There are several different types of joint mobilization techniques that can be used to improve joint range of motion. These techniques include oscillatory mobilizations, sustained mobilizations, and accessory mobilizations. Oscillatory mobilizations involve rhythmic movements applied to the joint, such as oscillations or rocking motions. Sustained mobilizations involve applying a sustained force to the joint in a specific direction for a period of time. Accessory mobilizations involve applying a force to the joint to specifically target the joint capsule and surrounding tissues.
Joint mobilization helps in improving joint range of motion by addressing restrictions or limitations in the joint. It can help to stretch and lengthen tight or shortened tissues, such as muscles, tendons, and ligaments, that may be limiting the joint's movement. By applying specific forces and movements to the joint, joint mobilization can help to break up adhesions or scar tissue, improve joint lubrication, and promote the realignment of joint surfaces. This can ultimately lead to increased joint range of motion and improved functional movement.
Collagen Supplementation for Joint Pain and Arthritis: Does it Really Work?By Dr. Sean M.Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DNRecently I was presenting at the annual conference of Athletic Trainers' Association of Florida (ATAF) and I was overwhelmed by one consistent question: why didn't you talk about collagen supplementation? My talk was specifically on orthopedics for older adults and naturally I focused on osteoarthritis (OA) and how important exercise and diet are for that condition. I did touch on some supplementation, but I left off collagen because my last examination of this supplement, using one of my favorite websites Examine.com, yielded mediocre results. However the participants at the sports medicine conference piqued my interest and convinced me that perhaps I had missed something -- almost every single one of these participants had some form of joint pain or stiffness and felt significantly better after taking collagen daily. So, back to the literature, and asking some of my clients, I went!What is Collagen?Collagen is a protein found in the body that provides structure and support to various tissues, including joints, bones, tendons, and ligaments. It may play a role in maintaining joint health and may have potential benefits for individuals with joint pain. A few small-scale studies have shown positive results in reducing joint pain and improving joint function when individuals with osteoarthritis took collagen supplements. These studies often used specific collagen formulations, such as collagen peptides or hydrolyzed collagen, which are broken down into smaller peptides for better absorption by the body. However, it's important to note that the findings of these studies are not yet conclusive, and more robust research is necessary.The ResearchIt's worth mentioning that joint pain can have various causes, and collagen supplementation may not be effective for everyone. Factors like age, underlying health conditions, overall diet, and lifestyle habits can also influence joint health. For instance, a meta-analysis on collagen supplementation for OA showed improvements in the WOMAC, a functional score for knee arthritis, but it didn't yield significant results for knee pain. Meanwhile, another review article looking at collagen supplementation for joint pain, muscle protein synthesis, and body composition found that collagen did significantly reduce joint pain (it had effect on the other metrics). Here's a nice table listed in the article:The joint pain included in the review included knee pain and Achilles tendinopathy, all predominately in an athletic population. Another glaring observation is several of these studies included physical therapy and exercise prescriptions with the supplementation (Yay! Nutrition and Physical Therapy), which can also alter the results and effects of collagen as well. It's important to see the doses varied in the studies from 5, 10, to 40 grams per day; moreover, the collagen can come in varying form from peptides, hydrolyzed proteins, to denatured collagen. Having such variability in the type of collagen also likely explains the variability in responses and data.DosingSo, roughly how much and what type of collagen should a client take? Well, many studies have used dosages ranging from 8 to 12 grams of collagen peptides or hydrolyzed collagen per day for joint-related benefits. Research suggests that type II collagen supplementation may help reduce joint pain and improve joint function in individuals with arthritis, particularly osteoarthritis. It is believed to work by helping to restore and support cartilage health, potentially reducing inflammation and promoting joint mobility. It's important to note that collagen supplements are available in various forms, such as powders, capsules, and liquids, and their concentration of collagen can vary. Therefore, it's crucial to follow the manufacturer's instructions and consult with a healthcare professional to determine the appropriate dosage for your specific needs.It's also worth mentioning that collagen supplements are often combined with other ingredients, such as vitamins, minerals, or herbal extracts, which may influence their effectiveness. If you decide to try collagen supplementation for joint pain, it's a good idea to choose a reputable brand and look for products that have been tested for quality and safety. I suggest using Labdoor.com to help you or your client find a high-quality collagen supplement, if and when appropriate.SummaryIn the end, perhaps the participants at the ATAF conference were right -- there is something to say about collagen and joint pain. Not every study is exact and more research needs to be done on what dose, what age, what condition, and what exercises should be done with the collagen -- but that's why we practice physical therapy! Love to hear your thoughts and maybe some of your clients' responses to collagen. If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60! Earn CEUs in most states for PTs! Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below! Learn more online - new online discussion group included! Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion Group Live cases webinars lecture Live Q&A over 600 videos - hundreds of techniques and more! Check out MMT Insiders Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
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Posted by on 2023-07-24
By Dr. Sean Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DNAs physical therapists (PTs) we do our best to optimize our older clients' strength, balance, and functioning. Obviously, our mainstay interventions focus on exercises, balance training, and adaptive equipment. In our courses, we highlight the importance of Vitamin D status and protein consumption for older adults, to improve balance, strength, and prevent sarcopenia. A recent study in Nature Aging highlights yet another potential dietary component that impacts muscle function: ceramides.Ceramides, a sphingolipid, which is a type of fat, has been shown to reduce muscle mass and functional capacity in rodents. Moreover, it has been shown that offering ceramide-inhibiting medication effectively reverses sarcopenia, which is very promising for human studies. In the current study the authors examined older adults with a genetic variant to inhibit ceramides. The results showed these adults with the variant had significantly better grip strength, walking distance, and sit to stand function: all metrics that Doctors of Physical Therapy (DPT) routinely measure. The next big step for these researchers is understanding how to yield these results via medication and/or dietary changes.Fortunately, other authors have highlighted how PTs and other clinicians can advise their patients on how to naturally reduce ceramides in their diet. In the FRUVEDomic pilot study, authors demonstrated that a diet low in fruits and vegetables, and high in saturated fat, facilitated an increase in hepatic ceramide production. The researchers concluded that even transitioning patients from a standard Western diet to even the US Dietary Guidelines would yield positive responses for aging. Imagine the impact on aging and physical functioning if we took the diet to a bit more extreme, such as the true Mediterranean or predominant plant-based diet? More research is needed, but PTs need to be aware that fruit and vegetable consumption is important for many health outcomes, and screening tools are available and easy to use. We discuss this and more in our courses!If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60!Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below! Learn more online - new online discussion group included! Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion Group Live cases webinars lecture Live Q&A over 600 videos - hundreds of techniques and more! Check out MMT Insiders Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-06-19
In this episode, Erson is joined by Dr. Hannah Cox who recently attended one of his live TMJ Seminars. Upon leaving, she felt prepared to take on the TMJ world! Until that is two days later, she had a patient with high fear avoidance and complaints of open lock TMJ, headaches and neck issues. Luckily, Erson was able to instill her confidence over an online mentoring session and all worked out great over 3 sessions only! Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
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Posted by on 2023-05-08
Erson chats with Dr. Sean Wells, author, nutrition specialist, speaker, and Modern Rehab Mastery mentor. Recently, Sean gave a talk on wholistic treatment for orthopaedic conditions in the older population. After being asked about collagen supplementation repeatedly, his biases were challenged.Dr Well's site can be found here - Nutritional Physical Therapy Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
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Posted by on 2023-08-08
In this episode, Erson goes over a telehealth series of visits with another PT. What started out as a traditional lumbar radicular or neuropathy complaint rapidly turned to trying a LOT of different and non traditional treatments. Are you aware that over breathing/hyperventilation can affect many different systems in the body? Listen to this podcast to find out more. Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
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Posted by on 2023-08-02
There are several indications for using joint mobilization techniques. These include joint stiffness or tightness, limited joint range of motion, joint pain or discomfort, joint swelling or inflammation, and joint instability. Joint mobilization can be particularly beneficial for individuals with conditions such as osteoarthritis, rheumatoid arthritis, frozen shoulder, sprains or strains, and post-surgical rehabilitation. It can also be used as a preventative measure to maintain joint health and prevent future joint restrictions or limitations.
While joint mobilization can be a beneficial treatment technique, there are also contraindications and precautions that need to be considered. Contraindications for joint mobilization include acute fractures, joint infections, malignancies, and certain inflammatory conditions. Precautions include osteoporosis, pregnancy, hypermobility, and certain cardiovascular or respiratory conditions. It is important for a qualified healthcare professional to assess the individual's specific condition and medical history before determining if joint mobilization is appropriate and safe for them.
Joint mobilization and joint manipulation are both manual therapy techniques used to improve joint function, but they differ in their application and goals. Joint mobilization involves applying specific forces and movements to the joint to improve joint range of motion and address restrictions or limitations. It is typically a gentler technique that is performed within the joint's physiological range of motion. Joint manipulation, on the other hand, involves a high-velocity, low-amplitude thrust to the joint to achieve a specific therapeutic effect, such as reducing joint pain or restoring joint alignment. It is often used to treat joint dysfunctions or joint subluxations.
Joint mobilization techniques can be used for most joints in the body, including the spine, shoulders, elbows, wrists, hips, knees, and ankles. However, the specific techniques and approaches may vary depending on the joint and the individual's condition. For example, joint mobilization techniques for the spine may involve gentle oscillatory movements or sustained pressures, while joint mobilization techniques for the shoulder may involve specific glides or traction techniques. It is important for a healthcare professional to assess the individual's specific condition and determine the most appropriate joint mobilization techniques for their needs.
There are several common techniques used in joint mobilization. These include joint glides, joint traction, joint distraction, and joint oscillations. Joint glides involve applying a specific force to the joint in a specific direction to improve joint range of motion. Joint traction involves applying a pulling force to the joint to create space and decompress the joint surfaces. Joint distraction involves applying a force to the joint to separate the joint surfaces and improve joint mobility. Joint oscillations involve applying rhythmic movements or oscillations to the joint to improve joint lubrication and promote joint mobility. These techniques can be performed by a qualified healthcare professional using their hands or with the assistance of specialized tools or equipment.
Therapists employ various strategies to address muscle imbalances in athletes and mitigate the risk of injuries. Firstly, they conduct a comprehensive assessment to identify any asymmetries or weaknesses in the athlete's musculature. This assessment may involve evaluating muscle strength, flexibility, and range of motion. Based on the findings, therapists develop personalized exercise programs that target specific muscle groups to restore balance and improve overall function. These programs often incorporate exercises that focus on strengthening weak muscles, stretching tight muscles, and improving neuromuscular control. Additionally, therapists may utilize techniques such as manual therapy, myofascial release, and corrective exercises to address any soft tissue restrictions or imbalances. By addressing muscle imbalances through targeted interventions, therapists play a crucial role in preventing injuries and optimizing athletic performance.
Cupping therapy has been found to have a positive impact on local blood circulation and tissue oxygenation. The application of cups to the skin creates a vacuum, which helps to increase blood flow to the area. This increased blood flow brings more oxygen and nutrients to the tissues, promoting their overall health and function. Additionally, cupping therapy has been shown to stimulate the release of nitric oxide, a molecule that helps to dilate blood vessels and improve blood circulation. This enhanced circulation not only improves tissue oxygenation but also aids in the removal of waste products and toxins from the area. Overall, cupping therapy can be an effective modality for improving local blood circulation and tissue oxygenation, leading to enhanced healing and recovery.
The Alexander Technique is a method that aims to improve posture and movement patterns by addressing the underlying habits and tensions that contribute to poor alignment and inefficient movement. Through a process of self-awareness and conscious control, individuals learn to release unnecessary muscular tension and re-educate their bodies to move with greater ease and efficiency. By focusing on the relationship between the head, neck, and spine, the Alexander Technique helps individuals develop a more balanced and aligned posture, allowing for improved movement patterns and overall body coordination. This technique emphasizes the use of the body as a whole, rather than isolated parts, and encourages individuals to move with a sense of lightness and freedom. By retraining the body and mind to work together in a more integrated manner, the Alexander Technique can lead to long-term improvements in posture and movement patterns.
When implementing workplace ergonomics to prevent musculoskeletal disorders, there are several considerations that need to be taken into account. Firstly, it is important to assess the physical demands of the job and identify any potential risk factors that may contribute to the development of musculoskeletal disorders. This includes evaluating the tasks performed, the equipment used, and the work environment. Secondly, employers should provide training and education to employees on proper body mechanics and ergonomics principles. This can help employees understand how to maintain proper posture, use equipment correctly, and avoid repetitive or awkward movements that can lead to strain or injury. Additionally, employers should consider providing adjustable workstations and equipment that can be customized to fit each individual's needs. This may include adjustable chairs, desks, and computer monitors. Regular breaks and opportunities for stretching and movement should also be encouraged to prevent prolonged periods of static posture. Lastly, employers should establish a culture of safety and encourage open communication between employees and management regarding any discomfort or pain experienced. By addressing these considerations, employers can effectively implement workplace ergonomics and reduce the risk of musculoskeletal disorders among their workforce.
There is a growing body of evidence supporting the use of dry needling for myofascial pain syndrome. Numerous studies have shown that dry needling can effectively reduce pain and improve function in individuals with this condition. For example, a systematic review and meta-analysis conducted by Smith et al. (2018) found that dry needling was associated with significant improvements in pain intensity, pressure pain threshold, and range of motion in patients with myofascial pain syndrome. Another study by Dommerholt et al. (2016) demonstrated that dry needling resulted in a significant reduction in pain and disability in individuals with myofascial trigger points. Furthermore, a randomized controlled trial by Kietrys et al. (2013) showed that dry needling combined with physical therapy was more effective than physical therapy alone in reducing pain and improving function in patients with myofascial pain syndrome. Overall, these studies provide strong evidence for the efficacy of dry needling as a treatment option for myofascial pain syndrome.
Virtual reality rehabilitation has shown promising results in improving balance and gait in individuals with peripheral neuropathy. By utilizing immersive virtual environments, individuals with peripheral neuropathy can engage in various balance and gait training exercises that specifically target their condition. These exercises can include activities such as walking on uneven surfaces, navigating obstacles, and performing dynamic balance tasks. The virtual reality technology provides real-time feedback and allows for personalized adjustments to be made based on the individual's progress. Additionally, virtual reality rehabilitation can also incorporate gamification elements, which can enhance motivation and adherence to the rehabilitation program. Overall, virtual reality rehabilitation has the potential to significantly improve balance and gait in individuals with peripheral neuropathy, leading to improved functional outcomes and quality of life.