Common symptoms of lymphedema include swelling in the affected limb, which can range from mild to severe. The swelling may be accompanied by a feeling of heaviness or tightness in the limb. The skin in the affected area may appear thickened or hardened, and there may be a loss of flexibility or range of motion. Some individuals may also experience discomfort or pain in the affected limb, as well as recurrent infections or cellulitis. It is important to note that the symptoms of lymphedema can vary from person to person, and may worsen over time if left untreated.
Lymphedema is typically diagnosed through a combination of medical history, physical examination, and imaging tests. The healthcare provider will first review the individual's symptoms and medical history, and may ask about any previous surgeries or treatments that could have contributed to the development of lymphedema. During the physical examination, the healthcare provider will assess the affected limb for signs of swelling, skin changes, and other characteristic symptoms. Imaging tests, such as lymphoscintigraphy or MRI, may be used to visualize the lymphatic system and confirm the diagnosis of lymphedema.
Erson tells a story of getting back to rock climbing after a 20 year break. After a finger injury that wasn't healing, he got some totally unexpected great advice from another climber. What do you think of the solution and has anything similar ever happened to you? 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
Posted by on 2023-07-06
Tension-type headache (TTH) is a prevalent and burdensome condition that affects many individuals. Recent research suggests that the cervical spine, specifically the trigemino-cervical nucleus caudalis, may play a role in the development of TTH. This nucleus facilitates the exchange of pain signals between the upper cervical spine and the trigeminal nerve, which is involved in headache generation. Links between the upper cervical spine and TTHStudies have shown that individuals with TTH often exhibit musculoskeletal impairments. Common findings include forward head posture and restricted cervical range of motion. These physical dysfunctions may contribute to the headache symptoms experienced by TTH patients. Neck pain and sensitivity in the cervical spine are frequently reported alongside TTH and may worsen the clinical presentation of the headache. These symptoms could be epiphenomena resulting from the sensitization of the trigemino-cervical nucleus caudalis.While forward head posture is a common observation in TTH, its direct relevance to the headache remains a topic of debate. Similarly, the relationship between restricted cervical range of motion and TTH is not well understood. It is uncertain whether these musculoskeletal impairments are causative factors or consequences of the headache.Clinicians often use the cervical flexion-rotation test to assess upper cervical spine mobility, which has proven useful in diagnosing cervicogenic headache. However, its application and significance in TTH are not extensively studied. Further research is needed to elucidate the role of this test in TTH diagnosis and management.Another intriguing observation is the reproduction of headache pain through manual stimulation of the upper cervical spine in both cervicogenic headache and TTH. This suggests that referred pain from the cervical spine may be involved in the pathophysiology of primary headaches. Understanding this mechanism could lead to novel therapeutic approaches for TTH.Additionally, trigger points in the neck-shoulder muscles may contribute to TTH symptoms by generating muscle referred pain. These trigger points can refer pain to other areas, including the head, and may exacerbate the headache experienced by individuals with TTH. Managing TTH in practiceA multidisciplinary approach involving physical therapy interventions targeting musculoskeletal impairments, exercise, and psychological aspects is essential for the management of TTH. The effectiveness of cervical treatment approaches varies, and personalized strategies should be tailored to individual patients. Understanding the role of the cervical spine in TTH and differentiating between cervical components and sources can aid in the recognition and treatment of diverse headache presentations. Our cervical spine models help professionals manage the connections between TTH and the role of the cervical spine. Check out my exclusive blue nucleus anti-nocebo version!via Dr. Jerome Fryer - Dynamic Disc Designs 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 2023-07-05
Erson goes over an interesting TMJ case of posterior disc subluxation and severe pain with opening and eating. It turns out after significant improvement the patient was still checking for tenderness a bit too much. 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
Posted by on 2023-06-26
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
Lymphedema is often classified into four stages, based on the severity of the condition. In the early or mild stage, there may be minimal swelling that reduces with elevation of the limb. The skin may appear normal or slightly thickened. In the moderate stage, the swelling becomes more pronounced and may not completely resolve with elevation. The skin may become more fibrotic and there may be a loss of flexibility. In the severe stage, the swelling is persistent and may be accompanied by significant skin changes, such as thickening, hardening, or ulceration. In some cases, lymphedema can progress to a stage called lymphedema tarda, which is characterized by extreme swelling and irreversible tissue damage.
The main causes of lymphedema can be divided into primary and secondary lymphedema. Primary lymphedema is typically caused by a congenital abnormality or malformation of the lymphatic system. Secondary lymphedema, on the other hand, is usually the result of damage or disruption to the lymphatic system due to surgery, radiation therapy, infection, trauma, or other underlying medical conditions. Common causes of secondary lymphedema include cancer treatment, particularly for breast cancer, as well as lymph node removal or damage during surgery.
Treatment options for lymphedema aim to reduce swelling, manage symptoms, and improve overall quality of life. The mainstay of treatment is a comprehensive approach known as complete decongestive therapy (CDT), which includes manual lymphatic drainage, compression therapy, exercise, and skin care. Manual lymphatic drainage involves gentle massage techniques to stimulate lymphatic flow and reduce swelling. Compression therapy involves the use of compression garments or bandages to support the affected limb and prevent fluid buildup. Exercise, such as specialized lymphedema exercises or low-impact activities, can help improve lymphatic flow and reduce swelling. Proper skin care, including regular moisturizing and protection against injury or infection, is also important. In some cases, surgical interventions or other advanced therapies may be considered.
While lymphedema cannot always be prevented, there are steps that can be taken to reduce the risk or minimize the severity of the condition. For individuals at risk of developing lymphedema, such as those undergoing cancer treatment or with a family history of the condition, it is important to follow any preventive measures recommended by healthcare providers. This may include avoiding trauma or injury to the affected limb, practicing good skin hygiene, maintaining a healthy weight, and engaging in regular exercise. It is also important to be aware of the signs and symptoms of lymphedema and seek prompt medical attention if any changes or concerns arise.
Complications associated with lymphedema can include recurrent infections, cellulitis, and lymphangitis. These complications can occur due to the impaired immune function and compromised lymphatic drainage in the affected limb. Infections can lead to further swelling, pain, and discomfort, and may require antibiotic treatment. If left untreated, recurrent infections can cause progressive damage to the lymphatic system and worsen the symptoms of lymphedema. In severe cases, lymphedema can also lead to skin breakdown, ulceration, and the development of lymphangiosarcoma, a rare form of cancer. Therefore, it is important for individuals with lymphedema to closely monitor their symptoms, practice good skin care, and seek appropriate medical care to prevent and manage complications.
Individuals with hypermobility syndrome should follow specific exercise protocols to help manage their condition. These protocols typically focus on strengthening the muscles surrounding the joints to provide more stability and support. Exercises that target the core, such as planks and bridges, can help improve overall stability. Additionally, low-impact exercises like swimming and cycling can be beneficial as they put less stress on the joints. It is important for individuals with hypermobility syndrome to avoid high-impact activities that may exacerbate joint instability. Stretching exercises should also be included in the exercise routine to maintain flexibility, but caution should be taken to avoid overstretching. Working with a physical therapist or exercise specialist who is knowledgeable about hypermobility syndrome can help individuals develop a personalized exercise program that addresses their specific needs and limitations.
The Feldenkrais Method is a somatic educational approach that addresses chronic musculoskeletal pain by focusing on improving movement and body awareness. Through gentle and mindful movements, individuals are guided to explore different patterns of movement and discover new ways of organizing their bodies. This method emphasizes the connection between the mind and body, and aims to retrain the nervous system to move with greater efficiency and ease. By increasing body awareness and promoting more efficient movement patterns, the Feldenkrais Method can help individuals with chronic musculoskeletal pain to reduce tension, improve posture, and alleviate pain. Additionally, this method encourages individuals to develop a greater sense of self-care and self-regulation, empowering them to take an active role in managing their pain and promoting overall well-being.
Iliotibial band syndrome (ITBS) is a common overuse injury that affects the iliotibial band, a thick band of connective tissue running along the outside of the thigh. Biomechanical factors play a significant role in the development of ITBS. These factors include excessive pronation of the foot, tightness or weakness in the hip muscles, and poor running or cycling mechanics. Excessive pronation can lead to increased stress on the iliotibial band, while tight or weak hip muscles can alter the alignment of the pelvis and increase strain on the band. Poor running or cycling mechanics, such as excessive hip adduction or internal rotation, can also contribute to ITBS. Managing ITBS involves addressing these biomechanical factors through a combination of stretching and strengthening exercises, orthotics or shoe inserts to correct foot pronation, and gait analysis to improve running or cycling mechanics. Physical therapy may also be recommended to address any underlying muscle imbalances or weaknesses. Additionally, modifying training intensity and gradually increasing mileage can help prevent overuse and reduce the risk of ITBS recurrence.
Mindfulness-based stress reduction (MBSR) has been shown to be effective in reducing pain intensity in patients with chronic pain. Numerous studies have demonstrated that the practice of mindfulness, which involves paying attention to the present moment without judgment, can lead to significant reductions in pain perception. By cultivating a non-reactive and accepting attitude towards pain, individuals with chronic pain can experience a decrease in pain intensity and an improvement in overall well-being. Additionally, MBSR techniques such as body scans, mindful movement, and meditation can help individuals develop a greater sense of body awareness and enhance their ability to cope with pain. Overall, MBSR offers a promising approach for managing chronic pain and improving the quality of life for patients.
The Alexander Technique has a profound impact on the posture and movement of musicians. By focusing on body awareness, alignment, and balance, the technique helps musicians develop a more efficient and effortless way of playing their instruments. Through the use of gentle hands-on guidance and verbal instructions, the Alexander Technique teaches musicians to release unnecessary tension and use their bodies in a more coordinated and integrated manner. This leads to improved posture, as musicians learn to align their spine and limbs in a way that supports optimal movement and reduces strain. Additionally, the technique enhances the musician's kinesthetic sense, allowing them to have a greater awareness of their body in space and make more precise and controlled movements. Overall, the Alexander Technique empowers musicians to achieve a more natural and balanced posture, resulting in improved performance and reduced risk of injury.
The McKenzie Method, a widely used approach for the classification and treatment of sciatica, employs a comprehensive system to assess and manage this condition. It categorizes sciatica into three main subgroups: derangement, dysfunction, and postural syndrome. The derangement subgroup involves a mechanical displacement of the intervertebral disc, causing nerve root compression and resulting in leg pain. Dysfunction refers to a loss of normal movement in the spinal joints, leading to irritation of the nerve root. Lastly, postural syndrome is characterized by pain arising from prolonged poor posture. Treatment within the McKenzie Method focuses on specific exercises and movements tailored to each subgroup. For derangement, directional preference exercises are utilized to centralize and alleviate leg pain. Dysfunction is addressed through mobilization techniques to restore normal joint movement. Postural syndrome is managed by correcting posture and implementing ergonomic modifications. By accurately classifying sciatica and employing targeted interventions, the McKenzie Method offers a comprehensive approach to effectively treat this condition.