By Jeremey DuVall
From breaks to bruises to bursitis, physical therapists have a special knack for assessing the human body and helping restore it back to optimal performance. Armed with cutting edge equipment and a huge background of knowledge, PTs can help diagnose and treat many common ailments and movement disorders. But despite having a slew of cool toys (laser therapy anyone?), their most useful tool for treatment may be their hands. Read on for the need-to-know on the most popular treatment options for whatever injury might come along.
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Let's Get Physical -- The Assessment
The first step in the treatment process of any good physical therapist is evaluation. Expect therapists to ask detailed questions about how the injury came about, but also do some expert sleuth work (since the injured area may be a result and not the starting point of poor movement). According to Dr. Mike Reinold, a Boston-based PT and therapist for the Red Sox, therapists may be able to reduce the pain quickly, but that will only be temporary unless they address the root cause of the problem.
Although patients may come to see therapists for a variety of causes, low back aches, knee pain, and overuse injuries are among the most common complaints. Following a thorough investigation, therapists will begin to lay out a treatment plan, which will commonly include passive modalities (ice, heat, laser therapy and electrical stimulation to name a few). But more often than not, manual therapy -- a term that includes many methods of restoring tissue function like massage, stretching and exercise -- is the foundation for the assessment and treatment of an injury, Reinold says. Just don't anticipate hopping (or running, swimming, or lifting) back into activity right away. According to Dr. Eugene Babenko, a physical therapist based in New York City, the average length of care for musculoskeletal (read: bone and muscle injuries) can be anywhere from four to six weeks.
Putting The Pieces Together -- The Treatment
Ready to get going on the road to recovery? Before heading to your local PT office blindly, Greatist consulted with Reinold and Babenko to break down the most effective treatment methods for a variety of ailments, big and small. Note: The following section covers general assessments, not meant to take the place of professional medical advice, which will vary on a case-by-case basis.
Best for: Any injury
This hands-on approach separates physical therapists from other health practitioners. Although manual therapy may refer to many things, therapists usually employ common tactics like stretching, massage, and hands-on strengthening exercises to reeducate the body into proper movement and mechanics. "Manual therapy is a prime method to removing movement restrictions and helping patients move better," according to Reinold. He also advises that manual therapy should form the backbone of any treatment plan, not modalities like ice and electric stimulation.
Best for: Injuries involving inflammation and swelling
Ice can be a major component of injury treatment. By constricting blood vessels after application, ice is an effective way to reduce and even prevent inflammation immediately following an injury. Cold therapy can also leave the joint more mobile and enhance manual therapy. Although it's difficult to nail down the most effective protocol, applying cold packs to inflamed areas has been shown to significantly reduce swelling in soft tissue injuries.
Best for: Injuries involving muscular spasms and tightness
Applying heat has been shown to decrease pain and increase mobility after some injuries -- mainly those involving soft tissue like muscles, tendons and ligaments. By making the tissue more pliable, the therapist can better stretch the affected area. Note: Heat is just one tool to help the therapist be more effective, Reinold says, it shouldn't be the main focus of a treatment plan.
Best for: Connective tissue injuries
By using sound waves (undetectable to the human ear) to generate heat deep in the body, ultrasound therapy can help loosen up tissues in preparation for manual therapy or exercise. How it works: Therapists use a wand (unfortunately not the magic kind!) to apply the sound waves directly -- and safely -- to the skin. Ultrasound has also been shown to increase ligament-healing speed in our furry counterparts (read: rats), though more studies are needed to show whether the same holds true for us.
Best for: Muscular or connective tissue injuries
Laser therapy uses specific wavelengths of light to stimulate healing (well below the skin so you don't feel a thing). Best-case scenario: The treatment can help reduce inflammation, muscle fatigue and pain. It can also allow the therapist to move the affected joint around easier with less discomfort.
Best for: Disc herniation
When we stand, our spine is consistently bearing our weight making recovery from back pain difficult, Reinold says. Traction involves separating vertebrae to allow more space for nerves and less compression on disc cartilage. Some research shows that traction can be effective for reducing pain and enhancing quality of life in patients with a herniated lumbar disc. And since it doesn't involve going under the knife, this can be an effective treatment option for those who can't afford a long recovery.
Functional Electrical Stimulation
Best for: Restoring muscular strength
It's electric -- no really. Electrical stimulation, also referred to as ESTIM, is a common treatment option to restore muscular function following a traumatic injury. By applying a minor but steady electrical stimulus, therapists can cause contractions from muscles that may otherwise remain dormant. This leads to restoring proper movement and function sooner than relying on exercise alone. While ESTIM can't restore movement in every case, research shows it can speed recovery following ACL and total knee replacement surgery over the course of a few weeks. Additional research confirms the use of ESTIM as an effective treatment option to restore function in hemiplegic patients (those with one side of the body paralyzed).
Best for: Any injury to stay healthy after treatment
It may sound obvious, but exercise is a go-to strategy to treat and prevent pain. But these aren't just any old run of the mill exercises -- they're hand-picked to help patients move better by strengthening targeted muscles and addressing any muscular imbalances that may exist, Babenko says. Also, keep in mind that many injuries can crop up (or recur) from a sedentary and repetitive lifestyle, Reinold explains. (Think: hunching over the computer or obsessing over that Instagram feed.) By performing any sort regular exercise, those with even the most sedentary day-to-day can avoid common nagging aches and pains.
Ready to get checked out? Many patients can be referred to therapy by their primary care physicians after an initial checkup. Additionally, new state-by-state direct access laws now allow those in pain to head straight to their local therapist (check your state guidelines for specifics).
Have you tried any of these therapies? Got any others to add? Share them in the comments below.
Disclaimer: Remember that none of this information should substitute professional medical advice. Always check with a doctor or physical therapist first once those aches and pains arise!
Special thanks to Greatist Experts Dr. Mike Reinold and Dr. Eugene Babenko for their help with this article.
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Sales trends on the average price per unit. - (MARCUS & MILLICHAP)
Marcus & Millichap said it expects northern New Jersey to continue to see growth in the multifamily market sector, according to a report recently published by the commercial real estate firm.
Northern New Jersey has become a highly-desirable alternative for Manhattan and Brooklyn residents because of its quality of life and affordability, the report said.
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Marcus & Millichap anticipates the economy to remain strong, too. Employment will increase by 1.7 percent, adding 36,000 new jobs in the northern region.
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The Trump administration is considering a proposal to mobilize as many as 100,000 National Guard troops to round up unauthorized immigrants, including millions living nowhere near the Mexico border, according to a draft memo obtained by The Associated Press.
The 11-page document calls for the unprecedented militarization of immigration enforcement as far north as Portland, Oregon, and as far east as New Orleans, Louisiana.
Four states that border on Mexico are included in the proposal -- California, Arizona, New Mexico and Texas -- but it also encompasses seven states contiguous to those four -- Oregon, Nevada, Utah, Colorado, Oklahoma, Arkansas and Louisiana.
Clerics united against Trump immigration ban
White House spokesman Sean Spicer said the AP report was "100 percent not true" and "irresponsible." ''There is no effort at all to utilize the National Guard to round up unauthorized immigrants," he said.
Governors in the 11 states would have a choice whether to have their guard troops participate, according to the memo, written by U.S. Homeland Security Secretary John Kelly, a retired four-star Marine general.
While National Guard personnel have been used to assist with immigration-related missions on the U.S.-Mexico border before, they have never been used as broadly or as far north.
The memo is addressed to the then-acting heads of U.S. Immigration and Customs Enforcement and U.S. Customs and Border Protection. It would serve as guidance to implement the wide-ranging executive order on immigration and border security that President Donald Trump signed Jan. 25. Such memos are routinely issued to supplement executive orders.
Also dated Jan. 25, the draft memo says participating troops would be authorized "to perform the functions of an immigration officer in relation to the investigation, apprehension and detention of aliens in the United States." It describes how the troops would be activated under a revived state-federal partnership program, and states that personnel would be authorized to conduct searches and identify and arrest any unauthorized immigrants.
Requests to the White House and the Department of Homeland Security for comment and a status report on the proposal were not answered.
The draft document has circulated among DHS staff over the last two weeks. As recently as Friday, staffers in several different offices reported discussions were underway.
If implemented, the impact could be significant. Nearly one-half of the 11.1 million people residing in the U.S. without authorization live in the 11 states, according to Pew Research Center estimates based on 2014 Census data.
Use of National Guard troops would greatly increase the number of immigrants targeted in one of Trump's executive orders last month, which expanded the definition of who could be considered a criminal and therefore a potential target for deportation. That order also allows immigration agents to prioritize removing anyone who has "committed acts that constitute a chargeable criminal offense."
Under current rules, even if the proposal is implemented, there would not be immediate mass deportations. Those with existing deportation orders could be sent back to their countries of origin without additional court proceedings. But deportation orders generally would be needed for most other unauthorized immigrants.
The troops would not be nationalized, remaining under state control.
Spokespeople for the governors of Arizona, Utah, Nevada, California, Colorado, Oklahoma, Oregon and New Mexico said they were unaware of the proposal, and either declined to comment or said it was premature to discuss whether they would participate. The other three states did not immediately respond to the AP.
The proposal would extend the federal-local partnership program that President Barack Obama's administration began scaling back in 2012 to address complaints that it promoted racial profiling.
The 287(g) program, which Trump included in his immigration executive order, gives local police, sheriff's deputies and state troopers the authority to assist in the detection of immigrants who are in the U.S. illegally as a regular part of their law enforcement duties on the streets and in jails.
The draft memo also mentions other items included in Trump's executive order, including the hiring of an additional 5,000 border agents, which needs financing from Congress, and his campaign promise to build a wall between the U.S. and Mexico.
The signed order contained no mention of the possible use of state National Guard troops.
According to the draft memo, the militarization effort would be proactive, specifically empowering Guard troops to solely carry out immigration enforcement, not as an add-on the way local law enforcement is used in the program.
Allowing Guard troops to operate inside non-border states also would go far beyond past deployments.
In addition to responding to natural or man-made disasters or for military protection of the population or critical infrastructure, state Guard forces have been used to assist with immigration-related tasks on the U.S.-Mexico border, including the construction of fences.
In the mid-2000s, President George W. Bush twice deployed Guard troops on the border to focus on non-law enforcement duties to help augment the Border Patrol as it bolstered its ranks. And in 2010, then-Arizona Gov. Jan Brewer announced a border security plan that included Guard reconnaissance, aerial patrolling and military exercises.
In July 2014, then-Texas Gov. Rick Perry ordered 1,000 National Guard troops to the border when the surge of migrant children fleeing violence in Central America overwhelmed U.S. officials responsible for their care. The Guard troops' stated role on the border at the time was to provide extra sets of eyes but not make arrests.
Bush initiated the federal 287(g) program -- named for a section of a 1996 immigration law -- to allow specially trained local law enforcement officials to participate in immigration enforcement on the streets and check whether people held in local jails were in the country illegally. ICE trained and certified roughly 1,600 officers to carry out those checks from 2006 to 2015.
The memo describes the program as a "highly successful force multiplier" that identified more than 402,000 "removable aliens."
But federal watchdogs were critical of how DHS ran the program, saying it was poorly supervised and provided insufficient training to officers, including on civil rights law. Obama phased out all the arrest power agreements in 2013 to instead focus on deporting recent border crossers and immigrants in the country illegally who posed a safety or national security threat.
Trump's immigration strategy emerges as detentions at the nation's southern border are down significantly from levels seen in the late 1990s and early 2000s. Last year, the arrest tally was the fifth-lowest since 1972. Deportations of people living in the U.S. illegally also increased under the Obama administration, though Republicans criticized Obama for setting prosecution guidelines that spared some groups from the threat of deportation, including those brought to the U.S. illegally as children.
Last week, ICE officers arrested more than 680 people around the country in what Kelly said were routine, targeted operations; advocates called the actions stepped-up enforcement under Trump.
A new law taking effect Monday gives thousands of New Jersey residents the opportunity to clear their criminal records.
Akil Roper with Legal Services of New Jersey said most offenders who've completed a court-ordered drug rehabilitation program can now have their entire record of arrests or convictions expunged.
That's a big deal because people are often denied employment because of a criminal record, he said.
"Expungement is a way to deal with that by getting folks around that barrier, both occupational licensing and it can essentially remove those convictions or arrests from a record when it's looked at by an employer," Roper said. "So it's a tremendous help for folks."
Being able to put that criminal record behind them can also improve access to housing and be a life-changing experience that gives thousands of residents a real second chance," he said.
"There's been a long push for folks who have drug problems, then suffer from addiction, to have them not be simply incarcerated but to get them into modes into rehabilitation and treatment,"Roper said. "And I think this is one step in that effort."
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