JOI Rehab Articles
By Andrew Heideman PT/ATC
Alter G Treadmill
JOI Rehabilitation is excited about our brand new Alter G
Anti-Gravity Treadmill which is now available for patient use at
our San Marco location! This unique device provides the
opportunity to exercise while lessening the impact on injured
muscles and bones while they are healing.
The Alter G Anti-Gravity Treadmill utilizes Differential Air
Pressure (DAP) technology developed by NASA which applies a
comfortable and even lift to your body. Your JOI clinician can
control reduction of the weight and force through your body from
100% to 20% of your body weight. This technology allows you
to utilize the normal mechanics of running or walking without the
pressure of full body weight through structures that are healing.
Indications for use of the Alter G:
Rehabilitation after surgery to the foot, ankle, knee, or hip
Gait training to focus on correction of improper running form
Reduced impact on your body while training
Strength and conditioning for older patients
The Alter G system is being utilized all over the world to help
elite athletes, weekend warriors, and patients of all types return to
their normal activity level. Top professional teams such as the
Boston Red Sox and the Los Angeles Lakers and top medical
centers such as the Walter Reed Army Medical Center rely on the
Alter G to help improve their patients’ outcomes.
Orthopedic Problems and Obesity
It has been reported that obesity is on the rise in adults and children in the U.S. Data obtained from the National Health and
Nutrition Examination Survey shows that 68.5% of men and women 20 years and older in the U.S. are overweight and almost 32%
are obese. Most people know that obesity contributes to the development of coronary heart disease, diabetes, high blood pressure
and colon cancer. Obesity is a contributing factor to back pain and symptoms associated with osteoporosis, osteoarthritis,
rheumatoid arthritis, degenerative disc disease, spinal stenosis and spondylolithesis. It has also been reported that being overweight
or obese increases the risk of orthopedic complaints such as tendonosis, bursitis, overuse syndromes and surgical complications.
Lack of exercise and bodily conditioning leads to poor flexibility and
weak muscles in the back, pelvis and thighs. The result may cause an
increase in the curve of the lower back causing the pelvis to tilt too far
forward. This type of posture increases stress on the structures of the
lower back and may ultimately weaken other areas of the spine such as
the neck which may also become painful. A sedentary lifestyle and an
unbalanced diet can affect the bone density or strength of the bones
(spinal vertebrae) that may increase the risk of compression fractures of
the spine. Disability suffered by obese subjects appear most strongly
related to lower body pain such as pain in the feet, knees, heel, and
lower back. Increased neck and shoulder pain is often attributed to
female patients. Such conditions have been reported to have major
negative impacts on quality of life measures among obese subjects.
The proportion of osteoarthritis attributable to obesity in middle-aged
women is estimated to be 63%. Current evidence suggests that the increased risk is more likely due to direct mechanical stress on
the joint rather than metabolic factors. Almost all subjects losing significant weight report improvements in their level of energy,
physical mobility, general mood, self-confidence and physical health. Studies following weight loss consistently show sustained
improvements in physical function and reduction in pain. The major improvement in quality of living in subjects with the knee,
ankle and foot pain supports the hypothesis that obesity causes or aggravates conditions producing these symptoms.
Data on weight loss as a treatment for osteoarthritis has shown that even small amounts of weight loss has favorable effects. A
reduction in weight has been shown to slow the progression of knee osteoarthritis. Weight loss and exercise lead to improvements in
pain, disability and performance in obese elderly subjects with established knee osteoarthritis.
If you want to take control of your overall health and fitness and lose unwanted weight, there are many weight loss programs
available. Well-known programs such as Weight Watchers and Jenny Craig have been successful for many people.
What is a Splint Orthosis?
Hand injuries, such as tendon lacerations or other upper extremity injuries, such as broken bones,
can occur in a variety of ways. A splint can protect and immobilize these joints, and depending on
the injury, there can be a variety of splints. Splints are made out of a heat sensitive plastic which is
custom molded with use of hot water. Typically a sock is placed on an individual’s hand while the
splint is being molded for comfort. This splint can typically be taken off for certain activities of
daily living (ADLs) such as showering or dressing. It also can be cleaned with soap and water. Just
be extra careful, as dogs and other small animals like them too!
The most common reason a splint is prescribed is for protection and immobilization. A splint for finger fractures is called a safe
position splint. This requires the patient’s metacarpophalangeal (MCP) joints to be bent approximately 70 degrees. This is needed
for proper healing. The site of the fracture will determine the length of the splint. If the fracture is closer to the tip of the finger, the
splint may only need to be hand-based. If the fracture is lower into the hand the splint may need to be forearm based. Another
common splint is a Long Arm Splint. This requires the patient’s elbow to be flexed at 90 degrees and the forearm in a neutral
position. This is common splint for most injuries, such as elbow fractures and surgeries needed to relocate nerves in the elbow.
While typically used for immobilization and protection, a splint can be used to increase range of motion (ROM) in joints. With
injuries, an individual can develop stiffness in joints. Static progressive or dynamic splinting can help increase the motion. These
types of splints are made through the use of springs or elastic bands that increases movement. These splints are initiated and
controlled by the patient and can be adjusted for comfort and to set the appropriate stretch. All splints are prescribed by a physician
and it is up to the doctor and your therapist to determine splinting frequency and duration.
What are Joint Mobilizations?
If your therapist mentions “joint mobilizations” or “mobs” as part of your treatment plan, here
is a brief explanation of what that means.
Your Physical Therapist’s Role
During your first visit to physical therapy, your therapist performs an examination and
evaluation which includes relevant tests and measurements related to your injury. One of these
measurements is your joint mobility. Joint mobility is the amount of movement a joint has when
it is passively moved. A joint may be hypermobile (too much movement/lax) or hypomobile
(too little movement/tight).
If your therapist determines that you have a joint that is hypomobile, he or she may perform joint mobilizations on the tight joint.
Joint mobilizations are defined as “skilled, passive movements” to a joint. They are used to stretch out the joint and surrounding
tissues and to loosen restrictions. They are similar to stretching a muscle, except that they are performed by applying a force directly
through the joint itself. The end result is an increase in range of motion and/or improved joint alignment.
Another use for joint mobilizations is to decrease pain. When used for this purpose, the mobilizations are gentler and are not
intended to stretch the joint or increase motion. This technique can be used on a painful joint, whether it is tight, normal, or even lax.
Clinicians will often use both types of mobilizations on a tight joint to increase mobility and decrease pain.
If your therapist performs mobilizations intended to increase joint mobility, he or she will likely have you follow up with
stretching or range of motion exercises to maintain the gains in mobility made during mobilization. This is where your homework,
or home exercise program, comes into play. You must maintain the motion that is gained or the joint may become tight again.
Remember the old adage: use it or lose it!
To schedule an appointment with JOI Rehab, please call 904-858-7045