if you have any additional questions,
Sincerely,

Ed Deboo, PT
ed@integrativephysicaltherapyservices.com
https://www.facebook.com/IntegrativePT

Getting your haircut in India, Evidence Based Medicine, and CranioSacral Therapy

indian haircut

“Evidence Based Medicine” (E.B.M.) is all the rage. Many would say if your treatment technique isn’t Evidence Based, don’t bother, save your money, the guy’s probably a quack. From a clinical standpoint, I live in both worlds: the black and white, Evidenced Based one, where you can measure the effects of your intervention and prove your worth, and the grey world of “something’s happening, just not sure exactly what it is”. With the medical field trending towards E.B.M. many grey areas of therapy which may be extremely beneficial are being slowly squeezed out. Case and point: Cranio-Sacral Therapy (C.S.T.) My disclaimer is that although I utilize cranial techniques, I am not a CST therapist, nor do I plan on becoming one.

If you look at the research and the scientific validity of the claims made by Cranial therapists’, there is absolutely no evidence that supports the claims made. The research that is cited by those in support of CST therapy are of very poor design and do not stand up to the rigors of the scientific method of research. Many in the scientific world think CST is a complete sham, a snow job, right up there with snake oil.
For those who do not know what CST is, “CranioSacral Therapy (CST) is a gentle, hands-on approach that releases tensions deep in the body to relieve pain and dysfunction and improve whole-body health and performance. Using a soft touch which is generally no greater than 5 grams – about the weight of a nickel – practitioners release restrictions in the soft tissues that surround the central nervous system. CST is increasingly used as a preventive health measure for its ability to bolster resistance to disease, and it’s effective for a wide range of medical problems associated with pain and dysfunction.”
Yet a Google search reveals many training institutes, classes all over the world, and lists of certified practitioners. Many people who have had cranial work done (myself included) report the benefits of this work. What gives? This is where things get muddy.

Bring in the Indian barber. If you have never been to India, I suggest you go just to get the “haircut experience” (Oh, the food and that Taj Mahal thing is ok too). It shouldn’t even be called a “haircut”, but rather a “follicle shortening cranial experience”. First, the (kind of clean) hot towel over your face to warm the follicles and prepare them for the dance that is to follow. As you start to fall into your trance, the old school, straight razor shave commences (those with trust issues, skip the shave). You now have the choice of a quick tea break before you actually get the haircut, just scissors, comb, and clippers. The next wave of bliss comes in the form of a hot oil facial and scalp massage that flows down into a neck massage and finishes with a quick, neck pop that would make most Chiropractors beam with pride. I stood up off his chair completely relaxed, in a better mood, better looking, more neck flexibility, ( I did smell a bit weird), and I swear taller. So did something happen during the “Follicle Shortening Cranial Experience”, hell yeah, and No, it wasn’t evidence based, but I sure felt a whole better.

So maybe the cranial therapist isn’t moving cranial bones or anything else they claim, but “something” is happening that can make you feel much better. It could be as simple as giving our stressed out nervous system a “time-out”.
Cheers,
Ed

Stop the insanity! Put away the Ultrasound and Electrical Stim for the treatment of shoulder pain

Shoulder

“I have shoulder pain, what should I do” Current research may offer some answers..First of all, stop wasting your time with ultrasound and electrical stimulation…..

Many P.T.’s continue to use “passive modalities” to help treat shoulder pain with mixed results. Personally, I found no long term help with such passive modalities like Ultrasound, electrical -stimulation, and Kinesio taping.

A recent study in the March 2015 issue of the PT Journal summarizes it pretty clearly “Ultrasound and interferential current (basically electrical stim with pads) therapy are not more effective than placebo therapy for non-specific shoulder pain” They also don’t have many positive things to say about Kinesio tape for long term shoulder pain.

Just something to chew on for the weekend…..Cheers, Ed

We are all connected ~ Leah Vong, OTR/L

fascia

When we think about the body, we need to consider it as a whole… a connected unit. For example, as far as the pelvis is from the neck and the liver from the shoulder, one can still have a profound affect on the other and on our global movement patterns.

Read More »

Welcoming Leah to our IPTS team!

Leah Vong, OT

Hello everyone,

My name is Leah and I am an occupational therapist working with Ed and Elizabeth here at Integrative. My focus as a practitioner is on mind and body, health and wellness. Occupational Therapists or OTs are trained to be able to look at “the whole person” including assessing ones roles, routines, daily activities, and habits as well as identifying barriers to optimal function in each individual’s daily life. In our training, OTs are taught to assess the physical, psychological, cognitive, spiritual, temporal, and cultural components of one’s life and how each of these affects our occupations or the activities that occupy our time (whether it be a leisure activity, job, self care task, care-giving task, etc). We then develop and provide a customized treatment plan based on each individuals goals and barriers, with the goal of facilitating optimal functional performance in that person’s valued occupations and daily activities. With this holistic approach, I believe it is possible for a wide variety of people to achieve health and wellness.

Manual therapy (hands on therapy in which we work with the tissues and structure of the body) is very important in that it can facilitate physical and psychological healing by decreasing our pain and tension and increasing our mobility, function, and mental and emotional health. In addition to treating the body physically, it is important to consider the stress and social support we have in our lives, as well as our sleeping, eating, exercising, and relaxing habits. All of these areas have an impact on the tension we hold in our tissues and therefore our structural health and pain levels. On the same token, releasing physical tension can alleviate emotional or mental stress from the body.

Thank you for allowing me to introduce myself and for taking the time to read these thoughts. Feel free to email me if you would like any additional information about occupational therapy or the services I offer at Integrative. Stay healthy and well this winter.

Sincerely,

Leah Vong, MS, OTR/L
leah@integrativephysicaltherapyservices.com

Myofascial Trigger Point Class in Bellingham, WA

TrP class picture

I have heard from a few people who wanted to take the Myofascial Trigger Point class last January, but had prior plans so……I will be offering the Introduction to the Self Treatment of Myofascial Trigger Points class again Saturday, March, 28th at our clinic, 2114 James Street, Bellingham, WA

. The time of the class will be from 9:00 am to 4:00 pm at a cost of $145. Class size will be limited to 20 so please call Darcy at (360) 715-8686 to secure a spot.

7 hours of continuing education credits will be issued for those who need the hours for their profession. The class is open to not only health care practitioners, but anyone else who is suffering from musculoskeletal pain and wants to learn techniques that may help. Last class we had a great mix of yoga and Pilates teachers, PT’s, an OT, PTA’s , massage therapists, and clients. Let me know if you have any questions.

Cheers,

Ed Deboo, PT

 

Class update: Introduction to the Self Treatment of Myofascial Trigger Points.

Finding Psoas trigger point 1/31/2015 Summary of the first “Introduction the Self Treatment of Myofascial Trigger Points” class held January 24th, 2015.

It was Thanksgiving 2014 and we are watching the Seahawks demolish the 49 er’s . It was in the euphoria of the win (and a few beers) that I decided I needed to take the plunge and set a date to teach my first “real” class of the new year: January, 24th, 2015.

My first class went very well and it was a blast. I couldn’t have asked for a better group, as we had clients, OT’s, PT’s, PTA’s, massage therapists, yoga teachers, and Pilates teachers all represented. As a Physical Therapist, I’ve been an advocate for self Trigger Point work as a home exercise program for years as this can be a very simple, but effective method of helping daily, “vanilla” complaints of musculoskeletal pain. It was from this belief that I decided I should make a 1 day class about this topic and cover common muscles that I treat daily. I will be offering the class again March, 28th, 2015 and registration has opened. Please call Darcy at 360 715-8686 to register. Hope to see you there, Ed

Posture and Pain: How strong is the link?

significant kyphosis but no back pain!!

significant kyphosis but no back pain!!

 

Posture and Pain: How strong is the link?

When I was in PT school, we had a whole unit dedicated to the evaluation, assessment, and treatment of “postural dysfunctions”. Likely enemies included excessive kyphosis (rounded upper back), leg length difference, muscle imbalances/tightness from side to side, elevated or depressed shoulder girdles, tight psoas, winging scapula, forward neck posture, and the ever popular “anterior tilted pelvis”.

Like many who came before me, I started my career thinking the above stated had huge implications for pain and spent a substantial amount of time giving corrective exercises and pointing out the many “flaws” my patient had. I then started to notice a number of clients without the obvious structural flaws but they still had pain, now what and who do I blame?

A critical review of the literature and years of clinical experience can often make you question your foundational beliefs and lead to a paradigm shift in the way you practice. A bit wiser and grayer now, I realize that static postural differences are factors but not something to get overly excited about. As Aaron Rodgers of the Packers told the legion of fans as they started to panic at the beginning of the season, just
R-E-L-A-X. So your neck has lost its normal curve (you don’t need a $100 pillow), your right shoulder is a bit higher than the left, and one foot drops in a bit more than the other: not a big deal in the big picture. I have treated numerous patients that many would say have “good posture” and, unfortunately, they have chronic back or neck pain. And likewise, many patients who have significant postural challenges that have no pain in that area.

Meet “Claire” ( I used “Claire” because I was accused by my daughter of always using “Mary” for a fictional name so I switched it up, thanks Hope) who presented to my clinic with a significant thoracic kyphosis but NO appreciable back pain. But how is that possible? There is strong evidence in the literature that structural evaluations have little to no direct effect on pain. But what is an issue is “postural strain”. How long are you sitting at your computer to read this long winded post that is way too long and what kind of position is your neck in? How about lifting those Christmas boxes from the attic? The common denominator is movement. This is where we should be putting our efforts with manual therapy, exercises, and corrective movements.

Learning to avoid postural straining positions and learning to move in a safer, more efficient manner would serve us all much better than worrying about an “out of place pelvis” or a “crooked back”. Check back soon for a video on the “hip hinge” to help save your lower back,  until then, be safe and happy,

~Ed

Double Crush Syndrome: Why you need to know about it

upper extremity nerves

Sharing some thoughts from an interesting client seen in the clinic last week. What happens when the diagnosis doesn’t fit the clinical picture? For example, the client who presents with lateral elbow pain and is given the diagnosis of “tennis elbow” or technically “lateral epicondylitis”. This would seem plausible except for one reason: this particular client doesn’t play tennis and the pain is in the non-dominant hand. Now what?
One possible explanation is a phenomenon called “Double Crush Syndrome” that was first presented back in 1973 by Dr.’s Upton and McComis, MD who postulated that “damage to a nerve at one site along its course may sufficiently impair the overall functioning of the nerve cells so that they become more susceptible than would normally be the case to trauma at other sites”.
What exactly does this mean? A couple things to first keep in mind. Anytime you see “Syndrome” attached to anything (Fibromyalgia, Chronic Fatigue, and Myofascial Pain are all common Syndromes), understand that is medical code for “not really sure what’s going on”. We know “something’s up” just not sure what so let’s guess. Since the nerves that travel down and innervate the arm and hand start up at the neck, any “injury” to the nerves as they leave the neck can make them more likely to be irritated anywhere along the chain afterwards. What should be a sore wrist from computer work could turn in to Carpal Tunnel Syndrome (yes, there’s that word “syndrome” again) from a nerve irritation in the neck. This can also be said for lower extremity issues: plantar fasciitis, shin splints, Achilles tendonitis, etc. that could all have a lumbar spine or sacral “nerve” issue that could be clouding the clinical picture.
So what if you are like my client who’s having arm (or leg) pain that can’t be explained and you were questioning whether or not you have “Double Crush Syndrome”? Luckily, there are many tests that can be clinically done to determine if there is a “neuro-dynamic” component to your pain and if so, how it changes the course of treatment. Hope you enjoyed my ramblings, there is power in knowledge.
Cheers,
Ed