Modern Mom Experts

How do I know my treatment is the right one?

Posted by Andrea Jurgens at 3/1/2010 11:09 AM PST

How do you know if you are undergoing a treatment that your doctor or therapist likes, or a treatment that it is actually related to what research supports? This is an interesting question that I think one should ask themselves and their healthcare providers. Many treatments providers recommend are supported by their own experiences, not by research.

Oftentimes, clinical experience is important, but it is necessary to ask the right questions when a provider is making recommendations. I address this subject, because there is often a discrepancy between a doctor’s recommendation and health coverage. In the New York Times, a doctor wrote an article expressing his anger that therapy was not a covered benefit as a treatment his torn hamstrings. "Why go to a physical therapist for as many as 20 sessions, in order to do strengthening exercises? Why not just go to a gym? If you have access to a gym, you might go to physical therapy for one or two sessions, learn what to do and then return to physical therapy in a few weeks to check on your progress. Often, you don’t need to go to physical therapy three times a week or five times a week"

These are statements I have made for YEARS at the HMO where I work. Oftentimes, people want what their neighbors said would be good or something they saw on television. At my office, our role is to get to the source of the problem, educate the member and really explain that rehabilitation is an active process that both the provider and the person must participate in. This can be hard when your neighbor goes to therapy 3 times a week. Most people just need to change a few simple things and strengthen certain muscles. They need the skilled hands of the therapist to get the body moving in the right direction.

It is also very important to know your provider well. You should understand their experience and what type of training they have had. There is a difference between a therapist and a therapist with an OCS - Orthopedic Certified Specialist. A Physical Therapist with OCS (or any other CS derivation) means that they have had enough training to understand the evidence and research regarding effective treatment. They have also passed a written exam as a form to measure their knowledge.

Also remember that healthcare is a business. I question why your treatment must be done in the clinic 3 times a week. Is your doctor trying to help you, or is he trying to bill your insurance? It is important to understand that each person must be their own healthcare advocate. You must ask questions, make sure you understand your role in the recovery proves, and then invest the time to get better. And it can take time.

You only get one body. It’s the beginning of 2010, and there is no better time than the present to make an investment in YOU.

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Doctor says I have a pinched nerve, what happens now?

Posted by Andrea Jurgens at 1/19/2010 9:16 PM PST

The word pinch can conjure up bad memories of forgetting to wear green on Saint Patrick’s Day. So when a doctor or nurse uses words like “pinch” or “bulge,” you can get lost in the word instead of really understanding how it relates to your body.

Most of our everyday movements cause slight pinches on our nerves. In fact, just turning your head to see what your crazy kids are doing in the back seat while you are driving pinches your nerves. Nerves are okay being pinched. It is a normal part of how we move. When a doctor says you have a pinched nerve, I wouldn't completely stress; it takes a lot to really “ruin” your nerves. Nerves love a good "pinch," and the nerve you are dealing with is just inflamed and sensitive. So part of your recovery is to change how you talk about it. It is important to understand that pinching is okay. Do not let it overwhelm you.

First, realize that it will get better. It is just a sensitive nerve. You will then start to release other chemicals in your brain, which actually may help reduce the inflammation on the nerve. It is like your brain has its own pharmacy of pills. Next, move through smaller ranges of motion to the point of slight discomfort. Then, back off. This may feel funny, but movement is the key to helping the nervous system learn what is normal. So keep moving and don't avoid the motions that bother you. Just learn to gradually move in small motions and back off while keeping good posture. Before you know it, you will have full range of motion without discomfort or pain.

Now sometimes there are areas called "nipping" regions (as an Australian would say). These areas are usually at the spine (nerve root) or the wrist. It may require learning to keep these spots more supported or stable to prevent the "nipping". Once you learn to keep those spots still, the nerve will heal, and you will be able to return to your active lifestyle.

So get moving again and learn to believe it is going to get better!

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My teen spends a lot of time texting, will this increase his risk for hand injuries?

Posted by Andrea Jurgens at 12/15/2009 12:09 PM PST

I think this is a very insightful question and I can't help but believe the constant repetitive use of the hands could affect our children later in life but then I think of musicians or others who pick up a skill very young and do it for 25-30 years with minimal pain. Why is that?

Well it might have something to do with the ability to keep balanced or like a therapist would say to take “postural reversal” breaks. So if you hold your body or hands in one position too long then moving your hands and thumbs in opposite direction 25-30 times will off-set the repetitive stresses. For instance, if you are using both of your thumbs to text on the blackberry then they are probably slightly bent and close to your index finger, therefore my postural reversal would be to straighten my thumbs out and move them away from my index finger and open my hands widely. Then to take it a step further would be to then actually move my arms also up and outward away from my body as I do the movements for the hand. This would then allow the muscles and nerves to move in the opposite direction to prevent any inflammation and equalize the stressors on the joint. I say this because I have worked with studio musicians and they must spend many intense hours in the studio with limited time for "real" breaks and thus teaching them to just move their body between sets in opposite directions based on the instrument they play gets them through the taping and allows them to keep playing for hours and even years.

Also I recommend having down time where you rest in an opposite position from how you normally hold your body during the day. This can be very beneficial for instance if you sit all day then spend time lying flat on your back or even on your belly. If that’s too hard then when sitting spend time straightening out your knee and pulling your toes to the sky to move the tissues in the back of your leg. Movements like these can help off-set the static positions from the day and keep the muscles and nervous system healthy. Plus it’s just so simple to do and will keep you pain free later in life.

I hope this helps... advances in technology are unavoidable but you can still control how you move and use technology. You are the greatest machine so keep moving but in many directions! Share these tips with your teen!

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Do you have an opinion on foot surgeries like a bunionectomy?

Posted by Andrea Jurgens at 12/15/2009 12:07 PM PST

You asked, so here is my opinion on podiatrists and orthopedists. Please accept my apologies podiatrists and orthopedists, but sometimes, you are a waste! I use a strong word to get your attention, so let me clarify.

When your big toe is turned sharply towards the outside of your foot, it is clearly time to have surgery. To do the surgery just on pain alone is unwarranted. This opinion could be very long winded, but I am going to keep it very short. The big toe is at the bottom of your body and leg chain. Thus, how your wear your top half is affecting the bottom half. My best advice is to see a physical therapist who will not only look at your foot but will also analyze your gait and test the muscles of your hips and legs. Weakness from muscles above (hips and knees) can make your body collapse. This puts more pressure on your big toe with every step. This also puts pressure onto the joints and nerves, which causes pain. I always believe the initial pain is your clue to start taking a look at not only your body's strength, but the kind of shoes you are wearing!

I know that surgery can seem like the quickest way to reduce pain, but my fear is that your pattern of movement will continue post surgery. The pain will return if you do not alter the source of what initially forced your toe to migrate outward.

Good luck! Tread lightly!

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How do I survive a long drive?

Posted by Andrea Jurgens at 12/15/2009 12:05 PM PST

Long drives can be difficult for the body. You are stuck in one position for too long, and our muscles and joints like movement. The simple solution is to take breaks at least every hour for 5-10 minutes, and then get back in the car and drive. I know that is usually the hardest thing to do, because we are always in a hurry, but it is the best solution. If this is not an option, the next best thing is to sit in your car with good posture. How you hold your spine is very important. It is so simple. The goal is to keep the angle of the hips and knees at 90-degrees and keep your shoulders over your hips.

Another option is to take the weight off pressure zones like the buttocks and spine by using your arms along the side of your body to take the pressure off. Do this for 30 seconds about 5-6 times. It’s kind of like doing a tricep extension move while sitting in the car. This movement decompresses the spine and gives tissues increased blood flow. This will allow you to drive further before you need to pull over for a break.

Hope this helps! Drive safe!

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I do not like my body post baby, especially my belly, but I don’t have time to exercise?

Posted by Andrea Jurgens at 6/17/2009 10:04 PM PDT

I do not like my body post baby, especially my belly, but I don’t have time to exercise?

I understand your frustration; let me say it loudly… I have a post baby belly! That’s right… maybe you would like to call it a muffin top but whatever your preference it’s there. It’s there looking up at me all the time and it can even frustrate someone who knows how to change it. Why can’t things be like they were? I wasn’t perfect maybe a slight lump but now it’s slightly more exaggerated. Regardless I am not loving my body and I need to because I have a daughter and the last thing she needs to live with is a mom who is over-critical about her own body. So I understand the changes that occur and the stress of finding time to do it all. Maybe you need to think more about how you currently are prioritizing; you may need to find a little time to self reflect on how you want your health to be because like a bank, you need to prepare your body now to live a long and healthy life.

Regardless, who doesn’t want a hot body and be an amazing mom and professional? In my line of work (Physical Therapist) I feel even more pressure. The last thing I want to do is work with people with this “gut” sticking out. So as I increase my workout routine during lunch and in the evenings after my little one is in bed, I know anything is possible when it is part of your top priorities. Now there are days I am exhausted but nothing that a little coffee can’t fix. I meet a lot of moms as a physical therapist, sometimes they come in under the guise of back pain but their bodies never really got it together post baby.

Really I understand it’s not the priority after the baby but your health should be. Most moms are the foundation of every family; so whether it’s your belly or your arms you deserve to find a little fitness time for yourself. Self-respect comes from respecting yourself and the shrine that houses your being. Now don’t mix that with the idea that everyone needs to look like the gal on the cover of Glamour but moms need to be healthy; taking care of yourself will only help you take better care of your family.

Back to my point, my poor abdominal tone… abdominals are more than the tension you feel in the front. Abdominals wrap all the way around to your back to attach from anterior to more laterally so when you are working those frustrating abdominal muscles you want to feel a circumferential tightening in the front and sides. This is important because as you are doing your 100th sit up (joking) make sure you are using the muscles in its entirety and if your not sure you need to ask someone who does know.

My other message you’ll hear many times from me is “you get what you train for”… stolen from my idol Dr. Shirley Sahrmann. So when you are doing crunches there is a rounding of the spine. If that is your only way to train the muscle you may find yourself with a posture that looks like Ercle (from Family Matters) or any other nerd. Your abdominal workout should focus on holding your body in the best position possible so crunches alone may not be the best plan, diversity is the key. Lastly, turning on your abdominals doesn’t mean sucking in like you are trying to put on the jeans that were left in the dryer for too long. By the way, if that tends to be your method for recruiting then you may want to seek further assistance in training that muscle group.

Now I kind of feel like I was lecturing but you only get one body to live in your whole life… I feel some people will take better care of their teeth than their body and yet it is our vehicle for moving and participating in the world around us; you can keep your mouth shut and not see the cavities!

So whether you are chasing your kids at the park or cleaning your house like you are training for the Olympics you have to move, move quickly and often. Playing in spurts with your kids is the easiest way to burn calories. It’s your choice and remember most people are influenced (90%) by what you do versus what you say. Last time I checked most parents say things like they want their kids to be happy and healthy and thus its time to start modeling that behavior. Find a friend, a support group, during nap time or just play with your kids and move!!

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