Download - ADVANCE for Physical Therapy & Rehab Medicine

More documents

Recommendations

Info

scapula continued from page 10 [uPPER-ExTREMITy REHAB] be lower repetition and higher weight as well as higher repetition and lower weight. For the scapular stabilizers, endurance exercises are emphasized due to the demands placed on the scapular muscles from repetitive throwing. The athlete can progress from more isolation exercises in prone, supine and side lying to standing positions where the shoulder is in the 90/90 position to more accurately replicate throwing. Finally, the physical therapist should include neuromuscular stabilization training to help promote stability and kinesthetic awareness of the shoulder during functional activities. Rhythmic stabilization exercises in multiple positions as well as proprioceptive neuromuscular facilitation (PNF) techniques are excellent options to add to the treatment plan. The overhead throwing athlete has a complex interaction of factors that can lead to injuries in the upper extremity. A thorough examination that could include categorizing a patient with “SICK” scapula can help direct treatment more accurately and facilitate a speedier recovery for the athlete. n references are available online at www.advanceweb.com/pt Daniel Lorenz is director of physical therapy at Specialists in Sports and Orthopedic Rehabilitation, Overland Park, KS, and an adjunct faculty member at Rockhurst University in Kansas City, MO. VALIDATED RESULTS WITH ULTRASOUND. PROVEN VERSATILITY WITH EVERYTHING ELSE. Increase patient compliance Complement ultrasound therapy Enhance cryotherapy Calm the pain between T.E.N.S. Intensify soft tissue massage Provide fast pain relief for muscles & joints PAIN RELIEVING GELS FREE! ULTRASOUND STUDY & SAMPLE (800) 527.4923 ADVANCE for Physical Therapy & Rehab Medicine 21
Cut the Claims Physical therapists can help companies maximize business profits by reducing workers’ compensation claims, cost and lost work days By gerry Catapang, PT, DPT, Mgs Workers’ compensation claims secondary to spine and extremity injuries, coupled with lost production and related costs, burden our economy to the tune of about $80 billion a year. Workers’ comp insurance companies state that musculoskeletal disorders (MSD) represent 55 percent of claims and 65 percent of costs. Employers can pay out $1 million per year per 500 workers for the costs associated with MSDs. Let’s explore the challenges and the possible solutions to assist employers in maximizing business profits while lowering workers’ comp claims and costs. Detecting the Cause It is always challenging for health care providers, case managers and company safety officers to know exactly when and how a workrelated injury happened. The number one factor that determines the cost of a workers’ comp claim is often not the severity of the injury or the cost of medical management. The top issue that determines the cost of a claim is the “attitude” of the injured worker’s supervisor to whom the employee reports the problem. Therefore, the most important cost-determining factor is the supervisor’s response to the initial complaint of pain. How the supervisor reacts when the injured worker claims the accident occurred at work determines whether the employee will commit to getting better or will have to deal with conflict over the claim. The Politics of Work Injury Production supervisors often assume that MSD claims are faked. Because of these assumptions, employees delay reporting pain and injury for fear of intimidation and/or harassment. This results in an increase in treatment cost. Top management often takes an aggressive stance against claims, denying most, and refusing a worker’s return to work until the worker is 100-percent recovered. Workers themselves often do not believe the claims of their coworkers. This creates tension throughout the entire workplace, resulting in claims and slow injury recovery. 22 ADVANCE for Physical Therapy & Rehab Medicine Companies and their supervisors may restrict workers’ access to treatment services in order to prevent a problem from becoming a formal workers’ comp claim. This claim may be then pushed onto the health insurance policy. This is not legal. A company may allow treatment but pay the medical provider off the books without documenting the injury. This is also false record-keeping under OSHA. Treatment and Management Keys To acquire the best treatment results, it is important to quantify the cause of the pain. Is the cause purely mechanical in origin? Is it a medical condition manifesting as physical pain? Is the cause of pain related to a mental condition? Is it a combination of all three? 1. Use the ideal medical providers to examine and treat your injured workers. Not all medical providers catering to the needs of injured workers are the same. Not all physical therapists specialize in orthopedic physical therapy and/ or industrial rehabilitation. This is important: If your business is located in an HMO health care environment, physicians don’t have to send your injured worker to their hospital for treatment. It’s your company’s choice. You decide. 2. Organize the workers’ comp team--and be involved. The team includes physicians, physical therapists, nurse case managers, company safety officers, supervisors/department heads and the injured worker. Physicians are responsible for evaluating and treating diseases. Orthopedic manual physical therapists are responsible for evaluating sand treating the physical dysfunctions related to the [INDuSTRIAl REHAB] spine and extremities causing pain. Case managers, supervisors and department heads assist injured workers to return to work by helping them find the medical and physical treatments they require. Psychiatrists and psychologists also play a role in pain management. 3. Separate the workers who need medical services and those who are just taking advantage of the system. Orthopedic manual PTs play an important role in the evaluation of possible movement restrictions in the spine and extremities that can result in neck, back and extremity pain. Physical injuries would cause mobility restrictions in the soft tissues, muscles and joints. These movement limitations will cause the surrounding structures to compensate and cause pain. Once these movement restrictions are examined, identified and addressed, there is nothing to pull or compensate. Therefore, pain should be decreased or eliminated. Should the cause of injury be purely physical, patients should start feeling better after a few orthopedic physical therapy treatments. If the pain is the same or worse after three to four treatments, then it’s time to reassess. Physicians may need to further examine the patient for possible medical abnormalities and/ or for more diagnostic procedures that might need to be performed. Should medical findings be normal and/or movement restrictions in the spine or extremity are back to normal, then the possibility of the patient’s emotional reaction to pain can be considered. Use of the McGill Pain Questionnaire during the initial assessment is always beneficial. Test results can reveal a patient’s emotional reaction to pain (possible faking) in relation to recovery. This can also be useful to physicians in deciding whether to refer the injured worker to a psychiatrist and/or to a pain management program. The Biggest Management Mistake Supervisors’ good knowledge and background of MSD can totally change the atmosphere of the workplace. This can be achieved through neck-arm and back MSD school programs as well as supervisor training in managing the injured worker. Once the education and training have been accomplished, the supervisors and management team (with perhaps few exceptions) not only have a better understanding of the problem and how to deal with it, but they will also have a more constructive attitude toward the claims and issues. Therefore, when kylE kIElINSkI
Page 1 and 2: Our digital editions give you two u
Page 3 and 4: Don’t win an iPad... Cross ss Cou
Page 5 and 6: contents ADVANCE FoR PHySICAl THERA
Page 7 and 8: [lETTERS To THE EDIToR] Referral-fo
Page 9 and 10: [MANAGEMENT FOCuS] Strengthening Re
Page 11 and 12: [uPPER-ExTREMITy REHAB] Diagnosis:
Page 13 and 14: [CoVER SToRy] kylE kIElINSkI retire
Page 15 and 16: [CoVER SToRy] componentry repair wh
Page 17 and 18: [NEuROLOGIC REHAB] Miracle Movers B
Page 19 and 20: [NEuROLOGIC REHAB] supplemented by
Page 21: [PIlATES] patterns. Breathing is of
Page 25 and 26: [wHEELCHAIR/SEATING] wheel Master P
Page 27 and 28: [wHEELCHAIR/SEATING] From start to
Page 29 and 30: [ClASSIFIED MARkETPlACE] Tell Adver
Page 31 and 32: EDUCATION OPPORTUNITIES JULY 21-22,
Page 33 and 34: EDUCATION OPPORTUNITIES 2012 Traini
Page 35 and 36: EDUCATION OPPORTUNITIES (Continued
Page 37 and 38: EDUCATION OPPORTUNITIES (Continued
Page 39 and 40: Aquatic Therapy Resource Directory
Page 41 and 42: EMPLOYMENT OPPORTUNITIES New York Y
Page 43 and 44: EMPLOYMENT OPPORTUNITIES Pennsylvan
Page 45 and 46: EMPLOYMENT OPPORTUNITIES North Caro
Page 47 and 48: EMPLOYMENT OPPORTUNITIES National,
Page 49 and 50: Brand name, custom embroidered polo
Page 51 and 52: Men’s Tee Black. #14668 $18.99 S-
Page 53 and 54: Introducing the newest innovation f
Page 55 and 56: Have you visited advancehealthcares
Page 57: Lokomat ® Functional Locomotion Th

Download - ADVANCE for Physical Therapy & Rehab Medicine

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?