Sunday, October 1, 2017

Alpaca Bag for Peru!

There are too many memories of my time on the inaugural Mechanical Care Everywhere mission trip to Peru.  As each day passes I am amazed at how small the world is becoming to me and how many similarities we all share.  Cusco and New Orleans are both Roman Catholic cities and share many similar customs.   Masks, celebrations, Catholic school uniforms, and even a second line parade following a funeral reminded me of home.  However, never have I found it so important to assist the patient in becoming self-reliant and independent of the therapist as I did in my short time there.  In the small mountain village of Ccorca, there are no therapists to treat the people.  What better system is there besides MDT which is based on the assessment and following education of the patient in self-care to assist these people in their musculoskeletal problems.  Frequency of flexion and poor sitting posture are not unique to the technological world as we know it but is an issue in underdeveloped areas as well.  Women, men and children in this area work very hard farming and raising livestock without the assistance of machinery that we are accustomed to using here in the United States.   This means hours of flexion planting and harvesting potatoes, heaving lifting and carrying, miles and miles of walking in mountainous terrain and you guessed it:   very little extension. 
Patients line up and wait to see us

Having traveled hours to get to our makeshift clinic, patients were lined up waiting to see us.  Many people were expecting pain medication as they do here but were so grateful to find non pharmaceutical methods to manage their symptoms.  Many patients had tears in their eyes as they thanked us for the time that we spent assessing them and giving them tools to manage their symptoms on their own.   Many women could not wait patiently in line and would do their best to interrupt my evaluation of another to insist that I see them by tapping on my shoulder or thrusting their intake forms into my view.  They were desperate for help!
Not an easy life in Peru


This was a common job of the people I evaluated.  I had assessed an 85 year old woman who carried a pack such as this and had walked two hours to seek care and had to rush back to take care of her animals before it turned dark.  Extension in standing over a table abolished her painful symptoms in minutes.  There were tears in both of our eyes as we hugged each other after the assessment.  Was this something she could do?  Yes.  Was this something she could do on her own?  Yes.   No need for endless visits to the clinic which is something that would not be possible in this culture. 



Sustained slouched postures



I remember reading many years ago that Robin McKenzie wanted to reach as many people as possible to allow them the tools to treat their own pain.   Colin Davies reminded us that this was indeed part of his mission and that he would be proud of our efforts in Peru.   I am proud to have served and hope to do more in the future.  Yes, "Alpaca bag for Peru" and beyond with Mechanical Care Everywhere!😏


For more information on Mechanical Care Everywhere you can visit the website:  http://www.mechanicalcareforum.com/mce/ and please consider a small donation for future endeavors. 

Tuesday, May 23, 2017

Should I Work Out if I Have Lower Back Pain? Part 1



This is a question I hear all the time...actually it is generally phrased "When can I work out?"  I wish there was an easy answer for this, but it depends.  There are absolute contraindications or Red Flags, meaning you shouldn't exercise until medically cleared to do so.   These include:

ABSOLUTELY NOT!
  • It the pain is severe and you are having numbness, tingling and weakness in your leg
  • If you have lower back pain after a recent car accident
  • If you recently had back pain and now you have changes in your bowel or bladder function, meaning you can't pee, or you are peeing without knowing in, or pooping on yourself without trying.
  • If you don't feel well with your lower back pain
  • If you have a high fever or you start sweating with your lower back pain
  • Develop other problems in addition to back pain, clumsiness...
  • If you have had a previous history of cancer or tumor.

You may be thinking, I wouldn't even think of asking that, but I have had a few patients in the past that I recommended they go to the Emergency Room.  If you are experiencing any of the above, I recommend the same for you.  You may need need some imaging to rule out something serious like a broken bone, infection, or cancer.   Of course, you wouldn't want to make any of these problems worse.  

Stay tuned for Part 2 next week when we will discuss return to exercise in the absence of  Red Flags.

Wednesday, February 15, 2017

The Season of "Mardi Gras Float Riders" Shoulders


· · ·
These little ladies – my hens,  have little to worry about when Mardi Gras comes around.  However, if we lived just a little south of here they would probably be an integral part of the chicken run or “Courir de Mardi Gras.” 

Happy Mardi Gras!



Physical Therapists and Orthopedists all over the Greater New Orleans area know that they will be seeing many patients with sore shoulders after their annual rides on Mardi Gras Floats. 










            Throw Me Something Mister! 

A little self –care goes a long way


While throwing beads, practice stopping the activity as soon as you feel discomfort in your shoulder and rest for about 30 seconds.  This will allow your shoulder to recover.  A good habit to get in is actually stretching your shoulder blades together with your hands clasped behind you – 3-5 reps with 3 second holds. 
If you have rested about 5 days and are still suffering with a painful shoulder you can actually try a commonly prescribed McKenzie exercise for shoulder mechanical pain.  This exercise is called shoulder extension in standing.  Place your affected arm behind you with the palm facing up by internally rotating your shoulder.  Stretch in this position to the end range.  You can hold this stretch for 30 seconds or perform sets of 10 – 15 repetitions.  As with any exercise if it makes your pain worse or obstructs motion – don’t do it and see a McKenzie practitioner. 


A great friend of mine, Joel Laing, Dip. MDT a physiotherapist from Melbourne Australia, a great mate, has a you tube video with some more helpful tips.

Reference:
McKenzie, Robin, Grant Watson, and Robert Lindsay. Treat Your Own Shoulder. Raumati Beach, N.Z.: Spinal Publications New Zealand, 2009. Print.