We will remain opened for you our patients

Pro Motion Rehab continues to be here for you during this time that affects all of us in our world today. We understand that you are still in need of Physical and Occupational Therapy and the services that we offer. So, we have decided to remain here for you under normal business hours.

We have protocols in place for cleaning our surfaces, equipment, linens, and hands before and after we treat you.  As always we thank you for trusting us with your safety and will continue to be a provider who cares for our community.

To ensure we all stay safe and healthy, if you have any symptoms shown on this graphic, or have come in contact with anyone who has these symptoms. Please self-isolate yourself for the recommended time. We will reschedule your appointment.

From the Pro Motion Rehab Team
828-837-0400

Who are we?

Pro Motion Rehab Inc. is located in Murphy, NC and was established in December 2006. We are a family-owned and therapist operated facility, using state of the art equipment providing individualized attention. We specialize in neck, back, knee, hip & shoulder therapies. Our patient-centered approach combines the unique power of  Physical, Occupational and Massage Therapies.

Physical Therapy Relieves pain by using specialized forms of the below-mentioned therapies and Teaches you how to manage and take control of your pain or problem through education, instruction, and self-care.  Physical Therapy creates strength through safe, sound and specialized exercises under the supervision of your therapist, and Promotes free motion in the joints through exercises and mobilization. It Improves athletic performance by using superior training techniques and equipment to increase your speed, strength, and agility. It also makes you feel better by stimulating endorphin and serotonin release and enhancing self-confidence.

Physical Therapists … typically go to school for 6-8 years consisting of college, graduate, professional, and doctoral training. A state board license is required before entering into practice.

Are You a Candidate? Seek our Therapy services immediately if you suffer from:

1.    Parkinson’s Disease

2.    Stroke

3.    TMJ

2.   Arthritis

3.   Back Problems / Pain

4.   Carpal Tunnel Syndrome

5.   Dizziness

6.   Fibromyalgia

7.   Migraine Headaches

8.   Work or Auto Injury

9.   Sports Injury

10. Shoulder Pain or Problems

11. Knee Osteoarthritis

12.  Weakness or Fatigue

13.  Elbow / Wrist / Hand Pain

14.  Neck Pain

15.  Knee or Hip Pain

16.  Ankle Pain / Injury

17.  Decreased or Limited Endurance

18.  Balance Problems or Vertigo

19.  Limited Movement

20. Had a recent joint replacement, arthroscopic surgery, or procedure that limits your function.

Some of our therapies include: Orthopedic Rehab, LSVT Big and Loud utilizing our Solo Step Track System for Parkinson’s Disease, Cold Laser, E-Stim, ATM2, Biodex Isokinetic, and Balance System, Anodyne, Decompression, Spider Taping, Manual Therapy and so much more … which assists your own body’s healing power. We provide Don Joy Braces for patients with a specific need.

If you have exhausted your medical benefits for Physical Therapy or you are ready to follow your own exercise program, but would like a little help in pain management, strengthening and maintaining your physical health  following your therapy, we have a supervised gym program called the 30/30/40. You can exercise independently for 30 minutes utilizing our facility and equipment and we will render appropriate modalities for up to 30 minutes, all for only $40.00.

If however, you are interested in a self-pay Physical Therapy program with one of our highly trained and licensed therapists, overseeing your entire program, you have the option to pay a reduced community service rate that does not get billed to your insurance plan.

More information about our services can be found by visiting our website at ProMotionRehab.com You will love the results you get from the treatments provided by our caring staff of professionals. If you have any questions, please call during our regular business hours and one of our courteous staff will do their best to find an answer. We sincerely appreciate any comments or suggestions you may have to offer that will enhance our services.

 It is our goal to provide the highest level of care as we strive to meet your therapy needs.

Pro Motion Rehab Inc.

Physical, Occupational and Massage Therapies

2810 W. US Hwy 64 Suite 1

Murphy, NC 28906

828-837-0400

Fax 828-837-0404

http://www.promotionrehab.com

June 2020 Newsletter

ALL OUR PAST NEWSLETTERS 
https://www.smore.com/u/promotionrehab

Peripheral Neuropathy

Research has shown that strengthening exercises for peripheral neuropathy moderately improve muscle strength in people with PN.

In addition, exercises to help peripheral neuropathy, when done regularly, may reduce neuropathic pain and can help control blood sugar levels.

A comprehensive physical activity routine includes four kinds of activities:

• Aerobic Exercise
• Flexibility Exercise
• Strength Training Exercise
• Balance Exercise

Refer to a physical or occupational therapist, regarding an exercise program that’s right for you.

Physical Therapy may be helpful in maintaining strength, mobility, and function regardless of the underlying cause of Peripheral Neuropathy (PN). Patients with diabetic neuropathy may also benefit from physical therapy, however, diabetic neuropathy patients must also tightly control their blood sugar levels to prevent major fluctuations. The objectives of physical therapy include: Maintaining and improving functions via a range of motion – a passive range of motion exercises consist of progressive stretching and self-stretches Strengthening muscles – this includes exercising against increasing resistance, use of weights, and isometric exercise Balance training provides stability and prevents falls Physical therapists can also recommend braces and/or splints to enhance balance and posture Splinting is often used in the treatment of compression mononeuropathies, such as carpal tunnel syndrome

Occupational therapy is instrumental in helping a patient cope with the functional, vocational, and social impact of peripheral neuropathy by:

Improving sensory-motor skills
Teaching the patient to avoid exposure to environmental or industrial toxins
Teaching self-care activities
Teaching the patient safety issues, (e.g., paying more attention to the terrain when walking since falling or tripping may pose a risk for patients with PN)
Teaching the patient to pay attention to issues which involve automatic functions (e.g., learning how to change positions smoothly to avoid a sudden drop in blood pressure and the risk of falling)

Aerobic Exercise
Increases your heart rate, works your muscles and raises your breathing rate. For most people, it’s best to aim for a total of about 30 minutes a day, between 3-5 days a week. If you haven’t been very active recently, you can start out with 5 or 10 minutes a day and work up to more time each week. Or split up your activity for the day — try a 10-minute walk after each meal.

Here are some examples of aerobic exercise:

• Take a brisk walk (outside or inside on a treadmill)
• Take a low-impact aerobics class
• Swim or do water aerobic exercises
• Stationary bicycle indoors

Flexibility exercises also called stretching, help keep your joints flexible and reduce your chances of injury during other activities. Gentle stretching for 5 to 10 minutes helps your body warm-up and get ready for aerobic activities such as walking or swimming.  Here are some flexibility exercises you can do at home.

Calf Stretch
Place one leg far behind you with the toe pointed slightly inward.  Take a large step forward with the opposite foot.  With the front knee slightly bent lean forward keeping your back heel on the floor.  You should feel a muscle stretch in the calf of your back leg.
Hold:  15-20 seconds on each leg
Repeat:    3 repetitions each leg/2 times a day.

Seated Hamstring Stretch
Sitting on the front half of a firm chair, place one leg out straight with the foot pointing up.  Bend the opposite knee so that your foot is flat on the floor.  Center your chest over the straight leg, and slowly straighten your back until you feel a muscle stretch in the back of your leg.
Hold:  15-20 seconds on each leg
Repeat:    3 repetitions each leg/ 2 times a day.

Plantar fascia Stretch
While facing a door frame, place your heel as close to the door frame as possible.  Slowly lean forward, allowing your heel to slide back as your toes extend upward. To increase the stretch, bend the front knee toward the door frame.  You should feel a muscle stretch in the bottom of your foot and along your heel cord.
Hold:  15-20 seconds
Repeat 3 repetitions each leg/2 times a day.

Strength training exercises help to make the muscles stronger and more injury resistant. It can help you regain lost strength in your muscles through constant training routines. Here are some strength training exercises you can do at home.

Kitchen Counter Calf Raises
While standing at the kitchen counter, place two fingertips on the counter. Stand on one foot lifting the other heel off the floor, standing on your toes (as you strengthen your muscles, try to alternate your heels as shown in the picture below).  Slowly lower yourself to the floor and repeat.  Once you are on your toes control your lowering Do not just drop down to the floor.
Repeat:    10-15 times
2 repetitions on each leg /2 times a day.

Chair Squat
Using a firm chair with armrests, position your feet in a split stance with one foot at the base of the chair and the other foot placed comfortably in front and slightly out to the side.  Slowly transfer your weight forward until your legs are supporting your body weight.  Slowly press up with your legs to standing.  To lower yourself, slowly reach for the chair with your hips.  Touch the chair with your hips and press back up for your next repetition.  Do not “plop” in chair or rest in between repetitions.
Repeat: 10 -15 times
2 Repetitions/2 times a day.

Seated Dorsiflexion
While seating on the front half of a chair place both feet flat on the floor.  Gradually pull the toes and ankle up as high as you can.  Slowly let them down. To make this exercise more challenging position your feet closer to your body.
Repeat:    10-15 times
3 repetitions/2 times a day.

Balance
Keeping your balance system healthy is especially important if you have problems due to illness, such as joint pain, weakness or dizziness. Balance training can help you get back to normal, and overcome feelings of stiffness or unsteadiness. Balance, in particular, is emerging as an important element for the elderly. Older muscles are smaller and slower and respond less efficiently when you need to brace yourselves, making you more vulnerable to falls.

Kitchen Counter Calf Raises
While standing at the kitchen counter, place two fingertips on the counter. Stand on one foot lifting the other heel off the floor, standing on your toes (as you strengthen your muscles, try to alternate your heels as shown in the picture below).  Slowly lower yourself to the floor and repeat.  Once you are on your toes control your lowering Do not just drop down to the floor.
Repeat:    10-15 times
2 repetitions on each leg /2 times a day.

Hip Flexion
Hold table or chair with one hand, then one fingertip, then no hands; then do exercise with eyes closed, if steady.  Stand straight: holding onto table or chair for balance. Slowly bend one knee toward chest, without bending waist or hips.  Hold the position for 5-10 seconds.  Slowly lower leg all the way down. Repeat with other leg.
Hold: 5-10 seconds
Repeat: 2 repetitions on each leg/2 times a day.

Hip Extension
Hold chair or table with one hand, then one fingertip, then no hands; then do exercise with eyes closed, if steady. Stand 12 to 18 inches from a chair or table. Bend at hips; hold onto chair or table. Slowly lift one leg straight backward. Hold the position for 5-10 sections. Slowly lower leg and repeat with other leg.
Hold: 5-10 seconds
Repeat: 2 repetitions on each leg /2 times a day

Side Leg Raise
Hold chair or table with one hand, then one fingertip, then no hands; then do exercise with eyes closed, if steady. Stand straight, directly behind chair or table, feet slightly apart.  Hold a chair or table for balance.  Slowly lift one leg to side, 6-12 inches.   Slowly lower leg and repeat with other leg. Your back and knees are straight throughout exercise.
Hold: 5-10 seconds
Repeat: 2 repetitions on each leg/2 times a day

Original Article
https://www.foundationforpn.org/living-well/lifestyle/exercise-and-physical-therapy/

Adhesive Capsulitis

The Role of Physical Therapy in Adhesive Capsulitis 

Adhesive capsulitis (frozen shoulder) occurs as the shoulder joint ligaments that hold the shoulder bones to each other become inflamed, prohibiting free movement from the shoulder joint. Risk factors often include a previous shoulder injury or surgery, open-heart surgery, hyperthyroidism, and diabetes in patients. Before a physician prescribes or refers to surgery, patients must often undergo months of nonsteroidal anti-inflammatory medications (NSAIDs) and steroid injections. Recent studies continue to point out the improvement given to patients who undergo physical therapy as part of their rehabilitation after surgery. Physical therapy could also benefit patients without the trauma of surgery.

STUDIES PROVE THE BENEFITS OF PHYSICAL THERAPY

Physical therapy, including joint mobilization, strengthening, and stretching exercises, improves outcomes for patients with adhesive capsulitis. Five studies recently reviewed showed an improvement in patient pain or functional outcomes. Two separate studies found that physical therapy improved shoulder motion and improved functional outcomes such as the patient rating of pain or disability.

The aim of the first study was to determine whether the addition of PT following joint distention improved shoulder ROM and function and to determine if PT is cost-effective. The 144 participants in the study received 6 weeks of treatment totaling 8 visits for 30 minutes each. The PT treatment goals were to improve the glenohumeral joint range of active and passive motion by stretching soft tissue structures around the joint, and to improve strength, particularly within the newly gained passive range; as well as to help patients regain proprioception and normal shoulder and trunk mechanics. The results showed the PT treatment group displayed significant improvements in shoulder motion at 6 and 12 weeks when compared to the control group who received a sham ultrasound.

Another study compared 119 adults (38 male; 81 female) with adhesive capsulitis, defined as shoulder pain and limitation of passive ROM in all directions that interfered with ADL. The aim of the study was to determine the effectiveness of PT in patients with adhesive capsulitis. Both the control group and the study participants were given Ibuprofen treatment consisting of 400mg 3x/day for 3 wks.

Physical therapy consisted of mobilization and passive joint stretching exercises to patient tolerance. The treatment group was also instructed to perform in-home exercise 4 days a week. These included pulley exercises (active-assisted) for 5 minutes and hot packs for 20 minutes followed by active non-assisted exercises using a towel and a wall for 5 minutes. The study results showed after 3 weeks the treatment group had significantly greater improvements in the abduction and internal rotation compared to the control group. In both studies, patients demonstrated dramatic improvement in a relatively short period of time.

A third study looked at the efficacy of an intra-articular steroid injection with physical therapy, alone and in combination, among patients with adhesive capsulitis who were also taught a home exercise program. Study participants received 4 weeks of treatment and were assessed at 3 months, 6 months, and 12 months after the treatment. The 93 adults were given steroid treatments consisting of 40mg Triamcinolone injected into the shoulder joint space under fluoroscopic guidance. The physical therapy treatment consisted of 12 one-hour sessions for 4 weeks (3 sessions/week).

The authors concluded that a corticosteroid injection combined with a home exercise program was effective in improving shoulder pain and disability in patients with adhesive capsulitis and that the addition of supervised PT to corticosteroid treatment provided faster improvements in ROM.

A PHYSICAL THERAPIST CAN HELP

Physical therapy continues to aid patient healing both after surgery and in other treatment plans which may ultimately prevent the need for surgery in the first place. Patients that require surgery are shown to dramatically improve through therapy. The therapist’s role is to reduce patient pain and increase functionality and healing. With quality therapy, patients will be on their way to recovery.

Pain Management without meds using Physical Therapy

PAIN MANAGEMENT WITHOUT MEDICATION USING PHYSICAL THERAPY

In recent years, a lot of emphases have been laid on the management of pain in patients. There are now specialist pain management teams who are experts in managing pain medically using a variety of drugs.

However, medical therapy is not the only avenue and physical therapy plays an important role in the rehabilitation and management of pain that accompanies various clinical conditions.

Let us take osteoarthritis for example. There is ample evidence suggesting the benefit of exercise therapy in managing pain in these patients.

In addition, they provide strengthening exercises that can increase muscle tone and strength, and can enhance patient mobility.

This begs the questions – what is it that physical therapists can offer?

There are a number of different treatment options that they can discuss with patients to manage pain, and these are listed below.

1. Passive physical therapy - This involves providing treatments without involving any exercise. Some of the treatments include ultrasound therapy, deep heat therapy, ice pack application and even TENS machine application. TENS has been found to be extremely useful in managing post operative pain and even pain secondary to dysmenorrhoea.

2. Active physical therapy - This includes hand-on treatment such as therapeutic exercises, massage therapy, traction treatments, and joint manipulation.

Therapeutic exercises have been defined as ‘bodily movement prescribed to correct an impairment, improve musculoskeletal function, or maintain a state of well-being’.5 It can include aquatic therapy that brings with it a reduced amount of stress on the joints due to buoyancy and therefore a greater ability to provide a range of movement exercises. Exercises are aimed at improving local blood circulation, increase joint mobility and reduce pain significantly. In the event that patients have too much pain, passive ROM exercises are useful to help reduce the pain that occurs due to muscle stiffness and joint contractures.

Massage therapy includes traction-based movement that stretches the muscles gently, thus maintaining their tone and reducing pain. There are a variety of massage therapies that are available, and discussing these in detail is out of the scope of this article. Traction therapy is similar to massage therapy and provides similar benefits.

Conclusion
There is no doubt that physical therapists provide invaluable input in managing pain in patients with a variety of clinical conditions. In working in close conjunction with physicians, they can ensure a great reduction in pain and a significant improvement in the quality of life.

What's your excuse!

We started a "WHAT'S YOUR EXCUSE?" to hear and see what your excuses are for not coming to Therapy during this time? lol Feel free to post your excuse and share it with us.

From your Pro Motion Rehab Team We are opened as an essential business and working to get you and keep you well :) 828-837-0400

Stop back to see more as we post them daily on our facebook page @
https://www.facebook.com/ProMotionRehab.828.837.0400

Community Outreach Lunch

Pro Motion Rehab, showed their appreciation by delivering a Homemade Spaghetti Lunch to many in our community. A special thank you goes out to ShoeBooties Restaurant and Linda Knowles for donating the dessert. We are a veteran owned local and essential business.

Our motto for all that choose us for their Physical, Occupational or Massage Therapy needs is to “Come as a patient, and leave as a friend” for more information call us @ 828-837-0400 or visit us on our web page @ https://www.promotionrehab.com

 Pro Motion Rehab Team, and Linda Knowles

 Randy is making the sauce

 Spaghetti Lunch to our local Police

  Spaghetti Lunch to our local Health Department

  Spaghetti Lunch to our Sheriff's Office

  Spaghetti Lunch to our local Fire Station

  Spaghetti Lunch to our local Dispatch 911 and Deputies

 Spaghetti Lunch to our local EMS

Thank you to all of you from Pro Motion Rehab for serving our community and keeping us safe!

God Bless and protection prayed over all of you.

Pain and Sleep

For a long time now, there has been the existence of a bidirectional relationship between sleep patterns and pain.

While it is clear that pain disturbs sleep, more research has been conducted on how a disturbed sleep pattern affects pain.

The relationship between sleep and pain is complex, primarily because pain is a state of hyper-vigilance, while sleep is one of hypo-vigilance. But disturbed sleep can in fact result in a higher pain perception and lower pain threshold.

In a detailed analysis, it was demonstrated that alterations in sleep patterns during different stages of the sleep cycle resulted in a trend for decreased pain thresholds. In particular, they demonstrated that recovery sleep following interrupted slow-wave sleep but not interrupted REM sleep resulted in a higher pain threshold.

Previous work has also shown an increased pain perception in healthy subjects who were deprived of stage 4 sleep (deep sleep or slow-wave sleep) when compared to those deprived of REM sleep

There are a number of clinical conditions causing pain that are associated with poor sleep patterns. Migraines, fibromyalgia, rheumatoid arthritis, and osteoarthritis are just a few. While there remain minor differences in the altered sleep patterns in these patients, it appears that the slow-wave sleep pattern is altered by an intrusive burst of alpha waves. This has been shown to bear a positive correlation to pain.

The exact pathophysiology behind this complex relationship between sleep and pain is still not clearly understood. As previously mentioned, it could be due to intrusive alpha waves during a restful slow-wave sleep or non REM sleep that could be a cause. Patients with pain experience longer periods of lighter sleep (stage 1 and 2) and very disturbed deeper sleep (stage 3 and 4).

In addition, there could be a complex interplay between various neuro-mediators that regulate sleep and pain. Patients may also be on pharmaceutical drugs that could further complicate the relationship.

An alteration in this complex relationship between pain and sleep patterns can be seen in other medical conditions too. Traumatic brain injury and burn injuries can result in reduced sleep and increased pain perception. Cognitive-behavioral therapy appears to play a role in treatment, and other treatments must be directed achieving a full undisturbed sleep cycle in patients suffering from pain. Pharmacological treatment such as non-steroidal anti-inflammatory drugs and opioids may be required to aid this.

Conclusion - 
From the brief discussion above, there appears to be a complex relationship between sleep and pain perception. There are insufficient studies to ascertain the exact relationship, and what therapeutic strategies may be adopted. Future work may reveal this hidden link in more detail.

Neck Pain and de Quervain’s Disease

Physical Therapy Management of Smartphone Induced Neck Pain and de Quervain’s Disease

The smartphone has no doubt been a tremendous technological advancement of the 21st century, but has unfortunately brought with it a number of health problems that have recently been recognized. The culture of spending hours on the phone texting, gaming and even browsing the internet has resulted in 'text neck’ and de Quervain’s disease. While it is understandably difficult to let go of these devices, in some cases symptoms can be severe enough to prevent patients from using the smartphone. Physical therapists are these days are more involved with patients who develop the symptoms and are able to offer safe and effective treatment.

Text neck and physical therapy

‘Text neck’ is a result of maintaining an abnormal posture while spending hours on the phone. These abnormal postures can include ones adopted when lying in bed and using the phone or and even sat for hours on the couch As a result, the muscles in the neck are constantly stretched and put under abnormal strain. Over time this can result in spasm of the neck muscles and cause pain.

Physical therapists identify this as a problem and can describe exercises that allow for loosening of the neck muscles and reduce pain. Treatments can vary from spinal mobilization to long courses of exercise therapy. Studies have shown that manual therapy involving spinal mobilization provides better short-term results while exercise therapy provides better long-term results.1 More focus treatments combining the two have shown significant benefits and improvements in pain, disability and patient-perceived recovery.2 Unfortunately, there do not appear to be any clinical trials that specifically address neck pain and its relationship to the use of the smartphone. The reports that have been published mostly relate to patient-reported symptoms rather than randomized controlled trials.

Physical therapy and de Quervain’s disease

In patients with de Quervain’s disease, physical therapists are able to offer a number of different treatment options. In most cases, the rest is advised to allow for the healing of the inflamed tendons. Sometimes, physical therapists who are trained in administering steroid injections may inject a dose of corticosteroids in the inflamed area. Topical steroids can also be used and can be encouraged to penetrate the joint and tissues using ultrasound or iontophoresis. This helps relieve pain significantly.

In addition to the above treatments, patients will also be offered different stretching exercises that help reduce the pain and stiffness in the wrist. These can include the wrist flexion and extension movements, radial deviation exercises and even stretching of the adductor muscles and the thumb. Application of a supportive thumb spica splint has also been found extremely useful.

In the early stages of de Quervain’s disease, physical therapists may use ice packs to reduce edema and inflammation. They may also collaborate with occupational therapists to enable patients to manage their activities of daily living when recovering at home.

Conclusion 
There is anecdotal evidence that excessive smartphone usage causes neck pain and de Quervain’s disease. Physical therapy is directed towards managing the symptoms and restoring mobility. It is essential that people who use their phones excessively be aware of these risks and always make sure they take rest in between.