New Heights is excited to announce that the Portland clinic is moving to a new location in late Fall 2014! Just a few miles from our current location, the new clinic at NE 58th and Glisan is twice the size of our current facility, offering more space and amenities to help you on your road to recovery.
What can you expect to find in our new clinic?
The gym will double in size, with no foot traffic through the area to distract you from your workout.
Skylights will fill the space with natural light.
Treatment rooms will be larger with better lighting.
Better area parking and indoor bike parking.
Eco-friendly construction with not a lick of waste: We are hard at work repurposing the old growth timber and metal found on site into desks, doors, cabinets, shelving, and tables.
Easy access off I-84 Eastbound.
Most importantly, our same great staff will continue to deliver excellent care!
Even more exciting? We plan on offering classes and events to promote wellness in the community. Let us hear from you, we’d like to learn what you’re interested in seeing in our new space! Acupuncture? Yoga? The possibilities are endless! And, since we’re all about pain reduction, please let us know what we can do to make this transition as pain-free as possible.
New Heights owners Donna Gramont and Kevin Poe enlisted their spouses Phil and Nicole to help with the project. They have been working every weekend for months…check out their work! Better yet, subscribe to our blog and we’ll keep you updated on the construction progress and let you know when our Grand Opening celebration will be!
The old growth timber and metal found on site is being repurposed into desks, tables, bookshelves, and cabinets.
Donna planes the wood flooring to restore its original beauty.
Low back pain, or LBP, is something most people will experience at some point in their lives. In fact, 50% of working Americans will have back pain during their career. It is the leading cause of disability in Americans under 45 years of age, it costs employers $7.4 BILLION dollars a year, and it is the third most expensive health condition in the US, second only to cancer and heart disease. The costs in decreased quality of life, family disruption, depression, and general health are immeasurable. If you are the person suffering from low back pain, the statistics don’t mean much, you just want a solution.
There are many different approaches to treating low back pain and unfortunately, no universal solution that works for everyone. A research study performed in 1994 looked at 98 people with no complaints of LBP. They completed MRIs on all individuals and found that 52% of these patients did in fact have positive disc bulges in their lumbar spines. This demonstrates that a positive finding on an MRI, x-ray, or CT scan does not mean it will always be associated with pain. In addition, several studies have shown the same statistical decrease in disability in individuals who underwent a lumbar fusion vs. those who received back care education and exercises.
So, how does one decide how to treat their low back pain?
Number one: recognize that if this is your first injury, there is a very good chance that you will spontaneously recover without professional intervention. We have a wonderful mechanism in our body called homeostasis where our body is always trying to restore itself to normalcy. Often, just having this knowledge will decrease the stress response which will often decrease the pain response without intervention.
Second, don’t stop moving. The human body heals by moving white blood cells into damaged tissue, and then removing waste. With immobilization comes stasis, or stagnation, of fluid, swelling, muscle inhibition, and nerve irritation. That does not mean continue doing activities that increase pain, but rest combined with graded, low intensity movement is best for promoting healing.
Third, evaluate if you need a health care professional’s guidance. When back pain is accompanied by leg symptoms such as numbness and burning, you should seek medical attention. If back pain is accompanied by urinary frequency or loss of control of the bladder, you should go to the ER. If back pain has not improved in one to two weeks with ice, rest, graded movement, and over the counter medication, you should see your health care professional.
WHO TO SEE?
There are many people who can help with your back. Since I am a PT, I am going to share what we do. This doesn’t mean there aren’t other professionals who can help you. The questions that you should expect ANY provider to answer are:
What do they believe is the primary problem?
What will the provider do to address your problem?
Approximately how long does the provider expect to see you? This is sometimes a difficult question as back pain is complicated, but the provider should be able to give you a general idea.
Physical therapists will conduct a thorough evaluation which will include looking at range of motion, strength, posture, neurological function, general tissue health, and endurance. They will ask you about your pain, your past medical history, current medications, level of activity, sleep, work, and what your specific goals are.
Therapists evaluate the entire system and may find areas of involvement away from your low back including your feet, hips, neck, or mid back. Once the therapist has completed their examination, they will explain why you are having pain, their treatment plan, any precautions you may need to take to prevent re-injury, and will give you specific instructions for what you can do at home to manage your condition.
This piece, to help you to self-manage your condition, is crucial to the long term success of your treatment. Therapists empower patients with knowledge so that patients can treat themselves. In this way, you are in charge of your health, and not dependent on a practioner or technique for pain relief.
In the initial stages of therapy, when the primary goal is to decrease pain, therapists will use a variety of techniques, each specific to your condition. These may include:
manual therapy techniques, such as joint mobilization/manipulation if you have a segment or segments that are not moving functionally or to promote fluid movement within a joint
soft-tissue mobilization, to address muscle and fascia restrictions and to allow optimal muscle function
nerve mobilization, to improve circulation and mobility in the nervous system itself
microcurrent, to decrease inflammation and speed healing
exercise, initially to improve circulation and facilitate endorphins and to prevent muscle atrophy and promote normal movement patterns.
Exercise can also be used to restore range of movement (ROM) and to inhibit pain. As your pain decreases, exercise becomes even more important as you re-build strength and endurance in the muscles that stabilize your spine and work on specific functional activities for your work and home life.
Therapists at New Heights use primarily the STEP exercise concept which stands for Scientific Therapeutic Exercise Progressions. This involves dosing your exercise regimen to the specific tissue that is injured as well as using appropriate resistance to the stage of recovery that you are in. There is considerable evidence to support the STEP concepts and many times patients are surprised that they do not have a significant increase in soreness during or after exercise, in fact most often they have less pain.
In addition to hands on treatment and exercise, your therapist will also communicate with other health care professionals on your team, make suggestions for additional resources (for example, nutritionists, chiropractors, acupuncturists, naturopaths, and physician specialists ) if needed, and communicate with your workman’s compensation representative if your injury occurred on the job.
During your course of treatment, your therapists will be updating your home program and when you complete therapy you will have all the information you need to prevent re-injury and to maintain your low back health and function. Your therapist will also provide their email information for future questions.
A physical therapist’s primary purpose is to help your body return to the most optimal state possible and to restore the majority of your pre-injury function. Our job is to make you not need us, and we are pretty good at it!! A back injury or chronic low back pain does not need to be a lifelong condition, appropriate care and your commitment to your home program is the key to solving this common injury.
Maureen “Mo” Lefere, PT , ASTYM Certified, works at New Heights Physical Therapy Plus, Vancouver Clinic
New Heights values the collaborative relationships it shares with other healthcare providers because we believe a team treatment approach pays big dividends for both patient and practitioner alike. By working cooperatively with practitioners in other disciplines, we are able to share treatment perspectives and use complementary coordinated care to improve our patients’ health.
New Heights physical therapist Brooke Floode enjoys just such a professional collaboration with Portland acupuncturist Boynn McIntire of All and One Acupuncture. Together they are co-treating a patient who suffers from low back pain. Below, Ryan S. shares his moving account of how great minds working cooperatively have addressed his health issues and helped him look forward to his treatments and workouts.
“I am one of many who suffer from lower back pain causing mild to intense pain for long durations. Some days I cannot physically move, and even worse, cannot be a playful dad with my son. I did the standard routine and saw my doctor, then a few more doctors, none of which had any helpful medical advice so I became a “suffer in silence” patient. Since I had no empirical evidence but my word and a clean x-ray, I tired quickly from the feeling of being herded like livestock through the clinic, all for a ten minute visit with a pre-determined out-come: nothing. My eyes started opening up to the realization that something, anything, had to be done before my symptoms took over my life and become permanent.
After concluding the clinical route was not a reliable option for me, through my search for a better quality of life I heard experiences from close friends and colleagues about alternative medicine called acupuncture. I remember being at work in serious pain when a friend told me about his acupuncturist. I joked around about the subject being naive, however, my friend told me it helped him for over two years until he medically needed double hip surgery.
Many people could not explain to me the process of acupuncture, but all had the same outcome, it worked. I tossed aside my ignorance and began doing my research for an acupuncturist starting with internet searches, reviews, and ratings. Over a few weeks of deciding if acupuncture was an alternative medical route I wanted to try, all my research and word of mouth kept leading me to All and One Acupuncture by Boynn McIntire, LAc, MAcOM. Since acupuncture is not invasive, I had nothing to lose, and my pain was not going to treat itself. I booked my first appointment.
I had no idea what to expect, I watched YouTube videos and heard stories told, yet, my experience was unlike anything I was expecting. I had my summary and symptoms listed, just like I had told time and time again at the clinic. I was ready for my first consultation. I met with Boynn, quickly gave her the highlights of my back pain and was ready to be on my way. What I did not expect was her taking time to ask me questions, follow-up questions, and inquire about my previous and current health history. I got to explain myself without feeling judged or rushed, an unusual experience and a perplexing feeling at first, seeing Boynn take my symptoms seriously.
I have been a patient of Boynn for almost a year and see her weekly, I am amazed every time at her warmth, attentiveness, and professionalism, which is just the starting point to what Boynn brings to the medical community. Her knowledge of treating the body as a whole instead of pieces promotes the best environment to feel comfortable, voice my opinion on treatment, and give my feedback, thus each visit truly astounds me. Even better for me, I leave pain free and feel like I’m ready to move boulders.
In January of 2014 I was telling Boynn that my goal for the year was to get my back healthy, starting with gaining insight into the underlying cause of my back pain. Boynn suggested I try physical therapy, and gave me a couple of options. I live in Vancouver Washington, and since I found such great care in Oregon I decided it is well worth the travel for good care, so I booked an appointment at New Heights Physical Therapy Plus with Brooke Flood, DPT, COMT, BikeFit Pro Certified, at their Portland clinic. I assumed I knew more about physical therapy than I did acupuncture being a former weight lifter, I figured resistance training, isometrics, some body weight exercises, no problem. I was wrong again.
Meeting Brooke showed me how attentive, receptive, and knowledgeable she is in her profession, just to name a few of the many desired qualities in a medical professional. Brooke walked me through my first exercises, which were completely different than a weight lifter’s mentality.
Brooke is fantastic at explaining and visually demonstrating muscle movements for how my body needs to adjust in order to complete my exercises properly and safely.
She does a great job of reining me in by preventing me from hurting myself when I try to extend muscle movements full range like a weight lifter. I am learning a new mentality of thinking smaller but activating a targeted muscle or muscle groups, for instance, all that may be required is a two to four inch resistance stretch, I am not trying to lift a car. I am constantly learning new exercises, body mechanics, and core stability from Brooke, who is very thorough making me feel better about my exercise program every time I see her.
left to right: Dave Murphy, Ryan S., and Boynn McIntire, LAC, MAcOM at New Heights Physical Therapy Plus
Recently Boynn and Brooke were able to schedule a time to sit in with me and observe each other’s methodology for treating my lower back. For both of these medical professionals to take this kind of interest and dedication in a patient by an on-site face-to-face visit in an effort to co-treat is something I would have never thought possible. I am still amazed that Boynn and Brooke were able to arrange this and it is hard to describe how grateful I am to both of these women for their time, effort, and inspirational personalities.
Each brings their unique skill sets to complement one another, for instance, I finished a great lower back session with Brooke aimed at activating the smaller muscles (multifidus) then followed up the next day with Boynn where she applied acupuncture to the muscle groups used during physical therapy. In my experience this process, physical therapy followed by acupuncture, relieved the pain and pressure built up from sore muscles that were activated during physical therapy exercises and aided in a more comfortable recovery time.
With Boynn McIntire of All and One Acupuncture and Brooke Flood of New Heights Physical Therapy Plus I feel I have an immensely knowledgeable, and incredibly capable team, which I am continuously amazed at how well they complement and enrich each other’s abilities. It is an incredible feeling to get excited for an acupuncture treatment or an exceptional lower back workout.”
New Heights Physical therapist Brooke Flood and her dog Mason
If you’ve ever injured a knee, Achilles, or anything that involves movement, you know that healing can be a long, drawn out process, especially if you had to get surgery. During that time you’re in pain, inconvenienced, and just wish it would end. Well, if you’re someone that doesn’t want to experience that long wait again, there’s good news: a new treatment has arrived called platelet rich plasma therapy. Doctors claim that it can speed up the healing process by manipulating your body’s own restorative abilities. You probably know the process better as PRP.
What Injuries Can PRP Be Used For?
The limit to which injuries and diseases PRP therapy can treat have yet to be found. Currently there are studies that support its use for treating a whole bevy of ailments. PRP is rapidly emerging as a treatment for ACL and MCL injuries such as tears, knee pain, osteoarthritis of the knee, spine injuries, rotator cuff tears, pelvic pain, jumper’s knee, back and neck injuries, and tennis elbow.
As PRP therapy is a fairly new treatment here in the United States, there aren’t as many studies as experts would like. Within the next few years we expect to see several randomized, blinded, placebo controlled studies to give the treatment more validity. However, there have been several cohort studies – as well as anecdotal evidence –that’s showed the treatment is effective. Based on the success we’ve seen with our patients we expect this treatment to grow in popularity rapidly over the next couple years.
A lot of high priced athletes who make a living from the health of their bodies swear by the treatment. Tiger Woods received four injections of PRP therapy after knee surgery in 2009, and Kobe Bryant went all the way to Germany for a similar treatment in 2013. The reason Bryant – and other stars like New York Yankees’ Alex Rodriguez – go to Germany for treatment is because the United States Food and Drug Administration says that any procedure like PRP can only be used minimally, whereas places like Germany allow a more enhanced experience, such as the inclusion of stem cell use.
PRP therapy is a lot simpler than you might expect. When you go to the doctor’s office for the treatment, a sample of your blood will be drawn from your arm into a vial. The blood is then spun down in a special type of centrifuge that concentrates the blood’s own platelets.
Blood platelets are an important part of the healing process, they attach to the injury and release growth and healing factors. These are all a part of what our body normally uses to heal injuries.
After the platelets are separated during the spinning process, the doctor will usually use an ultrasound to pinpoint the injury and inject the platelets directly into the injured area.
The patient will then have anywhere between two to eight times more platelets to heal his/her injury with. The treatment is enhancing the body’s own healing process; it’s really just that simple.
Are You A Candidate?
If you’ve failed traditional non-surgical treatments like HA injections or physical therapy and are hoping to avoid surgery, PRP therapy could be just what you need.
PRP can treat injuries to your knee(s) from activities such as playing basketball or football, jogging, weight lifting, or even everyday things like climbing stairs or walking.
You may also want to consider PRP therapy if you have nagging pain from previous injuries like tripping and landing on your knee, or being involved in a car accident. Schedule a PRP consultation with one of our physicians or your primary care doctor to determine if you’re a good candidate for this new procedure.
PRP therapy uses the patient’s own blood, and because of that there is very little risk for any kind of rejection. Although there are a small amount of patients who may have an adverse reaction to their own blood, it is very rare. Because it is only a simple blood draw and injection, there is no need for anesthesia, opening the wound, or a hospital stay. Highly convenient, the procedure is done in our office, and lasts about an hour.
Some patients complain about a dull ache in the spot of the injection, and because PRP uses a needle there is always a chance that an artery or vein could be damaged and cause a blood clot. If that happens, the clot is treated like any other clot with blood thinners, but risk factors like these are very low and should always be discussed with your physician before moving forward with the procedure.
If this sounds like something you might be interested in, online chat and message health boards with people who’ve already completed the procedure can give you a firsthand account of their results and are an excellent resource. Also, ask around to see if anyone you know has had it done, you might be surprised. There are a lot of variables – including cost – so you can never ask too many questions. If you live in the Portland area give us a call for any questions you might have about the procedure, and schedule a consultation. Living with knee pain just isn’t worth it, and new treatment options are now available.
Thanks to everyone who very generously donated medical supplies and shoes for Morgan to take to Haiti today! Morgan will deliver 150 pounds of donated supplies and volunteer her awesome physical therapy skills to the people living in one of the poorest regions of Haiti.
This is Morgan’s third trip to Haiti. She travels with the group Phoenix Rising for Haiti , a multidisciplinary team of medical professionals that treats thousands of people in the city of Port-de-Paix on the Northwest coast. The population there is completely underserved and has very limited, if any, access to healthcare of all types.
The team delivers a variety of medical services, including the casting and fitting of artificial limbs and orthotics, and treating musculoskeletal injuries. Morgan will spend her time over the next two weeks teaching patients how to walk with their new legs, treating children with neurologic conditions such as cerebral palsy and muscular dystrophy, and helping patients recovering from work-related falls and injuries.
Morgan says, “The weeks (volunteering) are amazing and deeply moving. We all work harder than ever, beat ourselves up, lose sleep, get sick, and feel great! It’s shocking how much we can help these people, via hands on treatment, information, training, and simple equipment.”
I love to ride my bike. It is one of the most convenient, fun, healthy ways to get around the city and stay fit. I ride in the sun, the wind, the rain, the sleet and sometimes even the snow. I’m nearly as reliable on my wheels as the postal service! As a physical therapist and bike advocate, there is a phrase I hear all the time: I would really like to ride my bike more, but I just don’t feel safe on the road.
So, this post is devoted to safety tips, planning strategies, and awareness elements that will keep you safe and confident while riding your bike. These tips are geared toward both the novice biker who is currently dusting off his wheels in preparation for the spring AND the experienced cyclist, who is just waiting for the day she can remove her fenders and gortex shoe covers!
The main elements we need to address are: visibility, comfort, and respect for the road and all those who use it.
Tip #1: VISIBILITY!
There is no better way to be safe on the pedal than by being seen. This doesn’t mean you have to sing opera with wild hand gesticulations or wear only neon colors head to toe, though neither would hurt. It does mean that you shouldavoid wearing dark colors at night. It also means using appropriate lighting. When cycling at night, during dusk, or when it’s raining, bikes should have at least one white headlight in the front and one red tail-light in the rear. Law requires this at night, but remember the goal is to be seen, so use them whenever visibility is compromised (eg. when it’s raining and people’s windshield wipers may not be perfectly clearing each droplet from their windshields).
Be sure to place your blinkers in visible areas. Often lights attached to back pockets or bike bags can be covered accidentally by clothing or placed to far to the side, making them less visible to cars directly behind you. Additionally, a light on your wheel spokes, so that you are visible from the side, is quite helpful. And while you can also wear reflective vests, a cheaper and more creative solution is to decorate the back of your jacket, pants, bike, or bag with reflective tape. This cannot be underestimated; reflectors are magic when car headlights are applied!
Another aspect of visibility is awareness of whether or not you are seen. Attempt to always make eye contact with drivers, other cyclists, and pedestrians before proceeding to turn or making your way through intersections, even when you have the right of way. Making eye contact establishes the fact that both commuters actually see each other and takes the guess work out of making a safe crossing.
Lastly, be aware of your surroundings; this includes the type of road you’re on, whether or not you are in a bike lane, and what type of other people/vehicles are around you. Most cyclists who are injured by vehicles are hit when cars are making right turns and do not see the biker.
TIP TO REMEMBER: when proceeding through any intersection, ALWAYS position yourself at least a few feet
behind the bumper of the car in front of you. Though they may not have a turn signal blinking, they may
intend to make a right hand turn or decide to at the last minute. If you are next to them, you will be
in their blind spot and in a dangerous situation. If you are behind them, you will be able to see their
intentions more clearly and hit your brakes to slow down if you need to. This positioning also places you
directly in front of the car behind you (VISIBILITY) so that they are aware of your presence.
Tip #2: COMFORT
…ahhh yes. Many times I have heard people say, I would like to ride my bike, but it’s uncomfortable and the weather isn’t always great. Numero Uno: Welcome to the Pacific Northwest. But moving beyond the fact that Oregon (and many other states) does not provide windless sunny days with the consistency some might hope for, there are heaps of ways and strategies that will keep you comfy on your bike, no matter what the circumstances!
First of all, if your bike is uncomfortable, you may simply need to have changes made to your bike’s set up. It could be as simple as moving your seat, changing the angle of your handlebars, or learning the correct position on your bike. Luckily, there are skilled physical therapists (and you might know a few) who are trained to do cycle fits and can make changes to your bike to appropriately fit your anatomy or teach you exercises to improve your position, comfort, or efficiency when pedaling!
If you are pedaling frequently, the importance of having a good fit can not be overstated.
Preparing appropriately for the weather, or the possibility of weather, is another key factor in being comfy cozy on your bike! First and foremost, dress in layers! Nothing beats the elements of hot and cold like variety. It may be 10 degrees cooler in the hills than it is in the valley and you should plan accordingly.
Secondly, purchase, borrow, or find in a free box some good rain gear. It’s truly amazing how impervious to wet Gortex can be; and how much easier it is to get your pedal on in the rain when you know you’ll still be dry once you strip off your waterproof layer upon arrival. Additionally, you can bring extra clothes with you to change into or leave a spare set at your common destinations. For example, I leave my work clothes at work, along with an extra pair of dry shoes…never mind that half the time I opt for barefoot status…but that’s another story.
Being comfortable on your bike also includes an amount of confidence in yourselfon the road. If you feel hesitant to ride your bike amidst cars, there are simple steps you can take to be sure you have a comfortable and safe route. For one thing, improving your visibility to cars (see above) will give you confidence that everyone knows you’re there. Also, take bike routes or side streets anytime it’s possible. If you live in lovely Ptown, you’ll find no shortage of preferred marked bike routes and bike lanes; most outdoor or bike shops sell maps that specifically detail these. Mapping your routes accordingly will dramatically decrease the number of cars you get close to while pedaling and you will get to see more fantastic bike commuters like yourself!
If you don’t feel confident about your balance on a bike, particularly at intersections when a stop is required, try these tips:
When you stop at an intersection, DO NOT try to continue sitting on your seat with both your feet touching the ground on either side. This is a precarious position full of terrible teeter totter possibilities. INSTEAD, bring your seat off your saddle and place one foot (or both) on the ground. Lean your bike slightly down towards the foot you have placed on the ground (the other may be on the pedal still). This will give you a more stable gravitationally affected triangle AND it will have you in the ready position to push down on your pedal and restart when that light turns green!
Practice your starts and stops around your neighborhood (that’s right, where everyone can see you). This will help you gain confidence in going at different speeds, stopping appropriately, and restarting…without any other cyclists or cars to worry about.
Tip #3: R.E.S.P.E.C.T.
find out what it means …for you…sing with me now!
No matter where you’re going or what kind of bike you’re riding, you should always always ALWAYS respect the road.Remember that it is a very hard surface and fairly unforgiving to your amazing flesh covered body. I could rant about wearing a helmet, but I will assume that if you’re smart enough to be reading this blog, you likely R.E.S.P.E.C.T your brain and the way it currently functions, so I will not address its importance specifically in this article.
Respecting the road also meansadhering to the rules.Stop at signs and lights that involve the color red, use appropriate signals for turning and indicating a change in direction, and just say no to agro! Remember, you have nothing to prove out there and in a fight between you and a heavy metal box with wheels, you will always lose. Keep this in mind.
Some of these tips go back to visibility and communication. Just because you’re wearing that superstar helmet does not mean that cars or other cyclists can read your mind. Tell us what you’re going to do before you do it! Biking on the street is like having a relationship, the more open and forthright you are, the less likely that anyone will get hurt.
Riding a bike is one of the funnest, bestest, most awesomest ways to get around. Making every pedal a comfy cozy happy safe ride can only help! More power to the pedal!
Morgan’s commute to New Heights is 30 miles round trip. This is the view from her bike during the February snow storm.
According to the CDC one out of every two people in the United States will develop symptomatic knee osteoarthritis (OA) by age 85. Factors such as age, weight, gender, activity level and genetics can increase or decrease the likelihood of developing OA in your lifetime. Although there is no cure for osteoarthritis of the knee, there are more treatment options available than ever before, especially if detected in its early stages.Continue reading