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TMJ: A Real Mouthful

February 4, 2020 by Gabby Leave a Comment

TMJ

The temporomandibular joint (See why it’s abbreviated?), also known as the TMJ, is the joint that connects your jaw to your skull. The mandible attaches to the temporal bone which is part of the skull. The joint is located just in front of your ear and is surrounded by muscle, bones, blood vessels and nerves. Problems in this area can often lead to neck pain and headaches, ear and face pain, or your jaw locking or snapping while you chew. This is known as temporomandibular dysfunction (TMD). Studies are unclear as to why, but the research shows that more females have TMD than males. Go figure.

Causes

The most common causes of TMD include trauma and osteoarthritis. Grinding your teeth is the most common type of trauma. This can result in inflammation of the joint and spasms of the surrounding muscles which help you chew. This occurs most often at night while you sleep and can be difficult to control. This inflammation of the joint can also happen with clenching habits such as chewing gum or fingernails, usually stress habits. Degeneration of the joint can also occur, as it can with other joints in the body such as the knee and hip.

A final cause of TMD includes rheumatoid arthritis which can again cause inflammation in the joint and deterioration of the cartilage in the area. As mentioned previously, symptoms may include your ear ringing, headaches, neck pain, dizziness, facial pain and difficulty opening the mouth completely. Another common symptom is lock jaw, when the jaw either cannot open all the way or when the jaw is stuck in an open position. Not a very fun symptom.

Treatment

So how do we treat TMD? The treatment for this disorder is multifaceted. It involves the physical therapist, primary physician and dentist, all of which play an integral role. Your doctor can prescribe anti-inflammatories to help control the inflammation in the localized area. Your dentist may recommend a night splint or mouth guard created to help stop you from grinding your teeth at night. Finally, a physical therapist assists with soft tissue work both inside the mouth and outside the jaw in order to prevent and decrease spasms of the muscles for chewing. Joint mobility to the mandible will also help with improved biomechanics and smooth motion of your TMJ.

If you have significant TMJ pain, it’s important to take steps to alleviate it before it gets worse. Don’t hesitate to come in and let us help you start a plan to become pain free.

Post written by: Casey Badder, PT

Much Ado About Foot Pain

February 2, 2020 by Gabby Leave a Comment

Ouch!

Pain in your feet is no joke. Especially for those of us who find ourselves on our feet for long hours every day (aka just about everyone). If you find yourself feeling more than the usual aches and pains, it can quickly become a problem. If you have severe issues, if your walking or ability to stand is being seriously impeded, physical therapy at our office can help. However, there are some things you can do at home that can make a big impact and get you back on your feet without the pain.

A Hot Soak

First, your best friend when it comes to pain relief in your feet can be your bath tub. A hot soak for your feet and legs in the tub is great for increasing blood flow. Increasing blood flow helps your body repair the damage that causes pain. It also helps loosen and relax your muscles. Ten to fifteen minutes soaking in a hot bath is all you need to maximize the pain relief.

Do not underestimate the benefits of a relaxing hot soak. (Cat not recommended.)

Exercise

Second, you can help correct the pain you are feeling in your feet by strengthening the muscles in your feet. Working out the muscles in your feet is not exactly something you see people focusing on at the gym every day. But some simple exercise can help you see big benefits. You’ll just need a couple of things from around your house. Find yourself a handful of marbles, if they are different sizes then all the better. Next, find a plastic cup. Sit down on the edge of a chair or your couch and place the marbles on the floor next to the cup. Using only the toes on your feet, pick up the marbles one by one and drop them into the cup. It may seem simple, and a little silly, but doing this exercise a few times per day will help build muscles in your feet that you otherwise don’t work directly. Stronger muscles help your foot to function the way that it needs to in order to be pain free.

Chill Out

We’ve covered heating up, exercise, and last comes cooling down. What you’ll need for this last at-home technique is a water bottle. Stick the water bottle in the freezer and let it freeze solid. Now what you have is firm, cold roller for your feet. Place the frozen water bottle on the floor, and place one foot on top of it. Apply downward pressure and roll the bottle along the entire bottom of your foot. Doing this stretches and massages the bottom of your feet, breaking down scar tissue. The cold helps reduce inflammation, another important aid in pain relief. You want to chill your feet, but don’t do over do it.

With these three tips you can make a big difference and be happy on your feet again.

Battle of the Bulge

January 25, 2020 by Gabby Leave a Comment

Understanding Disc Bulges

Disc bulges can be caused by immediate trauma or injury (sports injury, auto accidents, etc.), as well as long-term trauma such as improper posture. Discs are located between each of the vertebral bodies of the spine. The discs are the shock absorbers of the body. They also help to give the spine more movement and flexibility as we twist and bend.

The discs are shaped like a hockey puck and are made up of cartilage, which is tough and leather like. Each of the discs is constructed like an onion, layered in rings. At the center of each disc is a watery, gelatin-like center called the nucleus. The discs have a high content of water and this is what makes them flexible. As we age, the discs lose some of their water content and become less flexible. This makes the layers of the “onion skin” more brittle and weaker.

What Is Causing the Bulge?

As we do activities that place us in a bent or “flexed” position (sitting, driving, reading, or watching TV), the low back can lose its natural curve, and pressure from the nucleus can be exerted on the back side of the discs. Over time, one layer at a time of the “onion skin” splits or cracks and the gelatinous center moves closer to the outside. Eventually this nucleus begins to distort the shape of the disc, causing the disc to bulge. This can happen to the direct back side but most often is slightly to one side or the other. (In rare cases, the bulge can be on the front side.)

The pain is caused because the back side of the disc has many nerves. Another factor is that the spinal cord is directly behind the disc and, as the bulge increases, it begins to irritate the nerves that are attached to the spinal cord. In the low back, these nerves travel down the leg. This can cause feelings of pain as far down as the foot and toes, as well as numbness or tingling in the leg and foot. This is called sciatica.

Fixing the Problem

One way to help with this problem is by beginning flexion or extension exercises. If this is done often, the layers of the annulus can begin to heal and can form scar tissue. As the disc heals, the bulges reduce in size and take the pressure off the nerves, decreasing or eliminating the sciatica.

“Traction” may also help relieve the sciatica. Consult your doctor or health professional to see if this is an option for you.

Another item that can keep the low back in its proper curve is a lumbar roll. The lumbar roll is placed behind the low back while you sit, and helps keep the back in its proper curve.

In some cases, surgery may be necessary if the exercise, traction, and lumbar roll do not resolve the condition. Your doctor or therapist will show you the exercises best suited to your situation.

Post Written By: Travis Rohner, PT

There’s No Fun in Foot Dysfunction

January 24, 2020 by Gabby Leave a Comment

Posterior Tibial Tendon Dysfunction

The posterior tibial tendon is one of the major supporting structures of the foot. It an important part that helps it to function while you walk. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon,that impairs its ability to support your arch. This flattens your foot. And that’s problem, because that can be painful. More painful than stepping on a Lego.

PTTD is often called adult acquired flatfoot. That’s because it’s the most common type of flatfoot developed during adulthood. PTTD is usually progressive (which means it will keep getting worse) especially if it’s not treated early.

Causes

Weakness and overuse of the posterior tibial tendon is often the cause of PTTD. In fact, you will usually feel these symptoms after repetitive motion activities that involve your tendon, such as running, walking, hiking or climbing stairs.

Symptoms

Symptoms of PTTD may include pain, swelling, a flattening of your arch and an inward rolling of your ankle. As the condition progresses, the symptoms will change.

For example, when PTTD initially develops, you will feel pain on the inside of the foot and ankle (along the course of the tendon). The area may also be red, warm and swollen.

Later, as your arch begins to flatten, you might still have pain on the inside of your foot and ankle. But at this point, your foot and toes begin to turn outward and your ankle rolls inward.

As PTTD becomes more advanced, your arch may flatten even more. The pain often shifts to the outside of the foot, below your ankle. At this point, the tendon has deteriorated considerably, and arthritis often develops in the foot. In more severe cases, arthritis may also develop in the ankle.

Nonsurgical Treatment

Because of the progressive nature of PTTD,we advise early treatment. If treated early enough, your symptoms may resolve without the need for surgery, and progression of your condition can be stopped.

In contrast, untreated PTTD could leave you with an extremely flat foot, painful arthritis in the foot and ankle and increasing limitations on walking, running or other weight bearing activities.

Post Written By: Clint Bunker, PT

We All Fall Down

January 9, 2020 by Gabby Leave a Comment

The Upward Costs of Falling Down

Falls are the leading cause of fatal and non-fatal injuries in elderly people. In fact, every 19 minutes, someone dies from a fall related injury. In recent research, Medicare and Medicaid are expected to spend over 100 billion dollars on fall related costs by the year 2030. So how can you identify if you are at risk for falls?

What Causes Falls?

Some risk factors include things that you can’t control, like your age. Others may include if you have a chronic health condition or polypharmacy, when you are taking multiple prescriptions at the same time. Consult with your primary care physician regarding the medications you are currently taking and how they may affect your ability to keep your balance. Two other factors that can affect your balance are your vision and hearing. Consult with your optometrist for a routine eye exam to rule out glaucoma and cataracts or a change in your vision. Also, a hearing exam will help to reduce potential risk factors.

There are, however, several risk factors that you can control to help your balance. Physical therapy can help with some of these. Weakness, decreased endurance, and poor flexibility can all affect your balance. Physical therapists can assist you in addressing these factors which can help improve your balance and decrease your risk for falls. By doing this, your confidence will also improve which can often lead to improved balance. Finally, a physical therapist can suggest if an assistive device can help you in walking. Assistive devices can also help you in your daily activities and help prevent falls.

Get Your Confidence Back

Feeling like you may be losing your ability to balance can be an awful experience. If you feel that you are a fall risk, or have recently had a fall, feel free to contact our office to get some advice on how we can help you get you get balanced on your feet again. The strengthening and treatment we provide can help give you back the confidence you need.

Post written by Casey Badder, PT

Back to Back Basics

January 9, 2020 by Gabby Leave a Comment

As I continue in my career as a physical therapist, one of the most common problems I treat is lower back pain. This can affect anybody, from the young to the old. There are various reasons that one can have low back pain, but most of the time there are common issues that those who are in pain share. A little information can help in order to reduce your pain.

First off, let’s review a little about your spine. Your spine is flexible and can move in different directions based on the positioning of the facet joints, the movable areas of the spine, and where those individual segments connect the bone above and below it. There are also muscles which attach directly to the bones of the spine, and those adjacent to it which can cause problems. It’s often abnormalities in these muscles that can be the cause of your back pain. Certain muscles can be weak or tight which can limit mobility. This causes pressure where there shouldn’t be, and that causes pain.

Muscles which can cause trouble:

Hamstrings: The hamstrings are a group of muscles on the back of your upper leg. If these are tight, they affect how your hip bones move. If they are really stiff they can rotate your pelvis backward, which pulls at your spine. A great way to stretch these is to sit in a chair with your leg extended in front of you, your heel on the ground, and lean forward keeping your back straight. Most people want to reach down the leg but I suggest keeping your hands at the top of your leg and supporting your straight back. Hold this for 30-45 seconds. Perform this move about 3 times, and do a set a few times per day.

Piriformis- Next, the piriformis is a muscle that is beneath your glute muscle group. Most people know where their gluteus maximus is. Well, this muscle is right beneath it. It runs from your sacrum, which is what you sit on, to behind the big bump on the outside of your upper leg called the Greater Trochanter. An easy way to stretch this is to sit and cross the affected leg over to where your ankle is resting on your opposite knee. Your lower leg should be as flat as possible. Gently lean forward until you feel a gentle stretch in the back of your buttock. Hold this for 30-45 seconds. Do this three times in a row, a few times per day.

Stretching not Screeching

Lastly, and the most important thing about stretches is: they should not hurt! If they hurt, you’re going too far. This is so important because a stretch that hurts is typically a muscle contraction, which is a shortening of the muscle. This is the exact opposite of what we are trying to achieve, so don’t do it! Remember these two factors are just the tip of the iceberg of what can be causing your pain. If you want to get more details, please consult with a professional so you can get properly diagnosed in order to return to all of your daily activities. Happy stretching!

Post written by Rod Walker, PT

Blog

TMJ: A Real Mouthful

TMJ

Causes

Treatment

Much Ado About Foot Pain

Ouch!

A Hot Soak

Exercise

Chill Out

Battle of the Bulge

Understanding Disc Bulges

What Is Causing the Bulge?

Fixing the Problem