It’s what gives us the ability to walk on two legs and stays with us our entire life, balance. Our balance and vestibular system develop as we grow from a baby all the way through adulthood, and then begin to decline. Most people don’t know their balance is not optimum until they suffer a sports injury, trip and fall, or lose their balance in the shower. No matter what your age, balance affects your ability to be active.

Can you do this?

• Stand next to a counter or sink barefoot with your hand gently grasping the counter surface.
• Put one foot directly in front of the other, so that one heel is touching the opposite toes.
• Gently lift your hand up, but keep it close to the counter in case you need to grab it quickly. Try to hold this for 10 seconds (only do this if you feel safe or have someone nearby to help you).
• Now try it with you eyes closed.
• Do you wobble a lot or even lose your balance? Your balance needs work!

There are many reasons for our decline in balance:

• Changes in our vestibular system
• Changes in muscle mass, flexibility and strength
• Changes in eyesight
• Diminishing reflexes
• Previous injuries to ankle, knee, hip or spinal joints

How balance affects sports performance

The more aggressive you are in sports, the better your balance and reflexes have to be. Many ankle, knee, hip and back injuries in running, tennis and other sports are attributed to poorly performing balance. By incorporating simple balance exercises into your workout routine, you can set yourself up for success and prevent injuries, as well as enhance your sports performance.

How balance affects back pain

How you walk directly impacts your back and can actually be a big contributor to back pain. By improving balance, coordination and strength in your hips, pelvis and legs, your spine will be supported and guided, reducing strain. This in turn, helps your back function normally without aggravation and inflammation. Balance activities are an important component of our SPINE Program for relieving back pain.

Preventing falls

According to the Centers For Disease Control (CDC), over 2.5 million adults were treated for nonfatal injuries in emergency departments in 2013. In older adults, falls are the leading cause of fatal and nonfatal injuries. Most people don’t think about keeping their balance in shape, until it is too late and they fall, fracturing an arm, leg or injuring their back. The good news is that most falls can easily be prevented, simply by the regular exercising of your balance system.




What you can do

You can improve your balance, and it involves performing simple balance exercises. Try this easy exercise to strengthen your balance:

Calf Raise

• Stand facing and lightly touching a wall with your hands.
• Slowly raise up and down on your toes.
• Repeat 10 times, rest, then do 2-3 more sets.
• Try without holding on for a greater challenge.

The first step in preventing an injury or fall is testing your balance and being honest with yourself that your balance needs work. Our physical therapists can make a big difference in improving your balance and vestibular system, improving your ability to be active, safely. Call Hess Physical Therapy today to learn more about our specialized programs and how you can get back to an active, pain free lifestyle!

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

From the time we learn to take our first steps, we also begin to learn what it feels like to fall. Likewise, we learn to hold onto things like the edge of a table or our parents’ fingers to avoid falling. This natural avoidance to losing our balance is an important thing to have. According to the Center For Disease Control, one out of five falls will result in a serious injury such as a broken bone or a brain injury. Falls are not to be taken lightly!

On the flip side of that coin, we also cannot stop our daily activities due to the fear of experiencing a fall. Being cautious and avoiding certain activities or areas that may make us more prone to falling is wise, but like the CDC also notes, keeping active is one way of keeping us stronger, which can also help us avoid falling. Another way to help us build strength and fight the potential of falling is by exercising regularly. These 10 exercises, when done under the supervision of your physical therapist, can help you regain your balance and reduce your risk of falling.

1. Simple Leg Lift – For this exercise, start with a kitchen chair setting in front of you. Steady yourself by holding onto the back of the chair, and raise one foot off the ground by bending your knee and bringing it up toward your waist. (It is preferable that you let go of the chair back so that you are balancing on your own without assistance, but if you’re unsure or unsteady, keep your hand on the chair.) Hold this position for 5-10 seconds, then try closing your eyes and holding the position for 5-10 seconds. Now use the other leg and do the same exercise.
2. Weight Shifts – Another exercise to begin with is a Weight Shift. Stand with your feet hip-width apart. With your hands to your sides, or on your hips, lift one foot an inch or two off the floor and hold it there for 20-30 seconds. Set it down and repeat with the opposite foot. Do this as many times as you feel you can without getting too tired. As time goes by, the goal is to increase how many reps you do. If needed, you can also use a chair with this exercise to help give you added balance.
3. One-Legged Clock – Standing on one foot, extend your arms straight above your head, as though you are signaling 12 o’clock on a clock face. Leaving your right hand on the “12,” move your left hand to the three, six, and nine o’clock positions (pausing at each position). Return your left hand to the 12, and repeat the movements using your right hand. Now, switch feet and repeat. To increase your workout, do it with your eyes closed.
4. Tai Chi – Whether you sign up for a class, or follow along to online videos, Tai Chi has been shown to improve balance for its practitioners.
5. Yoga – Like with Tai Chi, yoga has also been shown to improve the balance of those who practice it. Again, you can opt to take a class, or you can workout to an online video or DVD.
6. Heel-to-Toe Walk – This exercise is simple, yet effective. Walk 20 paces forward, heel-to-toe. If needed, do this within arm’s reach of a wall to help you with keeping your balance. After you go forward 20 paces, go backward 20 paces — toe-to-heel. Doing this on a regular basis can help you regain a sense of balance.
7. Squats – To do a squat, stand with your feet hip-width apart. Bending at the knee, and not the waist, squat down toward the floor, holding your arms straight out in front of you. Pretend you are sitting in an invisible dining chair. If needed, keep a chair in front of you to help you get up and down. This exercise will help strengthen your leg muscles, which is crucial for the prevention of falls. An alternative way to squat: start with your back and heels against a wall. Keeping your arms out in front of you, bend at the knee and slide down the wall to a seated-like position (again, pretend you are sitting in an invisible dining chair). Using your legs, push yourself back to a standing position. Having a wall behind you can be a big help when you’re starting out or if you need additional help with balance.
8. Back Leg Raises – You can hold on to a kitchen chair when doing these leg raises, or you can place your hands on a wall, whichever is most comfortable for you. Once you have your chosen your preference, you will stand on one leg while raising the other one behind you. Try not to lean forward or bend the knee of the leg you’re raising; just lift your leg as far off the ground as is comfortable for you, hold it for a couple of seconds, and let it back down. Do this for 10 reps, then do the same thing with the opposite leg. This helps to build lower back muscles as well as buttock muscles.
9. Side Leg Raises – Like with the Back Leg Raises, you can use a wall or a chair to steady yourself with. Then, standing on one foot, lift your other foot out to the side. Go as high as you are comfortable with, hold it for a couple of seconds, and let it back down. Again, do this for 10 reps, then repeat with the opposite leg. This exercise not only helps strengthen your buttocks, but it also helps with your thigh muscles and your hip muscles.
10. Stability Ball – This ball may look like an over-sized beach ball, but it’s anything but. Just learning to sit on a stability ball can help improve your core strength, as well as your balance. After getting the hang of sitting on it, you can then incorporate it into various workout activities. You can sit on it while using dumbbells, or you can use it while doing sit-ups. It’s a very versatile tool to help improve balance and stability.

While these exercises can be a good starting point to help you improve your balance and reduce your risk of falling, your physical therapist may have additional exercises or variations that they can tailor specifically for you.

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

To your better balance,
George Hess

Do you find your shoulders aching at the end of the day or when having to lift your arms? Whether your pain is from an old injury or just from moving all day long, try these simple techniques to feel better and stronger.

Why Your Shoulders Hurt

Your shoulders are the most complicated joints in your body and one of the most easily injured. They have to move through an incredible 180 degrees of motion, while still maintaining stability and strength. Some of the most important muscles in the shoulder are actually the smallest.

The rotator cuff is a series of 4 muscles that form a cuff around the shoulder (glenohumeral) joint. Although they are small, they are vital to guiding how the shoulder joint moves. When these muscles are weak or injured, the head of the humerus bone can jam up into the socket of the shoulder blade, causing inflammation and pain.

Try these simple actions to improve the health of your shoulders and alleviate that nagging ache or sharp pain for good.

• Keep your shoulders aligned by doing postural exercises – The number one reason for repetitive injury and pain in the shoulders is poor posture. With prolonged slouching, the shoulders protrude forward changing the mechanics of the way your shoulders move. This weakens your rotator cuff and shoulder blade (scapula) muscles. It predisposes you to injury.
• Strengthen your rotator cuff muscles – By keeping your rotator cuff muscles strong, you help guide your shoulder joints throughout the day, lessening the chance for injury and inflammation to occur. A simple exercise to perform is lying on your side with your top arm straight up towards the ceiling. Now slowly lower the arm down towards your hip, but not all the way, then back up to the ceiling. Repeat 10-15 times for 2 sets every other day. Stay within a pain free range of movement. Stop if you have any pain or talk to one of our therapists if you have any questions.
• Improve your scapula stability – The scapula (shoulder blade) is a part of your whole shoulder complex. It has many different muscles attached to it, pulling at just the right time for proper shoulder movement. Every time you reach, pick up or pull, you use your scapula. Improve the stability of them by performing scapula exercises. A simple exercise is standing against a wall and gently trying to pinch your shoulder blades together, while keeping your arms relaxed. Perform 10-15 repetitions, holding the contraction for 5 seconds.

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

For active people with rotator cuff injuries, the most commonly asked question is whether or not the injury will heal without need for surgery. In 2012 the American Academy of Orthopaedic Surgeons revealed studies reporting that surgical repair fails in about 57% of rotator cuff cases. Non-surgical treatment of rotator cuff injury succeeds in about 50% of cases. It seems, then, that opting first for a non-invasive method has just as much potential for success as surgery.

Anatomy Of An Injury

Rotator cuff injury is common because the four major muscles involved in rotating the arm in the shoulder socket are used frequently every day. Each time a person moves their arm they are using their rotator cuff. The “cuff” is created by muscles surrounding the shoulder blade, working together to form a cuff of tendons that cover the top portion of the arm bone as it enters into the shoulder socket. The cuff serves to keep the ball of the arm bone properly positioned within the socket.

Lifting is the most common action that will become painful with a rotator cuff injury. You may feel pain as muscle tissue of the rotator cuff is pinched between the bones of the ball and socket joint. This condition may sometimes be commonly called bursitis. Rotator cuff pain becomes more likely in active adults as they age due to the normal effects of wear and tear or repetitive movement. Just as a rope will fray if constantly rubbing against a sharp edge, the tendons of the cuff will also eventually wear and possibly tear. Symptoms are usually noticeable as:

• Sharp pain down the side of the arm when reaching upward or behind.
• Throbbing pain at night during sleep.
• Pattern of pain across the shoulder and down the arm.

Non-Surgical Options

Physical therapy may be the first recommendation by a physician. In addition to a method of treatment, there are also many things an individual can do outside of a physical therapy environment to aid in recovery.

Rest: Rest the rotator cuff by limiting range of motion, especially overhead reaching.

Support: Compression wear is available with devices designed to specifically support the shoulder and rotator cuff. Often called a sling or sleeve, many have designs that integrate heat and ice therapies that further help to reduce inflammation and pain as well as accelerate healing.

OTC Medication: Non-prescription drugs like ibuprofen or naproxen can help reduce swelling and manage pain.

Exercise: It is important to continue to strengthen the affected shoulder and maintain flexibility. However, exercises and stretches should be adapted so as not to further exacerbate an injured rotator cuff that is in recovery.

Flexibility Exercises

Crossover Reach Stretch

1. Standing or sitting, raise affected arm chest high and reach across the chest.
2. Using the opposite hand, apply gentle pressure just below the elbow and hold for about 30 seconds.
3. Switch arms and repeat.

Back Hand Clasp Stretch

1. Clasp both hands behind you with arms lowered.
2. Slowly raise clasped hands as long is it does not cause pain. Hold for 30 seconds.
3. Release hands and relax for 10 seconds then repeat stretch.

Strengthening Exercises

When using weights in exercises to improve strength, select a weight that will not cause pain during use.

Pendulum Swings

1. Using a table for support, lean over with one forearm resting on the table top, back parallel to the floor, and dumbbell in the other hand hanging straight down.
2. Gently swing dumbbell back and forth for 30 seconds.
3. Switch arms and repeat.

Therapy Goals

Treatment approaches for rotator cuff injuries should have in mind multiple goals:

• Healing the injury.
• Managing pain.
• Maintaining range of motion.

Moderate immobilization with compression wear and limiting movement will help accelerate healing of the affected muscles. Proper use of ice, heat and over-the-counter medications can give a person pain management options within their control. Commitment to a regular stretching and exercise program will help to prevent atrophy of the affected muscle while waiting for the injury to heal.

A person does not have to be a professional athlete to experience a painful rotator cuff injury. Such an injury can occur just through the normal effects of aging and the everyday activities a person engages in. Pain from rotator cuff injuries can stay with a person for years. It is also very common to have a repeat performance of injury after a prior injury has healed. That is why once the problem arises it is important for any sufferer of rotator cuff injury to modify their lifestyle to include habits and methods that are pro-active in maintaining rotator cuff health. Don’t perform the recommended flexibility and strengthening exercises only after an injury occurs, make them a regular part of your daily health regimen.

Also keep in mind that healing properly from a rotator cuff injury can take a very long time. Be patient and stay committed to your physical therapist’s advice on how to care for your injury. For more information regarding rotator cuff health and injury recovery, consult medical experts who are committed to non-surgical approaches first.

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

A rotator cuff tear is a common and serious injury. To fully recover from this type of injury it is vital to go through proper rehabilitation. The goal is to strengthen these muscles while not overworking them. Due to the complicated nature of the shoulder joint, it is best to seek the help of a professional when working through your rehabilitation.

The Rotator Cuff Muscles

First, it is important to understand what this injury is, so you know how it will be treated.

The anatomy of your shoulder looks like this; the ball of your shoulder sits in a very shallow socket created by your shoulder blade and collar bone. Holding this ball into the socket and keeping it stable are four muscles called the "rotator cuff". This rotator cuff is made up of the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles provide stability while also allowing for a wide range of mobility.

If you have a "tear" of the rotator cuff then you have torn through one or more of these muscles or tendons. Each person is different but some of the typical signs and symptoms of a rotator cuff tear are as follows:

First would be pain. You should not have shoulder pain as it is not normal and should not be ignored. It warns you that there is something wrong and will continue to get worse unless addressed. Although pain is present, it doesn't always mean that a tear is present as well. A muscle or tendon strain, tendonitis, or bicep issue could also be the culprit. However, these issues can lead to tears in your rotator cuff if left untreated, so be sure not to overwork with pain.

Swelling can also be present with a rotator cuff tear, so if your shoulder is swollen, you should seek medical attention. Another sign would be a loss of motion. If you are unable to raise your arm as high as you were before the pain, then chances are there could be something wrong.

Keep These in Mind

There are a few important things to keep in mind when working out your shoulder:

• Don't overdo it with heavy weights. You do not want to lift something that your shoulder isn't able to handle. Make sure to consult your therapist.
• Important to warm up the shoulder before beginning strength training. Follow your therapist's specific warm up routine.
• Don't get frustrated during these workouts. These injuries take time to heal and it will take time to return to previous form.
• Ice will help after workouts to reduce swelling and help your shoulder heal properly.
• Make sure to give your shoulder the rest it needs. Don't overdo it with unnecessary activity. Avoid any sports or strenuous activity until you are fully healed. If you are unsure, consult your therapist.
• If you are looking for a more intense workout, you are still able to work lower body. Just be sure to avoid stress to the shoulder as your therapist recommends.

Injured rotator cuffs are serious injuries, but it's not one that you can't recover from with the right therapy and pace. Remember, shoulder rehabilitation takes time and it is important to give your shoulder the proper time it needs. Always consult your doctor or therapist before trying anything on your own, because the last thing you want is to make things worse for yourself.

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

1. Find out if you have a balance problem
   Are you falling or tripping more often? Do you feel like you rely on a friend or furniture to walk safely from one place to another? Have you changed your normal lifestyle to accommodate the fear of a potential fall? If you have answered yes to any of those questions, you may have a balance problem. Balance is dynamic. There are several component parts that contribute to balance such as the musculoskeletal system, the somatosensory system, the vestibular system, and the neuromuscular system. All systems play an equal role in contributing to someone's overall stability. It is absolutely necessary to determine which system(s) are impacting your balance to appropriately treat and find optimal outcomes. You can determine which systems are impacting your balance by contacting your doctor or physical therapist.
2. Safety First
   The next step in reducing your potential for falling is to review your home to ensure that it is environmentally safe? Do you have throw rugs throughout your home? Do you have limited lighting in your hallways and walkways at night? Do you have staircases without handrails on either side? Do you have excessive clutter throughout the rooms in your house? If you have answered "yes" to any of these questions, then you may be at risk for falling from environmental hazards. Modifying your environment is a quick and easy way to decrease ones fall risk and improve someone's safety in the home. Eliminate obstacles, such as scatter rugs, clutter, and phone and electrical cords. Install handrails on stairs and grab bars near toilets and bathtubs. Install non-skid strips in bathtubs and showers and use only non-skid bath mats. Keep items you use often in cabinets you can reach easily without using a step stool. Another important step in safety is to review your daily activities. You certainly don't want to restrict your activities, but you should be aware of activities that may put you at risk. This includes rising quickly from a lying or seated position to standing.
3. Take charge of your physical condition
   Take charge of your physical condition by exercising regularly (always consult with your doctor before starting a new exercise program) and getting regular physicals. Keep your eyeglass prescriptions updated with regular eye exams. Poor vision can increase someone's fall risk.  Be aware and monitor any side effects your medications. Many medications are known to cause dizziness or even fatigue, both of which can increase your risk for falling. You should not limit your participation in health activities or regular exercise. Ironically, inactivity itself can increase your risk for falling. Prolonged inactivity can decrease muscle strength and flexibility. In addition, it can decrease your ability to react to sudden changes in your environment, such as a slippery floor or uneven surfaces outside. By remaining active in your daily life, you maintain your strength, flexibility and coordination, as well as your ability to keep your balance in a variety of conditions. More importantly, act now! Stop making excuses on why you have balance problems. Do not wait until you fall. Take charge of your physical condition and your surroundings. If you notice that you are unable to confidently perform certain daily tasks, you are falling or tripping more frequently, and/or you are experiencing symptoms of dizziness you should contact your doctor or physical therapist for an appointment to discuss your symptoms.

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

Everything you do in your daily life, whether for daily living, work, or fun requires balance. Walking, getting up from a chair, cleaning the house, and reaching in the cupboard are all activities that require balance. All of these tasks require balance control but should be automatic processes that require minimal attention to balance. However, when there is a balance problem, these processes are no longer automatic and take conscious effort. It can cause disruptions in your daily routine and increase you risk for falls.

What is balance?
Balance is a complex process that depends on three components:

1. Sensory systems to communicate incoming information about our body and its relationship to the environment around you
2. Your brain to process this incoming information
3. Your muscles and joints for coordinating the movements required to respond to the brain's interpretation to sensory input

Balance control is accomplished without requiring our conscious attention. When there are balance deficits, we have to exert conscious effort to try to overcome obstacles and complete daily tasks. It can result in fatigue, shortened attention span, and reduce a person's ability to complete several tasks at once.

Loss of balance
In a normal healthy individual, the three senses of vision, hearing, and touch work together to perceive where the body and head are in space. They provide information about the environment around us.  These sensory systems communicate with the brain to ensure optimal stability. When a person has a balance disorder, one may have a problem in any one of these systems or multiple systems. The risk of developing one or more of these problems increases with age due to potential degenerative changes that occur over time, infectious diseases, and/or the effects of injuries accumulated over a lifetime.

Identify, treat, and improve balance
Balance can improve and fall risk can reduce! Although age, past medical history, and medical conditions play a role in someone's overall balance, it does not limit them from improving balance. Balance is quickly learned and improved when practiced. The key component of improving one's balance is understanding what component part of balance is compromised. Because of the complexity of balance control, not all balance problems are the same. Determining the cause of a balance disorder and what treatment options are the most appropriate can be difficult. However, there have been significant advances in evaluation and treatment approaches for balance disorders that have proven to be highly effective and offer relief to those suffering from imbalance or dizziness. There are also medical professionals and clinicians who are specially trained to apply these evaluation and treatment methods.

It is not uncommon for individuals with a history of balance problems to regain their balance control through accurate diagnosis followed by specific medical treatment and/or rehabilitation exercises. Balance can be practiced, balance can improve, and fall risk can decrease!

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

Dizziness is a term that is used for a variety of sensations that can mean different things to different people. Spinning, wobbly, unsteady, and lightheaded are some of the few words people use to describe their dizziness.

Dizziness can be caused by a number of different factors. One potential cause of dizziness includes a problem within the balance control mechanism. For example, vertigo can be caused by a disturbance in a particular part of the inner ear - the vestibular system. The number one symptom with vertigo is spinning. The vestibular system provides your brain with information about your head in relation to gravity. When there is miscommunication between your inner ear and your brain, the result may be dizziness, vertigo (spinning), imbalance, disorientation and possibly nausea and vomiting.

Vertigo is not the only cause of dizziness. There are several other reasons why someone may feel dizzy. However, no matter what the cause, dizziness is a symptom that can be treated when appropriately diagnosed. Diagnosing takes the appropriate clinical examination to determine the cause of your symptoms. When diagnosed, appropriate treatment can resolve your dizziness.

Do not IGNORE your symptoms of dizziness. Several people mistaken dizziness for the normal aging progress, hormonal imbalance, or make excuses and blame their symptoms on their imagination. The truth is, none of these statements are accurate.

It is important to seek medical attention from your doctor and/or physical therapist to discuss your symptoms of dizziness.

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

Lumbar Spinal Stenosis. Big words for an unbelievably common problem. Lumbar spinal stenosis is a condition affecting the lower back where the spinal cord one or more of the vertebral foramina become narrowed due to one of several causes. It is painful and causes pain, weakness, and numbness in the lower extremities. Read on to learn more about this condition.

What exactly is this condition?
The lumbar area is the lower back, specifically made up of five vertebrae in the lower back area. The spinal cord runs through the spinal canal and nerves come off the spinal cord and exit through small openings in the vertebrae called foramina. These nerves control the sensations and movement in the lower extremities – buttocks, legs, toes, etc. Sometimes, the spinal canal or the vertebral foramina narrow and begin to put pressure on the spinal cord and the nerves. This causes pain, numbness, and weakness possibly diagnosed as lumbar spinal stenosis.

What causes lumbar spinal stenosis?
According to the Mayo Clinic, some people are born with a small spinal canal, but most spinal stenosis occurs when something happens to reduce the amount of space the spinal cord or the nerves have available. It is most commonly diagnosed in people over the age of 50. Some causes are:

• Overgrowth of bone – wear and tear on the bones of the spinal column can sometimes cause osteoarthritis to develop and bone spurs to grow into the spinal canal. This is the leading cause of lumbar spinal stenosis.
• Herniated disks – the disks between the vertebrae wear out with age and compress. As this happens, some of the material inside the disk runs out and into the spinal column putting pressure on the spine.
• Thickened ligaments – the ligaments that hold the bones together may thicken over time and begin to bulge into the spinal canal.
• Tumors – benign or cancerous abnormal growths occur within and along the spinal canal and membranes, putting pressure on the spinal cord and nerves.
• Injuries – injuries from accidents or even swelling of tissue after back surgery can put pressure on the spinal cord and nerves.

What are the symptoms?
Symptoms of lumbar spinal stenosis are typically pain or cramping in the legs and buttocks, especially after walking or standing. Often sufferers have numbness or weakness of the lower extremities. The pain is usually relieved by sitting down or even bending over. The symptoms may mimic other disease states such as sciatica, diabetic neuropathy, or peripheral vascular disease. The symptoms often continue to worsen over time and even lead to a loss of bowel and bladder control. It is very important if you have persistent pain, numbness, or weakness in your back, legs or arms to visit your doctor to find out the cause and seek treatment.

How is lumbar spinal stenosis diagnosed?
Your physical therapist will diagnose the disease by first discussing the symptoms and medical history, including how long the symptoms have been present and when they are better or worse. Next is the physical exam including assessment of range of motion of the back and the legs.

Are there treatments for lumbar spinal stenosis?
In most cases, patients with lower back pain and sciatica due to spinal stenosis can recover without medications, injections, or surgery. This is where a thorough evaluation from a therapist trained in hands-on manual therapy is crucial. He'll be able to determine specifically which muscles and joints in your spine need to be worked specifically with the skilled use of his hands.

Another thing we see is that it's common for people who have spinal stenosis to limit their activities which leads to weakness and often more pain. Physical therapy can help to strengthen muscles and improve endurance. It can help develop and maintain flexibility of the spine and it can help improve balance that may have been lost while suffering with pain and discomfort.

In most cases, patients need not worsen to the point where they would need surgery. Although some less invasive procedures have been developed in recent years, however, there are always risks with any surgery so your doctor will discuss the options and weigh the risks and benefits with you to allow you to make an informed decision.

Can it be prevented or treated at home?
Unfortunately, because it is a degenerative disease, lumbar spinal stenosis cannot be prevented. It is often just a normal part of the aging process, but exercising and physical therapy can often minimize the symptoms and limit progression of the disease. Outlook for recovery depends on the severity and duration of symptoms when it is first diagnosed as well as response to conservative treatments.

Home treatments include applying hot or cold packs, performing prescribes exercises, maintaining a healthy weight and using a cane or walker when necessary to reduce the stress applied to the lumbar area or provide relief from pain.

If you or a loved one has been diagnosed with lumbar spinal stenosis, the professionals at Hess Physical Therapy  are here to help with your therapy needs. Contact us to help you get started on the road to recovery.

Our locations:

• Kennedy: (412)-771-1055
• Crafton: (412)-458-3445
• Allison Park: (412)-487-2787
• Bethel Park: (412) 835-2626
• Atlasburg: (724) 947-9999

Website: www.hesspt.com

Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.

Many people have never heard of the sacroiliac (SI) joints and have no idea of where they are or what their function is within the body. But those who suffer from sacroiliac joint pain are all too familiar with the joints themselves and the pain caused when something goes wrong with them.

Where Are the Sacroiliac Joints?

If you look at the word "sacroiliac", you'll see that it describes two areas in the body:

• "Sacro" sounds a little like "sacrum", which is a triangular-shaped bone in the lower part of the spine, centrally located just below the lumbar spine. The sacrum, unlike most of the spine, is not mobile. It's made up of five vertebrae that are fused together.
• "Iliac", the second part of the word, refers to the two large bones (ileum) that make up the pelvis.

The target="_blank"sacroiliac joints, or SI, are what connect the spine to the pelvis. The sacrum and the illiac bones are held together by a group of strong ligaments. There is very little motion at these joints. Most of the motion in the area around the pelvis is either facilitated by the hips or the lumbar spine. The joints act primarily as shock absorbing structures.

There are numerous terms for pain in the SI joints, including SI joint dysfunction, SI joint syndrome, SI joint strain or inflammation. All refer to a condition that causes pain in the SI joints stemming from different causes.

Causes of Sacroiliac Joint Dysfunction

As with most joints in the body, the SI joints are covered by a protective layer of cartilage. When this cartilage is either damaged or worn away, the bones begin to rub against each other, eventually causing degenerative arthritis (sometimes known as "osteoarthritis") to develop.

Aside from aging, one common cause of SI dysfunction is pregnancy. Hormones released during pregnancy allow the ligaments to relax, allowing for more movement in preparation for childbirth. The increased movement in the joints can and often does cause increased stresses and abnormal wear. In fact, any condition that changes the normal walking pattern puts stress on the SI joints that can lead to pain. This might be one leg that's longer than the other, or pain in another joint such as the hip, knee or ankle, that causes a change in the way a person walks.

It's not only too much movement in the SI joints, that can cause problems — too little movement (hypomobility or fixation), can also lead to pain. The area where a person feels pain depends on whether the problem is caused by too much motion in the SI joints (hypermobility), or too little:

• Too much movement typically causes pain in the lower back or hip area which sometimes radiates in the groin area.
• Too little movement usually results in pain on one side of the lower back or buttocks which sometimes radiates down the leg (similar to the pain of sciatica).

Other disorders that affect the body's joints can sometimes cause pain in the SI joints. These include:

• gout
• rheumatoid or psoriatic arthritis
• reactive arthritis
• ankylosing spondylitis (a form of inflammatory arthritis that always affects the SI joints)

Symptoms of an SI Disorder

As mentioned, a problem with the SI joints causes symptoms ranging from lower back, hips, buttocks, groin and legs. The pain is usually worse with prolonged sitting, rolling in bed, getting in and out of bed, getting in and out of the car. Sometimes, there may also be stiffness in the SI joints and a burning sensation in the pelvis.

Diagnosing Sacroiliac Dysfunction

The first step in diagnosing a problem with the SI joints, is gathering a medical history and performing a physical exam. The physical therapist will ask questions to try to ascertain whether there are any underlying disorders that could be causing a patient's pain. Because there are other conditions that can produce similar symptoms, it's basically a process of elimination that helps narrow down the diagnosis.

Certain "signs" can also help the doctor differentiate SI pain from pain coming from other sources such as the lumbar spine or the hips. Various tests can be performed during the physical that can help pinpoint or isolate the source of the pain. Putting the hips and legs in certain positions and then applying pressure can move or apply pressure to the SI joints to determine if they're what's causing the pain. In other words, the physical therapist actually tries to "provoke" pain in the SI joints.

Treatment Options

Physical therapy is often very useful in treating SI joint pain. A physical therapist will prescribe exercises and stretches that can often go a long way toward providing significant pain relief.

What's even more helpful is a specialty field in physical therapy called manual therapy. It's form of therapy where the physical therapist uses skilled techniques learned through additional training that helps move the pelvis and the spine, and optimize the condition of the muscles surrounding the sacroiliac joints.

But it all starts with a thorough and comprehensive physical examination. A good evaluation lays the foundation for successful treatment.

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Disclaimer: this information is "not medical advice" and is used at the site visitor's own risk.