Do you know someone who is experiencing sore or tight muscles and looking for an inexpensive therapeutic tool? Foam rollers may be beneficial. A foam roller is simply a cylindrical piece of extruded hard-celled foam. They usually come in one-foot or three-foot lengths. One of the variations is the half roll. They are flat on one side and are often used by beginners. For densities, they could either be low density rollers or high density rollers. High density rollers are more durable and are a good choice for people who are not severely deconditioned and not in acute pain.
Foam rollers are most effective when used as part of your daily stretching therapy. A roller should be used before and after activity, and always roll before you stretch. This will help to warm up cold muscles and prepare them for deeper and more aggressive stretching. To use a foam roller correctly, start by placing your body on the roller and slowly roll up and down the sore muscle. If you find a knot or tight band, hold that spot and try to feel the tissue release and soften underneath the pressure. If an area is very painful when using the roller, rest assured that as the tissue starts to loosen up you should be able to roll with less pain.
Foam rollers are a form of self-massage. Massage is effective at mobilizing soft tissue such as muscles, neural tissue, fascia and tendons. It’s similar to stretching, but because you’re applying pressure to an isolated area, you’re able to focus the mobilization on a specific spot. Rollers assist in breaking adhesions within and between muscles and fascia, and accessing areas that are difficult to treat with conventional stretches. Commonly treated areas are the neck, back, hip, leg or even the full body. The end result is increased flexibility and more normal movement patterns. Foam rollers can be beneficial for sleep issues, headaches or stress relief.
At the SpineOne Rehabilitation Programs, all of our clients are introduced to the use of foam rollers at some point in their program. Since rollers are adaptable for any skill level, they have been proven beneficial in our efforts to teach our clients self-management of their pain conditions. It is important to have proper instruction prior to starting a foam roller program. To learn more, contact our professionals at SpineOne.
Contributors – Roy Mena, Spine Exercise Specialist
Amy Posada, PTA, CSCS, Spine Exercise Specialist
RehabOne Medical Group is proud to announce the opening of our Functional Restoration Programs, in our Salinas office. Our expanded services will include medically-supervised programs to assist pain patients in achieving optimized function in their lives. Starting March 1st, we will be accepting new referrals and look forward to working with your patients/clients. If you would like to make a referral, please fax patient/client demographics and insurance information to (408) 445-0875.
Functional Restoration Programs (FRPs), also referred to as chronic pain management programs, chronic pain treatment programs, and comprehensive pain programs, have existed for quite some time. The earliest programs were only available at medical centers and required lengthy hospital admissions. Changes in medicine over the past several decades have shifted the trend in providing this type of treatment to privately administered outpatient programs. Functional restoration became popular in the 1990s when health care providers and payers, frustrated with costly and ineffective treatment, began seeking alternative approaches to managing chronic pain.
The conceptual framework of functional restoration programs involves an interdisciplinary team approach to delivering care. While there is no consensus about who comprises the team, it generally includes licensed healthcare professionals such as physicians, physician assistants, chiropractors, physical therapists, physical therapy assistants, occupational therapists, nurses, psychologists, marriage family therapists, and/or social workers. Other team members may include ancillary healthcare providers such as kinesiologists, fitness trainers, vocational counselors, acupuncturists, and/or nutritionists, in addition to administrative support personnel.
The fundamental goal of functional restoration is to optimize or (in the most ideal, but unfortunately rare circumstances) completely restore function after an illness or injury that has left someone with residual impairment and limitations. In order to achieve this goal, functional restoration programs rely on a paradigm shift from the biomedical model of care (e.g. to identify the cause of symptoms à treat the cause à cure the symptoms) to a biopsychosocial model, which relies on an integrated, rehabilitative approach to long-term management of an illness or injury.
This biopsychosocial model has been widely used for many decades in the treatment of spinal cord injury, head injury, stroke, multiple sclerosis, polio, and various neuromuscular injuries and disorders. In these instances, cure is not yet possible and the emphasis is on maximizing function. Functional restoration programs rely on the same principles and apply it to chronic pain conditions that have not responded and/or are not likely to respond to standard medical treatment.
A comprehensive evaluation is the initial step. The purpose of the evaluation is to not only obtain baseline functional data, but also to determine factors favoring a good outcome as well as obvious or potential barriers to treatment. The evaluation also introduces the patient and their family to the team. Developing trust and rapport is part of the evaluation process since they too will become an integral part of the team once they are accepted into the program. A critical part of the evaluation includes identifying functional goals that are important and meaningful to the patient and that can realistically be achieved within specified timeframes. Equally important is identifying patients that are not medically or emotionally stable or ready to participate in this type of treatment.
Functional restoration programs generally involve the patient participating in physical activities directed on improving strength, endurance and cognitive-behavioral therapy to assist them toward acceptance and to help reframe their thoughts and actions to healthier living. Additional treatment may include nutritional guidance, relaxation classes, vocational counseling and return to work planning, yoga and/or tai chi. The interdisciplinary team typically meets weekly and as needed to review the patient’s progress, barriers to treatment, and strategies to assist them in overcoming those hurdles. Some functional restoration programs have aftercare or transitional programs to help patients maintain gains and/or minimize the risk of relapse after program completion.
At present, there are no universally agreed upon short-term or long-term outcome measures for functional restoration programs. However, there is evidence-based scientific data documenting the benefits and cost-effectiveness of these programs for the treatment of chronic pain. The key to achieving a successful and sustainable outcome relies heavily on empowering the patient to regain control and responsibility over their health and well-being, while at the same time minimizing their reliance on healthcare professionals, which ultimately translates into reduced utilization of healthcare resources.
Michael Post, M.D.
Chief Medical Officer RehabOne Medical Group
Diplomate, American Board of Physical Medicine & Rehabilitation
Subspecialty Board Certification in Pain Medicine
Diplomate, American Board of Pain Medicine
Qualified Medical Evaluator
Gatchel, R.J. & Okifuji. Evidence-based Scientific Data Documenting the Treatment and Cost-Effectiveness of Comprehensive Pain Programs for Chronic Nonmalignant Pain. The Journal of Pain, Volume 7, No 11, 2006: pp 779-793.
Gatchel, R.J. & Mayer, T.G. Evidence-informed management of chronic low back pain with functional restoration. The Spine Journal, Volume 8, 2008: pp 65-69.
California Division of Worker’s Compensation, Medical Treatment Utilization Schedule. Chronic Pain Treatment Guidelines, 2009, pp 30-32, 49.
American College of Occupational and Environmental Medicine, Occupational Medicine Practice Guidelines, Second Edition, 2004. pp 113-114.
Once we make a decision to improve our lifestyle, it is important to be able to execute a plan so that we are successful and meet our goal. Planningfor this change in habit is as important as changing the habit it self. It is the key that will lead to a successful lifestyle change. Below are some tips on making healthy lifestyle changes, or form new habits, in 2013.
- Make sure the new habit you want to create is specific and measurable. For example, a habit of “drinking morewater” is insufficient whereas a habit of “drinking 6 glasses of water a day” is easier to do and measure your success.
- Do it in the same place, same time, and same surroundings – if possible, for the first few weeks. You need to set up reminders to help you remember the action at the time you want to do it or you may end up at the end of the day remembering that you were meaning to start your new habit but forgot. When cues like time of day, place and circumstances are the same in each case it is easier to stick to your new habit (e.g. taking vitamins after brushing your teeth). During the time before the action becomes a habit, you will need to use these external reminders. Make it easy for yourself to remember what you are trying to do: certain ritual times (waking, leaving the home, before turning on the TV) help best. Alarms, notes, friends to call you, rubber bands on your wrist, or a reminder in your phone to remember to complete your new action work well, too.
- Plan for triggers - You may get discouraged being tired after a long day at work which may trigger you to think that you’re too tired to go for a walk after dinner (new habit). The key is to find out what your triggers are — and then plan ways to avoid or cope with them if they are a barrier to your lifestyle improvement. Certain people, places, events or situations sometimes trigger a lapse once you’ve started. When a lapse happens, don’t get discouraged. Learn from the lapse and get back on track as soon as possible.
- Make it Daily – Consistency is critical if you want to make a habit stick. If you want to start exercising, go to the gym every day for your first thirty days. Going a couple times a week will make it harder to form the habit. Activities you do once every few days are trickier to lock in as habits. An action you will take everyday or even many times a day will take only two to three weeks to install. An activity that you will only do once a week but have decided should be a habit because it is something you want to do can take up to twelve weeks to install!
- Pick ONE habit, and focus on that one new habit
- Commit to your new habit for a minimum of 21 days to a month. Research states that it takes a minimum of three weeks to develop a new habit
- Most important, make it easy to succeed! Don’t jump into something you have to make a big change to accommodate – make it easy enough to succeed and earn an ‘A’ for the day.
You want the habit of waking up 20 minutes earlier but keep pushing the alarm snooze. Make it hard to stay in bed. Move the alarm, make it louder, put it on a “hard-listening” music station, set the coffee on a timer so it’s ready when you get up, or set the TV on a timer.
Want to start cooking your own meals? Don’t try to cook ALL of your own meals in the onset. Just aim for one meal per day. Create a schedule you will be successful with in the beginning – again, make it super easy!
Want to quit drinking soda? Instead of replacing a twelve pack of diet soda per day, replace just the cans you drink at work with mineral water (or any diet soda alternative). Make it so easy you know you’ll be able to do it.
At Spine One, we review these principles with our clients from Day 1, and continue working with these concepts with our clients throughout treatment, so that the journey in rehabilitation becomes a life style change. When it is a lifestyle change, the chances of sustainable success after completion of the program are much greater.
Submitted by: Robin Balchen, Clinical Program Manager at SpineOne
RehabOne Medical Group is proud to announce our newest member of the team, Sree Kumar, PA-C!
Sree Kumar grew up in India. When she moved to California she worked as an inpatient Clinical Dietitian for Santa Clara Valley Medical Center. Sree then pursued Physician Assistant program at Stanford School of Medicine while simultaneously earning a Masters degree in Medical Sciences from St. Francis University. After earning her degree at Stanford, she worked as a Primary Care Physician Assistant and encountered patients with acute and chronic pain who were not able to have full, functional lives due to inadequate pain control. Sree believes in the multidisciplinary approach of the RehabOne team and looks forward to utilizing effective pain control to improve the quality of life of her patients. Sree will be working with Dr. Allen Kaisler-Meza in our San Jose office.
At RehabOne Medical Group, we treat people at all stages of disease and in all phases of outpatient rehabilitation. There are many patients that suffer with varied levels of ongoing inflammation and pain that limit their function and decrease their overall wellness. As healthcare providers, it is our responsibility to empower our patients with many different tools to manage their pain and functional limitations. We have discovered that our best outcomes are generally a result of many effective self-care habits, strategies and techniques that combine to improve overall wellness and reduce overutilization of healthcare services.