With age comes wisdom. But, unfortunately, physical issues such as arthritis and decreased mobility also come as part of the aging package. If you've been afflicted by these types of discomforts, then listen up. More and more people are turning to physical therapy as an arthritis treatment. And they swear by it.
Carolyn Anderson's arthritis had gotten so bad that she couldn't bend her left hand index and middle fingers enough to touch her thumb. She figured the joints had just worn out with age, and that's how they were going to stay.
Her condition made it difficult to play the organ at Trinity Episcopal Church services, where she'd played for nearly 40 years.
"It was getting increasingly difficult to do anything that involved my thumbs," she said. "I've been playing the piano since I was 4 years old, and over time the cartilage just wore out.
"Those fingers were like sticks. If I couldn't reach a note (on the organ) the way I used to, I'd figure out a different way of doing it."
But after two months of treatment with occupational therapist Rob Abney of Owensboro, Ky., Anderson regained the use of her fingers and is nearly pain-free.
At first, she went to three sessions a week, then "graduated" to two and is currently seeing him once every two weeks while also doing exercises at home.
"I never missed a Sunday of playing the organ, but I wore splints," Anderson said. "On Easter Sunday, I played without the splints. I couldn't believe it. I felt like I had a new pair of hands." Abney, and physical therapists, can help people regain mobility, whether it's in small joints like Anderson's, or in multiple areas for as something as complex as walking.Physical therapy aims to maintain, restore or improve function where disability is related to neuromusculoskeletal, pulmonary and cardiac systems. It includes stroke victims, injured athletes, children with cerebral palsy or muscular dystrophy, amputees, those with spinal cord injuries or burns, arthritics, and those who experience pain in joints and muscles. A physical therapist assesses the degree of physical impairment, interprets the results and implements therapeutic programs, working in conjunction with a physician. Therapeutic procedures include specific exercise programs to restore strength, coordination and mobility of muscles and improve endurance by building heart and lung capacity. Patients will typically have one-hour sessions with physical therapists, then be assigned activities to be performed several times daily by the patient at home. "When Rob manipulated my hands he'd say, 'I can feel it's getting better,' but I couldn't tell a difference," Anderson said. "He'd use paraffin therapy and ultrasound to clear up inflammation. But then the last week, it's been like a miracle. I never thought my hands would be back to the shape they're in.
"All that therapy together helped my mobility. My thumbs are almost without pain." Abney said his practice, Hand Therapy, sees a lot of patients with osteoarthritis in the hands and knees. "We're coming up with some specialized equipment for both of those to reduce the load on the joint and gradually build it back up so they can tolerate that load again," Abney said. "For the knees, that means finding a way to reduce the load that you incur while walking, but at the same time, keeping a patient walking so that he can build the strength of the cartilage back up so the cartilage can do its job as a shock absorber." Abney said it takes about six weeks of therapy, two to three times a week, to see improvement. Home exercises or activities are crucial, Anderson said. Abney worked on Anderson's right hand three years ago, and now realizes how important exercises at home are. "I didn't follow through at home like I should've, but this time made a believer out of me," Anderson said. "I do everything at home he tells me to, because what he tells me works." Julie Ellis has had two knee replacements and two back surgeries and swears by physical therapy, even though the process can be painful. At one session following knee surgery, she sat upright on a bench with her leg dangling over the edge. One therapist held her thigh down while the other pushed the lower leg as far under the bench as possible to stretch the tissue.
"I had tears in my eyes," said Ellis, who works for Owensboro Public Schools. "But they're working to get your muscles back in tone, and to do that, they have to bend the knee and then straighten out the leg. "It was very painful. The first three weeks of therapy you hurt and wonder if you're seeing progress. Then you turn the corner, and by the sixth week you can do more, and by the ninth week, you go back to your normal routine." Ellis said her knees feel "great." "Last week, I found myself running a short distance, and I don't often run anywhere, but when I did, I didn't feel any discomfort," she said. "I even forgot I had two knee replacements. Before the replacements, they were sore all the time." Bruce Mauzy, director of Therapeutic Services at Owensboro Medical Health System, oversees about 60 physical therapists who work in the hospital, OMHS HealthPark and in patients' homes. They perform physical therapy, occupational therapy, speech and recreational therapy and audiology. His department works with about 15 to 20 people a year who have had anterior cruciate ligament surgery from contact sports. The great majority of their patients have shoulder and knee problems. "We see a lot of shoulder problems because people use their arms overhead (at work)," Mauzy said. "The shoulder is such an unstable joint. The knee is the largest joint in the body, and we do see a lot of knee problems, too. People put a lot of stress on their legs."
"A lot of people here start out with bursitis, and they don't move the joint so they end up with a frozen shoulder," Mauzy said. "Or to move the shoulder, they use the shoulder blade and then they wind up with neck pain. "If your knee is not tracking right, you get problems with your feet. If you have plantar fasciitis, then you wind up with back problems. It's like a chain reaction. The body tries to compensate for one problem, but then you wind up with a problem elsewhere." For joint swelling, a physical therapist may use ultrasound, which pushes the swelling off the joint. Ultrasound uses electric current to treat pain caused by arthritis, tendonitis, bursitis and other types of body inflammation, as well as nerve damage, post-surgical pain and muscular pain. For most patients, the sensation is of warmth or mild tingling. Mauzy said the most-common problems his department sees involve back, neck, shoulder, knee and stroke patients, who may have to work an entire side of the body. When girls reach puberty and their pelvis widens, their kneecaps tend to start popping out, Mauzy said, and spurs may develop under the kneecap. "Girls who are gymnasts and can do backbends, by the time they're 30 years old, those loose joints wear out," Mauzy said. "When you see their X-rays, they look like they're 70. They get a degenerative change."
For every patient's problem, physical therapists set a goal. If they're experiencing a pain level of eight (on a scale of 0 to 10), then the goal is to halve the level after a few weeks of treatment, followed by pain elimination a few weeks later. "After surgery, there's a certain healing time, but you still have to get a patient up and moving," he said. "If a person has a rotator cuff repair for their shoulder, you've got to let the area heal, but if you don't use it at all, the whole shoulder capsule will freeze up, so when it's safe, you've got to use motion and strengthen the area around it." Mauzy said patients may experience some pain in therapy. As a physical therapy student at the University of Kentucky, Mauzy was sent to the UK hospital's intensive care unit to work with his first patient. "This guy had tubes coming out of him, and I was afraid to touch because I thought I would hurt him," he said. "My instructor said I wouldn't be doing the guy any favors if I didn't do what needed to be done, that he would end up with worse problems later. "You have to take the long-term approach. You don't want to hurt them, but you want a good outcome."
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