Battlefield Acupuncture & Physical Therapy

Battlefield Acupuncture (BFA) was developed by Dr. Richard Niemtzow in 2001 following 9-11 to deliver quick and effective pain relief for military personnel.1,2 It was also designed to alleviate dependency upon the use of narcotics and allow expedited care for seriously injured military personnel.3 BFA is a form of auriculotherapy, a treatment utilized in health care in which the outer part of the ear (auricle) is stimulated to address conditions in other areas of the body.

BFA consists of up to 5 acupuncture points (per ear) in which semipermanent needles (ASP needles) are placed with the intent to last 2-7 days until they fall out.1,2 Needles are placed in a particular order in one or both ears, with pain values assessed after each placement. When pain levels are decreased to 0-1/10 on the National Pain Rating Scale the provider stops the treatment.4 

Image from the Battlefield Acupuncture (BFA) Handbook, 2021.4 

Mechanisms 

Auricular acupuncture as a whole has been thought to influence the central nervous system with data related specifically to the BFA protocol supporting the notion of a widespread activation of the CNS.

The stimulated neural structures of the ear activate portions of the brain that cause a release of serotonin, dopamine, norepinephrine, and b-endorphins,1,6 which are related to natural pain reduction, emotion & sleep regulation, sensory input, inflammatory regulation, and stress reduction.1,6,7 BFA has been shown to be a simple, low-risk, cost-effective, and immediate tool to treat patients centrally in many different settings and situations.   

Utilization 

BFA was primarily designed for and continues to be used for the immediate reduction of pain. It has been shown to reduce chronic pain intensity better than placebo pills, sham needling, usual care, or medications, with a greater effect on patients with higher baseline pain scores.11,12 Notably, it has been used to treat acute or chronic condition such as low back pain, postoperative pain, neuropathic pain, headache, migraine, and phantom limb pain in amputees.1,2,13,14,15,16 Studies have shown immediate pain reductions in 80-95% of patients on treatment day. Follow-up data shows a continued reduction of pain in 52-70% of patients 7 days following treatment, with each treatment effect lasting 1-2 weeks on average.13,18,19 Insomnia and mental health treatments have also been supplemented with BFA, showing a reduction in insomnia severity, subjective sleep quality, improved relaxation, and improved daytime dysfunction in veterans with PTSD.6,10,12,21,22

BFA has also been utilized in the military setting to reduce opioid use and has been a successful method both in emergency combat care and in the operating room.9,23 It is a simple procedure to perform that is a safe, fast-acting, portable, and cost-effective alternative to opioid medications.9,10 This success could be transferred into the physical rehabilitation setting with postoperative pain during initial physical therapy sessions to improve mobility and function, patients with chronic pain and hyperalgesia that are unable to tolerate manual therapy, and patients with chronic regional pain syndrome or other central disorders to address the central dysfunction in order to then treat the peripheral dysfunction.  A case study done by Guthrie and Chorba shows the utilization of BFA as a tool to allow a patient experiencing little success with traditional physical therapy to reduce pain from a consistent 9/10 to 2/10, improve sleep levels, and improve daily function to gain benefits with physical therapy and lasting relief.27 Another participant described the benefits of BFA as allowing him to go to the gym and perform physical therapy with greater ease and less pain.14 deWeber and Lynch describe 8 athletes treated with BFA almost immediately before competition with varying ailments, reducing pain dramatically and allowing them to perform their sport.16  

Physical therapists certified in dry needling are highly qualified with many hours of training addressing needling risks, mechanisms, and advanced techniques. Consult your PT or contact the Wellness Institute if you think you might benefit from the use of Battlefield Acupuncture in treating your chronic or acute conditions.

The Forgotten Art of Squatting

A 2014 study in the European Journal of Preventive Cardiology found that test subjects who showed difficulty getting up off the floor without support of hands resulted in a three-year-shorter life expectancy than subjects who got up with ease!  It turns out that the “use it or lose it” theory is true!

Photo by Reuters/Stringer.

In the Western world, entire populations have abandoned the squat—to the extent that it is now viewed as undignified! Resting has become synonymous with sitting in much of the developed world and is mainly associated with the attainment of affluence of the middle and upper class. From desk chairs to dining chairs to commuting and TV watching with only brief respites for walking from one chair to another!  Other than short intervals for exercises we spend most of the time sitting.  So much so that it is detrimental to not only the knees but now is affecting our overall health.

Much of the world still squats daily, whether to rest, to pray, to cook, to share a meal, to give birth, or to use the toilet (squat-style toilets are still the norm in Asia and much of underdeveloped Africa.)

The medical fraternity is now noting that our failure to squat has metabolic, biomechanical, and physiological implications on our health.

Most moving joints in the body are synovial joints—a capsule surrounds each joint containing synovial fluid which is the “oil” in the joint providing nutrition to the cartilage that covers the ends of the bones (hyaline cartilage) and the meniscus (fibrocartilaginous). Movement and compression stimulate the production of synovial fluid nourishing the joint surfaces allowing smooth pain free mobility.   Failure to use the whole joint—not bending the knees past 90 degrees—results in degeneration of the joint surfaces that are not being used as no synovial fluid reaches these surfaces and the whole joint stiffens resulting in the dreaded “osteoarthritis (OA)” and  the “bone on bone” diagnosis.  Note that the Greek work “arthro” (άρθρο) means “joint,” hence arthritis means  “inflammation of the joint”—inflammation is not a disease…it’s a response!  On the other hand, Rheumatoid Arthritis, Psoriatic Arthritis and Gouty Arthritis are autoimmune diseases where the body is actively attacking itself.  These diseases have a relatively low prevalence, but Osteoarthritis is widespread and is not an autoimmune disease hence does not fall under this category.  OA is degeneration of the joint surfaces (cartilage) due to lack of use which deprives the joint of healthy nutrition.

Hence, the ability to perform a full squat is an indicator of overall health, i.e., the ability to move body weight in an efficient manner.  It recruits most of the muscles in the lower extremity effectively placing a healthy stress on the muscle, tendons, ligaments and joints that results in strengthening of the structures via Wolf’s Law.  Wolf’s Law says that bone and other soft tissue structures in a healthy individual will adapt to the loads under which it is placed and will result in a remodeling process over time to become stronger.  The extra work (defined as the product of force and displacement) will increase stress to the system and stronger joint, bones and muscles are the result.  This extra work increased metabolism, and makes the system more efficient including the digestive tract.

So, start squatting, it’ll change your life along with your joints!

Ease Your Aching Head

A Guide to Headaches and How Physical Therapy Can Help!

Headaches, migraines, jaw, and facial pain plague 1 in 4 US household. If you or someone in your family suffers from this, you know it can be debilitating and is a stressor on the entire family. It can put a damper on your relationships and even holidays and family vacations. Medications can help manage symptoms, but the chronicity of these symptoms often leaves associated stiffness and pain that can affect the neck and shoulders. Many individuals experiencing migraines and facial pain have gone for years without knowing physical therapy was even an option.

There are 3 main diagnoses that are differentiated by your symptoms and guide treatment.

1. CERVICOGENIC HEADACHES (CGH):

• These are often unilateral and due to stiff facet joints in the neck and can occur with or without a migraine.

• Whiplash, arthritis, forward head posture, or repetitive use at work may create tightness in the facet joints of the neck.

• Mobilizing the joints at the base of the head and neck as well as releasing the associated soft tissue is very effective at reducing CGH.

2. MIGRAINES:

• These often involve aura, tunnel vision, tinnitus, speech impairment, and changes in smell or taste.

•   A trigger (hormones, stress, food, medication, caffeine, sleep, etc.) can bring these on for hours or days.

• This appears to be caused by overactive nerve cells that signal chemicals like serotonin and cGRP which create swelling in blood vessels that line the brain.

•    Improving joint mobility in the upper cervical spine has been shown to reduce firing activity along C2 and C3 which supply the posterior head and neck with sensation. These nerves roots also have dense connections with the trigeminal nerve which supplies with face and jaw area.

3. TEMPOROMANDIBULAR JOINT DISORDERS (TMD):

• This involves pain and clicking that limits mouth opening and may make it difficult to eat or chew crunchy foods.

•  The trigeminal nerve supplies sensation to the face, TMJ, and muscles of mastication involved in mouth opening.

• Performing joint mobilization to the TMJ can improve range of motion and decrease pain with mouth opening. Mobilization to the joints of the neck can decrease firing of the C2/3 nerves and in turn the trigeminal nerve. This is due to dense neural connections that create the trigeminocervical nucleus and allows for feedforward and back between the neck and head/ face.

PHYSICAL THERAPY TREATMENTS FOR HEADACHES

•  Joint mobilization/ manipulation, cupping, dry needling, and exercise can improve range of motion, decrease nerve firing, and relax adjacent muscles to improve pain.

• Have you tried therapy before and it didn't work, id so…was it with a therapist that had specialist training in this area?

• While therapy may not be the answer for everyone, we encourage you to give us a try. Only 1% of Physical therapists are fellowship trained so there's a good chance you haven't seen one yet. Logically you probably would not have your general practitioner perform hip surgery!  Similarly, this area truly requires a unique skill set!

CITATIONS:

1.       Migraine Facts. Migraine Research Foundation. https://migraineresearchfoundation.org/about-migraine/migraine-facts/. Published January 15, 2021. Accessed February 8, 2021.

2.       Al Khalili Y, Ly N, Murphy PB. Cervicogenic Headache. [Updated 2020 Aug 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507862/

3.       How a Migraine Happens. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/how-a-migraine-happens. Accessed February 8, 2021.

4.       Touche, R., Fernandez- de las-Penas, C., Fernandez- Carnero, J., Escalante, K., Angulo- Diaz- Parreno, S., Paris- Akemany, A., & Cleland, J. A. (2009). The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders. Journal of Oral Rehabilitation, 36(9), 644–652.doi:10.1111/j.1365-2842.2009.01980.x

5.       Machado, E., Machado, P., Wandscher, V. F., Marchionatti, A. M. E., Zanatta, F. B., & Kaizer, O. B. (2018). A systematic review of different substance injection and dry needling for treatment of temporomandibular myofascial pain. International Journal of Oral and Maxillofacial Surgery.doi:10.1016/j.ijom.2018.05.003

Soft Tissue Mobilization vs Massage.....What's the difference?

Soft tissue mobilization is a form of manual therapy performed by licensed physical therapists or physical therapist assistants to loosen soft tissue restrictions and improve movement and muscle activation

The soft tissue structures in the body include muscles, tendons, ligaments, and their protective covering known as facia. When these structures become tight, it can impair mobility and cause pain. Soft tissue mobilization is a form of manual therapy performed by licensed physical therapists or physical therapist assistants to loosen soft tissue restrictions and improve movement and muscle activation. Currently, there are many different types of soft tissue mobilization other than just the traditional “hands on” approach. Some of the more specialized techniques that are performed at the Wellness Institute include Instrument Assisted Soft Tissue Mobilization (IASTM), Cupping, and Body Tempering.

• Instrument Assisted Soft Tissue Mobilization (IASTM): IASTM uses specialized tools to mobilize scar tissue adhesions and myofascial restrictions in order to improve pain, increase mobility and maximize muscle recruitment and activation. When an injury occurs to the soft tissue and it’s not treated right away, adhesions and scar tissue can form. The use of the instruments causes microtrauma to the soft tissue which in turn stimulates a local inflammatory response. This then cause remodeling of the scar tissue and promotes better movement.

• Cupping: A myofascial release technique that involves the use of negative pressure with suction cups to create lifting of the soft tissue. Due to injury, inflammation, and change in tissue over time, the tissues become thickened and less mobile. The lifting of the tissues improves circulation to the area to promote healing, reduce pain, and improve mobility. Where IASTM and Body Tempering is more compressive manual therapy, cupping is more decompressive.

• Body Tempering: Invented by an Olympic power lifter Donnie Thompson, Body Tempering is a form of soft tissue mobilization that uses weighted steel cylinders that weigh from 22-200lb, that are held statically or moved along the length of the muscle. BT has been shown clinically to be a beneficial treatment alternative to traditional stretching, foam rolling, and deep tissue mobilization to facilitate repair of muscle strains, improve soft tissue extensibility, and reduce pain. While traditional massage is aimed at working out stress in the body, medical soft tissue mobilization is directed at restoring normal function to the affected structures.

Build Stonger Bones With Weight Training

Why is weightlifting important for all ages? Aside from improving overall health and strength, weightlifting can improve bone density and help prevent osteoporosis as we age. In an article posted by the Harvard Medical School, "Osteoporosis should be a concern for all of us. An estimated eight million women and two million men in the United States have osteoporosis. It is now responsible for more than two million fractures each year, and experts expect that number will rise. Hip fractures are usually the most serious. Six out of 10 people who break a hip never fully regain their former level of independence. Even walking across a room without help may become impossible.". So, how does weightlifting increase our bone density? To put it simply; as we train with weights our body is stressed, our body responds to this stress by increasing the strength of the structures to meet the demands placed on them. This increased stress on the muscle causes the body to increase the size of individual muscle fibers, which increases the bulk of the muscle. When our muscles increase in size, we are able to generate more force through them. This in turn causes increased stress on the tendons that attach the muscle to bone, and as a result the stress on the bony attachment for that tendon. As previously stated, our body will respond to stress by strengthening the bodies structures. The force generated by the muscle and tendon on the bone cause the body to lay down more bone matter increasing the thickness of the bone itself at the attachment site. It is in this way that we can improve the quality of bone in our skeletons as we age and help prevent the development of osteoporosis.

Are vegetable oils healthy?

“Vegetable” Oils Are Killing You!

This misleading product is hidden in almost everything we eat! Despite some of the heart healthy claims and labels, they are misleading and bad for your health!  The question is what are vegetable oils? First off, they are not vegetables at all!  Originally, cotton seeds, were considered industrial waste and used for making candles and soaps.  In the early  1900’s a scientist at Proctor and Gamble discovered that the seeds could be changed into hydrogenated oil with the appearance of a solid that resembled animal fats and could possibly be used as cooking oil…the birth of the all too familiar Crisco.  This solved the problem of butter and fat going rancid and dramatically extended shelf life.  Although branded a heart friendly vegetable oil the process of hydronation creates trans-fatty acids (similar products made from corn, soybean, sunflower and canola have entered the market) and this trans-fat is so unhealthy that the Food and Drug Administration has recently, after 100 years of production, prohibited food manufacturers from adding it to foods and beverages. This substitute, like high fructose corn syrup, (another chemical) is now hidden in almost everything and research has shown that they are directly linked to almost every chronic disease including cancer, obesity, Alzheimer’s, and Type II diabetes.

This “vegetable” oil has been marketed aggressively for almost a century, all to the detriment of the public.  Like saturated fats, trans fats are a major contributor to clogged arteries which increase your risk of both heart attack and stroke. There is strong evidence that trans fats raise low-density lipoprotein (LDL) or "bad" cholesterol levels which contribute to the buildup of fatty plaque in arteries; at the same time lowers the good cholesterol (HDL) which serve as protection for your arteries.  The Mayo clinic reports that trans-fat is considered the worst type of fat you can eat. Researchers at the Harvard School of Public Health in Boston suggest that replacing trans-fats in your diet with good fats (such as avocado, olive oil, nut oils, butter etc.) can reduce diabetes risk by as much as 40%.

Help yourself by swapping out the bad fats for the good fats and reduce your risk!  The chart below created by Dr. Cate, leading authority on nutrition and human metabolism.

Oil chart by Dr. Crate

https://drcate.com/about-drcatecom/

Press Release- New Clinic on HHI

 http://savannahceo.com/news/2019/07/wellness-institute-celebrates-fifth-anniversary-second-location-high-level-certification-professional-staff/

https://www.savannahbusinessjournal.com/news-categories/hea/9332-july-19-wellness-institute-celebrates-fifth-anniversary-with-second-location,-high-level-of-certification-for-professional-staff.html

Qigong and Martial Arts Classes Starting in June

Qigong, qi gong, chi kung, or chi gung is a holistic system of coordinated body posture and movement, breathing, and meditation used for the purposes of health, spirituality, and martial arts training.  “Qi” meaning “vital energy” and “Gong” derived from the phrase Gong Fu, meaning "time and effort", hence the practice of Qigong is "time and effort improving our vital energy".  With roots in ancient Chinese medicine, philosophy, and martial arts dating back 400 years, qigong is traditionally viewed as a practice to cultivate and balance qi (chi). The Qigong offered is from "The Stillness Movement Lineage"; what separates this from others is the use of "Intent, a manifestation that occurs utilizing energy." It is a high-level discipline effecting body, mind, spirit and destiny.

What does it entail?

Qigong sessions, similarly, to other disciplines like Tai Chi, incorporate a wide range of physical movements, including slow, meditative, flowing, dance-like motions.  Martial Arts Qigong is used to increase strength, flexibility and balance by bringing qi into the muscles, bones and tendons through specifically designed routines. Qigong incorporates movement practice and hands-on therapy.

Martial Arts Qigong—specifically the Ryukyu Kempo—has its roots in Okinawa and Chinese Kempo (Kempo meaning "Fist Way").  The many hand techniques and the movements patterns taught will show the diligent student the precise angle and direction to disable an attacker, regardless of size or strength.  This system also utilizes the energy channels to short circuit the opponents energy including rendering them unconscious. Small Circle Jujitsu utilizes small joint locks, e.g. finger lock, which are banned in Mixed Martial Arts competition because of their effectiveness.

Qigong and Pain

Clinical Qigong techniques were all derived and proven in the Qigong Hospitals in China.  Qigong is used by integrative medicine practitioners to complement conventional medical treatment due to its safety and effectiveness. Integrative medicine blends conventional and complementary medicines/ therapies with the aim of using the most appropriate of either or both modalities to care for the patient as a whole".  By regularly practicing Qigong, one can calm the mind and emotions decreasing stress thereby allowing the body to function better. The use of this holistic practice has been reported in the literature to provide benefit to many medical conditions including chronic pain and disease.  

Why us?

The Wellness Institute strives to offer healthy lifestyle options to our clients.  We feel that this philosophy ensures quality of life, improved energy and aiding the body’s natural defenses.  Qigong fulfills this mission.  Due to this holistic approach to health, Brion Beller has teamed up is the Wellness Institute.  Brion is a graduate of Michael Lomax's Institute of Chinese Energy Healing Certification Program as a Master Instructor of Qigong Classes and Advanced Clinical Qigong Therapy. Brion is a 7th Dan Black Belt Grandmaster with over 40-years’ experience in Martial Arts.  He is certified through the National Qigong Association as a Level III Advanced Instructor and Level III advanced Clinical Practitioner and has clients around the world that utilize his Energy Healing skills. His skillset includes Okinawan Ryukyu Kempo, Small Circle Jujitsu and Hawaiian Kempo.

Classes Offered

·   Qigong Group class for improvement of vital energy…                                   $60pm

·   Clinical Qigong: one on one with pain reduction guaranteed or money back…    $75 per session

·   Small group Martial Arts Classes - Ryukyu Kempo and Small Circle Jujitsu …        $95pm

Starting June 3rd 2019

Mondays & Wednesdays: Qigong 6:00pm Small Group Martial Arts at 7:30pm

Our therapists have impressive credentials

Therapists at the Wellness Institute are among the most highly trained in the Lowcountry.  The team has an unmatched skill set that places them above what is available in the local market. Training to the fellowship level requires postdoctoral professional, one-on-one training under the direct supervision of leaders in the field of that specialty. It is intense and the qualification is held by less than 2 percent of practicing therapists.

Check out these impressive credentials…..

 Dr. Craig Weyer

• Fellowship trained in Manual Therapy

• Doctorate in Physical Therapy

• Certified Orthopedic Manual Therapist (Australian Maitland Method)

• Diploma in Osteopractic Manipulation

• Certified in Dry Needling

• Certified in Spine Manipulative Therapy

• Certified Athletic Trainer

Dr. Lauren Lee

• Fellowship trained in Manual Therapy

• Doctorate in Physical Therapy

• Diploma in Osteopractic Manipulation

• Certified in Dry Needling, Spine Manipulative Therapy and Manual Therapy

Dr. Andrea Schultz

• Board-Certified Clinical Specialist in Women's Health Physical Therapy

• Doctorate in Physical Therapy

• Sits on national board, CAPP-Pelvic Committee

• Certified in Dry Needling

Dr. Wade Welsh

• Fellowship trained in Manual Therapy

• Doctorate in Physical Therapy

• Orthopedic Clinical Specialist

• Diploma in Osteopractic Manipulation

• Certified in Dry Needling

• Certified in Spine Manipulative Therapy 

• Certified in Manual Therapy

• LSVT Big Parkinson’s Certified

Ginger as a safe herbal supplement for nausea and vomiting of pregnant women (NVP)

by Jamie Duran

Nausea and vomiting of pregnancy (NVP) is an unfortunate symptom that many expecting mothers experience, with 75% of pregnant women affected from these symptoms (Herrell, 2014). People tend to call this “morning sickness,” however, only about 1.8% of expecting mothers report that these symptoms only occur in the morning (Herrell, 2014). If a non-pregnant individual had such symptoms they could easily take medication to help relieve symptoms, however most pregnant women just have to suffer through them. It is not advised for pregnant women to take certain medications due to the harm that it may cause to herself and the developing baby. Ginger, also known as Zingiber officinale or Zanjabeel, is a very common herbal supplement used as a treatment for conditions such as motion sickness, nausea, and vomiting (White, 2007). Ginger is a reasonably safe alternative to any other pharmaceutical drug for pregnant women with pregnancy-induced nausea (White, 2007). It is a common, natural remedy that has been consumed for years and is known to help with an upset stomach. Natural remedies such as ginger are commonly utilized due to their safety, ability, and infrequent adverse health effects (White, 2007).

There are various pharmacologic and non-pharmacologic treatments used for NVP; however, some lack evidence of safety and benefit (Herrell, 2014). Expecting mothers are advised to seek treatments that pose little to no threat while treating NVP symptoms. Due to ethical challenges, research on drug therapy for pregnant women is very limited (Matsui, 2015).

Ginger is a plant member of the cardamom and turmeric family (White, 2007). It is typically used for culinary purposes as a spice to flavor food.  Bradley (1990) reports, “Zanjabeel is on the U.S. Food and Drug Administration’s GRAS (generally recognized as safe) list and the British Herbal Compendium documents no adverse effects”. Zanjabeel is considered a safe alternative to certain medications and has a variety of benefits. Sasidharan and Nirmala (2010) notes, “More than three quarters of the world population rely on plants and plant products for health care”. Natural remedies like ginger have been used all over the world for countless years, exemplifying safety and effectiveness.

            Ginger contains antiemetic properties, but the exact mechanism of action is uncertain (White, 2007). An antiemetic drug is a drug that prevents or treats vomiting. Although the process is unclear, it is assumed that ginger inhibits serotonin receptors and exerts antiemetic effects (White, 2007). The antiemetic effects happen at the level of the digestive system and in the central nervous system (White, 2007). Ginger contains Shogaol and Gingtol, which have local effects on the digestive system (Ozgoli, Goli, & Simbar, 2009).

Nausea and vomiting symptoms are unpleasant side effects of some pregnancies. Finding treatment could be frightening especially when the potential for adverse side effects exist. Ginger is a natural remedy suitable for pregnancy that is safe with little to no side effects. Health professionals should educate women who are or want to become pregnant about the benefits of using ginger for NVP.

References

Bradley P. British Herbal Compendium. Bournemouth. British Herbal Medical Association., 1990.

Herrell, H. E. (2014). Nausea and vomiting of pregnancy. American Family Physician, 89(12), 965-970.

Ozgoli, G., Goli, M., & Simbar, M. (2009). Effects of ginger capsules on pregnancy, nausea, and vomiting. Journal Of Alternative And Complementary Medicine, 15(3), 243-246. doi:10.1089/acm.2008.0406

Sasidharan I, Nirmala MA. Comparative Chemical Composition and Antimicrobial Activity of Fresh and Dry Ginger Oils (Zingiber officinale). International Journal of Current Pharmaceutical Research, 2010; 2: 40-43.

White, B. (2007). Ginger: an overview. American Family Physician, 75(11), 1689-1691.

Proper form in everyday movements

Proper form while working out is crucial in order to prevent injury. If someone needs help with proper exercise form there is plenty of help out there to make sure you are doing it correctly (personal trainers, gym employees, and machine diagrams). As this is helpful and important to know for injury prevention while exercising, many people injure themselves in their normal everyday lives. Just as it is important to practice proper form while exercising is it important to know and practice good form in our daily movements. Practicing proper form will help prevent injury and slow down the aging process that causes our aches and pains.

Here are some examples:

Entering your Car:

Turn your back toward the seat keeping your legs together, then sit in the seat.  While keeping the legs together bring your legs into the car. Do the same as you step out, bring both legs out first and then stand up.

Swinging your legs separately, as we tend to do could throw the sacroiliac joint (SI joint) out of position, which can lead to back issues.

Reaching:

When reaching, take a step with the reach to create an energy transfer when grabbing an object. This will take the stress of holding the object off of your back.

When reaching for a high object step into the reach.

When reaching for a low object step into the reach while keeping a flat back and bend the knees.

Rotating laundry:

Keep a flat back and bend at the knee like a squat. Keep the squat position the entire time you are grabbing laundry in order to keep your back safe. If your legs get tired stand up straight to take a break.  

 Picking up heavy objects (laundry basket):

Use your legs to squat down to the object while keeping a flat back and tight core. Stand up using your legs while keeping the object close to your body.

Keep the object close to your body while carrying.  

Sitting: Sit up tall with shoulders back, head straight while keeping a tight core and an even distribution of weight on the legs. Try not to cross your legs as this may throw off the SI joint. Sitting up straight will help prevent injury and take stress off the spine.

Standing up:

Scoot to the edge of the chair; bring your feet back towards the chair and hinge at the hips to lean forward. Once you lean enough where your bottom starts to come off the chair, stand up.

Getting out of bed:

Starting on your back, roll to your side, use both hands to push upper body up, then bring both legs off the bed until you are in a sitting position then carefully step off of the bed. Sweeping (vacuuming, moping):

Keep a flat back and soft knees, step with the broom. Use slow longer sweeps not short fast motions.

 Tips:

Always keep a flat back

Use your legs to pick up low objects

Do not use jerking motions

Keep your core tight

Take your time

Think before you move

Exercises to improves these movements:

Bridges

Sit to stands

Squats

Rethinking treatment for low back pain

See what the reports are about Back Pain

https://abc30.com/health/health-watch-rethinking-treatment-for-low-back-pain/4537531/

By Margot Kim

Monday, October 22, 2018 05:39PM

Two studies out of the University of Washington say seeing a doctor may not be the best first option for low back pain. Both studies show that decreased activity, opioids, and surgery don't work for most patients. Here's what these experts suggest instead.

Bianca Frogner, PhD, a Director at Center for Health Workforce Studies and Associate Professor in the Department of Family Medicine at University of Washington was moving boxes into this new house, when she said, "My legs just kind of buckled out from under me, and I just felt this excruciating pain going from my back down to my legs."

Her team had analyzed 150,000 insurance claims and found that patients who saw a physical therapist first for low back pain lowered their probability of getting opioids prescribed by 89 percent, advanced imaging by 28 percent, and an emergency room visit by 15 percent.

Professor Frogner told Ivanhoe, "A physical therapist is telling you to move your body in certain ways, and it seems almost too easy that the only thing you need to do is stretch."

Physical therapy worked for her, without drugs or a doctor.

Pain management specialist Judith A. Turner, Ph.D., a Professor at University of Washington School of Medicine and President at International Association of the Study of Pain reviewed many studies and found that surgery is not indicated for most low back pain problems.

"All too often, people get the advice to stop everything that they're doing, rest, take some opioid medication. And, we know now that's the wrong treatment," explained Professor Turner.

Instead, she found most people responded better to exercise and cognitive behavior therapy like relaxation and pain-coping skills that train the brain to respond differently. Professor Frogner said insurance coverage often dictates what treatment people receive for pain.

She also stated, "I think there just needs to be more studies to understand whether we're really incentivizing patients to see the best provider for the kind of care they need."

Professor Frogner said people in all 50 states have the right to see a physical therapist without a doctor referral but their insurance policy may require doctor referrals. Many patients don't take advantage of this because their insurance copays may be higher for a physical therapist than for a doctor.

Contributors to this news report include: Jennifer Winter, Field Producer, Roque Correa, Editor and Rusty Reed, Photographer.

Meet Our Massage Therapists

Call us to find out about our Introductory Massage Discounts

Welcome John Perez:

John Perez was first introduced to massage therapy as a client while on a golf trip to Las Vegs. He studied massage therapy in Maumee, Ohio at Stautzenberger College. Upon graduating he worked in a chiropractic office from 2007 to 2010 in the Toledo, Ohio area, where he performed Myofascial Release work on clients prior to their Chiropractic adjustments. For the next 6 years, he worked at the Wellness Center in Findlay, Ohio with an instructor with the Freedom from Pain Institute. John further continued his education and studied Myoskeletal Alignment Therapy under Dr. Eric Dalton who developed this therapy treatment method. Now here at The Wellness Institute and their team of Physical Therapists and specialists he joins them and brings his knowledge and experience. John is Certified with the Titleist Performance Institute from Oceanside, California. This certification allows him to screen and evaluate the clients posture and movement patterns and restrictions. TPI golf screening is very useful in pin-pointing the mobility restrictions that inhibit a golfer from achieving their full playing potential. Once the movement restrictions are uncovered John is able to improve the muscle imbalances allowing for a more efficient golf swing. Additionally, he is a Certified Myoskeletal Alignment Therapist which also provides relief from pain and discomfort. John has also continued his education in the fields of Sports Massage, Medical Cupping, Traction work with Inversion table, Kinesio/Rock taping, Instrument Assisted Soft Tissue Mobilization (IASTM), Myofascial Release Techniques, and Full Body Golf/Sports Stretching. This additional training has increased his knowledge and ability within the Advanced Massage Therapy and Bodywork fields and has enabled him to work with clients and athletes at all levels. He is ready to treat clients here at the Wellness Institute.

Cathy Lortie:

Cathy holds a Bachelor’s Degree in Interdisciplinary Studies / Cultural Studies. She holds two basic teacher’s certifications and an advanced certification in yoga. She is also a graduate of the Technical College of the Lowcountry Massage Therapy program, and is licensed by the state of South Carolina. She received training in Swedish, Deep Tissue, Pre-Natal and Sports Massage.  Cathy has been with the Wellness Institute for 4 years and teaches Yoga classes as well as being a Massage Therapist.

Posture

by Jamie Duran

Throughout our lives we have always heard commands like “Stand up straight!”  “Act like a book is on your head!” “Suck your belly in!”  

As time goes on, and your mother is not there to remind you, our good posture is easily forgotten. We tend to sink into a more “comfortable” slouched position when standing, sitting, walking, driving, etc. This “comfortable” position may give us a temporary relief but it brings a high risk of pain and injuries. A forward head position causing a change in the gentle curve of the neck causing a pinch in the mid cervical spine.  Over time this can cause a pinched nerve and radiating pain into the arm! The risk costs way more than temporary comfort especially because it can be easily prevented with a few simple exercises.  

Studies have identified impaired activation of the deep cervical flexor muscles, the longus colli and longus capitis, in people with neck pain. It has been shown that retraining these deep cervical muscles will decrease neck symptoms and increase the stability of the cervical spine improving the ability to maintain a balanced, pain free posture of the cervical spine. (Falla, D., Jull, G., Russell, T., Vicenzino, B., & Hodges, P. 2007).

Correct posture is extremely important for a pain free lifestyle. Good posture will help reverse current or future injuries and reduce neck pain. Implementing postural stretches and exercises into your everyday routine will aid in prevention for any new pain and injuries.

It’s easy! Add these simple exercises into your daily routine (even 5 minutes a day) and be mindful of good posture in your everyday life.

Practice sitting up straight! Stay mindful about your sitting posture, Chest up, belly in, shoulders back, and chin back. Try not to sit for extended periods of time, even just standing up and walking around for a few seconds will make a big difference. Set an alarm to remind you to sit up straight and to get up and walk around. 

Chin tucks will help strengthen your cervical postural muscles and prevent a “forward leaning head” doing 3 sets of 10 tucks a day takes no time and will help tremendously.

Upper trap and levator stretches can be preformed throughout the whole day. Not only do they feel amazing but also help loosen up those stiff muscles from bad posture.

Rows, extensions and scapular retractions, these three exercises are key to keeping your posture strong. Keeping your postural muscles strong will make standing up straight easier and you will be able to think about it less because your body will naturally pull you upright. Adding a resistance band it optimal but not necessary, just make sure you SQUEEZE! Preform 3 sets 10 for best results.

Standing pelvic tilts will not only help engage our core when we stand but also keep you mindful of good lumbar posture as well. We tend to stick our bottoms out when we stand up straight for good posture, however it is necessary to keep a neutral spine, and practicing these tucks will give us the correct posture we need. 

Doorway or pec stretch is important especially in today’s technology driven world (phone and computer use). Our chest is in a constant caved position in turn will shorten these muscles and make it harder to stand and sit correctly. Using any doorway, place your arms on either side at a 90-degree angle and step into the stretch. You should feel a nice comfortable stretch along your chest and shoulders. Pop into any door you see throughout your day and aim for 60 seconds comfortable stretch.  

Sources:

Falla, D., Jull, G., Russell, T., Vicenzino, B., & Hodges, P. (2007). Effect of Neck Exercise on Sitting Posture in Patients With Chronic Neck Pain. Physical Therapy,87(4), 408-417. doi:10.2522/ptj.20060009

Dr. Craig weyer presents at sun city hilton head island

Wellness Institute Managing Partner Craig Weyer, PT, DPT, M.ED, ATC, COMPT,  recently gave his second presentation at Sun City Hilton Head about Posture: A Real Pain in the Neck.  

The lecture covered the importance of maintaining good posture, osteoarthritis and the associated mechanisms that cause pain. He discussed proactive steps to improve this painful, limiting condition.

We'd like to say "thank you" to Cherie Bronsky and the Sun City Hilton Head Community Association for organizing the free presentation for residents. It was a great turnout, and we hope that the material was useful to all in attendance. 

Dr. Weyer is available to speak to a variety of organizations. Please contact the Wellness Institute at 843-547-4058 for more information. 

Congratulations to Andrea Schultz on her Board Certification!

Andrea Schultz, PT, DPT, has become the first Board-Certified Clinical Specialist in Women’s Health Physical Therapy (WCS) in the low country.  She has also added a Certification in Dry Needling to her repertoire, allowing her to expand her treatment intervention options for both pelvic and orthopedic conditions.  Our pelvic and pregnancy programs continue to grow under her leadership.  Congratulations!!

Meet Our Massage Therapists

Call us to find out about our Introductory Massage Discounts

Welcome John Perez:

John Perez was first introduced to massage therapy as a client while on a golf trip to Las Vegs. He studied massage therapy in Maumee, Ohio at Stautzenberger College. Upon graduating he worked in a chiropractic office from 2007 to 2010 in the Toledo, Ohio area, where he performed Myofascial Release work on clients prior to their Chiropractic adjustments. For the next 6 years, he worked at the Wellness Center in Findlay, Ohio with an instructor with the Freedom from Pain Institute. John further continued his education and studied Myoskeletal Alignment Therapy under Dr. Eric Dalton who developed this therapy treatment method. Now here at The Wellness Institute and their team of Physical Therapists and specialists he joins them and brings his knowledge and experience. John is Certified with the Titleist Performance Institute from Oceanside, California. This certification allows him to screen and evaluate the clients posture and movement patterns and restrictions. TPI golf screening is very useful in pin-pointing the mobility restrictions that inhibit a golfer from achieving their full playing potential. Once the movement restrictions are uncovered John is able to improve the muscle imbalances allowing for a more efficient golf swing. Additionally, he is a Certified Myoskeletal Alignment Therapist which also provides relief from pain and discomfort. John has also continued his education in the fields of Sports Massage, Medical Cupping, Traction work with Inversion table, Kinesio/Rock taping, Instrument Assisted Soft Tissue Mobilization (IASTM), Myofascial Release Techniques, and Full Body Golf/Sports Stretching. This additional training has increased his knowledge and ability within the Advanced Massage Therapy and Bodywork fields and has enabled him to work with clients and athletes at all levels. He is ready to treat clients here at the Wellness Institute.

Cathy Lortie:

Cathy holds a Bachelor’s Degree in Interdisciplinary Studies / Cultural Studies. She holds two basic teacher’s certifications and an advanced certification in yoga. She is also a graduate of the Technical College of the Lowcountry Massage Therapy program, and is licensed by the state of South Carolina. She received training in Swedish, Deep Tissue, Pre-Natal and Sports Massage.  Cathy has been with the Wellness Institute for 4 years and teaches Yoga classes as well as being a Massage Therapist.

Arthroscopic Surgery for Meniscal Tears May Be Unnecessary in Many Cases

Could one of the most popular surgical procedures in the United States be unnecessary many of the approximately 700,000 times it is performed each year?

A study published in the New England Journal of Medicine suggests that might be the case for arthroscopic surgery to repair a torn meniscus—particularly if the tear is a result of wear and aging, as opposed to a traumatic event.

As the New York Times reported ("Common Knee Surgery Does Very Little for Some, Study Suggests" - December 25, 2013), a Finnish study of 146 patients between the ages of 35 and 65 found that those who had arthroscopic surgery had no better level of satisfaction 1 year later than had others in the study who had undergone a mock surgical procedure.

"Those who do research have been gradually showing that this popular operation is not of very much value," Dr David Felson told the Times.

Check out our group training classes!

If you're looking to get in shape, lose weight, or improve your fitness, then try our group training classes at the Wellness Institute. Check out our video to learn more...

Therapist specializes in urinary urge and stress incontinence

Andrea Schultz is the only board certified Women's Health specialist in the Low Country which qualifies her to treat men and women with Pelvic Health issues. Our full pelvic rehab program will continue to include treatment for all pelvic diagnosis as before including: pelvic pain, constipation, fecal incontinence, lumbosacral and coccyx pain among many others.

We are excited about the expansion of our pelvic rehab team as it will improve scheduling options for our patients, and thus speed their recovery.