Do your homework!

Have you ever been to physical therapy? Are you thinking about it? Maybe you’re seeing a physical therapist right now. Whatever the case may be, there is likely one request from your therapist or therapist assistant: Please, do your homework! Your home exercise program, that is. Home exercise programs (HEPs) are extremely important to success in physical therapy, especially if you have been diagnosed with knee Osteoarthritis (OA) by your physician. This has been proven true by several different studies, and one giant study that included more than 4,000 patients with knee OA. What exactly is “success”? That giant study found that patients with knee OA who completed home exercises independently had very similar reductions in pain and improvements in function as those who completed exercises with a licensed rehabilitation professional. What does that mean for you? It means that if you and your doctor are not ready for a knee replacement, one visit to a physical therapist for an exam and personalized exercise program has the potential to significantly improve your symptoms. It also means that the “A” word (arthritis) doesn’t have to be so scary!

So, maybe you’ve tried a HEP, but you and your doctor have decided that it is time for a knee or hip replacement. There’s still good news! If you’ve already seen a therapist once or twice, you’ve likely already learned exercises following surgery, how to use a walker, and what to expect following your procedure. It’s a win-win! If that isn’t convincing enough, consider this: Another big study of more than 4,500 patients with knee and/or hip replacements showed that there is a 29% reduction in the number of visits to a surgeon/doctor/therapist after surgery simply if those people saw a physical therapist one time prior to their surgery. That translated to approximately $1,200 in savings!

To summarize, if you have been diagnosed with arthritis in the hip or knee by your physician, ask her or him whether physical therapy would be beneficial. If you’re already seeing a therapist, make sure you do your homework!

-Edwin Porras, SPT

Works Cited
1. Anwer S, Alghadir A, Brismée J-M. Effect of Home Exercise Program in Patients With Knee Osteoarthritis. Journal of Geriatric Physical Therapy. 2016;39(1):38-48. doi:10.1519/jpt.0000000000000045.
2. Warsi A, Lavalley MP, Wang PS, Avorn J, Solomon DH. Arthritis self-management education programs: A meta-analysis of the effect on pain and disability. Arthritis & Rheumatism. 2003;48(8):2207-2213. doi:10.1002/art.11210.
3. Preoperative Physical Therapy Results in ‘Significant’ Reduction in Postoperative Care Use for Patients Undergoing Hip or Knee Replacement. APTA. http://www.apta.org/PTinMotion/News/2014/10/2/PreOperativePT/. Accessed December 11, 2018.

Pelvic Organ Prolapse: When It All Falls Down

By Chelsea Lynch, PT, DPT

If you’ve had a child, there is a 50% chance that you are experiencing pelvic organ prolapse (POP). POP is the descent of the vaginal wall and is often described as a feeling of heaviness or pressure in the pelvis. Some women describe the feeling of “everything falling out.” Incontinence, difficulty emptying the bladder and bowel, and discomfort during intercourse can be associated with POP. POP is an extremely common condition that should not be a source of shame or embarrassment.

POP is caused by weakening of the connective tissues that hold the pelvic organs in place. Women who have had multiple vaginally deliveries, are obese, or have chronic cough or constipation are more likely to have pelvic organ prolapse. If you look at the opening of the vagina, you may see what looks like a bubble of pink gum. It is often thought that this is the bladder falling out but it is actually the vaginal tissue being pushed downwards.

Many women rush to the surgeon when they see this “pink balloon” but this should not be the first step. A pelvic physical therapist can help you strengthen the muscles that support your organs to reduce POP. There are additional interventions such as pessaries (an internal support device) or external support garments that can also play a role in reducing symptoms.

If you feel like you may be experiencing POP, contact your provider to get a referral to physical therapy to begin treatment. POP is not “just a normal part of aging.” Take charge of your health and address your POP today.