By Andrew Heideman PT/ATC


Here are some of the frequently asked questions (FAQ) JOI therapists are faced with on a daily basis.

image of a patient receiving physical therapy of the knee

JOI Rehab FAQ for physical therapy

JOI Rehab FAQ – What are 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 spondylolisthesis. Overweight or obese increases the risk of orthopedic complaints such as tendinosis, bursitis, overuse syndromes, and surgical complications.

Osteoporosis Stages

Osteoporosis stages. close-up of human bones with different density. bone disease. aging process.

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 appears most strongly related to lower body pain such as pain in the feet, knees, heel, and lower back.  Such conditions have major negative impacts on quality of life measures among obese subjects.

Risk Factors of Osteoarthritis

The proportion of osteoarthritis attributable to obesity in middle-age women is approximately 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 knee, ankle, and foot pain supports the hypothesis that obesity causes or aggravates conditions producing these symptoms.

The Effect of Weight on Arthritis

Data on weight loss as a treatment for osteoarthritis has shown that even small amounts of weight loss have favorable effects. A reduction in weight will 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.

image of ActivArmor waterproof casts

ActivArmor waterproof casts

JOI Rehab FAQ -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 heat-sensitive plastic which is custom molded with the 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. You may clean it with soap and water. Just be extra careful, as dogs and other small animals like them too!

Reasons to Use a Splint

The most common reason a splint  for protection and immobilization. A splint for finger fractures is a safe position splint. This requires the patient’s metacarpophalangeal (MCP) joints to be bend approximately 70 degrees. This is necessary 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 flex at 90 degrees and the forearm in a neutral position. This is a common splint for most injuries, such as elbow fractures and surgeries to relocate nerves in the elbow.

While typically used for immobilization and protection, a splint may help to increase the 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 use springs or elastic bands that increase movement. The patient can be adjust the splint for comfort and to set the appropriate stretch. Your doctor and your therapist will determine splinting frequency and duration.

JOI Rehab FAQ – What are Joint Mobilizations?

If your therapist mentions “joint mobilizations” or “mobs” as part of your treatment plan. 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 moving. 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  “skilled, passive movements” to a joint. They will 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 do not stretch the joint or increase motion. This technique can be used on a painful joint, whether it is tight, normal, or even lax.

Manual Therapy

Clinicians will often use both types of mobilizations on a tight joint to increase mobility and decrease pain. Your Role 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 you gain or the joint may become tight again.
Remember the old adage: use it or lose it!

We also now offer Direct Access to Physical Therapy please watch the video below to learn more!

To schedule an appointment for physical or occupational therapy, call 904-858-7045 or call any of the 12 area JOI Rehab Centers.

Related Articles:

Trevor Lawrence Video and How to get rid of tennis elbow.

JOI and JOI Rehab

JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.

You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.

To make appointments with JOI Rehab, please call 904-858-7045.

Book An Appointment with a JOI Physician

Book An Appointment with a JOI Physician.By: Drew Heideman, PT, ATC

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