Fatigue from Long COVID is variable day to day. Some days energy levels are good, and the person is active and productive during the day.  Then after a good day (and possible overexertion) the next few days (or even a month)may present with disabling fatigue.  This leads to frustration, not knowing which each day will bring.   Our society, work and home expectations lead people to push through the fatigue, ignoring their bodies, until they physically just can't do it anymore and present with other complications.  These symptoms have been labeled as Post Exertional Malaise (PEM), and it can be caused by not just physical, but also mental activities.  Post-exertional symptom exacerbation is a feature of the inability to produce sufficient energy on demand. 

PEM has been a symptom that has been long identified with other chronic disorders such as Epstein Barr Virus, MS, and Chronic Fatigue Syndrome. One technique that has been used by those suffering from PEM is labeled "Stop, Rest, Pace". 

• STOP: When one has overexerted their body and is unable to function physically or mentally, the first response should be to STOP, not push through.
• REST: After PEM, you must acknowledge the fatigue and rest your body until it is back to normal levels.  That may mean one hour, or three days.  When recovering from PEM, you must be patient and rest, or else you will have another immediate set back.
• PACE: Return to activities slowly.  Pace yourself to get back to your normal level slowly, in order to protect yourself from another exacerbation.   

If you or someone you love is suffering from symptoms of Long COVID or Post-Exertional Malaise, reach out and talk to one of our physical therapist to get expert advice and direction on recovery. 

A patient came into the clinic last week limping with knee pain and asked:
 
"I've had this knee pain for a few weeks now, I'm not sure what I've done to it but I've tried taking paracetamol and that didn't help.  I was trying to rest it so that it wouldn't hurt, but whenever I stood up and started moving, it hurt again so I had to sit down.  Now I'm wearing a brace to see if that helps, but I can still feel the pain when I take it off. Is there anything else I can do to get rid of the pain?"

I know how frustrating it can be when you're not sure what you've done to hurt your knee, and even more frustrating when everything you're trying to do to get rid of the pain - doesn't do a thing to make it feel any better.
 
Everyone always thinks and hopes that there will be a "quick fix" to their problem.
 
And because we see people confused, fed-up and even skeptical about what can be done to help with their knee pain, I wanted to address this idea of "quick fixes" for your knees - or for any joint problem, whether it's your knees, back, neck, wherever, and tell you why they're no good.
 
With that said here's the 3 most common "Quick Fixes" that people THINK ease their knee pain, but that actually do the opposite:
 
1. Reaching for Painkillers
 
When you're in pain, let’s face it, one of the easiest things to do is reach for the painkillers to "kill" the pain, quick.
 
It's also unfortunately the first option that your Doctor or GP will give you to help your knee pain.
But the thing is painkillers won't get to the root cause of your problem and actually do anything to fix it - they just mask the pain instead, which doesn't help anyone.
 
And at the end of the day, that pain will still be there when the painkillers wear off. So it's better to do something to fix your pain long-term instead.

2.)  Resting
When pain strikes, it's very tempting to do nothing but rest "in case the pain gets worse", which means many people end up laying on the sofa watching their favorite TV shows...
 
But when it comes to knee pain, 'rest' actually means to not do 'too much'.
 
If you rest too much (A.K. not move much at all), your joints will become stiff and tight, which can make your knees feel even more achy when you try to move them.
 
To actually help your knee, you could go swimming, go for a light walk, yoga or go for a cycle - basically any low impact exercise will help keep you moving and not place any added pressure on your knees.
 
And lastly...

3.)  Wearing a Support
 
Things like knee supports should ONLY be used as a last minute resort.
 
Wearing a support on your knee on a daily basis to try and ease the pain is actually masking the pain and creating an even bigger problem!
 
The best way I can explain it is to imagine you have a broken leg or arm and you have a cast put on.
 
After 6 weeks or so, when the cast is taken off, the muscles underneath are weak - it's exactly the same as wearing a support everyday.
 
Because it supports your joint, it takes the pressure off your muscles, but doing this everyday will make your muscles lazy which will make them weaker.
 
Once you take off that support because it's eased the pain, there's a very strong chance it could come back quicker and worse than before!
 
So there you have it, 3 'quick fixes' that people think ease their knee pain, but do the opposite!
 
Painkillers, rest, and wearing a support.
 
When it comes to your joints, these quick fixes are not the way forward to fix your problem long-term
 
If you want more information to recover from knee trouble, you can book a Discovery Visit with us to find out how to really help with the pain and not just mask it. We only have limited availability, so to make sure you secure your Discovery session in time, give us a call on: 504-313-6502, and if you know anyone who is suffering at the moment and they could benefit from this, pass our number their way to help put an end to it, quick.

If your body and spine has any underlying degenerative changes, pressure on the nerves may be increased and pain may be more intense with postural stress and fatigue.  Here are some common causes of back pain...

Spinal Stenosis- This is a narrowing of the spaces along the spine which increases pressure on the spinal cord and nerves.  Spinal stenosis symptoms may include leg weakness, numbness in the buttocks or the back of the legs, and relief by leaning forward.

Degenerative Disc Disease - With age, the protective discs between each vertebrae may have “wear and tear”, shrinking or loss of height due to loss of water, or bulging/herniated discs. The degeneration of the disc leads to pressure between the vertebrae and along the nerves coming out along the spine.

Hyperlordosis - Also known as “swayback”, this is an excessive curvature of the lumbar spine causing the stomach to stick out and the buttocks to become more prominent.  This increased curvature places pressure along the back of the spine. It also creates  a muscle imbalance between the abdominal muscles and back muscles, leading to core weakness and decreased spinal stability.  

Osteoarthritis - This is wearing of the cartilage along the bones in the joints, which affects the smooth movement of the bones and can cause pressure on surrounding nerves. 

Pinched Nerves or Sciatica -Pain from the nerves may be caused by pressure from any of the above changes in the bones, cartilage, or muscles surrounding the spine. ​

If you have been watching the Olympics this week you have seen stories of athletes performing remarkable feats while having some sort of injury.

How do they do that? High pain tolerance? Pure motivation? 

For us Non-Olympians, regular people, we frequently feel “fine” during the day, but then at night “it (back, knee, hip)  REALLY hurts”.   Does that sound more familiar to you?

Each of us perceive pain totally differently and there are multiple factors that affect our pain, besides just having a “high tolerance”.

Here are nine things you should know about pain. 

1. Pain is processed in the brain, not at the site of injury.  
We used to believe that pain originated within the tissues of our body. We now understand that pain does not exist until the brain acknowledges the signals from the nerves.  It is a warning sign that your body, or a specific part of the body may be in danger.  It is the way our brain and body communicate and serves as a defense against injury.  For example: Your hand is on the hot stove.  Your nerves send a message to the brain of extreme heat, you feel pain and you move your hand away quickly. 

2. The degree of injury does not always equal the degree of pain.
Think of a paper cut, those suckers hurt!!  That may hurt more than a broken bone because we have more sensory receptors in our fingertips than in bone. 

3. Despite what diagnostic imaging (MRIs, x-rays, CT scans) shows us, the finding(s) may not be the cause of your pain.
Advancements in imaging have been a powerful tool for modern medicine, but they are often give too much information.  For example,  multiple studies have shown that MRI of the back frequently find herniated discs in patients who don’t even have back pain.  See my previous blog that gives more information on MRI and false positives.

4. Psychological factors, such as depression and anxiety, can make your pain worse.
Pain can be influenced by many different factors, such as psychological conditions. One symptom of anxiety can be joint pain.  Some research notes that back pain is more common in those with anxiety or mood disorders than those without.  According to the Harvard Health Publishing “researchers have learned more about how the brain works, and how the nervous system interacts with other parts of the body, they have discovered that pain shares some biological mechanisms with anxiety and depression.”

5. Your social environment may influence your perception of pain.
Frequently, people’s pain level increases in a stressful situation, such as work or at a doctor’s office.  The pain signals may kick in as a form of “self-protection”.

6. Understanding pain through education may reduce your need for care.
According to a study of post-operative pain management, those who were educated pain expectations and management prior to surgery reported less severe pain during the first 24 hours postoperatively, experienced fewer and less severe pain medication side effects, returned to normal activities sooner, and used more nonpharmacologic pain management methods postoperatively compared with those who did not receive the education.​​  
This makes complete sense, because if we understand what is about to happen, the fear and anxiety levels are much less, and therefore pain perception is lower. 

7. Our brains can be tricked into developing pain in prosthetic limbs.
Also known as “phantom limb pain”,  patients who are recovering from an amputation can experience pain or tingling from the limb that is no longer there.  This confirms that pain in processed in the brain and it’s not always from the site of the injury. 

8. The ability to determine left from right may be altered when you experience pain.
Networks within the brain that help you determine left from right can be affected when you have severe pain. If you are experiencing pain, have you noticed your sense of direction is a bit off, or that you have difficulty focusing?  You can’t answer questions quickly, or you forget what you were going to get when you walked back into your bedroom?  Communication between your brain and your body is not always sharp when pain signals are involved and the experience of pain may not be exactly where the cause of pain is.  You may hear of this a radiating pain.   For example, people with a rotator cuff tear may feel the pain along the lateral side of their arm, not at the shoulder. 

9. There is no way to know whether you have a high tolerance for pain or not. Science has yet to determine whether we all experience pain in the same way. While some people claim to have a "high tolerance" for pain, there is no accurate way to measure or compare pain tolerance among people. We cannot compare how someone “feels” pain.  Pain experience may even vary in the same person depending on what is going on around them. 

If you have pain that limits your movement or keeps you from taking part in work, daily living, and other activities, call us for a free 30 minute consultation to find out how we can help. 504-313-6502 

Here are 7 tips from a Physical Therapist to help you "Age Well" and enjoy the Golden Years.  

1. Chronic Pain Doesn't Have To Be The Boss of You.  According to the Centers for Disease Control and Prevention (CDC), in 2016, an estimated 20.4% (50 million) US adults experienced chronic pain. We focus our treatments to address chronic pain without addictive pain medicines or medications that make so drowsy you can’t function.  A physical therapist-supervised exercise program addresses mobility, strength, and pain management while moving and at rest, improving your overall quality of life.  We help you be the boss over your symptoms.
2. You Can Still Build Muscle Strength When You Are Older.   Just because you have gotten weaker or lost muscle mass with age doesn’t mean you can’t build strength with what you have.  Multiple research studies have shown increased strength and actual muscle cellular growth with resisted training.  Sometimes, the biggest challenge is getting over our own belief that you are “too far gone” or “too old”.  Our physical therapist and personal fitness trainer can get you started at the right place and give you the right amount of push to build strength. 
3. Surgery is Not Always the Answer.  The phrase “At some point, you will need surgery” is probably overused by physicians.  If you aren’t at the point where you need surgery now because you can’t function, there are always non-invasive, non pharmacological options.  We can help you figure out what might work best for you. 
4. Exercise and Strength Decreases the Risk of Falls. According the the CDC, approximately 1 in 4 adult over the age of 65 had a fall last year.  Falls can affect someone physically and well as decrease confidence in one’s own safety which leads to more inactivity.  But falls are not a normal part of aging, they are a part of deconditioning, therefore - they are PREVENTABLE!!  
5. Bone Strength DEPENDS on Physical Activity and Weightbearing.  Osteoporosis or “frail bones” are a result of many factors, but without tension placed on the bones you can be confident that they will decrease in density.   According to the National Osteoporosis Foundation it affects more than ½ of American women and ¼ men over the age of 50.  
6. Our Hearts Desire Exercise.  Heart disease is the #1 cause of death in the US, and exercise has been proven as the top way to prevent it.  For those who are already suffering from heart disease or high blood pressure, appropriate exercises guided by a physical therapist or exercise physiologist is one of the treatments to improve your health. 
7. Our Brains Crave Exercise.  This past week, one of my patients spoke of her previous visit and exclaimed “My brain felt clearer than it has in months after I finished my session !” Yes!  Increased blood flow to the brain helps us think more clearly as well as regulating mood.  In addition, people who are physically active, including in the later years, have a decreased risk of dementia and Alzheimer's.  

So what’s the common denominator here?  Exercise and Physical Activity.  

If you need some guidance to get started, keep active, or just need a push to the next level, call for help at 504-313-6502 or leave us some information and we will call you!  Physical Therapists are Movement Experts and our fitness trainers can also set you up with a program and some accountability!
​

The first principle of water is buoyancy.  The definition is the amount of upward force equal to the amount of water displaced.   It's the same reason boats float. Because of buoyancy we feel unweighted in the water.   The deeper you are in the water, the more water is displaced, and the more lift you feel in the water.  Frequently, clients tell me,  my legs (or my body) just FEEL SO HEAVY.  That's where water becomes a solution.  Those heavy legs are unweighted, allowing for free movement.  We have people who can run in our pool who wouldn't be able to jog 10 ft without the assist of buoyancy.  Not only does it feel the unweighting relieve a lot of pain, but the movement builds confidence and feelings of achievement that are sometimes hard to get in the gym.  

The next principle of water is viscosity, which is technically "a measure of its resistance to deformation at a given rate".  Basically, how thick is the fluid.   It would be a lot harder to move through syrup than water because it's so thick.  But the cool thing about about water viscosity is that it allows you to control the amount of resistance in each movement. The faster you move in the water, the more resistance you will feel.  Each person can easily control the amount of resistance in each movement by controlling their speed. Liftng weights or using a machine can seem intimidating, plus, lifting weights only works your muscles in one direction. In the water, you get resistance in every diagonal or circular move you make. The water allows you to strengthen you bodies in movement patterns that you use everyday such as lifting, carrying, steeping, or climbing.  One client practices the movement pulling up her pants while in the water.  The movements don't matter how big or small.  

My favorite reason for water exercise or therapy is the positive emotional and relaxation state that being in and around water provides.  In his book, A Blue Mind: The Surprising Science That Shows How Being Near, In, On, or Under Water Can Make You Happier, Healthier, More Connected, and Better at What You Do, Wallace J Nichols talks about research shows the brain's reaction around water.  The research proves that water can put us in a mildly meditative state, decreases our stress hormones, and increases our ability to focus.  That state of mind is very difficult for those dealing with chronic pain, which makes getting in the pool, the perfect place to start a journey to recovery.

Last week I spoke on WWL about the importance of hip strength and how to do a quick screen at home to see if you have significant hip weakness.  Enjoy! 

FAQ's on CBD?  That seems like a lot of letters, right.  Well, I'm talking about CBD Oil or the full name, cannibidiol.  CBD oils and muscle rubs are the most popular products we sell in the clinic because they provide topical pain relief.  Each time someone tries it, we usually get a lot of questions, so I put together a short list of questions and answers (because inquiring minds want to know!)

1. What is CBD?  CBD is short for cannabidiol, which is a natural cannabinoid found in the industrial hemp plant.  The cannabidiol interacts with our bodies by mimicking and augmenting the effects of the compounds in our bodies called “endogenous cannabinoids”. The endocannabinoid system plays a crucial role in regulating a broad range of physiological processes that affect our everyday experience – our mood, our energy level, our intestinal fortitude, immune activity, blood pressure, bone density, glucose metabolism, how we experience pain, stress, hunger, and more.

2.  Where Does CBD come from? CBD comes from the hemp plant, which is part of the cannabis family of plants. It’s harvested to produce industrial products, including everything from CBD products to rope, clothing, and paper. It’s important to note that while hemp and marijuana are both plants in the cannabis family, they’re different in a few key ways. Hemp contains a higher concentration of CBD and a lower concentration of THC, while marijuana contains higher amounts of THC and lower amounts of CBD. THC is the intoxicating compound of cannabis. Our Nature’s Ultra CBD products are tested rigorously to ensure that they contain 0.0% THC (so no worries if  you have to take a drug test 😉)

3. Why add essential oils to CBD?  Research has shown that CBD work best in conjunction with THC for a "broad spectrum" effect; however, THC is still regulated by the DEA as a schedule I drug.  One reason the two molecules work together is the terpenes found in THC help deliver the molecules move through cell membranes.  Terpenes found in essential oils can increase the spectrum effect of the CBD to communicate better with nerves, neurotransmitters, protein receptors and enzymes.  In addition, the fragrances from the essential oils activates our olfactory system and stimulates regulatory brain activity for emotions, stress, and memory recall.

4. What is the recommended dosage for first timers? According to Dr. Oliver Wenker in his book "The Power of CBD and Essential Oils"  the recommended dosage is  50-200 mg/day for overall health and 100-700 mg/day for serious matters, if using an CBD isolate (which means no THC). The doses vary per person, but many see effect with very lose doses.

We sell Nature's Ultra CBD products infused with Young Living Essential Oils.  Call us at 504-313-6502 for more information about our products or look at our Young Living Website