Name, Clinic, time Frame with Results: Troy Ketchum, Ft Oglethorpe/Ringgold Georgia, 7 months

Birthplace: Alexandria, Louisiana

University(s) attended: Missouri Valley College, Louisiana Tech University, University of Tennessee at Chattanooga

Family Status: Married, 10 years

If I wasn’t a therapist I would be: Construction engineering/management or serving others in an organization like Compassion International

Currently reading: Killing Lincoln Bill O’Reilly

Currently Skimming: Million Miles In a Thousand Years Donald Miller, Raising a Modern-Day Knight Robert Lewis, and Get Out Chattanooga magazine

Last Movie Seen: The 2nd Sherlock Holmes movie

Favorite Sports Team: NFL: Saints, College Basketball: Duke, College Football: LSU  (I know this is blasphemy in the SEC but I’d skip any of them to watch the tour defrance, ironman world championships, or Nadal and Djokovic play Tennis)

Favorite Joint to Treat: Shoulder, Spine, Foot/Ankle, Knee, Hip in that order. I love what I do.

Favorite Treatment Technique: (the one that works) Mulligan SNAGs in Cervical Spine

Favorite Food to Cook: All things breakfast

Best Place Visited: Cape Town South Africa

Favorite Musician or Group: Matt Kearney

Biggest Influence on Career: Honestly, Jesus, otherwise I’d only desire to serve me and not others. Secondly, Danni Jones, PT for modeling the commitment and dedication to her patient’s I aspire to.

When I’m not at work I’m: Hanging with the Family, Church, Riding my Bike, Running, or Swimming

Goal(s) for next 12 months: Certify COMT, Near Completion of OCS, and get acquainted with the newest member of our family.

Results Physiotherapy, a Nashville based physical therapy company, has opened its 36th clinic in Mt. Juliet, Tennessee. Matt Broussard who has been with the company for the last 2 years has been promoted to be lead therapist in the new clinic. Tammie Lorentz who has also worked with Results in the Brentwood and Nashville clinics will be the lead support staff.

“This is a great chance for us to expand our involvement in Wilson County. The Mt. Juliet region has grown dramatically and the people that live there want quality healthcare choices in their own neighborhood,” says John Nelson, Vice-President of Marketing for Results.” Matt has done really well at our Smyrna clinic and is excited to make a difference in the community. When we spoke with physicians and people within the community it was obvious that the region needed a physical therapy choice like ours.”

The new Results location is in the Providence Medical Pavilion,
on Crossing Circle that comes off South Mt. Juliet Road just off
interstate I-40.

Results Physiotherapy is a Nashville-based privately owned physical therapy company with clinics across the state of Tennessee including Knoxville, Memphis, and Chattanooga.

Matt Broussard is in the final stages of completing his Certification in Orthopedic Manual therapy. ” I joined Results because of their genuine commitment to providing the best therapy for their patients. Everything this company focuses on is about improving patient outcomes. Everything they promised 2 years ago has also been true. I have become a better clinician and now I’m starting to help Craig O’Neil, Vice-President of Education, deliver their vision of clinical excellence to the next group of new clinicians. I am excited to make a difference for the people of Mt. Juliet.”

You can read more about Matt who is this month’s Results Therapist in the Spotlight here.

Name: Matt Broussard
Clinic: Mt. Juliet
Time Frame with Results: almost 2 years
Birthplace: Lafayette, LA
University(s) attended: University of Louisiana at Lafayette, B.S. Business Administration, Texas Woman’s University, DPT
Family Status: Married, no kids, one dog
If I wasn’t a therapist I would be: Professional Fisherman
Currently reading: The Old Man and the Sea
Last Movie Seen: Immortals
Favorite Sports Team: Houston Texans
Favorite Joint to Treat: Ankle/foot
Favorite Treatment Technique: Mulligan/Paris
Favorite Food to Cook: Anything Cajun, but I make a mean gumbo
Best Place Visited: Dominican Republic
Favorite Musician or Group: O.A.R.
Biggest Influence on Career: Troy Winward
When I’m not at work I’m: exploring Nashville with my wife
Goal(s) for next 12 months: turn our Mt. Juliet clinic into a great place to receive top-notch physical therapy, pass my OCS and COMT exams, and train my puppy to not eat all of my shoes.

Answer: Thanks for the question. I am sorry to hear about the challenging ordeal your husband and family has faced. We would be delighted to help.

While surgery for meniscal tears can correct mechanical impingement caused by the meniscus we now know it can also speed up some of the degenerative process on the bony surfaces of the knee. Our rehabilitation programs focus on restoring lower limb strength, core stability, and balance to reduce the stress and impact on the joint. Of significant importance is good hip control and strength to decrease the sheering/torsion forces on the knee joint. We would also assess your husband’s foot bio-mechanics to make sure he is in right footwear to adequately support his body and reduce impact up the kinetic chain.

Our programs are individualized to the patient’s needs and we would progress your husband at a rate that he could manage and adapt to, while also understanding what other health issues he is dealing and how this might limit his progress.

I am happy to call you if you would like to speak in person.

Thanks,
John

Answer: “Shin Splits” is a term that describes pain on the shin it does not describe the pathology. Commonly it is one of two things:
1) Inflammation of the muscle attachment to the bone. This is caused by a change in footwear, training type or intensity. If this continues for an extended period of time in can develop into 2) Stress Fracture.

The best thing we can do is get you over to our Brentwood clinic and perform a bio-mechanical assessment of your “foot type” and make sure your footwear is suited to your needs.

In the short-term make sure you are using ice immediately after any run and do not try and progress any training until we have assessed you. This issue needs prompt attention because of the risk associated with stress fracture development. Brandon is our running expert at Brentwood. I have cc’d him on this email.

Losing weight and exercising more to improve your health or looks, and stress management are among the top reasons to begin an exercise program in the New Year.  Regular exercise has been associated with more health benefits than anything else, and studies show that it reduces the risk of some cancers, increases longevity, helps achieve and maintain weight loss, enhances mood, lowers blood pressure, and even improves arthritis.  Keeping these resolutions beyond the second week of the year is the hard part.  However, studies suggest that if you set a specific goal or resolution, you are 10 times more likely to achieve your goal.  Setting goals to lose inches and pounds can lead to a decreased chance of success, so the goal should be based on creating a new habit.

The Next Step

The next step is committing to your goal. One of the most important factors of success in maintaining an exercise routine is doing something you enjoy. If you find something you really enjoy, the inches and pounds will drop before you know it.  If you hate running and it feels terrible to all of your joints, chances are you won’t be continuing to run by mid February.  On the other hand, if you love to dance, finding a fun Zumba class at the gym or church with a group of friends increases your chances of success.

Avoiding overtraining

The most discouraging part of starting an exercise routine, especially if you have been sedentary, is doing too much too soon.  Sore muscles and aching joints are common deterrents to continuing with your regular program, causing many people to give up early on their New Year’s resolution and move back into their old habits. Some soreness is expected when you begin a new exercise routine, however with your zeal to be a better you, it is quite common to injure yourself because of improper form, muscle imbalance, or performing exercises/activities that your body is not quite yet ready to take on.

You’ve come so far already and if the ache or injury begins to limit your ability to exercise, quitting becomes the next step for many. Don’t allow your desire to become a new you to be cut short, when seeking a solution from your physical therapist can, in most cases, quickly address the problem.

Consult with a Physical Therapist

Consultation with a physical therapist when an ache continues for 2-3 days or when an injury occurs is one of the best things you can do to prevent further injury. A physical therapist is trained in assessing and determining what is the actual root cause of the problem and then developing a course of action to begin to correct the issue. One of the goals of a good physical therapist is to find ways for their patients to continue on with their exercise routine without further injury, if at all possible.  Finding the right level of exercise specifically for you is no different than prescribing the right amount of medicine.  Too much can be very harmful and too little can be of little value.There are many factors that should be considered in designing an exercise routine specifically for you and your physical therapist can also properly assist you with this. These include: current level of fitness, current or past injuries or surgeries, and medical history.

Start Small

The best way to begin and maintain a successful program is to start small.  A 20 minute walk around the neighborhood is a great start. When it comes to weights, high reps and low weight is the best way to condition not only your muscles, but is the safest on your joints and ligaments.  If an exercise class, like Yoga, Spin or Boot Camp, is an hour-long class, start with 30 minutes the first time and then progress until you are keeping up with the rest of the class.

Highly Trained in Assessing Cause of Pain

The physical therapists at Results Physiotherapy are highly trained in assessing you for any muscle or joint problems that may limit you beginning and/or maintaining an exercise program. Most health insurances now allow individuals to self-refer to physical therapy without a referral from a physician.

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Are we treating Back pain effectively?

Currently, the US ranks 46^th among industrialized nations in health care outcomes yet it ranks number 1 in costs per capita.

Medicare data illustrates that from 1996 to 2004 (risk adjusted), there was:

• 629% increase in expenditures for epidural steroid injections
• 423% increase in opioids prescribed
• 307% increase in spinal fusions
• It is also noted that there is a direct correlation between MRI/CT rates and surgeries.

All of this increase in invasive treatment of musculoskeletal problems may be justified if patients’ quality of life and independence was preserved, however that isn’t the case.  In fact, the evidence paints a much different picture.  Social Security disability statistics suggest that disability from musculoskeletal disorders is rising not falling—from 20.6% to 25.4% in 2005.

About 80% of health care and social costs related to low back pain are attributed to the 10% of patients with chronic pain and disability.  This implies that meaningful interventions to reduce the recurrence of low back pain would allow significant cost savings in the current health care system.

Physical Therapy has been shown to be an effective cost saver and has been shown to have good outcomes:

• In a 2007 Annals of Internal Medicine systematic review of non-pharmacologic therapy, the authors demonstrate the benefit of Manual Physical Therapy and exercise in both sub-acute and chronic low back pain as well as moderate evidence for the use of spinal manipulation in acute low back pain.
• A review article published in the February 2009 Journal of the American Academy of Orthopaedic Surgeons recommended that in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective treatment is Physical Therapy combined with anti-inflammatory medications.

Recent economic studies have demonstrated that physical therapy can be an effective treatment choice for patients while saving them significant money.

The Virginia Mason Hospital system in Washington State was under significant pressure from local employers and health insurance companies to reduce the costs of its services. One of the hospital solutions was to use physical therapy for low back pain treatment prior to specialty care. The outcome of this procedural change has just been published in Health Affairs (Sept. 2011). The results were significant.

• Costs were reduced per episode by 55%.
• There was an overall reduction in utilization – less medications, less physical therapy visits, and reduced number of physician visits.
• Patient satisfaction improved, indicating better outcomes from treatment.

Health Services Research (Oct 2011) has just published a study that compared physician referral to physical therapy, with patient self-referral to physical therapy, (direct access).

• The total number of physical therapy visits were reduced by 14% when patients accessed physical therapy directly.
• The physician referred group received significantly more concurrent care – more medications, more imaging, more interventions.
• There was a staggering 87% reduction in episodic costs when the patient came directly to physical therapy.

Physical therapy ranks among the top treatment choices of Consumer Reports readers with back pain, according to a 2009 survey of more than 14,000 Americans with back pain. Physical therapist treatment and other “hands-on” therapies outranked treatment by medical specialists and primary care providers, a result that should prompt more patients to seek conservative options as a first line of treatment for their back pain.

At a time when people are responsible for paying a greater percentage of their health care services it makes sense to re-evaluate how we treat back pain to assure we maximize value. A conservative trial of 2-3 weeks of physical therapy may be your best and cheapest road to recovery. You can now come to physical therapy without having seen a physician first. You should find a physical therapy company where you see the licensed physical therapist at every visit, not just at the evaluation.

At Results Physiotherapy you are treated at every visit by the same licensed physical therapist. Our therapists will do a comprehensive “hands-on” examination that will pin-point the cause of your pain. The findings will form the basis of the treatment, which includes manual therapy techniques for improving joint mobility and flexibility, along with exercise prescription to impact the identified movement dysfunctions contributing to the pain.

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Memphis Area Director Logan Owens in Southwind, as well as Robert Saunders in Bartlett and Sarah Corrigan in Collierville successfully completed the examination. They join Trevor Ling in East Memphis and Meagan Moody in Cordova who have already received certification.

Successful completion of the MAPS examination demonstrates the highest level of competency in orthopedic manual therapy and exercise prescription. The test is both written and hands-on, with emphasis on clinical decision-making, advanced clinical practice, pathophysiology, and clinical case presentations. Preparation for the exam included over 130 hours of continuing education, along with a one-year internal training program.

Results Physiotherapy now employs more MAPS-Certified Orthopedic Manual Therapists than any other US company. Currently 22 of its therapists hold this certification, with 15 more eligible to sit for the exam in 2012.

“We are very proud of our therapists for passing this rigorous examination. This continues to allow Results Physiotherapy to provide the highest level of care for Memphis patients,” said Craig O’Neil, PT, Vice President of Education.

“Results Physiotherapy places a significant emphasis on training in manual therapy, which is a proven treatment for conditions such as low back pain, neck pain and other orthopedic conditions,” stated John Nelson, Vice-President of Marketing. “We also make sure each patient sees a licensed therapist at every visit. Patients deserve to be regularly evaluated and treated by a highly trained professional.”

About Results Physiotherapy

Results Physiotherapy offers the most advanced international techniques in physical therapy, proven to yield faster pain relief and more lasting recovery than exercise-only techniques. Based in Franklin, TN, the family-owned company operates 35 clinics across Tennessee and now in Georgia. The company remains on the cutting edge by continually educating its therapists to world-class professional standards.

Answer: Thanks for the question. Without knowing a little more about your symptoms it is hard for me to give you a likely diagnosis. We need to get you in to see Donnie at our Oak Ridge clinic as soon as possible. Donnie is a seasoned therapist, who also has a specialty in baseball that will make him an excellent choice for a shoulder issue. 

”Tearing/Crunching” noises can be heard when there is a “pinching” of the tendons in your shoulder and so may not necessarily mean that you have suffered a significant injury, especially with the lack of immediate pain. Having said this with the onset of soreness it would be best to get this evaluated asap. Donnie will be able to direct you on to an orthopedic surgeon if he is concerned that the damage is more significant than what it sounds like currently. 

The Oak Ridge clinic is open M-F and they have early morning and late afternoon/evening times. You do not need a physician referral, if you call the clinic they can set you up for an assessment. If you would prefer they contact you please reply with your phone number.

Thanks,
John Nelson

Answer: Carpal Tunnel is typically defined as entrapment of the median nerve which gives numbness/tingling in thumb and first two fingers as you have correctly identified. The ulnar nerve supplies the ring and little finger and would be the cause of the symptoms you are describing. This is unlikely to be tendonitis. The irritation/entrapment of the ulnar nerve may be occurring at your wrist, your elbow or maybe a related but slightly different issue coming from your neck. We should move quickly to get this assessed. We are always more concerned with “nerve” issues that other problem because it can end up causing weakness and loss of hand control.

Please call me; 615.512.8156 and we can discuss further or contact a clinic near you. Feel free to email with any other questions, concerns.

John Nelson