Physical Therapy

Best Breathing Method for Health

Buteyko Breathing Method

The goal of this breathing method is to affect not only the muscles in the body, but also the physiology of the body. While this breathing technique will produce relaxation and energy, it is important to remember that the fundamental concept is to limit your breath. If you would like to understand more about the physiology of this technique, you can start here: http://www.buteyko.co.uk/.

While it is best to do focused sessions of 15-20 minutes to help recalibrate your natural breathing rhythm, we find that any amount of this breath work will begin to improve your overall health.

How to Perform the Exercises:

All breathing should be done through the nose with mouth closed at all times. The mouth is for eating and the nose is for breathing. Focus on taking the smallest and most silent breath possible. Ultimately your breathing should be unnoticeable.

1. Begin by gently exhaling with little to no force. Don’t try to squeeze any air out, just let yourself deflate. If you exhale too far, you will feel your abdominal muscles contract to push extra air out, this is too much effort. Only release the air until you reach a natural resting state

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Managing Pain and Function Following Joint Replacement Surgery

knee-scar

More than 1 million patients undergo total knee or hip replacement surgeries each year in the US and numbers continue to climb. The trend might be easily explained by an increasing number of elderly people, but reports are showing that there is a growing trend for younger patients to opt for surgery.

No matter how old you are when you go for surgery, one thing is certain: you will feel pain.

For most patients this is not a new sensation. The majority of patients seek joint replacement surgery because they have been living with pain for extended periods of time. It is easy to think that surgery is a quick fix and in some ways it is. The new joint is ready to function immediately and many patients are beginning their physical therapy rehabilitation on the same day as their surgery. But what most people do not expect is how much recovery it will take to overcome the damage caused by the surgery.

The nature of joint replacement surgery involves deep penetration into the body that requires tissue cutting, splinting, stretching, stapling, nerve severing, and bone scraping/removal to name a few. Having a clear understanding of what you are getting into, and how much pain to expect following the surgery, will help you recover quicker and help you manage post-operative pain more effectively.

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Is your in-network insurance going to cost you more for physical therapy than going out of network?

health-insurance

When you decide to go to a physical therapist, you have taken the first step toward feeling better. Admitting you need help with your body from a professional is a big decision — but then what?

You ask Google who the best therapist is. You turn to friends and family for suggestions. Maybe you even call a few places to see if your insurance covers treatment there. Sooner or later you find the great divide in our healthcare system. Do I stay in network or do I go out of network?

When most people hear “out of network” there is a cringe response followed by dollar signs fading into the distance. This gut reaction exists because information on how insurance companies can dictate your treatment is largely swept under the carpet, leaving the consumer undereducated and under-served.

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Physical Therapy: The Ancient Practice and Overlooked Modalities of Insurance Companies

greek-body

It was the Ancient Greek Doctor and Founder of Western Medicine, Hippocrates, who first introduced Physical Therapy as a form of healing. But it wasn’t until the 1970’s that Western Medicine would formally allow Physical Therapists to have their own practices. Before then, most Physical Therapy was done in hospitals.

Alternative therapies these days are referred to as just about anything outside Western Medicine and hospitals, such as Acupuncture, Chinese Medicine, Ayurvedic Medicine, Naturopathic, Chiropractic. The list goes on. But lost somewhere between medicine and alterative is Physical Therapy: PT shouldn’t be overlooked, as it is one of the true and natural modalities there is.

A skilled Physical Therapist can examine, evaluate and treat patients from chronic illnesses to severe and mild injuries. Physical Therapists are known to reduce or eliminate pain. Benefits of PT can include recovering from falls, injuries and fractures; recovering from strokes; managing vascular conditions including diabetes; heart and lung problems; headaches and migraines; age related limitations including arthritis, facial nerve paresis, fibromyalgia, gastritis, insomnia; as well as ankle, knee, back, disc, shoulder, neck and TMJ pain. The list goes on and on.

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Headache Follow Up Treatment on Neck and Jaw

I arrived a bit early for my eighth visit with Shmuel Tatz, PT, PhD. His waiting room is a constant, relaxing oasis. There are three red velvet orchestra seats to choose from, numbered 13, 15 & 17. Or, there’s also a comfortable piano bench to sit on. Prominently placed in the waiting area is a beautiful bronze sculpture of healing hands. His two assistants are always kind, smart and soft-spoken. I’d had success with Tatz’ previous treatment, in essence with all his treatments, but last time Tatz had made a leap with my headaches. The head pain had disappeared for a few days and it hadn’t come back in its usual way. This time, my head was sore versus piercing.

Tatz whisked me into one of his private rooms, had me lie face up, and immediately placed cold laser therapy instruments on both sides of my neck and disappeared for at least twenty minutes or so. I’d become accustomed to the cold laser treatments from Tatz. From my understanding, the cold laser was first developed in Europe: A noninvasive form of light amplification. On this particular treatment I fell fast asleep.

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Physical Therapy for Severe Headaches

headache

When I went in for my seventh visit with Shmuel Tatz, PT, PhD, I was in pretty bad shape. Without exaggeration I was coming out of a three-day migraine, had been unable to keep food or water down, plus had heart palpitations on the right side of my chest which sent me into my local MD’s office – although the EKG checked out fine. During these dark hours of what I call a level nine headache, where communing with the outside world is not an option, I obsessed on what to do about these headaches and migraines that have high jacked my life. I was considering surgery as a possibility, for a previously diagnosed hiatal hernia, since some experts say that the GI tract can cause all sorts of headaches, dizziness and palpitations. For the record, my MD was not recommending it, more like I was desperate.

Tatz was, as ever, attentive and went straight to the problem that day: My head. He asked me to lie in the most comfortable position, in which I chose to be face up. His hands gravitated first to the crown of my head, in particular the top of my forehead. His fingers lightly massaged these areas as well as my temples. Then with the grip of his two hands he cradled the left and right side of my brain: the two hemispheres. He held them and massaged them in opposite directions. After awhile, he moved back to the temples, touching more firmly, then the neck and below the neck. Probing, and shaking and attempting to liberate the pent up tension. Then his touch become stronger across the surface of my entire head, especially the right jaw. Then he asked that I open, close and contort my jaw in constant motions while simultaneously his technique became more intense across all these areas of head and neck.

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Knee Treatment: Torn Meniscus and Loss of Cartilage

knee-treatment

Before heading to see Shmuel Tatz, PT, PhD about my knee, I’d heard from more than one doctor the WHAT NOT TO DO LIST: No stairs, no kneeling, no crossing legs, no sitting on floor, no squatting, no dancing. Plus I had a hard time wrapping my head around my previous physical therapist experiences: lots of clipboards and sessions with different PT’s each time and no results other than frustration. Still left with an imperfect knee that had suffered a few life-injuries. First there was the fall resulting in the tibial plateau fracture, then the torn meniscus, then the basic wear and tear, and loss of cartilage. The messages I was receiving from the medical community was to accept my ‘trick knee’.

That said, I wasn’t willing to give up and started asking friends and searching online for a specialist in physical therapy. One that might take insurance was another issue as I was on a pretty tight budget. After calling at least twenty PT offices, I reached Dr. Tatz’ office whose lovely assistant ushered me in immediately.

Tatz, the NYC acclaimed gray-haired PT, wasn’t much for words. He was more interested in what my entire body was saying to him and his reactions to my body versus vocabulary. His navigations seemed to be intuitive rather than straight out of a medical journal. He ‘tuned’ my body from the jaw down, gentle manipulations that made me feel thankful for the solid hour away from the pressures of NYC. Sometimes when seeing practitioners, I worry about what’s going on outside of the room rather than relaxing and healing inside.

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Rethinking Physical Therapy for Musicians

As natural as music is to the human ear, the same cannot be said for the process of making music. When compared to laughing, walking, crying, or even screaming, playing any instrument is not a natural function of the body. As musicians, we spend thousands of hours performing actions that our bodies are capable of, but not designed for. This inevitably leads to tension and discomfort — the feeling that something is out of tune, as opposed to the in-tune, fluid feeling that most of us remember from our childhood.

As an athletically inclined music student, performer, teacher — trained at NYU and the University of Michigan in clarinet performance — I have always had a keen awareness of the effects my physical condition had on my playing. So when it came to choosing a backup career, physical therapy seemed a natural fit. Searching for a therapist with a similar background that might be able to help me learn to work with musicians, I contacted Dr. Shmuel Tatz, whose work with performers had been described in a lengthy New York Times profile of him titled “The Therapist as Shaman.”

The Physical Therapy Assistant program I am enrolled in required only 50 hours of volunteer work, but I ended up working with Dr. Tatz for more than a 150. The experience has completely changed my concept of physical therapy and what is realistic when it comes to protecting our health as musicians.

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Steps to Treating Back Pain

back-pain-treatment

The first step is to have some form of cold/ice compress ready for your back. You can take a wet towel and place it in the freezer for an hour, or take ice and wrap it in a towel or use an ice pack.

The next step is to find a comfortable lying position for your back and spine. You can either lie directly on your back with your feet planted and your legs bent or your legs straight out in front of you. Another option is to lie on your less sensitive and painful side with a pillow for under your head and another pillow in between the knees. In this position you need to make sure your knees are close to your chest in order to have flection in the spine. A third option is to lie flat on your stomach and make a pillow for your head with your forearms and elbows and rest your forehead.

Once you have found a comfortable position for you, take your form of cold compress and place it on the sensitive/painful part of the spine. You should remain in pose and focus on breathing. The idea is to bring breath and air to the sensitive part of the spine and allow gravity to take over. Remain here for 15-20min.

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Treatment of the Face for Trumpet Player

For trumpet players, and most wind instrumentalists, there is a lot of activity in the face muscles and scalp while playing and practicing. Though we spend many hours trying to make our playing feel natural, playing any instrument is not a natural activity compared to laughing, crying, or even screaming.

From being in an unnatural position, it is inevitable that we develop discomfort in the body. Some people recover quickly after long periods of practice, but some people do not. They need help with the recovery process.

In an effort to improve recovery, control, and stamina, many people try to make stronger muscles. But this is the biggest mistake. The right approach is to make stronger muscles that we have better control over.

The first thing to learn is how to control the sphincters of the face, which are the eyes and mouth.

The second is the scalp. We know that using the muscles of the lips is important for wind musicians. But the lips are connected to the eyes, and the eyes are connected to the scalp. To keep the muscles of the head in harmony is the best way to support the embouchure.

The third area to address is the jaw. First we must learn to the move the jaw actively. This includes moving the jaw left to right, forwards and backwards, and up and down. After this we can progress to moving the jaw passively by holding it in our hands and moving it freely as if it were floating in space. The jaw should hang freely without fighting gravity.

After moving the jaw actively and passively, the third skill to learn is manual maneuvering and self-tuning. This includes self-mobilization, message, and the application of acupressure points.

When the musician has learned these skills he will have the tools to maintain his body and help it repair after demanding playing sessions.