Headaches!!! What can Physical Therapy do??? Paul Wortley PT Rocky Mountain Therapy Services
Take 2 Aspirin and Call Me in the Morning
FACTS During the past year, nearly 90-95% men and women have had a least one headache. Over 4 billion dollars are spent annually on over the counter pain medication for headaches. Employers loose an estimated 50 billion dollars each year due to absenteeism and medical expenses caused by headache, and those with migraines loose more than 157 million workdays each year.
TERMINOLOGY ETTH (Episodic Tension Type Headache) CTTH( Chronic Tension Type Headache) CERVICOGENIC Headache MIGRAINE Headache
What do you mean I have more stress in my life than I Should???
THE PROBLEM Life Gets in the Way Home /Occupational /Recreation Stress and how we react Bad Life Habits and how they get formed Proprioception and Getting Used to It Muscle Physiology / Starving for Hydration Myofascial Pain Syndrome / Stuck like Glue Trauma /Sports injuries / MVA s / Whiplash
What is the most Common Denominator? GUESS
THE Common Denominator is BAD POSTURE!!!
Your Head is a Bowling Ball 10 to 18 lb. Bowling Ball
Forward Head Syndrome
Standing
Cervical Lordosis
Standing Examples
Purse / Backpack Max Back Pack Weight <= 20% of weight
Flexion Addicted Society
Sitting / Computer / Phone We call them Computer Jockeys
Mom s Idea
I Pad / Car /Gameboy/ Texting
Physical Therapy Evaluation Get a Good History (Freq, Intensity, Duration) Record Baseline Cervical ROM Look for SB / Rotation deficits to the same side Look for postural deficiency Look for muscle trigger points
Computer Program Posture Analysis
Patients Headache Drawing
Physical Examination Positive for Occipital Neuritis Positive for Super orbital / trochlear neuritis
Secondary Problems to FHS The Gorilla Protracted Scapula's / palms face backwards Collapsed chest Upper and Middle Trapezius stress / Trigger Increase Levator Scapula muscle stress / Trigger
Upper Crossed Syndrome
Muscular Trigger Points
THE SOLUTION Awareness / Restore Proper Posture Changing Habits / 1 hour only on Computer Identifying Triggers Relaxation / return to normal muscle tone Stretching / return to normal muscle tone Coping with Stress / Need the right tools (Women: It s OK to be #1) Nutrition and Hydration / Water vs. Diet Coke Exercise and stretch the proper muscle groups
PHYSICAL THERAY HEADACHE TREATMENT Spine School / Posture Education & Practice Use of modalities / Ice-Heat- Electrical Stimulation Myofascial Release/Massage Relaxation and Breathing Training Spinal Mobilization Cervical Traction Aquatic Exercise / Posture Practice Gym and Cardiovascular Exercise Education/Implementation of Home Headache Program ( Headache Self Defense )
Posture Education and Application
Proper Standing
Proper Sitting
Proper Posture / Computer Add picture
Ice is my New Best Friend
Myofascial Release
Sub-occipital Release
Spinal Mobilization Prone thoracic Mobs Standing thoracic + C7-T1 Mobilization
Injections / Medications Trigger Point Injections Nerve Block Injections Facet Joint Injections Epidural Injections Pain Meds Muscle Relaxers Anti-Inflammatories
Cervical Traction Neck Trac vs over the door and under the chin
Postural Neuro-Muscular Pool Exercise Re-education
Postural Correction Exercise UBE Posture Chair by Body-Align
Postural Correction Exercise Seated Row Lat Pulls
Kinesiotape
EXPECTATIONS AND GOALS Reduce Headache: Frequency/Intensity/Duration Increase PPI index to 85% or greater Decrease Neck Disability Index to <10 over 50 Reduce Neck Pain: Freq, Int, Duration Reduce muscle tension Restore / Improve Cervical Lordosis Restore Cervical ROM to WNL Independent with home exercise / stretching Improve / Restore Proper Posture
RECOMMENDED DURABLE MEDICAL SUPPLIES Achey-Breaky Ice Pack System
RECOMMENDED DURABLE MEDICAL SUPPLIES Lumbar Support for Sitting
RECOMMENDED DURABLE Neck Pillow MEDICAL SUPPLIES
RECOMMENDED DURABLE MEDICAL SUPPLIES Neck Trac Cervical Traction Unit (When indicated)
RECOMMENDED DURABLE 90 Glasses MEDICAL SUPPLIES
But Doctor Isn t there just a pill that will make it all go away? If you are not willing to do what it takes to get better.go home and ENJOY your pain. You Earned It!!!
So How Long will it Take? Typical time frame to reach goals: 3 X per week for 2 weeks 2 X per week and X1 wellness for 2-3 weeks 1 X per week and X2 wellness for 4-6 weeks Then 30-60 days wellness ( FREE ) Each Treatment Session is about 2+ hours
Independence One of the biggest goals of treatment is: Have the patient become independent from me and not dependent on me Paul G. Wortley PT
Remember If you continue to do what you ve always done You ll always get what you always got. Positive changes DO NOT occur without taking appropriate action and positive changes on the physical level DO NOT occur without the persistence of doing the right things overtime!!! Our Job is to help set them on the The Path
It s a Team Approach Patient Physician Physical Therapist Working together Headache Sufferers can be helped!!!
Acknowledgements Thank You Dr. Phil Savia ( Headache Neurologist )
THANK YOU It has been an Honor!!!