September 2024 - GO PHYSIO

Injury Healing and Protein Intake: Insights from an Orthopedic Physical Therapist

In the realm of orthopedic physical therapy, one of the most crucial yet often overlooked aspects of recovery is nutrition—specifically, protein intake. While we frequently discuss exercise regimens and therapeutic techniques, the role of protein in tissue repair and overall recovery warrants closer examination. This blog post delves into why adequate protein intake is essential for healing injured tissues and how it supports athletes, both young and adult, in their physical activities. Understanding Protein’s Role in Tissue Repair Protein is fundamental for the repair and regeneration of tissues in the body. When you sustain an injury, whether it’s a sprain, strain, or surgical wound, your body needs to produce new tissue to replace the damaged one. This process requires an ample supply of amino acids, the building blocks of proteins. Amino acids are essential for synthesizing collagen, which provides structural support to tissues and plays a key role in wound healing. During the healing process, the demand for amino acids increases. The body uses these amino acids to create new cells and repair damaged ones, essentially rebuilding the injured area. Therefore, insufficient protein intake can slow down recovery, as the body lacks the necessary resources to efficiently repair tissues. The Disparity Between Perceived and Actual Protein Intake Many people have misconceptions about their protein intake. According to various studies and surveys, individuals often overestimate the amount of protein they consume daily. For instance, the average person might believe they’re consuming around 100 grams of protein per day, but their actual intake might be closer to 60 or 70 grams. This discrepancy can be attributed to a lack of awareness about the protein content in various foods and an underestimation of actual dietary consumption. Why Increased Protein Intake is Necessary 1. Enhanced Recovery and Tissue Repair: When recovering from an injury, the body’s protein needs can increase by 20-30% compared to normal levels. This is because the process of healing and rebuilding tissues is protein-intensive. For example, a person recovering from a significant muscle strain might need around 1.2 to 1.5 grams of protein per kilogram of body weight per day, compared to the standard recommendation of 0.8 grams per kilogram for the average adult. 2. Support for Athletes and Intensive Physical Activities: Athletes and individuals engaged in regular intensive physical activities also require higher protein intake. For youth and adult athletes, protein supports muscle repair and growth, especially after rigorous training sessions. Muscle protein synthesis (MPS) is a critical process where protein is used to repair and build muscle tissues. Inadequate protein intake can hinder MPS, leading to prolonged recovery times and decreased performance. 3. Prevention of Muscle Loss: For those undergoing rehabilitation or physical therapy, maintaining muscle mass is crucial. Adequate protein intake helps prevent muscle wasting, which can be a concern during periods of immobility or reduced physical activity. This is particularly important in rehabilitation settings where preserving muscle strength and function is essential for returning to normal activities. Practical Tips for Ensuring Adequate Protein Intake 1. Incorporate Protein-Rich Foods: Include a variety of protein-rich foods in your diet such as lean meats, poultry, fish, eggs, dairy products, legumes, and nuts. For vegetarians or those with dietary restrictions, plant-based proteins like tofu, tempeh, quinoa, and legumes are excellent alternatives. 2. Monitor Your Intake: Keep track of your daily protein consumption to ensure you’re meeting your needs, especially if you’re recovering from an injury or engaging in intense physical activity. Utilizing food diaries or nutritional apps can help you stay on track. 3. Consult with a Professional: If you’re unsure about your protein needs or how to adjust your intake, consulting with a registered dietitian or nutritionist can provide personalized guidance. They can help tailor your diet to support your recovery or athletic goals effectively. Conclusion Injury recovery and athletic performance are significantly influenced by protein intake. Understanding the disparity between perceived and actual protein consumption can help individuals better meet their needs. By increasing protein intake during recovery and intense physical activity, you can enhance tissue repair, support muscle growth, and ultimately improve your overall health and performance. As an orthopedic physical therapist, my goal is to support you in every aspect of recovery and performance. Addressing nutritional needs, particularly protein intake, is a vital component of a successful rehabilitation or training program. Don’t underestimate the power of a well-balanced diet in achieving your health and performance goals.

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The Hidden Epidemic: How Low Vitamin D Levels Can Affect Your Injury Recovery and Overall Health

Leave a Comment / Blog, Uncategorized / Sarah Zemen

Recent studies estimate that about 42% of Americans are vitamin D deficient, and many more have levels that are below optimal. This widespread deficiency is concerning, especially given the critical role vitamin D plays in maintaining various aspects of health. As physical therapists, we often see how low vitamin D levels can subtly but significantly affect recovery from injuries and overall well-being. In this blog, we’ll explore how low vitamin D levels contribute to physical injuries, neurological damage, and mental health issues, and what you can do to address this issue effectively. The Risks of Low Vitamin D Levels 1. Impact on Physical Injuries and Recovery Vitamin D is vital for bone health and muscle function. A deficiency can weaken bones, making them more susceptible to fractures and injuries. For those undergoing physical therapy, low vitamin D levels can slow down the healing process, making recovery from injuries more challenging. Insufficient vitamin D can also impair muscle strength and coordination, which complicates physical therapy exercises and increases the risk of further injury. 2. Neurological Damage and Impaired Function Vitamin D is essential for proper nerve function and neurological health. Low levels have been linked to various neurological issues, including impaired nerve function, balance problems, and cognitive difficulties. In physical therapy, these neurological issues can manifest as coordination challenges and reduced proprioception (the sense of body position). These impairments can hinder your ability to perform exercises correctly and safely, prolonging your recovery and increasing the risk of additional injuries. 3. Mental Health Implications Vitamin D deficiency is also associated with mental health issues, such as depression and anxiety. This can be particularly problematic for patients dealing with injury recovery, as chronic pain and rehabilitation can already be mentally taxing. Low vitamin D levels can exacerbate feelings of depression and anxiety, making it harder to stay motivated and engaged in your physical therapy regimen. Addressing vitamin D deficiency can help improve mood and mental resilience, supporting a more effective recovery process. Addressing Vitamin D Deficiency: Testing and Supplementation 1. Importance of Testing If you suspect that you might be suffering from low vitamin D levels, it’s crucial to get tested. The 25-hydroxy vitamin D lab test is the standard method for determining your vitamin D status. If your results indicate that you are low or deficient, taking action to address this deficiency should be a priority. 2. Effective Supplementation Practices To maximize the benefits of vitamin D supplements, consider the following: Take with Lipid-Containing Foods: Vitamin D is fat-soluble, which means it is best absorbed when taken with dietary fats. Incorporate healthy fats into your meals, such as avocados, nuts, or olive oil, to enhance the absorption of your vitamin D supplements. Include Vitamin K2: Vitamin K2 works synergistically with vitamin D to support bone health and calcium metabolism. It helps direct calcium to the bones and teeth and prevents it from accumulating in the arteries. Including vitamin K2 in your supplementation regimen can provide additional health benefits and support optimal vitamin D function. 3. Investigate Persistent Deficiencies If you consistently find that your vitamin D levels remain low despite adequate supplementation, there may be an underlying medical condition affecting your vitamin D metabolism. Conditions such as chronic kidney disease, liver disorders, or gastrointestinal issues can interfere with vitamin D absorption and metabolism. In such cases, consulting with an endocrinologist or a specialist is advisable to identify and address any underlying health issues that may be contributing to persistent low vitamin D levels. Integrating Vitamin D into Your Physical Therapy Plan If you are undergoing physical therapy, it’s important to discuss your vitamin D status with your physical therapist. They can adjust your rehabilitation program to account for any specific challenges related to low vitamin D levels, such as balance issues or muscle weakness. By addressing these challenges, your physical therapist can help you achieve a more effective and efficient recovery. In conclusion, vitamin D plays a crucial role in physical injury recovery, neurological health, and mental well-being. By understanding the significant impact of low vitamin D levels and taking proactive steps to address deficiencies through testing, effective supplementation, and possible consultation with a specialist, you can enhance your overall health and improve your recovery outcomes. Remember, a comprehensive approach to health that includes managing vitamin D levels can make a significant difference in your physical therapy journey and overall well-being.

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Periosteal Electric Dry Needling: The New Gold Standard for Knee Arthritis

Leave a Comment / Blog / Sarah Zemen

As an osteopractic physical therapist, I’m excited to share insights on a groundbreaking treatment that is swiftly becoming the gold standard for managing knee arthritis—periosteal electric dry needling (PEDN). This innovative approach is gaining momentum due to its impressive results, minimal risk, and cost-effectiveness, making it a game-changer for both patients and practitioners. Read more about our own arthritis treatment program here. What is Periosteal Electric Dry Needling? Periosteal Electric Dry Needling is a technique that involves inserting fine, sterile needles into the periosteum—the dense layer of connective tissue covering the bone—while applying a small electric current. This process stimulates the area directly adjacent to the bone, targeting the inflammation and pain associated with knee arthritis. Why PEDN is a Game-Changer 1. Extremely Low Risk One of the primary advantages of PEDN is its exceptionally low risk profile. The technique is minimally invasive compared to traditional interventions such as injections or surgery. Unlike surgeries, there’s no need for general anesthesia, which further minimizes risk. Most patients experience only mild discomfort, akin to a slight prick or muscle twitch. 2. Effective in Reducing Inflammation, Pain, and Stiffness Knee arthritis often involves chronic inflammation, pain, and stiffness, which can severely impact quality of life. PEDN has demonstrated remarkable efficacy in addressing these issues. The electric stimulation helps to modulate pain signals and promotes the release of natural anti-inflammatory agents within the body. Additionally, the technique encourages improved blood flow and tissue healing, which can significantly alleviate stiffness and enhance joint mobility. Patients often report noticeable improvements after just a few sessions. For most, this translates into better functional outcomes and a more active lifestyle. 3. Cost-Effective Compared to Alternatives When considering management of knee arthritis, PEDN stands out for its cost-effectiveness. Traditional treatments such as injections, medications, and surgery can be expensive and come with their own risks and side effects. PEDN, on the other hand, offers a more affordable solution without compromising effectiveness. The costs associated with PEDN are generally lower, and the need for repeated treatments is often reduced as the technique effectively addresses the root causes of pain and inflammation. The PEDN Treatment Process The treatment begins with a thorough assessment of the patient’s knee condition and overall health. Once a personalized treatment plan is established, PEDN sessions are typically brief, lasting around 20 to 30 minutes. The process involves inserting the needles into specific points around the knee, applying the electric current, and then removing the needles. Most patients experience a significant reduction in symptoms after just a few sessions, with ongoing improvement over time. Why You Should Consider PEDN If you’re struggling with knee arthritis and traditional treatments haven’t provided the relief you need, PEDN could be a viable option to explore. It’s particularly beneficial for those looking for a low-risk, effective, and cost-efficient alternative to more invasive procedures. As always, it’s important to consult with a qualified healthcare provider to determine if PEDN is right for you and to ensure it complements your overall treatment strategy. In summary, periosteal electric dry needling represents a significant advancement in the treatment of knee arthritis. Its effectiveness in reducing pain, inflammation, and stiffness—combined with its low risk and cost-effectiveness—makes it a compelling option for those seeking relief and improved function. As the field of physical therapy continues to evolve, PEDN stands at the forefront of innovative treatments, offering hope and enhanced quality of life for many patients battling knee arthritis. If you have any questions about PEDN or would like to learn more about how it might benefit you, feel free to reach out to our clinic. We’re here to help you on your journey to better joint health and overall well-being. Dr. Sarah Zemen PT, DPT, BSK, FAAOMPT, Dip. Osteopractic Author

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Safe & Effective Treatment for Cervicogenic Headaches

Leave a Comment / Blog / Sarah Zemen

Cervicogenic headaches, a type of headache originating from the neck, can significantly impact one’s quality of life. For those seeking effective relief, a combination of perineural electric dry needling and spinal manipulation is a potent, promising, and lasting approach. This was recently demonstrated in a large scale randomized controlled trial observing the effects of this combination approach on pain, disability, and headache frequency, duration, and intensity. In this blog, we’ll delve into the key concepts behind these therapies and explore how their integration can provide comprehensive treatment for cervicogenic headaches. Understanding Cervicogenic Headaches: Cervicogenic headaches are characterized by various issues within the neck region (which you may or may not be aware of) that can cause pain or seemingly bizarre symptoms in the head and neck and radiate to other regions of the scalp, jaw, ear, eye, or forehead. Cervicogenic headaches can seem complex due to the nerve pathways that are involved. Common origin of these issues may include anything from a past whiplash or concussion event, to prolonged postures such as desk and computer work. These circumstances can negatively impact the oxygenation and mobility of various structures within the head and neck including joint capsules, ligaments, muscles and tendons, nerves, and fascia. Traditional treatments often include medication, conventional physical therapy, and lifestyle modifications. However, the promise of a combination treatment protocol of perineural electric dry needling and spinal manipulation is a promising holistic and targeted strategy for addressing the root causes of these headaches with much less risk than taking medications. Perineural Electric Dry Needling: Perineural electric dry needling is a technique that involves the insertion of thin needles at specific points of an affected area (usually an area that was previously strained or injured, such as from a car accident years ago). Depending on the condition or diagnosis, there are established semi-standardized protocols which are recommended for faster and more complete healing. Each protocol typically involves needles to be left in place and gently stimulated by a specific electric setting known to reduce pain and inflammation and promote blood flow. Unlike the more common type of dry needling (trigger point), evidence-based needling is a is designed to obtain the full therapeutic effects with a fraction of the discomfort and soreness. Evidence-based perineural needling is known to modulate pain signals, promote the release of endorphins, and significantly improve blood flow to the area for up to several days following treatment. In the context of cervicogenic headaches, perineural electric dry needling aims to help re-structure and re-vascularize (form new blood vessels) in previously injured or strained tissues, reduce pain and tension, alleviate nerve irritation, and normalize the pH level in the affected region. Spinal Manipulation: Spinal manipulation, often performed by osteopractors, involves the precise application of a low amplitude force (low amplitude = minimal amount of motion) at a high speed addressing pathological fixations of the joints and tissues of the spine. These techniques are more comfortable and safer than traditional adjustments for patients. Based on recent large-scale studies, specific techniques that bias the upper neck joints as well as the upper back joints seem to be the most valuable targets when treating migraines and cervicogenic headaches. This manual technique is designed to inhibit abnormal, maladaptive chronic pain signaling, reduce reflexive spasming, and – like the evidence-based needling, stimulate the release of endogenous opioids. The Synergy of Combined Treatment: When perineural electric dry needling and spinal manipulation are used together, they create a synergistic effect that addresses multiple aspects of cervicogenic headaches. Perineural electric dry needling stimulates problematic tissue to return to a healthier state (homeostasis) by stimulating blood flow, calming nerves, and healing chronically injured areas. When spinal manipulation is performed in conjunction, it further enhances the effectiveness of perineural electric dry needling by optimizing central nervous system signaling in the brain and spinal cord. The benefits of spinal manipulation (safe forms of “adjustments”) have nothing to do with “alignment,” as there is no literature to support this notion, but instead that the benefits have everything to do with neural processing of pain within our brain, spinal cord, and subsequently our sensory pathways to and from the brain. Patient Experience and Safety: It’s worthwhile to note that these therapies are well-tolerated, with a much lower risk for adverse effects than even taking an over-the-counter such as ibuprofen. The combination of various types of treatment are tailored to each patient’s specific needs. Patients often report reduced pain, headache frequency, intensity, and duration after undergoing this integrated approach within a consistent plan of care. As with any medical intervention, it’s essential to consult with a qualified healthcare professional, such as a physical therapist specialized in the treatment of headaches, or an osteopractor, to determine the most suitable treatment plan for each individual. Conclusion: The combination of perineural electric dry needling and spinal manipulation is a promising avenue for individuals seeking relief from cervicogenic headaches. By addressing factors such as blood flow, inflammation, and the state of various joints and tissues, this holistic approach aims to restore balance to the craniocervical region, providing a comprehensive solution for those who experience the gripping pain of cervicogenic headaches. If you suffer from cervicogenic headaches, consider discussing these treatment options with your healthcare provider to determine if this integrated approach is right for you. To find an Osteopractor near you, visit the Osteopractor Directory on the AAMT website or ask our GO Physio providers for network connections. For readers interested in the scientific data about this treatment approach, please refer to the following RCT published in The Spine Journal in 2021: Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multicenter randomized clinical trial Dr. Sarah Zemen PT, DPT, BSK, FAAOMPT, Dip. Osteopractic Author

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