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Greetings to you all! I hope that you are enjoying this beautiful spring day!! 
As I was thinking about what I wanted to share with you, a question came to mind.  What does a 20 year old athlete, with a knee injury of eighteen months have in common with a 54 year old active person with a chronic shoulder injury and a 60 year old with a sudden sharp pain in her calf ? The answer?  They all eventually ended up at McDonald Physical Therapy getting direction and results!
The first case is very interesting. This young man injured his leg playing football at one of our local high schools. He was given two different diagnosis and ended up having knee surgery. He did not get better and was a very frustrated young athlete as he was unable to get back to normal athletic activities. His Mom ( a former patient who ironically also had a serious knee injury many years ago) gave us a call. 
What did we do differently? After listening to his story we called one of his previous physicians. We then went to the physician appointment with the patient and his mom. We helped clarify to his doctor what the young person was worried and complaining about pain in his leg. Once the physician heard this clarification, he better understood and together we came up with a direct plan for treatment at our clinic. This young man is now back to activities and happy.
The next case involved a patient who had been to their physician several times. This patient could not sleep because of severe shoulder pain. Surgery was an option given , but the patient was not open to that solution. This patient was recommended to our clinic. We diagnosed the shoulder to be a frozen shoulder and helped this patient regain the motion in the shoulder and get back to sleeping through the night. All is well and life is good!
The last case involves a patient of ours. She was finishing up her rehabilitation after having a total knee replacement. At a recent appointment we observed that she was walking with a noticeable limp that had not been there before. Upon seeing her walk in, sore but seemingly unconcerned, we asked her if she was ok? She said that she was. Our therapist did not accept her response and asked her to lie down on the exam table. The examine involved a test for a possible deep vein thrombosis (blood clot or clots in her calf) which was positive!  We immediately called her orthopedist to set up a test for this very dangerous diagnosis. The orthopedist called it in and had an appointment for her within the hour. (We called the orthopedist because she could have waited in the ER for a few hours and we were worried!) Our patient was given her results upon completing the test and found out that she had five blood clots! She was told she could either go to the hospital or go home. Since she is a hard working woman and was given the option to go to the hospital or not, she decided not, and went straight to work!
Here is where the McDonald Physical Therapy care differentiates itself. We were concerned, knowing her work ethic and called her immediately. We also called her family practioner, who was out of town and got him involved. Long story short, her family physician admitted her and she was in the hospital overnight. He informed our patient that these clots could cause death and this needed to be taken seriously. He put her on blood thinners and all is well. We have texted and called her a half dozen times since, to make sure she is well, and she is improving slowly and is very thankful!
People often ask me,"Why should I go to McDonald Physical Therapy, aren't all physical therapy places the same?" I feel awkward with this question as I know we all try to do our best. But I firmly believe, because we are privately owned and have established a strong culture that truly and deeply cares for each of our patients as if they were family, that we are unique in this fast paced medical world.
So, if you are frustrated with your pain or have an injury that is stifling your normal lifestyle, please call for an appointment so we can help get you back to your normal life!

Health Information
    Staying Active With Spinal Stenosis

    The condition is not a license to be sedentary; in fact, it's just the opposite.

    One Saturday afternoon, Erik Levitt was a normal dad who walked - even ran - with his daughter to her swim lesson. But that evening, he was immobile. "If I just put my foot down, it would be a stabbing pain and it would cause numbness and I couldn't walk," says Levitt, a 42-year-old telecommunications professional in New York City. But when the sun rose on Sunday, he was a normal dad again, able to play with his kids in the park. A similar cycle struck at a recent business conference, during which Levitt used a walking stick one day but didn't need it the next.
    "It's difficult to live with because it's never consistent," says Levitt of spinal stenosis, which he was diagnosed with via MRI in 2013 after his big toe, then entire foot, went numb during a physical therapy session for a different condition. The diagnosis describes a narrowing of the spinal column that limits the amount of space for the spinal cord, spinal fluid and exiting nerves. As a result, people like Levitt can experience muscle weakness, numbness, tingling and pain. In severe cases, they may experience bowel and bladder dysfunction and can lose control over their hands, says Dr. Afshin E. Razi, a clinical assistant professor of orthopaedic surgery at NYU Langone's Spine Center.
    "Buttoning [your] shirt becomes difficult because you don't feel the tips of the finger. People drop things out of their hand; they can't open a jar," he says. "And sometimes ... you become unsteady because the message is not getting from the brain down to your legs."
    Spinal stenosis is common among older adults, thanks to relatively normal age-related wear and tear on bones, says Dr. Matthew McCarthy, a neurologist at The Sports Neurology Clinic at The CORE Institute in Michigan. "Most people [over age 60] will have some sort of narrowing as a result of age-related changes, but may not have symptoms from it," he says
    But spinal stenosis, which typically affects either the lower back or neck, can also occur in younger folks like Levitt, who was born with a narrower-than-normal spinal column and also has psoriatic arthritis, a chronic condition that can inflame the spine's joints. Other young or middle-aged adults may develop the condition after suffering back injuries like herniated discs or even developing tumors. Some athletes are vulnerable too, particularly if they're involved in sports like football, weightlifting or gymnastics that put a lot pressure on their spine during play, training or both, McCarthy says.

    "People are aware of the severe spinal cord injuries - career-ending injuries" where they're carted off the field or court, he says. But unlike all the attention paid to the dangers of concussions and repeated head injuries, "a lot of the more chronic injuries ... might be underemphasized."

    But being aware of spinal stenosis is important since appropriate, timely treatment can improve functioning. In fact, even professional athletes can return to play after a diagnosis, although there's no established protocol for evaluating if or when they should do so, says Eric Robertson, a physical therapist who directs Kaiser Permanente Northern California's graduate physical therapy education program.

    "Just having a diagnosis is not a prognosis for immobility and the requirement to cease function or sports, even at a high level," he says. "It's a sign that everybody needs to recognize that this part of your body might need more attention."

    Here's how he and other experts suggest showing your back some love if you have spinal stenosis or suspect you might:

    1. Tune into neck and back pain.
    Don't think you have to be an athlete - or even active - to be at risk for spinal stenosis or other related conditions. In fact, more people are visiting spine doctors today thanks to their modern sedentary lifestyles that involve hours of hunching daily. "Computers, laptops, handheld devices are causing a lot more neck pain and back pain," Razi says. To prevent or help alleviate it, aim to get out of your seat every 20 to 25 minutes and to involve core-strengthening exercises into your weekly - if not daily - routine.

    2. See a professional (or several).
    If your back or neck pain is accompanied by potentially neurological-related symptoms such as muscle numbness, weakness, tingling or all of the above, talk to your primary care physician or see a neurologist, orthopedic surgeon or other spine specialist, Razi recommends. "Make sure somebody checks on [you] to make sure there's no significant progressive neurological problem," he says. "That can be permanent." If your concern is sports-related, consider visiting a clinician like a sports medicine doctor or sports physical therapist with expertise working with athletes, McCarthy suggests. "This is something that's amenable to management from a team," says Robertson, a spokesman for the American Physical Therapy Association.

    3. Know your options.
    If you receive a spinal stenosis diagnosis - often done through physical evaluations and tests that can help clinicians trace impairments to a particular part of the spine - "don't rush into surgery," suggests Levitt, who manages his conditions with anti-inflammatory, anti-anxiety and muscle-relaxing medications, as well as regular physical therapy. "[Physical therapy] is the difference between a pain-free day and a painful day," he says.

    Indeed, physical therapy that focuses on improving range of motion, balance and core strength, for instance, can be very effective, McCarthy says. "If you can improve the neck's stability and range of motion, you can actually improve the sort of functional capacity of the person's spinal canal to accommodate the cord and their nerves."

    When conservative treatments don't provide enough relief, surgery that helps create space for nerves may be the only option, Razi says. Although such procedures come with risks like the chance of needing additional back surgeries in the future, "most patients do very well," he says. Even NFL players who've undergone them have successfully returned to play.
    4. Keep moving.
    While people with spinal stenosis may find themselves hunching or sitting still to manage pain, experts recommend doing just the opposite. "Move more to slow the progression of degenerative changes," says Robertson, who encourages patients to walk in order to promote an upright position and help stabilize their hips. Levitt, for one, makes sure he gets up to walk while on frequent plane rides for business trips and stays involved in activities with deliberate, controlled actions like martial arts and softball. "The more active you are," he says, "the longer you will be active."
    ** article from U.S. News & World Report, by Anna Medaris Miller
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