MLCPT Blog

Check out our new program for Triathletes!

2012-01-24T15:27:00.005-05:00

Peak Performance Triathlon Training Program

Designed for optimal performance & conditioning

Functional screen by a physical therapist
Swim analysis & conditioning
Triathlon specific spin class
Strength training

Click this link to view more information about Peak Performance!

Torticollis

2012-01-16T11:34:00.006-05:00

Mary Lou Corcoran Physical & Aquatic Therapy’s Pediatric Team evaluates the infant/child’s range of motion, muscle tone, posture, developmental milestone and neuromotor status to identify areas of concern. A treatment plan is developed in conjunction with family/caregiver education. Without treatment, Torticollis patients’ fail to develop essential range of motion and eye convergence effecting the visual field, neglect of one upper extremity, jaw malalignment, scoliosis, muscle imbalances, poor balance, misshapen heads and extreme muscle tightness.

Therapeutic interventions include hands on techniques such as manual therapy, neuromotor re-education and modalities. Combination stretches into multiple planes of motion target the sternocleidomstoid muscle in supine, prone, sitting and side lying positions. One on one techniques utilize bilateral upper extremity task completion including fine motor skills and scapular stabilization.

Education of the parent(s)/caregiver(s) is provided through the use of interactive demonstrations along with illustrative handouts teaching proper hand positions, stretching techniques and positioning while emphasizing “tummy time” when the infant is awake and active.

MLCPT’s exclusive Pediatric Program was developed by two of our physical therapists with over 30 combined years of hands on pediatric clinical experience. Throughout the child's care at MLCPT, the Physician, parent(s)/caregiver(s), and therapist work together to help the child develop their maximum functional independence.

Persistent Wrist Pain Following Distal Radius Fracture

2011-06-03T13:18:00.001-04:00

Have you broken your wrist and still have experience pain with gripping and twisting activities like pouring a drink or turning a door knob? Did you believe that you have a sprained wrist, as a result?

A common problem from a broken wrist (distal radius fracture) is pain after the fracture has healed. The distal radius is commonly broken because it bears 80% of the force when falling on an outstretched arm. This is why more people break this bone (radius) instead of the other bone in the forearm, the ulna. However, although the fracture occurs at the “thumb side” of the wrist, there is a ligament complex located on the opposite side of the wrist called the triangular fibro cartilage complex (TFCC) that can be injured. Additionally, the distal radius bone can heal shorter than it once was which will ultimately produce more force though the articular disc and TFCC creating more pain.

Studies indicate that 35-50% of all patients with wrist fractures present with problems in the TFCC region. As a result, an individual who has a recent wrist fracture may begin to feel discomfort at the ulnar/pinky side of your wrist after the bone heals and they start to regain motion. People will often complain of clicking, increased swelling, weakness, and lack of motion. They have difficulty with activities such as turning a door knob/key as well as difficulty ironing, scrubbing, performing a push up, Yoga and pouring a drink.

Rehabilitation following a distal radius fracture involves the use of modalities, range of motion and strengthening exercises. How well healed the fracture is (based on x-rays) and when an individual begins physical therapy determine what exercises they should be doing. These exercises may need to be modified by a physical therapist especially when persistent wrist pain is present. Functional recovery for stable fractures without complications can be six months and 1-2 years for complex fractures. Fortunately, the rehab process does not take that long. It is the therapist’s role to educate the patient and assist them in making maximizing their outcomes both in the clinic and home setting. The goal of physical therapy is introduce the patient to all of the available tools and exercises available to manage their symptoms until recovery is complete.

The wrist is very complex and requires careful evaluation to develop a good plan of treatment to achieve maximal functional recovery. If you are experiencing these symptoms and would like to schedule evaluation with our upper extremity team please call Marylou Corcoran Physical and Aquatic Therapy (315) 637-4747.

Operation Walk

2011-06-03T13:03:00.003-04:00

Operation Walk is a non-profit organization that allows severely disabled arthritic patients in countries with underdeveloped health care systems to receive total-joint replacements at no cost. The recipients of care are afflicted with intense and unrelenting pain with mobility limitations that make the experience of a normal and productive life nearly impossible. The goal of Operation Walk is to enable people to return to their lives as productive members of society. To date, Operation Walk has conducted successful operations in Panama, Ecuador, Russia, Cuba, China, The Phillippines, Nicaragua, Peru, El Salvador, Vietnam, and the United States.

MLCPT is proud to announce that Julie Randall, PT, CSCS, LMT will be a member of an inter-disciplinary medical team that will be traveling to Kathmandu, Nepal in November 2011, the first journey for Operation Walk Syracuse. As a member of Operation Walk, Julie will be working closely with physicians (from St Joseph’s, SUNY Upstate and Crouse Hospitals), physical therapists, nurses and other health professionals; maximizing the post-operative outcomes of over 75 joint replacements to be performed in one week. While in Nepal, she will not only be responsible for the direct care of post-operative patients, but she will also serve as an educator, helping to instruct Nepalese health care workers in the latest techniques in rehabilitative science.

As you may imagine, the cost for such an endeavor can be staggering. In the United States, the charges for one hip or knee replacement can be in excess of $100,000, with the total cost being greater than $7,500,000. Fortunately, through the donations of more than 40 professionals, coupled with donations from implant and pharmaceuticals companies, the cost is reduced significantly. Contributions continue to be needed, however, to cover $200,000 in remaining expenses for team transportation, supply shipping, food, lodging, non-donated supplies and equipment repairs. If you have an interest in helping support Julie and Operation Walk, we would encourage you to visit the Operation Walk website to make a donation.

Don't Forget The Gluteals!

2010-11-25T14:42:00.005-05:00

Do you have a stubborn running injury that won't go away? Do you ignore working your gluts in your training while focusing on your quadriceps and hamstrings? Most people fail to recognize that many common running injuries are often traced back to weak gluteals, namely the gluteus maximus and the gluteus minimus.

The gluteus maximus is the larger of the gluteals. Its primarily extends your leg/hip while you are walking. If you have a weak gluteus maximus, you may develop limited range of motion in your hip, poor running form, slower speeds and muscle imbalance that often leads to injury. The smaller of these muscles, your gluteus medius, has an even more important role. Located on the outer surface of your pelvis, it is responsible for stabilizing and balance your hips. when balanced on one leg, as is the case when walking and running. With exercise programs designed without emphasis on the the gluteals, many runners and athletes suffer from poor balance, and they do not even realize it.

How are they able to run with poor balance? They compensate by using other muscles that aren't intended to be used for balance. Over time, runners with poor balance will develop bad form and alignment issues in their hips leading to pain and injury. Common running injuries due to weak gluts include ITB syndrome, patellar tendinitis, hip flexor tendonitis, achilles tendinitis and even plantar fascitis.

How do you check your balance to see if this may be your problem? Practice standing on one leg with your knee slightly bent and time yourself. Repeat the same activity on your opposite leg. Pay attention to see if one leg easier to stand on than the other and assess if you have pain while standing on either leg.

Another, more challenging test (if the first is too easy) is to try a single leg squat. Try standing on one leg and while maintaining your balance, complete a squat. Are you able to maintain your balance? Does your knee bow inward or outward? Do you have pain and/ or difficulty completing the task? If so, you may need to work on strengthening your gluteals.

Most people who run will experience at least one or more injuries over the course of their running career. There are many simple ways to prevent these injuries without spending hours at the gym, using fancy equipment or lifting heavy weights to achieve good results. Effective exercises to strengthen the gluteals and improve your balance can be done with no equipment and with a minimal amount of time/effort.

If you are interested in prolonging your running career or improving your running form/overall health, a visit to a knowledgeable physical therapist can be a very helpful and beneficial way to achieve your goals. Although the gluteals are important, they are just one of many muscles groups involved in running and other athletic activities whose dysfunction and imbalance can lead to injury. Mary Lou Corcoran Physical and Aquatic Therapy has experienced clinicians who work with runners and athletes at varying stages of their lives, helping them relieve pain and return to a lifestyle that is important to them.

Many injuries, if caught early, can be healed much quicker and easier if stopped before they are serious. Don’t wait until the pain is severe before looking for help. If you are experiencing pain, consider calling us at (315) 637-4747 to schedule an appointment with one of our physical therapists for an evaluation and movement analysis screening; it may be the best decision you make in your efforts to maintain an active and healthy lifestyle.

Posted by Julie Randall, PT

Kevin J. Reistrom, PT (1978-2010)

2010-10-31T14:17:00.000-04:00

Kevin J. Reistrom, 32, of Syracuse, was surrounded by his loving family as he was called home to be with the Lord on Wednesday, after a long and courageous battle with brain cancer.

Kevin was everything a great man could be. He was a loving son, brother, uncle, nephew, cousin, friend, and above all, a very loving husband. He worked very diligently at everything that he did in his life. He graduated from Henninger High School in 1996 where he excelled academically. In addition to his scholastic achievements, Kevin played varsity football and lacrosse, which culminated in him receiving the student/athlete award as a senior. Kevin also played the alto saxophone in the concert and jazz bands for 4 years at Henninger and was selected to play with the Stan Colella All Star band for several years. He successfully pursued and earned a Bachelor’s degree in Health and Exercise Science from Syracuse University in 2001 and then worked as a fitness trainer for Train to Attain. With his perseverance and commitment to life-long learning, this led him to SUNY Upstate Medical School where he not only earned a second Bachelors degree, but also earned his Master’s degree in Physical Therapy. He thoroughly enjoyed working at Mary Lou Corcoran Physical and Aquatic Therapy as a well respected physical therapist. It gave him a great sense of pride and satisfaction to help improve the quality of life for his clients.

Kevin is survived by his wife of 2 years: Jamie (Bottino Compton) Reistrom, his parents Carl and Mary Ellen Reistrom of DeWitt, his mother-in-law Luann Bottino of Syracuse, his maternal grandmother Carmella Dungey Peiffer, and his grandmother-in-law Shirley Bottino of Cicero. He is also survived by his sister Catherine (Adam) Smith of Savona, NY and his brother Carl (Lia) Reistrom of DeWitt. Also surviving are his five nieces and nephews whom he adored: Corissa, Shaina, and Aaron Smith and Celia and Luke (Godson) Reistrom as well as several aunts, uncles, cousins, and friends.

Kevin especially enjoyed spending time with his family at home and also at their summer camp on Oneida Lake. His close friends, John (Bubba), Andy and Alex shared many good and memorable times together. Kevin loved attending Yankee games, bowling, golfing, reading, listening to music, playing cards and various types of games. Kevin was truly a goal oriented, polite, dignified and loving man who will be missed by so many people in many different ways!

We miss your smile, we miss your laugh.
We miss your humor, we miss your gaffs.
We miss your wit; your quick remarks.
We miss your passion; your baseball smarts.

Our patients have lost an advocate; a man whose dedication was only exceeded by his compassion for all those who walked through our doors. But while they have lost a therapist, we have lost a friend. May you always be remembered fondly and with love by all those who were graced by your friendship.

We love you, Kevin.

Advocating For Optimal Physical Therapy Care Under Medicare: The Second Step

2010-08-28T16:39:00.002-04:00

The time is upon us to contact our representatives in the 111th United States Congress and remind them that November is coming, and we will let our votes speak for us! At this time, a greater than 21% reduction in reimbursement is scheduled to begin on December 1, 2010 for Medicare Part B Services. As was discussed at great length here, this is a remedy for a disaster.

I encourage all readers to click this link to send a message to your own elected official. If you are so inclined, I welcome anyone to copy/paste from the open letter below to make the process more efficient for you.

Spread this message as far and as quickly as you can: email, Facebook, Twitter, SMS…how the message gets out is not nearly as important as the impact our message can have if it is heard by as many people as possible!

An open letter to Congressional Leaders:

August 28, 2010

On June 24, 2010, you voted in favor of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, preventing a devastating permanent reduction of 21.3% in physician reimbursement for Medicare services. Unfortunately, the legislation passed is only effective through November 30, 2010, when a greater than 21% reduction in Medicare reimbursement is once again scheduled to be implemented.

The cuts, as currently projected, impact all health professionals including physicians, nurse practitioners, physical and occupational therapists, speech language pathologists, physician assistants, chiropractors, psychologists and more. Each of these practitioners usually employ a support staff including receptionists, medical assistants, billing specialists and other support staff. We do not believe it is likely that practitioners will be able to continue under their current business models with a greater than 20% reduction in reimbursement over the next 20 years, while rent continues to climb, inflation rises and malpractice prices continue to increase. Instead, businesses will fail, directly as a result of a precipitous drop in reimbursement. One needs not be a governmental research analyst to predict the cascade of events that follows including medical field unemployment/layoffs, fewer businesses open to meet the demands of prospective patients, long lines with longer waits to see a clinician. In many cases, clinicians will simply stop participating with Medicare and down size to accept only privately insured or cash pay patients.

As a direct consequence, there will be less choice for the Medicare patient as they have fewer offices with their doors open, and even fewer offices that participate with Medicare Part B insurance. The clinics/businesses that remain available to the Medicare patient will be swamped with too many patients to treat, and too little time. Regardless of the clinicians experience or good intentions, quality of care will most certainly suffer.

This is not acceptable. Our Medicare beneficiaries deserve better. Please be a voice in the United States Congress against the implementation of Medicare reimbursement reduction in December 2010, America’s seniors need your support and initiative to maintain the availability of high quality care that they are entitled to.

Sincerely,
Keith P. Waldron PT, DPT

Reprinted with permission from The Concerned Physical Therapist

MPPR: Congress Gets Involved

2010-08-17T16:33:00.001-04:00

Sixty-Eight members of the US Congress (including Mr Arcuri from a neighboring district) have weighed on the issue of MPPR in Medicare services provided in the outpatient therapy clinics nationwide.

Dear Administrator Berwick:
We Write to you to express our concern over the signiﬁcant cuts in payment for outpatient physical therapy, occupational therapy, and speech-language pathology services proposed by the Centers for Medicare and Medicaid Services (CMS) in the CY 2011 Physician Fee Schedule Proposed Rule. If implemented, these cuts would apply to outpatient therapy services furnished by outpatient clinics, hospitals, skilled-nursing facilities, home health agencies, comprehensive outpatient rehabilitation facilities and other entities.

CMS has estimated implementation of the proposed changes would result in a 12-13 percent out in payment for outpatient therapy services starting on January 1, 2011. Speciﬁcally, CMS proposed to reduce payments by 50 percent for the practice expense component of therapy procedures for the second and subsequent procedures or units of the service furnished during thesame day for the same patient. The rehabilitation community strongly believes that a cut of 50 percent is unwarranted and is concerned that CMS’ proposed policy is based on a ﬂawed assumption that there is duplication of services when rehabilitation services are billed. Therapy codes are unlike most other Current Procedural Terminology (CPT) codes in that the practice expense component for a typical visit is spread out among multiple codes since multiple services are typically provided to a patient during a visit. The purpose of spreading out the practice expense component was endorsed by the agency to prevent the chance of duplication.
Given that this represents a signiﬁcant cut to a group of services in the proposed Medicare Physician Fee Schedule and given the large number of Medicare beneﬁciaries who rely upon these therapies, we ask that CMS provide us with a detailed justification, including an explanation of the methodology used to calculate the new rates. We also ask that CMS work closely with stakeholders in the rehabilitation community toward the production of a ﬁnal rule that will not adversely impact access to care, particularly in rural and other underserved areas.
Lastly, Congress has acted on numerous occasions to extend an exceptions process to the Medicare Part B therapy caps, now scheduled to expire on December 31, 2010. In addition to reviewing the proposed fee schedule cuts for CY 2011, we also urge CMS to closely examine other therapy payment methods and altematives to the therapy caps that will preserve and improve access to necessary services for Medicare beneﬁciaries.

I would like to extend a sincere thank you to all the parties who signed onto this letter to Mr. Berwick. If your local congressional representative failed to be contribute to this letter, I would encourage you to contact them and ask them to send a letter as well if they have not done so already.

Reprinted with permission from The Concerned Physical Therapist

Advocating For Optimal Physical Therapy Care Under Medicare: The First Step

2010-08-09T16:32:00.001-04:00

The first, and most pressing issue at hand is that CMS (Center for Medicare and Medicaid Services) proposes to implement a multiple procedure payment reduction (MPPR) policy that would result in significant reductions in payment for outpatient therapy services. Specifically, CMS proposes to make full payment for the first 15 minutes of therapy service, then reduce a portion of payment each of the next 15 minutes of therapy service by 50%. The American Physical Therapy Association estimates that this reduction in reimbursement alone will result in a 12-13% reduction in reimbursement to the physical therapy service provider. Coupled with a scheduled 23% reduction in reimbursement in December 2010, physical therapy offices are being asked to take a 33% total cut in payment from Medicare. As discussed here, this is an unreasonable cut for the physical therapy provider withstand, and will only diminish the quality of care available to the Medicare beneficiary in the future.

CMS is only accepting letters regarding MPPR until August 24, 2010, so time is of the essence! Action is needed now, not later. We have approximately 2 weeks to make ourselves heard. For your convenience, sample letters have been provided at the links below to upload/attach onto the regulations.gov website (the content of the letter is too long to fit in the comment field provided).

Sample Letter for Concerned Citizens

Sample Letter for Physical Therapists

Time is short. Act now. Click here to be directed to Regulations.gov and let your voice be heard.

Reprinted with permission from The Concerned Physical Therapist

Physical Therapy Under Attack: Medicare To Make Devastating Cuts In Reimbursement

2010-08-09T16:25:00.002-04:00

A member of our staff has developed a blog of his own to keep the public informed of how quality medical care in the United States is being threatened by a significant reduction in reimbursement rates for Medicare Part B services. With his permission, we have decided to publish his content on our blog as well.

From The Concerned Physical Therapist:

On Saturday, August 7, 2010, President Obama’s Saturday radio address touted the benefits seen in Medicare after the passing of his health care plan earlier this year. According to an Associated Press report:

“Medicare isn’t just a program,” Obama said Saturday in his weekly radio and Internet message. “It’s a commitment to America’s seniors — that after working your whole life, you’ve earned the security of quality health care you can afford.”

“As long as I am president, that’s a commitment this country is going to keep,” he said.

An annual report this week from the trustees who oversee Medicare, including the Treasury and Health and Human Services secretaries, said the program will stay afloat for a dozen years longer than previously projected, due to the sweeping health care overhaul Obama signed in March.

Was the passage of the “Obamacare” really that large a boost to Medicare? Probably not…

In their recent annual report, the Trustees of the Social Security and Medicare trust funds reported that the projections include Medicare Part B (medical insurance) reimbursement cuts “by 18-21 percent in 2015, and by up to 10 percent in 2030 and beyond”. Additionally, CMS (Centers for Medicare and Medicaid Services) is looking to further reduce a portion of therapist reimbursement if the therapist spends more time with the patient*. To put it more simply, in order to be more efficient, Medicare is simply going to pay less for services to save money.

Some people may not see a problem with this plan. Perhaps they believe that health professionals already make too much money. Some people believe that health care, overall, is overpriced and a 20% reduction in price is a good thing. And while in some instances, those thoughts may be true, they unfortunately fail to tell the whole story.

The cuts, as currently projected, go to all health professionals including physicians, nurse practitioners, physical and occupational therapists, speech language pathologists, physician assistants, chiropractors, psychologists and more. Each of these practitioners usually employ a support staff including receptionists, medical assistants, billing specialists and other support staff. Is it a reasonable expectation for practitioners to remain in business with a 20-30% reduction in reimbursement over the next 20 years, while rent will continue to climb, inflation rises and malpractice prices continue to increase? No.

Businesses will fail, directly as a result of a precipitous drop in reimbursement. One needs not be a governmental research analyst to predict the cascade of events that follows. There will be a rise in medical field unemployment/layoffs. With fewer businesses open to meet the demands of prospective patients, lines will grow longer, and it will take longer to see a clinician. Some clinicians will simply stop participating with Medicare and down size to accept only privately insured or cash pay patients.

As a consequence. there will be less choice for the Medicare patient as they have fewer offices with their doors open, and even fewer offices that participate with Medicare Part B insurance. The clinics/businesses that remain available to the Medicare patient will be swamped with too many patients to treat, and too little time. Regardless of the clinicians experience or good intentions, quality of care will most certainly suffer.

As a physical therapist, I would like to focus on a scenario: a patient who needs physical therapy services after a total knee replacement. On average, a total knee replacement surgery (with hospitalization for 3 days) costs Medicare approximately $12,000 to $13,000, assuming there are no complications. After 2 weeks in rehabilitation (costing Medicare upwards of $6,000) or receiving home-care medical services (nursing, physical therapy, occupational therapy), the patient often arrives to their initial physical therapy appointment lacking the necessary range of motion and strength to walk without a limp. Their balance is poor, and they continue to present with a significant amount of pain and swelling. Even after Medicare has spent approximately $18,000 on this patient’s care over the course of nearly 3 weeks, aggressive rehabilitation, provided by a knowledgeable physical therapist, is often required to help this patient achieve their goals.

Unfortunately, this patient may find themselves in a quandry when trying to receive physical therapy in an outpatient setting. With the projected cuts to Medicare Part B reimbursement, rural patients are likely to have to drive farther for treatment as it is likely that smaller clinics with less patient volume are already working on limited profit margins, and are going to be hit hard in the months ahead. As clinics are forced to close their doors across the nation, patients will be left with fewer choices where they intend to receive their rehabilitation.

Wherever they choose to go, the patient will likely spend less time with their therapist next year than they would have 2 years ago. With Medicare paying less for a visit overall and reimbursing the therapist less as they spend more time with the patient (reducing a portion of reimbursement by 50% for every additional 15 minutes they spent with a patient), it is foreseeable that the amount of time spent in the therapy office will likely be diminished as well. The therapist will have no choice: they either treat a greater number of patients for less time, or see fewer patients for longer periods of time while receiving less in reimbursement from Medicare. The former keeps them in business, the latter has them in the unemployment line.

What happens to the patient who just had their knee replaced? It is impossible to say. Based on clinical experience, I would say that the best case scenario would have the patient walking with a mild limp with less than functional range of motion for the rest of their lives with recurrent bouts of tendinitis in the hips/knees and/or LBP from the stresses of walking improperly while favoring the “new” knee. The worst case scenario could involve the patient stepping off a curb with a knee that never got strong enough, falling to the ground with a resultant hip fracture, followed orthopedic surgery and more rehab and physical therapy…again with poor outcomes, setting the patient up yet again for another fall, or perhaps a loss of independent living. Both scenarios involve a return to the hospital or more physical therapy with a greater cost to Medicare. No one wins from this scenario. The patient fails to get better. Medicare has greater expenses for the overall care of this patient over their lifespan. Taxpayers then need to pay more into a system that is not helping patients to begin with.

Regardless of this patient’s outcome, the system is broken. A system that dis-incentivizes a clinician and creates an environment where choice is limited for the patient is a bad system. In an effort to rescue a failing Medicare insurance system, Medicare itself is directly creating an economical climate where excellent and effective treatment is no longer available to the patients they intend to provide coverage for.

I understand that apathy is easier than interest and participation, but the time for apathy has passed and the time for action is upon us. If we do not act now, and provide a voice of opposition to the dis-incentivization of physical therapy by Medicare, by the time the consequences come to fruition, it will be too late. Please…contact Medicare and tell them that cutting benefits for physical therapy is not a solution. Tell them that cutting reimbursement indiscriminately is short-sighted and will only further burden both the patient and the medical community with unnecessarily poor outcomes and greater financial burdens that neither the patient or Medicare can afford.

*Medicare pays physical therapists per 15 minutes spent with a patient. The new regulations proposed by CMS would reduce payment by 12-13% for each 15 minutes of service provided beyond the initial 15 minutes.

Medicare Cuts to Physical Therapy Benefits Will Likely Decrease Availability of Physical Therapy Care

2010-08-04T10:44:00.005-04:00

ATTENTION MEDICARE BENEFICIARIES: Medicare patients may be severely affected by a new regulations proposal.

Currently, there is a government proposed regulation to deeply cut Medicare payouts to Physical Therapy providers. The cuts, coupled with legislation that is already set to reduce reimbursement greater than 20% at the end of the year, are so severe, they will result in either (1) physical therapy practices closing their doors and going out of business or (2) ensuring far fewer practices accept Medicare in the future.

A lack of PT practices participating in Medicare, coupled with fewer choices for the consumer directly results in poor care (or no care at all) and bad outcomes. This begs us to ask the question:

"Is it fair to tell people who've paid Medicare their entire lives that they will no longer have access or availability to treatment, simply because Medicare itself created a climate where the treatment is no longer available?"

Consider for a moment the predicament for a person who breaks a hip. Without PT, the hip will certainly heal, but the musculature will atrophy to a point the patient will be disabled or will be left to figure out how to walk again on their own. The best case scenario would be a patient that lives in pain and walks with a limp. The worst case scenario would be another fall, another break, another stint in the hospital.

No one wins from this scenario. The patient fails to get better. Insurance companies have greater expenses for the overall care of this patient over their lifespan. Taxpayers then need to pay more into a system that is not helping patients to begin with.

Please...contact Medicare and tell them that cutting benefits for physical therapy is not a solution,but will only further burden both the patient and the medical community with unnecessarily poor outcomes and greater financial burdens that neither the patient or Medicare can afford.

Posted by Keith P. Waldron PT, DPT

Physical Therapy For Balance Problems

2010-07-28T09:47:00.002-04:00

Do you feel unsteady on your feet? Are you finding that you need to use a cane to feel safe when you leave your home? Have you recently fallen or found yourself losing your balance more often? These are the hallmark signs of balance problems, a condition that is often reversible.

Some people lose balance due to Parkinsons MS, cerebral palsy, peripheral neuropathy, a cerebrovascular accident (CVA), or some other neurological condition. Other people may have balance concerns that they incorrectly attribute to a normal consequence of the aging. Physical Therapists are trained to examine the multifaceted causes of balance deficiencies, and design a treatment program to reduce a person’s risk of falling.

During the examination process, your physical therapist conducts an assessment of musculoskeletal causes of poor balance. These include ROM/flexibility, muscle strength, and muscle tone. Good flexibility is essential as all muscles have an optimal length to work effectively to maintain balance. Muscle strength plays a role as well; muscles must contract in a controlled manner to correct for a loss of balance. Muscle tone can be an issue with those with neurological conditions as the damaged central nervous system may have a tendency to over or under utilize the correct muscles.

The physical therapist also takes into account sensory systems related to balance including the visual system, somatosensory system, and the vestibular system. Many people are “visually dependent” which means they use vision to adjust to changes that may upset their balance. The somatosensory system refers to neurological “receptors” in joints and muscles that, among other things, detect the position of body parts in space. The vestibular system refers to the sensory organs within the inner ear that are particularly important to balance when vision and somatosensation are unreliable, such as in a dark room or on a moving surface.

After a detailed balance assessment, which will also include functional tests to assess overall fall risk, your physical therapist is able to tailor an individualized treatment program to address the specific needs of each patient based on the findings of your examination. This will often involve therapeutic exercises to improve strength and flexibility as needed, and working with the appropriate sensory systems for improvement or adaptation.

From pediatrics to geriatrics, the skilled physical therapy staff at Mary Lou Corcoran treats patients from all phases of life. If you are suffering from balance difficulties, you may want to consider asking your physician for a prescription for physical therapy and make an appointment for an evaluation, the first step on your way to feeling more confident and steady on your feet.

Sources:
Motor Control: Theory and Practical Applications, 2nd ed. Shumway-Cook and Woollacott; Williams and Wilkins, 2001.
Mosby’s Medical, Nursing, & Allied Health Dictionary, 6th ed. Mosby 2002.
Course notes and handouts from “Assessment and Treatment of Balance Dysfunction: Systems-Based Task Oriented Approach,” presented by Jan Coy M.A., PT, September 15, 2003.

Posted by SHERRY MOSER, MPT

ARE YOU AT RISK FOR AN ACL INJURY?

2010-06-23T17:11:00.003-04:00

At one time, it seemed that the majority of injuries or tears to the Anterior Cruciate Ligament (ACL) happened to professional athletes. In recent studies, however, it is estimated that there are nearly 200,000 ACL-related injuries annually in the United States (1). Unfortunately, females (particularly athletes) are up to 9.7 times more likely to have ACL injuries than males. The increased rate of ACL injuries in central New York athletes was so dramatic by 2007 that Syracuse-area orthopedic surgeons held a meeting with all New York State Division III High School Athletic Directors to address the need for ACL injury prevention programs for the spring of 2008.

There are a variety of non-contact ways to tear your ACL including (but not exclusive to):

Trying to slow down while running
Jumping and landing off balance
Leaping and landing on one foot
Quick change of direction
Jumping and landing with stiff legs/knees

Why do non-contact ACL injuries to occur?

Poor functional movement is the main cause for non-contact ACL injuries. Muscles of the hips and legs that are tight, weak and lack coordination produce abnormal stress on the joints they surround. During activity, joints can be limited in normal motion by stressed muscles and produce abnormal stress on the ligaments that hold the joint together. The ligaments are then unable to handle the stress load on the joint and tear.

Why is the ACL injury rate so high among young females?

Young women have a higher rate of ACL injuries for two main reasons:

During adolescence, young women are begin to develop wider hips, producing greater biomechanical stresses in the knee joints
Young women are less likely to have the muscle mass developed around the hips and legs to adequately control stress on the knee

Can ACL injuries be prevented?

There is no guaranteed way to prevent ACL injuries, however, the risk of an ACL injury can be reduced through physical assessment and functional screening. Physical assessment of joint and muscle function occurs during an anatomical screen where each joint range of motion, muscle group flexibility, and muscle group strength are assessed throughout the trunk, pelvis and legs. In comparison, a functional assessment looks at how well the muscles and joints work together during specific movements, keeping proper body alignment and minimizing stress on the body. If you would like to determine your own potential risk for ACL injury, here are 2 functional tests you can try at home:

SQUAT TEST:Stand in front of a mirror, hands on hips, feet shoulder width apart and toes pointing straight forward. Squat down slowly and try to get your thighs parallel to the floor. You could be at risk for ACL injury if: (1) your heels rise off the floor, (2) your knees go inward, (3) your hips shift to left or right, (4) you lose balance and step out of squat position.

SINGLE LEG STANCE BALANCE TEST: Stand and lift your right foot from the floor, bringing your right knee forward and up to about waist height. Try to balance on your left foot for 20 seconds. Try the same test on your right foot for 20 seconds. You could be at risk for ACL injury if: (1) you are unable to maintain balance for 20 seconds, (2) your arms, non stance leg or upper body wave around during test

If you have difficulty with any of these tests, you may want to find a ACL Injury Prevention program or Sports Performance program to evaluate what you have to work on to avoid injury. Mary Lou Corcoran Physical and Aquatic Therapy offers an Athletic screening program and ACL Injury prevention program. These programs are administered by physical therapists who evaluate an individual's risk for injury based on medical history, anatomical screen, functional screen, running analysis and sport position played (if appropriate). After the screen, problem areas are identified and an exercise program can be designed to address these areas. This program can not only reduce the risk of ACL or other injury, but can improve sports performance.

If you have any questions regarding ACL injury prevention or Athletic screening please call 315-637-4747 or send an email inquiry to ptinfo@mlcpt.com.

Reference

(1) Gammons M, Schwartz E. January 5, 2010 Anterior Cruciate Ligament Injury. Retrieved from Medscape website: http://emedicine.medscape.com/article/89442-overview

Posted by TROY ANDREWS PT, CES

MLCPT- Racing For the Cure...and For Local Children

2010-05-26T13:36:00.006-04:00

On May 15th, MLCPT joined over 8,000 other central New Yorkers at the NYS Fairgrounds to raise money and increase awareness for breast cancer research at the Susan G Komen "Race for the Cure". The day was colder and windier than expected, but the weather could do nothing to dampen the spirits of those around us. Whether we were speaking with survivors and their families or groups of local youths/volunteers who were there to help in any way that they could, the collective energy at the fairgrounds filled us with a positivity that is difficult to put into words.

To show our solidarity as a team, MLCPT wore our Breast Cancer Rehab shirts that read "We Make BooBoos Feel Better", the Friday before the race and the day of the event. The shirts were designed specifically with the Komen Race in mind, but they were very warmly received in the clinic and there were many people who expressed an interest in acquiring one. So many patients, (both from our exclusive Breast Cancer Rehab program and orthopedic patients) requested shirts, we needed to place a second order of shirts. If you have any interest in a shirt for yourself (or someone else you may know), please do not hesitate to stop in or call for details.

The following weekend, MLCPT rallied together to participate in the 5k walk/run to benefit Charity for Children. For those who may not be familiar with the group, Charity for Children is:

"...a registered 501(c)(3) non-profit charitable organization dedicated to providing financial and educational services to needy families in Onondaga, Madison, Cayuga and Oswego counties with children who suffer from disabilities, diseases and disorders."

As one of the leading pediatric outpatient physical therapy offices in the Syracuse area, the staff at MLCPT witnesses first-hand the financial and emotional burden that many families experience in their efforts to do everything that they can for the health and wellness of their children. It was with those personal experiences in mind that we gathered at Green Lakes State Park to walk/run for yet another worthy cause. For the second weekend in a row, the sun chose not to shine, but it didn't prevent the event from being a tremendous success: a total of $10,000 raised for the charity.

The MLCPT team is proud to have spent the last 2 weekends working together to benefit the the CNY community. With a staff that is comprised of 3 cancer survivors and 2 parents of children with special needs, these 2 events in particular held a special place in our hearts and we are happy that we are able to contribute in some way. And although the race events themselves have concluded, the organizations that they benefit continue to provide a valuable service to the community all year long and would be grateful for any contributions that you can afford to give. Should you wish to make a donation please click the links below.

Physical Therapy Lobby Day

2010-05-26T11:51:00.003-04:00

On May 18th, Mary Lou Corcoran, joined over 400 other physical therapists state-wide in traveling to Albany to speak with local representatives in both the senate and assembly regarding the passage of S.4321 (Breslin) / A.8171 (Cahill), bills designed to unburden the physical therapy patient of unfairly high co-pays.

Physical Therapists throughout New York State have been lobbying for the passage of these bills for over one year, hoping to lessen the financial impact that physical therapy has on those who need to attend physical therapy. Currently, the bill being proposed would limit a co-pay to be no greater than 20% of the total physical therapy bill, mandating that the insurance company pays their fair-share. In many cases, the passage of this bill would lead to a 75% reduction in the amount of money billed to a patient who needs physical therapy services.

Brandon Roth of NBC Channel 3 in Syracuse, covered the problems facing patients with high co-pays prior to lobby day:

With your help, New Yorkers can work to take back control of their insurance plans and cease this unfair business practice of managed care companies. We implore all New York residents to take action. If you would like to make your own voice heard you can:

Call, email, and write your state legislators and tell them you want LOWER physical therapy co-pays; ask for fair-co-pays and ask them to support of two bills in the State Legislature, S.4321 (Breslin) / A.8171 (Cahill), which will prevent managed care companies from requiring patients to pay these excessively high co-payments for PT.
Sign the NYAPTA's Online Petition here
Tell your employer and health plan you oppose these high co-pays for your physical therapy.
Write a letter to your local newspaper.
Call your local media and invite them to tour your practice and discuss these high co-pays.
Pass this information along to your coworkers, friends, and family.

Susan G Komen Race For The Cure

2010-05-12T07:58:00.003-04:00

MLCPT has 16 participants this year in the Susan G Komen Race For The Cure. The event is Saturday, May 15th at the New York State Fairgrounds.

According to the National Cancer Institute, if trends continue, 1 in 8 females born today are likely to be diagnosed in the their lifetimes with breast cancer. The chances are simply too great that someone you know will be afflicted with this disease, if they haven't been already. The trends need to be reversed. Better treatment and a cure must be found.

It is not too late to sign up, if you would like to participate.

If you would like to help us reach our goal of $1500, we would be appreciative for any support that you and/or your friends or family members would be willing to provide. Should you be so inclined, you can click on this link to be redirected to our Komen Page. Once you are at our page, you can simply make a donation by clicking on the "Make a gift!" link as pictured to the right.

Thank you in advance for your support!

Posture: More Than Just Sitting Up Straight

2010-03-31T08:37:00.002-04:00

You have probably heard it over and over, or you may have even said it yourself: "You need to sit up straight." Everyone knows they should have good posture. Beauty pageant contestants practice with books on their heads to stand straight. People spend money on special chairs and sit on giant exercise balls to improve their sitting posture. But despite hours of practice or hundreds of dollars spent on the next great thing, when people are asked about their posture, they usually say, "it is hard to hold good posture."

If posture is just sitting up straight, why can it be so hard to maintain?

As an orthopedic physical therapist at Mary Lou Corcoran Physical and Aquatic Therapy, every assessment I perform starts with posture. Whether a patient comes in with a knee issue, a foot problem, back pain or even an elbow issue, I start with a postural assessment. Bad postural alignment influences every joint and every muscle in the body. If the postural alignment problem is severe enough, it can even effect internal organs.

When I assess posture, I am looking at more than just sitting or standing straight. That accounts for only one plane the body can move in, the sagittal plane (forward and backward). There are two other planes the body moves in, the frontal plane (side to side, or laterally) and the transverse plane (rotation). The frontal and transverse planes can be hard to see during static posture.

In assessing the human body, one plane of movement directly influences other planes of movement. For example, if a hip joint is posturally positioned into rotation, it limits movement of the hip into forward and backward movement. Also, if a hip is posturally positioned into rotation, it may prevent another area of the body (like the lumbar spine) from moving into forward and backward movement. In turn, if the lumbar spine cannot move forward and backward, it will influence the next area of the body, the ribs and thoracic spine. This process may continue to the top of the head and tips of the fingers. So asking your body to correct posture by moving one part of the body into one plane of movement without addressing the other areas and planes will actually inhibit your body 's ability to achieve "good" posture.

All of this can be complicated. That is where physical therapy becomes important. Throughout the course of a thorough examination, it is the role of the physical therapist to look at a patient's body to determine what might be too tight, too weak, too strong or too loose. Developing an understanding of each individual's posture guides the physical therapist to what needs to be corrected to take the negative influences off the posture of the body. For instance, neck pain may be relieved by stretching hip muscles to help correct the posture at the low back which directly places an undue stress on the neck.

Once neutral postural alignment is restored, it becomes easier to maintain a more upright posture. Unfortunately, the problem does not end there. Why do these postural imbalances occur? Everyone has habits and activities they do every day that create asymmetries, preventing them from maintaining good posture. Discovering what activities are having a negative impact and trying to find a good balance is necessary. One of the most important jobs of the physical therapist is to help the patient learn what can be done throughout their day to minimize the negative impact of their daily activities and work with the patient to develop a plan that helps patients attain (and keep) the balance their body needs to feel good.

With a keen eye and years of clinical experience, the physical therapists at Mary Lou Corcoran Physical and Aquatic Therapy can help you attain good postural alignment and balance across all planes and areas of the body, helping with problems that arise throughout the body and helping you "sit up straight".

Posted by Robert Wolfe, PT, CSCS

WIXT-9, The Real Deal On High Physical Therapy Copays

2010-03-09T09:19:00.002-05:00

The following news segment recently aired on WIXT-9 and helps shed some light on the issue of high physical therapy copays in New York and the impact they are having on patient care.

Christine Casciano: In an effort to keep premiums down, many employers are choosing health insurance plans that have much higher copays.

Dan Cummings: It is a double edged sword for many people, especially those who need physical therapy, because in many cases, they are being forced to choose between what (they) can afford and what (their) doctor prescribes.

Christine Casciano: And Consumer Investigator Jennifer Lewke has the Real Deal now on how physical therapists say that it is only hurting everyone involved.

Jennifer Lewke: Sue Skabinski owns 3 physical therapy offices in Central New York. Over the past few years, copays for her patients have gotten out of control.

Sue Skibinski: Thirty, forty, fifty and in some cases sixty dollars [copays] depending on the plan.

Jennifer Lewke: And keep in mind, most people require two or three visits per week. Who can afford that?

Sue Skibinski: We have seen a significant number of patients who, before, would require a month's worth of PT. Now they are telling me, "Look, I can only afford to come in three times. Can you just do whatever you can do in 3 visits?"

Jennifer Lewke: Which Sue says may be pushing people into unnecessary medications and surgery. One of her patients, Theresa Piering, is beyond frustrated.

Theresa Piering: ...fifty dollar copay, so I had to pay the full shot. I had both knees (meniscus rips) repaired.

Jennifer Lewke: Eventually it just got too expensive.

Theresa Piering: I was coming in (at the beginning) three times, then it went down to two...

Jennifer Lewke: Part of the problem is that physical therapy is technically considered a specialty, so you've got to pay the more expensive "specialist" copay.

Sue Skibinksi: If you go to a cardiologist, and the office visit fee is $400...the insurance company is paying $360 of it, and you have to pay a $40 copay, you have spent 10%. You have paid 10% of the cost of service. I don't think that anybody thinks that is unreasonable.

Jennifer Lewke: But a PT visit is no where near that amount. Sue and some of her colleagues around Central New York have these cards for patients with high copays to fill out. They plan on bringing them to Albany in May. They want to be given a copay designation of their own or at least be moved to primary care. Most everyone here at Westside Physical Therapy agrees that a change is needed.

Theresa Pierling: It's become ridiculous, you know? It's like, "Why even have insurance?"

Jennifer Lewke: The word "co"-pay is a bit misleading too. In order to be in-network, physical therapists have to agree to accept a certain amount, per visit, from an insurer. Sue has an agreement with MVP, for example, that she'll accept $42 per visit. Most of her MVP patients are paying a $40 copay. So, the insurer is really only paying $2. Makes you wonder if it is even worth the stamp and paperwork to bill the insurance company. Of course, they have to but you get the ridiculousness of all of this. That is the real deal...

Dan Cummings: Now because of the how the copay rules are written, there is really nothing that can be done about this until there is a change in the law. That's why those providers are petitioning the local politicians.

Take Action: Help Bring An End To High Physical Therapy Copays

2010-02-18T15:08:00.003-05:00

Imagine you are a single mother of 4 who goes to the store to purchase milk for you and your family. The last time you went shopping, a gallon of milk was $2.39. Today you walk into the store to discover that there is a new pricing plan in place. Strangely, if you buy only one gallon of milk, the store is only going to charge you $2.39, but if you purchase more than one gallon of milk, the price is going to double to $4.78 per gallon. How could this be? How would that be equitable? Isn't the store just making that much more money at your expense, and on a product they KNOW that you need for the health of your family?

Unfortunately, for subscribers of insurance plans in New York State (including Blue Cross Blue Shield, Pomco, and others) this is what is happening in regards to their physical therapy coverage. In an effort to cut costs, many of New York State's managed care companies have decided that because most patients have to attend physical therapy two to three times weekly, they are going to charge the patients more for services rendered at physical therapy offices than they will at other medical offices. Many insurance plans now charge their subscribers nearly 110% more for copays to physical therapy clinics than to their general practitioners. It is not uncommon for a patient to go to visit their physician's office for blood work, a diagnostic workup and evaluation for $20 and then be charged $50 for their copay when they attend their first physical therapy visit.

Mary Lou Corcoran Physical and Aquatic Therapy, in support of legislation endorsed by the New York American Physical Therapy Association (NYAPTA), is asking for your help in ending this unfair and inequitable practice of deferring cost from the insurance companies to the patient when it comes to receiving the care that they so desperately need. The NYAPTA President states:

"Physical therapy provides cost effective care that gets people back to work sooner, reduces pain and suffering and gives people the opportunity to live happy and productive lives by maximizing their potential for movement. Insurance companies have decided to place a barrier between physical therapy and their patients for purely financial reasons. Patients who need physical therapy are having a hard time keeping up with these high co-pays which are keeping them from finishing their care and reaching their goals. Managed care health insurers have designated physical therapists as specialists for co-payment purposes, allowing health plans to charge patients more per visit while maintaining reimbursement levels to physical therapists, thus shifting more of the cost burden onto the backs of consumers. These specialty co-payments add up for New Yorkers, since physical therapy frequently requires multiple visits over an extended period of time as the practice of physical therapy works in conjunction with the healing process."

As a worst-case scenario, the situation has gotten so bad that physical therapy clinics state-wide are actually being forced to accept co-pays from patients that are greater than the negotiated rate with that insurance company. The physical therapy clinics are left powerless, placing themselves at risk of being charged with insurance fraud if they accept co-pays that are less than their contractually obligated amount. Even worse, because of the resultant lack of affordability, the patient attends therapy less frequently per week than recommended by the therapist/physician and minimizing the positive impact that therapy could have on the patient's pain and difficulties with daily activities.

With your help, New Yorkers can work to take back control of their insurance plans and cease this unfair business practice of managed care companies. We implore all New York residents to take action. The NYAPTA encourages residents to:

Call, email, and write your state legislators and tell them you want LOWER physical therapy co-pays; ask for fair-co-pays and ask them to support of two bills in the State Legislature, S.4321 (Breslin) / A.8171 (Cahill), which will prevent managed care companies from requiring patients to pay these excessively high co-payments for PT.
Sign the NYAPTA's Online Petition here
Tell your employer and health plan you oppose these high co-pays for your physical therapy.
Write a letter to your local newspaper.
Call your local media and invite them to tour your practice and discuss these high co-pays.
Pass this information along to your coworkers, friends, and family.

Albany needs to act. They need to act now. Every day, week and month that goes by without legislation is another opportunity lost for a patient who desperately wants to get better, can't return to work or is in excruciating pain but can't get better fast enough; a direct result the insurance industries compulsive need to redirect the cost burden to the patient to maximize their own profits.

Kinesio Taping and Physical Therapy

2010-02-16T10:20:00.008-05:00

When sustaining an injury it often feels like the healing process takes far too long, there is a constant search for tools to make the process faster and easier. Fortunately, there is a non-invasive technique available that not only reduces pain and increases movement, but also supports injured muscles, facilitates weakened muscles and increases blood flow. The technique is called Kinesio Taping, and it may be an important addition to your physical therapy experience, helping you achieve your own personal goals faster.

In the hands of a trained clinician, Kinesio Tape can be used as a key component in the management of various orthopedic ailments including:

drop foot/wrist
plantar fascitis
achilles tendinitis
shoulder impingement
rotator cuff tendinitis
low back pain
neck pain
knee pain
muscle and tendon strains
ligament sprains
trochanteric bursitis
iliotibial band (ITB) syndrome

Unlike other forms of bracing and taping, Kinesio Tape is not designed to restrict movement, but instead to improve movement. Kinesio Tape is breathable and waterproof. It does not contain latex, so there is little to no skin reaction; allowing for the patient to use the tape frequently without suffering from skin irritation. It can be worn all day long (for several days), including for bathing and during sports, exercise and aquatic activities. Although it's exposure is increasing with more frequent use by high-level athletes (e.g. Keri Walsh, the gold medal winning Olympic beach volleyball player), you don't need to be an athlete to benefit from this ground-breaking technique. Originally developed by the Japanese physician, Dr. Kenso Kase, Kinesio Taping has begun to gain recognition in Western medicine as it has proven increasingly beneficial for people from all walks of life who are suffering from the effects musculoskeletal injuries.

A trained and experienced physical therapist will have the knowledge to utilize a variety of Kinesio Taping techniques designed to meet each patient's individual needs depending on the muscles, tendons, ligaments and joints that may be the source of a patient's pain and dysfunction. Kinesio Tape, by itself, will rarely serve as a stand alone treatment. However, when used in conjunction with other treatment methods (i.e. stretching/strengthening activities, massage, heat/ice, electrical stimulation, patient education, activity modification) a patient may find themselves getting better, faster than they had imagined possible.

An exciting new technique in the area of sports and rehabilitation, Kinesio Tape is a tremendous tool in the hands of a trained clinician. Physical therapists at Mary Lou Corcoran Physical and Aquatic Therapy have experience in the utilization and application of Kinesio Taping. If you feel that your pain or daily life could be positively impacted by Kinesiotape, call 637-4747 to schedule an appointment for an evaluation with a physical therapist at MLCPT.

Posted by Julie Wallace, PT

Volleyball Image provided by cmaccubbin and used with Creative Commons License.

MEDICARE PATIENTS ARE LOSING BENEFITS: TAKE ACTION!

2010-01-07T14:23:00.002-05:00

Unbeknown to many of their constituents, Congress has failed to prevent the implementation of an arbitrary therapy cap for all Medicare patients. As of January 1, 2010, all Medicare patients seeking speech, occupational, or physical therapy in an outpatient setting (under Part B) are subject to a cap of $1860 per calendar year. Physical and speech therapy have a combined $1860 cap and occupational therapy has its own $1860 cap. As a result, if you (or someone you know) needs physical therapy after a surgical procedure or suffers from a debilitating injury (i.e. total knee replacement or stroke, respectively) Medicare will likely only cover approximately 14-20 physical therapy visits. As a result, if a patient were to attend 3 sessions of physical therapy per week, they would be covered for less than 2 months of care prior to reaching their maximum Medicare benefit. After reaching their maximum benefit, patients are left to either go to a hospital for therapy (which is covered under Part A) or pay out of pocket.

What this means for the patient is that the United States Congress has limited the choices available to patients regarding their own medical care; forcing them to attend only hospital clinics should they need therapy beyond their cap. This is a significant obstacle for patients who reside in rural areas who do not find it convenient to travel to hospitals for their therapy services 2-3 times per week. Additionally, even if a patient is making significant progress in a local physical therapy clinic and has developed a fruitful relationship with the physical therapist of their choosing, Medicare will not continue to cover therapy services with that therapist, forcing the patient to pay "out-of-pocket" or change therapists.

Since 1999, the United States Congress has acted to prevent the implementation of these caps by initially passing several moratoria and later authorizing an exceptions process to allow patients to continue to receive rehabilitative services beyond the $1860 cap so long as the services were deemed "medically necessary". To date, Congress has not acted, and the caps are now in place. The American Physical Therapy Association (APTA) states in a recent press release:

"The lack of action by Congress is troubling, especially as it had the opportunity to attach a temporary extension to the caps exceptions process to the Department of Defense Authorization Act as it did with physician and provider payments, including those to physical therapists. APTA is discouraged and disappointed that Congress is allowing an arbitrary annual cap on outpatient rehabilitation services to be placed on Medicare beneficiaries on January 1, 2010. This is clearly inconsistent with efforts by President Obama's administration and the Democratic majority to reform health care by eliminating arbitrary limits imposed by private insurance companies. Congress must hold the Medicare program to the same standard. Ensuring payments to providers, including physical therapists, while allowing this cut to rehabilitation services for seniors and people with disabilities during the health care reform debate is gravely disconcerting."

If you are bothered and troubled by our legislators inaction, or you are angered over the obstacles now placed before Medicare patients in attaining proper rehabilitative care, Mary Lou Corcoran Physical and Aquatic Therapy encourages you to take action and contact your United States representatives at both the senate and congressional levels. The APTA has provided a simple online format to allow you to contact your senate and congressional representatives regarding the Medicare Part B rehabilitation caps here.

The only way that you can let Washington know that they need to do what is right for patients with Medicare is contact them. Do not allow your voice to go unheard!

Posted by Keith P. Waldron PT, DPT

Dizziness and Physical Therapy

2009-12-29T11:22:00.007-05:00

Have you ever stood up and experienced the sensation that the room is spinning around you? Most often this is a result of standing too quickly, standing too long, or low blood sugar. Usually the symptoms pass quickly, and there are no long term implications. Unfortunately many individuals endure these sensations on a daily basis as a result of a more complex diagnosis. The good news is many causes of dizziness are successfully treated by physical therapy.

Anyone who experiences dizziness on a regular basis, experiences dizziness in conjunction with a loss of balance or sickness, or becomes dizzy after any injury to the head should contact their doctor to discuss these symptoms. Once a Doctor determines the specific cause, an appropriate treatment plan may be developed.

Let’s begin with the most severe cause, a traumatic event such as a brain-stem injury, concussion, or whiplash. A motor vehicle accident that leads to a neck injury can result in cervical vertigo. Along with dizziness, cervical vertigo symptoms may include neck pain, decreased neck range of motion, pain in the shoulders or into your shoulder blades and headache. By treating the cause of the neck pain and headaches, along with improving neck range of motion, patients experience a decrease in occurrences of dizziness.

Another common condition is Begign Paroxysmal Positional Vertigo (BPPV), a result of debris collecting in the inner ear. Commonly referred to as “ear rocks”, this debris causes a disturbance to the neurons located inside the canals when it moves¹. Dizziness will occur with position changes such as getting in and out of bed, rolling over in bed, straightening up, leaning forward, turning your head while walking or sitting in the car. A physical therapist is able to create an exercise program to habituate certain head movements, improve balance, reposition the debris in the canal, and treat additional symptoms like neck pain¹.

Lesions in the vestibular system may impact the messages sent to the brain regarding your body’s position in space resulting in decreased balance, reduction in the ability to focus on an object, and a lower tolerance to motion². Physical therapy treatment will include exercises to improve balance, habituate head with body motions, and stabilization of visual focus on both moving and stationary objects.

Physical therapy had proven to be an effective treatment for many causes of dizziness. A prescription from a Doctor for a physical therapy evaluation is all you need to get started on the path to reduce dizziness caused by one of the above diagnoses. During the evaluation the physical therapist will obtain a complete medical history, perform tests to assess your balance and other symptoms. With the development of a treatment plan, your therapist will help you to overcome these conditions, allowing you to return to your normal daily living.

References:

1. Herdman S. Treatment of Benign Paroxysmal Positional Vertigo. Phys Ther. 1990;70:381-388.
2. O’Sullivan SB, Schmitz TJ. Physical Rehabilitation Assessment and Treatment: 4th edition. F.A. Davis Company, Philadelphia, 2001.

Posted by Jessica A. Knapp PT, DPT

Welcome to the new MLCPT.com

2009-11-03T16:15:00.005-05:00

Mary Lou Corcoran Physical and Aquatic Therapy is very happy to roll-out our brand new website! The new MLCPT.com is a new start for MLCPT in utilizing the resources of the internet to improve our patient's overall therapy experience; with its new features and design, MLCPT.com now serves as a virtual extension of our office.

It is our hope that patients, physicians, and community members will continue to find all the great information that our previous website design had to offer (practice philosophy, staff bios, and contact information) while enjoying the enhanced features of the new site (Blog, online patient forms, updated content).

The MLCPT blog will be an important part of Mary Lou Corcoran Physical Therapy's community outreach and educational program. It will be utilized to answer common and frequently asked questions, post news and updates about our practice, and provide information about the role that physical therapy and MLCPT staff has in improving the health, prevention and wellness of our community.

In the days, weeks and months to come we hope to be posting on the blog consistently, so we recommend that you stop by often, bookmark us or follow us via our RSS feed. There is sure to be some great information available in the near future!

But until that time...take a peak at, and become familiar with, the new MLCPT.com. We hope you like it as much as we do!

Posted by Keith P. Waldron PT, DPT