Please Join Flagler and Nova Southeastern University for its Inaugural Charity Golf Tournament. This event will aide the Scholarship Fund for the College Health Care Science.

$150 per person which includes breakfast, lunch buffet, and shirt.

At: The "Caddy Shack" course, Grand Oaks Golf Club.

Please call Richard at Flagler 561-833-1747 or contact Kevin Kunkel, PhD, PT tournament chair at 954-262-1748 for more details.

 

Contact: Richard Rinehart Assistant Administrator Phone 561 833 - 1747 Fax 561 833 - 1394

311 Golf Road, Suite 1000 West Palm Beach, Florida 33407 Phone 561 833 - 1747 Fax 561 833 - 1394

The Flagler Institute For Rehabilitation

Press Release    

The Flagler Institute for Rehabilitation is proud to announce. Emily Large PT, CYT, ERYT-500 has been invited to speak at this year’s Yoga Journal Conference. This is by invitation only and brings some of the top instructor in the field to teach.

 

MD's please call 561-833-1747 for more information on this exciting opportunity.

 

Flagler is accepting new referrals, please contact numbers above for further information

Weekend Warrior? Dont beat yourself up!

How to Avoid Weekend Warrior Injuries

It's important to be physically active, and avoid injuries at the same time. This is especially important for a 'weekend warrior'. If you are sedentary, it's extremely important to plan ahead in order to avoid exercise-related injuries. After all, the human body cannot go from 'inactive' mode to 'weekend warrior' mode in an instant.

Exercise intensity must be progressive; otherwise the risk for injury increases. After all, professional athletes prepare for months (sometimes years) to reach a certain level of physical performance. Athletes prepare their bodies for months during the off-season, as they prepare their body for an intense season. Weekend warriors tend to bypass 'preparation' and jump right into intense activity.

Common injuries include joint inflammation, muscle tears, and ligament sprains.  Most injuries can be treated with physical therapy after the acute symptoms have subsided. In severe cases, surgery might be needed.

Weekend Warriors - Do's and Dont's

It's important for weekend warriors to be realistic. For starters, don't expect your body to adapt right away to intense activities. If you have been inactive all week long, your body will not be prepared for physical challenges over the weekend. Make sure you have protective gear, and stay hydrated.

Warm up and Cool Down

A warm up is a simple, yet neglected way to avoid injuries. Eight to ten minutes of walking or light jogging, combined with some light stretching is a great way to prepare your body for progressive exercise intensity and minimize injuries. 

When you're finished with your activity, do not come to a sudden stop. Give your muscles a chance to recover by reducing your intensity, but keep moving. For example, if you have been running, don't come to a stop. Walk for the last few minutes. A cool down period helps restore blood circulation and reduce injuries.

Plan Ahead

Being realistic and planning ahead is important. For best results, get some regular exercise every day. This allows your body to adapt and prepare for your favorite weekend activities.

Physical Therapy For All Ages

If you are a senior weekend warrior, your body is more susceptible to tears, sprains, strains, and other injuries. In fact, there are almost 80 million 'baby boomers' in the United States alone. Physical therapy plays an important role in injury prevention for weekend warriors of all ages.

If you are one of the many weekend warriors this summer, here are a few ways that a physical therapist can help:

• Assessment of Your Body Mechanics/Movements – Your ability to do simple things like move, walk, sit and stand is important to us. We use this insight to create an injury prevention program.
• Home Exercise Programs – Once we have reduced your pain, inflammation and restored your muscle strength in the clinic, we'll design a personalized home exercise program for you. This will help you maintain your results in the comfort of your own home.
• Treatment Techniques - Physical therapy techniques include exercise, hot and cold packs, ultrasound, manual therapy, and much more to deal with different types of injuries.

As your physical therapists, we are committed to helping you do the things you enjoy over the weekend. Regardless of your age and activity level, physical therapy can help prevent injuries and improve well-being. Call us today. We will help you make the most out of your summer.

Special Announcement!!

Emily Large PT, CYT-500 will be teaching and speaking at this years Yoga Journal Conference, in Hollywood Florida from Oct. 31-Nov. 3.

This is by invitation and brings some of the top teachers from around the world to speak and teach.

Congrats Emily for being among the top in your field. We are happy to have you as a part of our team...

Summer Injury Prevention

Summer Injury Prevention 101

Summer is a time to have fun and spend time outdoors. It is an opportunity to enjoy the sunshine. It's a time when you can go out for a walk and roll down the windows and take in everything that nature has to offer. The weather encourages you to be active and venture outside.

The only caveat with outdoor activities is the risk of injuries due to twists, turns, and falls, among other reasons. The good news is that these injuries can be easily prevented with the advice of a physical therapist.

Physical therapists are licensed professional and experts in injury prevention and rehabilitation of injuries. If you want to make the most out of this summer, it's time to seek the advice of your physical therapist.

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Thought for The Day

A Safe, Fun Summer

Here are some tips that to ensure a safe, fun and injury-free summer:

1. Wear Protective Gear

When participating in contact sports, it is essential to wear protective gear appropriate to that activity. For example, wearing helmets, gloves, properly fitting shoes and shin pads (depending on the sport or activity) can prevent injury. Children are undoubtedly more prone to sustaining injuries such as scrapes, bruises, ligament tears, and even broken bones.

2. Stretching Exercises

Summer presents a tempting opportunity to jump into several activities. If your muscles are deconditioned from the long winter, it's important to plan ahead. You want to eliminate muscle tears and joint injuries, all of which form a part of the 'weekend warrior syndrome'. Stretching the muscles and warming them up adequately before and after exercising can help prevent muscle aches and joint pains. Your physical therapist will be able to advise you on the right stretching exercises to perform before and after participating in any activity.

3. Proper Body Mechanics

It's important to be careful when using equipment. Gardening tends to be a popular activity during the summer. Using a wheelbarrow to carry heavy objects is highly advisable. Your physical therapist will also give you great advice on how to avoid back injuries by teaching you how to use different muscle groups when lifting heavy objects.

4. Strengthen The Core

The core muscles refer to the abdominals and lower back. Exercises such as leg raises, crunches, and simple rotational movements can help strengthen the muscles of the back and abdomen. This can help in preventing injuries. To be on the safe side, ask your physician if it's safe for you to exercise. Your physical therapist will provide you with various exercises that can strengthen your core and prevent back, hip, and knee injuries.

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Message From Your Physical Therapist

The Best Summer Ever

Don't let the summer months pass you by because of an injury. Nobody wants to spend the summer stuck in bed because of a preventable injury. Visit your physical therapist today to learn about injury prevention this summer.

As your physical therapists, we want you to enjoy the activities you love without hurting yourself. Let us help you plan for a fun and exciting summer.

Call our office today to make an appointment. You can expect a detailed physical evaluation that consists of an evaluation of your strength, mobility and balance, among other things. If you find yourself out of shape or in pain after a long winter's rest, reach out to us. We'll help your body prepare for the best summer ever.

 

The Flagler Institute for Rehabilitation, Inc.

www.flagler-rehab.com

561-833-1747

Lupus and Physical Therapy:

There is more to do then you think!

http://www.youtube.com/watch?v=edhqiXciLIQ&feature=player_embedded

Characteristics/Clinical Presentation

Pathology

Histological changes within the body occur as a result of immunological changes or immunolgical attack associated with deposits of immune complexes within various tissues of the body.

SLE can affect many organs of the body, but it rarely affects them all. The following list includes common signs and symptoms of SLE in order of the most ...to least prevalent. All of the below symptoms might not be present at the initial diagnosis of SLE, but as the disease progresses more of a person’s organ systems become involved.
•“Constitutional symptoms (fever, malaise, fatigue, weight loss): most commonly fatigue and a low-grade fever
•Achy joints (arthralgia)
•Arthritis (inflamed joints)
This image illustrates the typical distribution pattern of the butterfly (malar) rash that can be a characteristic of SLE. This picture was included courtesy of: http://images.google.com/.

•Skin rashes
•Pulmonary involvement (symptoms include: chest pain, difficulty breathing, and cough)
•Anemia
•Kidney involvement (lupus nephritis)
•Sensitivity to the sun or light (photosensitivity)
•Hair loss
•Raynaud’s phenomenon
•CNS involvement (seizures, headaches, peripheral neuropathy, cranial neuropathy, cerebrovascular accidents, organic brain syndrome, psychosis)
•Mouth, nose, or vaginal ulcers”[1]

•The most common signs and symptoms of SLE in children and adolescents are: "fever, fatigue, weight loss, arthritis, rash, and renal disease."[5]

Associated Co-morbidities
•About 30% of people diagnosed with SLE are also diagnosed with fibromyalgia.[2]
•Atherosclerosis[6] [7]
•Lupus Nephritis- leads to End Stage Renal Disease (ESRD)
•Anemia[8]
•Some types of cancers (especially non-Hodgkin's lymphoma and lung cancer) [7][9] [10]
•Infections
•Hypertension
•Dyslipidemia
•Diabetes Mellitus
•Osteoporosis
•Avascular Necrosis [7]

Causes

There is no known cause of SLE, but research states that the interaction between a person's genetic make-up, immune system, hormonal balance, and environment could potentially cause SLE. At this time, autoimmunity is thought to be the primary causative factor of SLE.

There are certain factors that can predispose a patient to SLE including:
•Heredity- There is a high prevalence of SLE in first-degree relatives. The immune abnormalities associated with SLE can be triggered by both internal and external factors.
•Stress- It has been determined that stress can provoke changes in the neuroendocrine system causing changes in the function of immune system cells.
•Bacterial or viral infection- The Epstein-Barr virus has been found to be a risk factor for the development of SLE.
•Sunlight or UV exposure
•Immunizations
•Pregnancy- The evidence about whether or not pregnancy can cause exacerbations of SLE is very inconclusive because some studies state that pregnancy does affect the course of SLE, while others state that it has no affect on the course of the disease.
•Abnormal levels of estrogen
•Certain drugs- Drugs such as hydralazin, anticonvulsants, penicillin, sulfa drugs, and oral contraceptives can change the cellular responsiveness and immunogenicity of self-antigens and therefore make a person more susceptible to SLE.[1]

Systemic Involvement

There are many visceral systems can be affected from SLE, but the extent of the body's involvement differs from person to person. Some people diagnosed with SLE have only few visceral systems involved, while others have numerous systems that have been affected by the disease.

Musculoskeletal System:
This image was included courtesy of www.google.images.com
•Arthritis- typically affects hand, wrists, and knees
•Arthralgia
•Tenosynovitis
•Tendon ruptures
•Swan-neck deformity
•Ulnar drift

Cardiopulmonary/Cardiovascular System:
•Pleuritis
•Pericarditis
•Dyspnea
•Hypertension
•Myocarditis
•Endocarditis
•Tachycarditis
•Pneumonitis
•Vasculitis
1.Small Vessels Purpura
2.Large Vessels Papular Lesions
3.Arterial Thrombosis

Central Nervous System:
•Emotional instability
•Psychosis
•Seizures
•Cerebrovascular accidents
This illustration was included courtesy of http://www.medicinenet.com/.

•Cranial neuropathy
•Peripheral neuropathy
•Organic brain syndrome

Renal System:
•Glomerulonephritis
-inflammatory disease of the kidneys
•Hematuria
•Proteinuria
•Kidney failure[1]

Cutaneous System:
•Calcinosis
•Cutaneous vasculitis
•Hair loss
•Raynaud's phenomenon
•Mucosal ulcers
•Petechiae

Blood Disorders:
•Anemia
•Thrombocytopenia
•Leukopenia
•Neutropenia
•Thrombosis
Gastrointestinal System:
This picture was included courtesy of http://www.health.com/
•Ulcers--Throat & Mouth
•Ulcerative colitis/Crohn's disease
•Peritonitis
•Ascites
•Pancreatitis
•Peptic ulcers
•Autoimmune Hepatitis [11]

Medical Management (current best evidence)

The medical management for SLE is primarily drug therapy and is based upon the patients symptoms and systemic involvement. In addition to drug therapy, prevention is also very important when dealing with SLE. For patients with photosensitivities, flare-ups can be reduced if patients are cautious about the amount of sunlight or UV light that they are exposed to. Patients with SLE are also encouraged to lead a healthy lifestyle that includes: smoking cessation, controlling alcohol consumption, weight management, and regular exercise.[1][7] Exercise is beneficial for patients with SLE because it decreases their muscle weakness while simultaneously increases their muscle endurance. Patients with SLE are also encouraged to participate in support groups, ensure they are taking the correct dosages and amounts of medications, and ensure they visit medical professionals regularly.[1]

New Therapies

Topical Therapy/Medication

NSAIDS

Hormonal Intervention

Immunosupressant Therapy

IV Gamma Globulin

Apheresis

Stem-Cell Transplantation

Biological Therapy[12]

Physical Therapy Management (current best evidence)

Physical therapists can play an important role for patients with SLE during and between exacerbations. The patient's need for physical therapy will vary greatly depending on the systems involved.
•Education: It is essential for patients with skin lesions to have appropriate education on the best way to care for their skin and to ensure they do not experience additional skin breakdown.
•Aerobic Exercise: One of the most common impairments that patients with SLE experience is generalized fatigue that can limit their activities throughout the day.[1] In a study by Tench et al., it was determined that graded aerobic exercise programs are more successful than relaxation techniques in decreasing the fatigue levels of patients with SLE. Aerobic activity caused many of the participants with SLE to feel "much better" or "very much better" at the conclusion of the study. The aerobic exercise program consisted of 30-50 minutes of aerobic activity (walking/swimming/cycling) with a heart rate corresponding to 60% of the patient's peak oxygen consumption.[13] Another study, completed by Ramsey- Goldman et al., concluded that both aerobic exercise and range of motion/muscle strengthening exercises can increase the energy level, cardiovascular fitness, functional status, and muscle strength in patients with SLE. In this study, the patients completed aerobic exercise for 20-30 minutes at 70-80% of their maximum heart rate. The patients who completed range of motion and muscle strengthening activities met 3 times a week for 50 minutes sessions.[14]
•Energy Conservation: Physical therapists can educate patients on appropriate energy conservation techniques and the best ways to protect joints that are susceptible to damage.
•Additionally, physical therapists and patients with SLE should be aware of signs and symptoms that suggest a progression of SLE including those associated with avascular necrosis, kidney involvement, and neurological involvement.[1]

Alternative/Holistic Management (current best evidence)

Sometimes used in addition to medical treatment, alternative treatments are used to treat symptoms caused by SLE. These alternative treatments include:
•Homeopathy
This picture depicts acupuncture therapy that can be used to decrease pain. It was included courtesy of www.googleimages.com.

•Chiropractic
•Traditional Chinese medicines (acupuncture and Tai Chi)
•Ayurveda
•Naturopathy
•Massage therapy
•Meditation
•Biofeedback- In conjunction with medication, biofeedback has been shown to decrease a patient's pain and stress levels
•Herbs and Supplements
•Acupuncture- Some research reveals that acupuncture can decrease a patient's arthritis pain[11]

The Impact of Heel Pain

Have you ever experienced a sharp pain in your heel for no apparent reason? One of the causes of heel pain is a condition called plantar fasciitis. It is caused by inflammation of the plantar fascia, the tissue connecting the heel bone to the toes. The plantar fascia serves as a 'shock absorber' for the arch of the foot.

The patient typically experiences a stabbing sensation in the foot, especially when getting out of bed in the morning. It is not unusual for the pain to subside with movement or stretching. The pain tends to reoccur after prolonged sitting, standing, or walking.

Causes include weight, age, activity, and even gender. Certain activities that place stress on the heel (running, dancing) also play a role. Women are also more prone then men, especially when pregnant.

Too much tension in the plantar fascia can cause small tears in the tissue. When left untreated, the damage worsens and surgery may be warranted. Physical therapy plays an important role to reduce pain and help avoid surgery.

Importance of Exercise

Often, people who suffer from plantar fasciitis have tighter and weaker foot muscles. The physical therapist will conduct a detailed evaluation of the strength, flexibility and stability of the muscles and ligaments around your foot and ankle to determine the best course of action.

The right exercise program can strengthen the ankle and foot muscles, which reduces the strain on the plantar fascia. This helps break the cycle of pain and discomfort.

The physical therapist may also decide to combine exercises for plantar fasciitis with orthopedic shoe inserts. These are specially made inserts that are built to conform to the unique shape and arches of your feet. Pain medication (as prescribed by your physician), ice and rest are also helpful.

A Step in the Right Direction...

Surgery is an option but should be considered as the last resort.

Plantar fasciitis is best treated with a combination of exercise and lifestyle modification. As a weight bearing structure, your feet are under constant stress and strain every day. Healing can take several weeks (or months) and a physical therapist will work with the patient every step of the way. The best course of action is to work closely with a physical therapist and continue with the prescribed home treatment program.

As your physical therapists, we are committed to your health and wellness goals. If you know someone who is experiencing heel or foot pain, ask him or her to call us today. We look forward to hearing from you. Physical therapy is a step in the right direction.

Watch This Informative Video:
http://www.therapynewsletter.com/myarchive.php?userid=385&id=34470&secret=65838571ad4fb53e