​Prior to this Pandemic about 15% of the US population worked full time or part time from home.  With mandates that non-essential workers stay home that number has increased.  Many of you may have set up your home office in the dining room, den or bedroom.  You need to put some thought into the set up because you will be spending many hours in that chair, at that desk or table.  You may get away with slouching into a comfortable chair to read or play video games for an hour or two, but sitting in a chair for 8 hours a day is different.  Proper ergonomic work stations have become the norm for many businesses, but you may not have the space at home or the resources for all new furniture.   You have to get creative.
 
-You have to start with a sturdy straight back chair.  A dining room chair may suffice, but if you have a desk chair with wheels that is even better, so it can be moved easily without having to lift it to change positions.  Make sure that you sit back in your chair. If you put a rolled towel or lumbar roll in the small of your back it will make slouching while seated much more difficult.  Make sure your feet rest comfortable on the floor so there is not a lot of pressure on your thighs that may restrict blood flow to your lower legs.  If your chair is so high that your feet don’t reach the floor rest them on a box for support. 
 
-If you have to lean forward to see something more clearly it is safer to bend forward from the hips rather than flexing the spine every time. 
 
-Interrupting sitting every 30 minutes is recommended.  If you have to make a phone call stand up and walk around.
 
-Standing desks are a good alternative for periods of time, but not all day.  It is best to sit a while and stand a while and change positions from sitting to standing every 30 minutes.  Standing for prolonged periods increases the likelihood of developing varicose veins.  Standing to work requires more energy than sitting and puts a greater strain on the circulator system.  Moving around frequently is the key.
 
-Try not to sit on your bed with legs out in front of you and computer in your lap.  If you do this have someone snap a picture of you and it will be clear that your spine is not properly supported in this position.
 
-Put your computer in front of you  and make sure that  when you sit up straight you can see it right in front of you without bending your neck.   Many work surfaces are too low so you may have to elevate your screen on books to have it at the correct level.
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-Make sure the lighting in the room is good, so you don’t have bend over and squint to see the screen.  You may have to put a lamp to the side of your computer.  It is best not to have your back to the window , as it may cause a glare on your screen.  Don’t face the window either, so you are not looking into the light.  It is best to have your screen perpendicular to the window.
 
-If you have to look at documents, do not place them down on the desk or table, so you have to look down frequently.  Document holders that attach to the computer screen will help keep your neck straight while you are looking at documents.
 
-Put your mouse and keyboard at a height where your elbows are at an 80 degree angle while keyboarding.  Avoid resting your wrists on the hard surface of the desk.  The nerves that cross the wrist into your hand will not appreciate the pressure,  especially if you are prone to Carpal Tunnel Syndrome.  If you are not typing/keyboarding, let your hands rest in your lap or at your sides and relax them.
 
-You have probably picked up on a common theme here.  Posture, posture, posture.  Keep the spine in a neutral position for as much of the day as you can and the likelihood that you will develop back or neck pain is much diminished.  If you  get up and move around every 30 minutes, it is good for the spine and your circulation.
 
-It is also a great idea to go out and take a walk.  Walking has powerful health benefits.  Walking 30 minutes a day 3 times a week has been shown to improve cardiovascular endurance and reduce blood pressure and weight.  It is also a great stress reliever.  In these difficult times that we are all experiencing, reducing stress is a must.

​Sally Oxley      
PT, CHT, OCS, Cert. MDT

Let me first say that all of us at HPT are missing our friends and our patients that we are no longer seeing since the Pandemic.  We hope you are staying home and staying safe.  All of our routines are different now than they were a month ago and with those changes are potential issues.

-Most of us are sitting more which can cause an increased incidence of back and neck pain.  A good strategy is to get up every 30-45 minutes and walk around for a few minutes.  Since sitting is primarily a flexion activity, we recommend back bends after sitting for a 30-45 minute period of time.  Do it with your back up against your kitchen counter, so you don't lose your balance.
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Back bends: 

-As I drive around Huntington I see beautiful flowers, shrubs, trees and grass; not to mention  many more people working in their yards.  A good strategy to prevent back and neck pain as a result of this is to stand up every 15 minutes and spend 2-3 minutes bending backwards and looking up toward the sky.
 
Neck retraction and extension:

​-Too much sitting can also cause weakness in the legs and poor balance.  A good strategy here is to straighten your legs for 1-2 minutes every 30 minutes while sitting.
 
Hamstring stretch/knee extension:

​-Another helpful activity is raising up on your toes 20 times and raising your toes 20 times.  Place your hand on a surface to steady yourself.  Do 4-5 X per day.
 
Heel raises:

​-Upper back posture is also impacted by too much sitting.  Increased flexion of the upper back can affect the function of the neck and shoulders.  A good way to combat this is to place a rolled towel or lumbar roll behind you at the level of the lower shoulder blades while sitting, pull shoulder blades back and lean backwards.  Hold 3-5 seconds 10 X.  Do every 30 minutes.
 
Chair extension:

-Another good idea is standing with your back against the wall.  Pull shoulder blades together, hold for 5 seconds 10X, then push arms back against the wall and hold 5 seconds 10X.  

​Scapular retraction: 

​-While you are at the wall turn around and place your hands against the wall.  Slide your hands against the wall to keep shoulders flexible.
 
​Wall slide:

-Those of you who have had surgery for total knees, total hips, rotator cuff repairs, back surgery or any of the myriad of surgeries we see all the time should continue your home exercise programs during this period.
 
-It is a good idea to get outside for a walk and fresh air as long as you can maintain social distancing guidelines.  Do some deep breathing while walking.  It helps the isolation to walk with a friend if you maintain at least 6' from the other person.  Raising your body temperature has been shown to boost your immune system, so exercise a little more vigorously than usual to achieve a higher body temperature.
 
​-Please take extra precautions at home while doing maintenance and other tasks. Be careful on step stools so you do not fall.  Be careful while cleaning out low cabinets not to bump your head when getting up. (I know this from personal experience).  A mishap would be more difficult to take care of during present circumstances, but not impossible.  Our staff is here from 7am -12 noon Monday, Wednesday and Friday and 1pm-6pm Tuesdays and Thursdays if you would like to talk to us, 304-525-4445. If you hurt yourselves and want one of our therapists to take a look at you, we can do that.  We are wearing masks and would appreciate it if you would wear one also.  Attached are our e-mails if you would like to reach out with questions or any issues you may have.  As in the past almost 40 years we are here for you.
 
Sally Oxley PT – soxley@hptservices.com
John Oxley PT - joxley@hptservices.com
Mark Taylor PT - mtaylor@hptservices.com
Aleacha Wallington PT - awallington@hptservices.com
Kelly  Collier PT– kcollier@hptservices.com
Amy DeMoss PT - awright@hptservices.com
Derrick White PT - dwhite@hptservices.com

Sally Oxley      
PT, CHT, OCS, Cert. MDT

Whether you are doing a thorough cleaning of your house or tackling that outdoor to do list, follow these tips to avoid injury.

• Warm up.  It might seem silly to perform a warm up before cleaning or doing yard work but a few gentle stretches before working can prevent pain and soreness.
• Know your problem areas.  If you are prone to back injuries, then you don’t want to put unnecessary stress on it.  If you have thumb arthritis, you will need to be careful with prolonged pinching or grasping. 
• Pace yourself.  Take frequent breaks and replenish fluids to prevent dehydration.  It can be a long and physically demanding task to clean your house or yard, so space it out and don’t try to do it all in one day.  By taking breaks you will give your muscles time to rest and decrease the risk of injury. 
• Break up a big job into smaller ones If you are attempting a big job, especially alone, it is important to tackle that job with a plan. Break the one big job down into more manageable smaller jobs and complete those tasks one at a time.
• Avoid prolonged repetitive motions during activities such as cleaning, digging, planting, and pruning.  Once again take frequent breaks and stand up or walk to get out of a bent position.  Keeping your back in a sustained flexed position will lead to back pain and possible injury. 
• Wear gloves while performing yard work to reduce blistering and to protect your skin.
• Wear proper footwear. Avoid wearing flip flops, sandals, or slippers.  This will not only protect your feet but also decrease the risk of falls.
• Be careful on ladders! The ladder should be placed on a firm, level surface.  Avoid overreaching to decrease the risk of falls.  A good rule of thumb to follow is that your belly button should never pass the side of the ladder.  While inside, avoid climbing on furniture and use at a step stool instead. 
• Protect your knees.  While cleaning or working in the garden kneel onto a pad and avoid overreaching while in this position. 
• Mind wet floors!  Accidents from slipping and falling can be severe.  This is a perfect time to take a break and enjoy a nice beverage. 
• Use proper body mechanics.  When you do lift, use proper form!  Separate your feet, shoulder-width apart, keep your back upright and bend at the knees (squat) while tightening the stomach muscles. 
• Ask for help!  Instead of lifting that heavy object by yourself, wait and ask someone to help you.
• Listen to your body. If you are having pain, then stop and take a break. I know we are inclined to want to finish the job, but fighting through the pain could turn a small problem into a larger one. Spring cleaning tasks can be a strenuous on your body and your body will tell you exactly how it feels. If it is telling you to stop, listen!

             
​              To Schedule An Appointment Call 
                           304.525.4445

​               John Oxley 
PT, ​DPT, OCS, CSCS, Cert. MDT

Most physical therapists would consider themselves experts of the musculoskeletal system. Given that we have expertise in this area, there are many injuries or ailments that can be treated immediately by a PT. Most insurance companies no longer require a referral from a physician to start PT, and if after a PT evaluation and treatment, further intervention is required by a physician, then the therapist can help guide you to the appropriate referral. Here are some of the conditions that a PT could see first.

1) Recurrence of a past problem that was successfully treated by PT. If you have had a flair up of a previous problem that you went to PT for, then it is often unnecessary to see a doctor that is most likely going to send you back to therapy. The therapist should be familiar with your case and often the same treatments that worked last time will work again. This is especially common with flair ups of back and neck pain.

2) Muscle strains. Many times, these injures are associated with slipping or an athletic injury in an event. PTs are especially good at treating soft tissue injuries such as, muscle strains, and they have multiple options to make it feel better; like laser, massage, dry needling, E-stimulation and ultrasound. The faster the treatment starts the faster patients can start to feel better.

3) Ankle/knee sprains. These rarely require surgical intervention and often respond well to therapy. If the patient is able to weight bear on the injured joint for multiple steps and it is improving, then further treatment from an orthopedist is not likely. Though it is important to point out that some of these sprains can be difficult to truly evaluate until the swelling goes down. Often once the PT is able to help the patient get the swelling to decrease then a referral to a surgeon might be indicated if they suspect any tearing of ligaments.

4) Arthritic joint pain. Arthritis very common in the aging population. Many of these patients know they have an arthritic joint because they have been told so by a doctor on a previous visit. This does not require another appointment to diagnose the same problem. Many of these arthritic joints are not bad enough for replacement, but will
respond to over the counter anti-inflammatories, stretching and strengthening. The stretching and strengthening piece of the program is something that PTs prescribe every day and are experts at managing. Save your time and money and avoid the same diagnosis from the doctor that you have gotten before and go straight for immediate treatment.

5) Back/neck pain. Back and neck pain that has come on suddenly can be very painful. In many cases, this is caused by disc bulging and should be treated immediately because of the pain and suffering it can cause. Many PTs have had extensive training in the treatment of disc problems and if anyone has had nerve pain associated with the problem you know how painful this can be. Treatments include traction, manual therapy, and directional preference stretching to decrease the disc irritation on the nerve. Patients will also need extensive education about postures to avoid in order to
prevent the problem from getting worse.

If you or a loved one is suffering from any of the above-mentioned ailments, don’t hesitate to call your family PT and ask for an evaluation. These are ailments that we deal with every day and would be happy to quickly treat in an effort to get you back to full function as quickly and cost effectively as possible!

Family Medicine doctors are seen as an integral part of the healthcare delivery model because they are on the front lines treating patients, and whole families in some instances. They are seen as necessary to keep healthcare costs down because they help prevent problems from becoming severe and keep people from flooding the ER for every small event that takes place. The job of the family medicine practitioner is difficult because they seemingly need to know a little bit about everything. It is their job to manage some of the chronic ailments and refer out when people need more specialized care. This model seems to work well and I think it should be expanded.

The family practitioner model should be exported to the physical therapy world as well. The only difference would be that physical therapists would manage the numerous musculoskeletal pains that happen over a lifespan and the doctors would continue to handle everything else. I often hear from patients that they have a problem, but they will wait to bring it up with their doctor at their yearly or 6-month checkup. If PTs did checkups on people on a yearly or every 6-month basis, they could address many of the musculoskeletal issues that go untreated but cause dysfunction and limitation of activities.

When there is sickness in a family what do most people think to do first? Call their doctor to see if they can get in quickly to get medicine or treatment to find out what is going on. PTs could easily serve the same purpose for families. If you have a non-emergent issue such as acute back pain, a twisted ankle, or knee pain your family PT should be able to get you in within 24 hours to figure out how it should be managed. Management of these types of conditions rarely require a doctor and should ultimately be managed by a PT anyway. If we can adopt this model of healthcare with physical therapists for the musculoskeletal system, we could have a positive effect on reducing medical costs.

My message is clear! If you are an outpatient PT you should be offering your services to families and friends as a way to help manage aches and pains while decreasing unnecessary medical costs. If you are a potential patient you should make an effort to build a relationship with a local PT that will be there when needed to help you or your family members get out of pain quickly, efficiently and with a minimum spent on unnecessary visits, procedures, and tests.

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