March is National Sleep Awareness Month

The average healthy adult needs at least 7 hours of sleep each night, yet many of us are getting much less sleep than that. Sleep is important for both our physical and emotional health and should be as much of a priority as eating a healthy diet and exercising. In honor of National Sleep Awareness Month, we have compiled some tips to help you create good sleep habits and reap the benefits of a good night’s sleep. 

Establish a good sleep routine:

• Eliminate exposure to electronic devices at least 30 minutes before bedtime.

• Go to bed and wake up at the same time every day (yes, even on the weekends).

• Plan on spending 8 hours in bed to get at least 7 hours of sleep.

• If you are having trouble falling asleep after 20 minutes, don’t stay in bed and get frustrated. Instead, get up and do something relaxing like read a book or meditate until you feel tired again, then go back to bed.

Create a sleep-friendly environment:

• Keep your bedroom quiet, dark, and cool when it is time to sleep.

• Silence electronic devices to the extent possible.

• If outside noise is an issue, try using a sleep sound machine or app to play white noise or other soothing sounds.

Eat and drink your way to better sleep:

• Don’t eat a large meal less than 3 hours before bedtime.

• If you’re hungry before bed, eat a small, healthy snack. Berries, a banana, nuts, or yogurt are some good options.

• Cut off caffeine at least 6 hours before bedtime.

Back Pain? Try PT First!

You probably already know that back pain is a common problem. What you might not know is “non-drug treatments like physical therapy" are the first treatment recommended for back pain. Unfortunately, many providers don't always follow this, and treatments are often recommended based on opinion rather than research. This means insurance companies and patients often end up spending a lot of money for outcomes that are less than stellar. 

Here's how it usually goes: You go see your doctor with back pain. They might give you medication, recommend rest, some stretches and send you for x-rays or an MRI. Next you will likely be referred to a specialist like an orthopedic surgeon. Chances are you won't be having surgery, so the specialist will either refer you to PT, or back to your primary care physician where you'll end up with a PT referral. The path will look different for each person, but the end result is usually the same - multiple failed treatments, imaging you probably didn't need and a delay of weeks or months to get to a physical therapist. In fact, guidelines suggest first time non-traumatic lower back pain patients should not be sent for an MRI or X-ray before trying physical therapy first. 

Multiple large studies have looked at the effects of early physical therapy on low back pain with impressive results. One of them was done in 2006 in Seattle by Virginia Mason Health Center. They teamed up with Aetna and Starbucks to send workers with back pain to see both a physical therapist and physician for their first treatment. Use of MRI dropped by 1/3, people got better faster, missed less work and were more satisfied with their care. The cost savings was so great, that Virginia Mason was losing money on treating back pain and Aetna ended up paying them more for PT treatments because Aetna was saving so much money. Intel ran a similar program with their employees, getting people with back pain to a PT within 48 hours. Previously it took about 19 days for people to get to a PT. With the earlier access, patients completed their care in 21 days, compared with 52 days previously and costs dropped between 10 and 30%. Intel also found more satisfaction with care and a faster return to work. 

The data is out there that proves physical therapy is the cheapest and most effective treatment for most people's low back pain. It's clear that people with back pain should start treatment with their physical therapist. If you are having back pain, tell your doctor you would like to try physical therapy as your first option and call us at 518-489-2524 to schedule!

Home Exercise Program (HEP) Compliance and Common Questions

Contributed by Tony John, PT

How do we assist patients with compliance to their HEP?

Research has shown that only 35% of patients are compliant with their HEP. Here at Repsher & Associates Physical Therapy, we strive for 100% compliance. We understand that our patients have work, school, and/or family commitments. We are also aware that many of our patients may have never participated in structured exercise before. Due to this, we strive to make our HEPs practical, concise, and realistic.

We not only want to help you, but also help you help yourself! Here are just a few steps we take to assist patients with compliance to their HEP:

• We educate our patients on the importance of their HEP and how it can impact their goals.

• We design our HEPs to take no more than 20 minutes to complete.

• HEPs are customized to the specific patient, not just to the specific diagnosis.

• HEPs are updated frequently, depending on patient progress.

Common questions from patients regarding their HEP:

Q: “Should I stop exercising if it hurts?”

A: It is normal for new exercises to cause some discomfort. It takes time and practice for your body to get used to it. If your pain significantly increases during or after your exercises, stop the exercises until consulting with your PT.

Q: “Do I have to do exercises at home in addition to attending PT sessions?”

A: Considering there are 168 hours in a week, spending 1-3 hours per week in PT is simply not enough time to consistently correct a deficit that may have taken months or even years to develop. Still speak to your physical therapist to see if your program can be adjusted to accommodate your commitments.

Q: “How do I know if I’m doing my exercises correctly at home?”

A: At Repsher & Associates Physical Therapy, we have the capability of sending our patients videos of their individual exercises to educate and reinforce proper form. In addition, we are always delighted to review home exercises with patients during their office visits.

If you have questions about your HEP, we are happy to help! Ask your PT at your next appointment or give us a call at 518-489-2524!

What is a Home Exercise Program (HEP) and Why is it Important?

Contributed by Tony John, PT

A home exercise program (HEP) is an individualized set of therapeutic exercises that a patient is taught by their Physical Therapist to be completed at home, to complement and reinforce their program in the clinic.

In addition to these exercises, the HEP may also include activities to avoid to minimize the chance of reinjury, as well as the application of lower level modalities, such as heat or ice.

Why is a HEP Important?

• Home exercises reinforce what you have learned during your PT visit. This will promote a more rapid progression to the next level of your rehab program.

• Home exercises can help improve muscle memory. This muscle memory is helpful when new exercises are added during your rehab sessions.

• Home exercises often turn out to be the beginning of a new active, healthy lifestyle!

• Home exercises help prevent reinjury.

• For patients with chronic or progressive conditions, home exercises are often beneficial long term to maintain strength and functional gains long after in-office PT visits have ended.

• Research shows that patients who comply with a HEP are up to 5 times more likely to successfully achieve their rehab goals than those relying only on their in-office PT visits!