Dear Valued Clients,

Thank you for choosing Turning Pointe Physical Therapy, Inc. for your physical therapy needs.  We are excited to provide you with the highest quality of care.  In the interest of quality and excellence, keeping costs down is a big factor. In order to keep costs at a reasonable level, as well as expedite customer communication, we would like to start sending correspondences via electronic mail (e-mail), such as Billing Statements, Payment Receipts, New Client Intake Forms, etc… If you are interested in receiving these correspondences via e-mail, and allowing us to not send them via the standard postal service, please send an e-mail message to the address below stating as such.

Example: “I, Jane Doe, agree to have all correspondences sent via e-mail and will no longer desire a paper copy.” If you desire a specific paper copy, such as annual statement, sent via postal, please state that in your response, otherwise, all correspondences will be via e-mail upon receipt of your message.

Sincerely,

Nola B. Petrucelly, CEO                                     E-mail: admin@turningpointept.com

To hurt is as human as to breathe.

J. K. ROWLING

There has been no person who has not experienced some type of injury or trauma in his/her lifetime. We are all connected in the rawness of life by the pains and joys it brings. Why, then, is it that we often feel disconnected from human compassion and nurturing when seeking medical care? I’ve experienced, and frequently clients relay to me, the feeling of being passed through the medical system without thought or care.  It’s as if the personhood has become irrelevant while the disease/condition is paramount as a separate entity.

I often think about why I decided to pursue physical therapy. 19 years ago, I was an injured dancer with little help from the medical community with rehabilitating my painful knees. It wasn’t until I met Linda Kozora, PT that I saw someone with the passion to provide education for better function while also giving support through the process of healing. This life changing event impressed on me a kindness that could exist in the medical community and the power that compassion and encouragement can have on a person dealing with an injury. Lately, though, it seems as if this passion-driven practitioner has gone missing, with the act of healing being replaced instead by “fixing.”

A recent article in the Wall Street Journal was very poignant on this subject. http://blogs.wsj.com/speakeasy/2012/04/25/should-a-doctor-be-like-a-gardener/

In this article, Victoria Sweet illustrates a fantastic paradigm shift in viewing the human body while also touching on our ability to offer our humanness to our clients as a connection point for the facilitation of healing.

Sweet’s thoughts on facilitating healing in patients are comparable to several of the types of therapy we provide here at A Turning Pointe Physical Therapy. Structural Integration, the brainchild of Ida Rolf, was born from the philosophy that   “When the body gets working appropriately, the force of gravity can flow through. Then, spontaneously, the body heals itself.”  The underlying principles of Structural Integration are rooted in the notion that balancing the body in all directions, front to back, side-to-side, inside to outside, promoting an integration of all connective tissue within the body. Since the body works together as a whole, any misalignments interfere with this wholeness. Rolf believed that through integration, wholeness and balance could be restored, thereby reducing emotional as well as physical stress. This philosophy is what led me to begin practicing Structural Integration (Rolfing) and to open A Turning Pointe Physical Therapy in 2003.

Similar principles of self-correction are mirrored in Frank Lowen’s Dynamic Manual Interface (DMI) work. DMI utilizes the body’s self-corrective mechanisms to improve tissue mobility, biomechanics and system balance.  While the basic concepts of DMI are simple, the training for the hands and the mind is extensive. Laurie Levine-Lowen, OTR and Gene Suzuki, PT are two very gifted providers who are passionate to provide DMI at A Turning Pointe Physical Therapy.

A key in the interplay between practitioner and client lies in the dialogue that occurs in a session. There is value in both diagnosing and treating, but more important is the education that the practitioner can give the patient. This is especially highlighted in the Hanna Somatics work provided by Serena Coleman, MPT. Hanna Somatics is a technique developed by Thomas Hanna which involves neuromuscular retraining through the body’s own feedback system.  The client is guided through movements to increase their awareness of a particular pattern of neuromuscular dysfunction which is causing pain, discomfort or limiting their abilities.  Then with the assistance of the therapist, the client develops a new integrated pathway to achieve movement in a healthy, balanced, and non-painful approach.

Craniosacral therapy (CST) and Visceral manipulation (VM) are two additional services provided at A Turning Pointe Physical Therapy by Donna Harmon, PTA and Linda Kozora, PT. These methods are specifically designed to help the body to self-correct. CST, as defined by Upledger, is a gentle, hands-on approach that releases tensions in the tissues that surround the central nervous system. The releases help to relieve pain and dysfunction and improve health and performance. VM, as defined by the Barral Institute, assists functional and structural imbalances throughout the body including the musculoskeletal, vascular, nervous, urogenital, respiratory, digestive, and lymphatic systems. VM is an integrative approach to treatment that focuses on the dynamics of movement as they relate to the organs, membranes, fascia, and ligaments in the body.

Finally, Manual Lymphatic Drainage (MLD) is another service provided at A Turning Pointe Physical Therapy. Damage to the lymphatic system can occur in many ways including surgery, radiation, chemotherapy, trauma, and vascular insufficiency. Since the lymphatic system aids the immune system in removing and destroying waste, debris, dead blood cells, pathogens, toxins, and cancer cells, damage to this system can cause excessive lymph fluid to accumulate in the tissue.  By providing MLD and educating the client is self-massage at home, the lymphatic vessels are stimulated to push the backed up lymph fluid into small capillaries to allow for drainage, filtering, and excretion of this fluid. Nola Petrucelly, PT and Donna Harmon, PTA provides MLD at A Turning Pointe Physical Therapy.

It has long been my belief/philosophy that an integrative approach to care combined with compassion has proven to be the best combination to facilitate healing. A quick fix in medicine loses sight of how the body is made to heal itself. Additionally, when we realize that a body is estimated to have over six trillion reactions taking place at any given moment, even a small bit of support for the healing process can ignite a more permanent resolution. Just as Voltaire once stated “amuse the patient while nature cures the disease.”

Nola Petrucelly

“Feel better”

Another protest?  Not quite.  Just an idea to nudge you towards better health and a better life.

How does your chronic pain affect your daily life?  Does it make you grumpy towards your family and friends?  Do your co-workers know full well when you’re having a flare-up?  Does the idea of going out and playing in the beautiful fall colors fill you with dread?

The most powerful tool in any person’s care plan is the desire within you to rid yourself of ailments and strive to live a fuller, pain-free life.  You hold the key to your own fitness.

Now, how do you get there?  It’s usually a combination of factors; diet, exercises, visiting your physician and, of course, physical therapy.  At ATP and Medical Lake PT, our therapists give you their full attention for the duration of your visit.  No undertrained PT Assistants, no under-paid/trained aides that just put hot packs on you.  You get nothing but the full attention of a highly trained therapist that has dedicated to removing or reducing your pain through alternative yet proven therapies.

Rolfing, Somatics, Dynamic Manual Interface, Visceral Manipulation, Pelvic Floor work, Craniosacral Techniques, Trigger-Point….more than I can mention.

Our great folks can only do so much until you great folks decide to take charge of your health.  If you think that physical therapy may fit in with your health and wellness goals, give a us a call or drop us an email to find out how we can help.

“Feel Better!”

Available Appointments

Osteoporosis, Falls and Broken Bones

Falls Prevention Awareness Day is a great time to learn about the link between fall-related injuries and osteoporosis.   The good news is it is never too late to identify and treat osteoporosis or to prevent falls to avoid broken bones.   Speak to your healthcare provider about how to reduce your risks for osteoporosis and falls, about getting a bone density test, and about medications, if necessary, to treat osteoporosis.

How are falls and osteoporosis linked?

• 1 in 10 falls in older adults end in serious injury such as a broken bone. If we can prevent falls, we can prevent broken bones of the hip, spine and wrist.
• Vitamin D deficiency is a risk factor for both falls and broken bones. Daily vitamin D intakes of 800-1000 IU (international units) and 1200 mg (milligrams) of calcium are associated with reduced falls and broken bones in older adults.
• Regular physical activity and exercises that combine weight, muscle strengthening and balance helps reduce the risk of falls and actually improves the health of your bones

Take action to prevent osteoporosis and falls

-Eat a balanced diet rich in calcium.

-Take vitamin D supplements.

-Get regular physical activity.

-Don’t smoke.

-Limit your alcohol.

-Check your home for safety.

-Talk with your doctor about a screening test.

What is osteoporosis?

Osteoporosis is a disease that causes bones to become thin, weak, and more likely to break. Although you can break a bone in any part of your body, the most common broken bones associated with osteoporosis are the spine, wrist, and hip.

You have the power and ability to minimize your risk of injury-by-falls and increase your health.  We can help!

“Feel Better!’

Group Health has spoken.

GH Termination Letter

We received this letter via courier just this afternoon.  We have made appropriate notifications to those directly affected and will be attempting to contact each and every ATP and ML client we have that is in the Group Health network.

Over the weekend, we will be mulling our options but in the meantime, we encourage you to notify your GH representative for clarification of your status and to voice your opinion.

More on Monday.

Enjoy your weekend, dear Friends.

The human body and brain are marvelous devices with interacting complexities that science and medicine are barely beginning to unravel.  Despite the vast amounts of what we don’t know, we DO know quite a lot about pain and pain management.  In just the past five years, we have found that it’s quite often personal and lifestyle choices we make that affect our chronic and persistent pain level more than anything else.  There is a time for pharmaceuticals and there is a time for surgery but those times are not nearly as often as conventional medicine normally dictates.

More often than not, with a stronger knowledge of pain types and how our bodies send and receive pain, we can be empowered to manage or mitigate our pain more effectively.  The end goal is to live a rich and full life, no?  Imagine how much improvement there could be in your life with your persistent pain reduced by 50%.  How about 25%?  While the goal is a 100% reduction in pain, any lessening is an improvement.

The amusing video below explains, in clear and simple terms, how pain works and affects us.  Simply by understanding pain better, we can make positive choices in our own care.

Watch, learn and, go ahead, “Feel Better!”

Though written by therapists for therapists, this article gives patients a wonderful and informative view of this innovative healing practice. On our staff we have two highly experienced therapists that are more than proficient with Visceral Manipulation; Laurie and Linda.

Give us a call and “Feel Better!”

Nola

Visceral Manipulation for Low Back Pain

Published in Massage Message Journal, January/February 2009

By Dee Ahern, P.T. and Judy Russell, B.A., B.SC,

As we watch a graceful ballerina or enthusiastically cheer on our favorite tennis or football players, is it only the agility and ease of movement of the musculoskeletal system that we observe?

Or is it that which lies within the cylinder that forms the torso that often is responsible for creating the flow of movement patterns visible to the naked eye?

Have you worked with clients precisely applying manual therapy techniques that relate to the fascial system, the neuromuscular system, or the craniosacral system, yet your clients are not experiencing long lasting relief from low back pain and dysfunctional movement patterns?

A primary focus of orthopaedic and musculoskeletal education for massage therapists when addressing low back pain has been the study of how the structures that lie behind the spine influence the spine’s mobility and function. The curriculum presented in the Visceral Manipulation Program offers a method for assessing and treating the influence of those structures that lie in front of the spine. Those influential structures can include organs and their fascial attachments, peritoneum, the greater omentum or blood vessels. Visceral Manipulation is commonly called “organ specific fascial mobilization”. It addresses dysfunction within the contents of the cylindrical torso.

Visceral Manipulation was developed by Jean-Pierre Barral, a Registered Physical Therapist and Osteopath. He holds many positions including Director (and Faculty) of the Department of Osteopathic Manipulation at the University of Paris, School of Medicine, in Paris, France and Chairman of Department of Visceral Manipulation on the Faculty of Medicine Paris du Nord. He developed this form of manual therapy based on his theory that each internal organ rotates on a physiological axis. Each internal organ also has a relationship through fascial attachments to the spine. Today, his Visceral Manipulation courses are taught around the world by certified teachers who successfully complete a rigorous training program with the Barral Institute.

Consider the following orthopaedic dictum: any structure that crosses a joint has the ability to restrict that joint. It is certainly true for muscles. This also holds true for organs. Barral’s in-depth study of patterns of stress in tissues of cadavers at the Lung Disease Hospital in Grenoble, France complemented his interest in biomechanics in living subjects. He recognized the potential for the organ system to create lines of tension within the body. This observation was fundamental to his development of Visceral Manipulation. His interest was also piqued when a client confirmed he felt relief from back pain after going to an “old man who pushed something in his abdomen.” Since that time he has worked with researchers in France and North America to create evidence-based data, documenting changes in the viscera with the use of x-ray fluoroscopy, endoscopy, Doppler and ultrasound before and after manipulation of the organ.

How do organs become restricted? They can become restricted by a direct trauma (fall on a soccer ball), acute/chronic illness (pneumonia), absorbing the force of a motor vehicle accident (seat belt trauma), or scar tissue formed after surgery. We take approximately 24,000 breaths a day. Our heart beats 120,000 times per day. Any lack of mobility in these structures could promote chronic spinal restrictions – e.g. the attachment of the pericardium to the lower cervical and upper thoracic spine via the thoraco-pericardic ligament.

The mesenteric root of the small intestine can limit the mobility of the spine as it crosses the third and fourth lumbar vertebra. A mechanical restriction at the first lumbar vertebra may be influenced through constant irritation of an old appendectomy scar stimulating the autonomic nervous system. The cecum/appendix and L1 share this viscero-somatic interchange. Decreased flexibility of the fascial connection between the bladder and the head of the femur can limit the mobility of both structures. Chronic dysfunction of the right and left sacro-iliac joint can result from decreased mobility of the cecum and sigmoid respectively. A ptosed kidney on the anterior surface of the psoas muscle can compress one of five nerves (e.g. ilio-inguinal) in the vicinity. In fact, Jean-Pierre Barral has found through his clinical treatments and research that up to 90% of musculoskeletal problems have a visceral component.

The key in Visceral Manipulation is to find the most significant area of reduced mobility. A restriction will pull the surrounding tissue towards it. Another Orthopaedic dictum is that „the body hugs the lesion (restriction).? With training, your hands will feel the pull of tissue to the area that is causing the greatest mechanical tension in the body – this is an evaluation technique known as „Listening?. You will also learn to evaluate visceral mobility – the ability of an organ to move freely in three dimensions in its anatomical environment. In addition, you will be able to feel visceral motility – the organ’s inherent tissue motion. Like joints, organs must move to stay healthy. They have sliding surfaces that articulate with each other, with muscles, with ribs and with the spine. You will be able to ascertain what is normal or abnormal. This is not unlike what we learn about joints. The efficacy of treatment depends on the accuracy of your assessment and the specificity of the application of gentle manual forces in three dimensions to promote the health of the organ and relief of restriction in the body. There can be an immediate response to treatment or a response that becomes apparent over several weeks time as the body unravels a long standing restriction.

Gail Wetzler, P.T. of Orange County, California performed a clinical study that examined the neuroreflexive and structural relationship between the internal organs, their attachments and the musculoskeletal low back when in a state of dysfunction. The conclusion of the study showed that low back spinal dysfunction may be more effectively and efficiently resolved with the addition of Visceral Manipulation into the treatment program.

We cannot imagine our practices without these tools. It is exciting, rewarding and challenging. Visceral Manipulation tests your knowledge of anatomy and inspires you to learn more. We invite you to be curious and learn to look inside the body for possible organ specific fascial restrictions that may be causing low back pain, as well as other dysfunctions in the body. For more information about the Visceral Manipulation, the Barral Institute and the availability of courses in your area, we encourage you to visit www.barralinstitute.com.