Pickleball has been reported as one of the fastest-growing sports among the adult population in recent years. Whether its popularity stems from the exercise it offers, its resemblance to tennis, or the camaraderie it fosters during matches, many enthusiasts find it addictive. As expected, with the game’s increasing popularity, there has been a rise in the number of injuries associated with pickleball.

Lower extremity injuries, such as muscle strains, ligament sprains, and fractures, were among the top reported injuries leading to emergency room visits.¹ Slips, trips, and falls are identified as the primary causes of these injuries. While we don’t intend for this information to discourage you from enjoying this endearing game, we strongly recommend taking an active approach to injury prevention by following our three suggestions.

Firstly, prioritize enhancing your balance. Incorporate activities like balancing on one foot for 30 seconds into your daily routine, such as during tooth brushing, dishwashing, or commercial breaks. Once you’ve mastered this, challenge yourself by passing a small, weighted object (only 2-5 pounds) between your hands in various positions. Increase the difficulty by performing these exercises on an unstable surface like a carpet, yoga mat, or pillow. The objective is to refine your balance and minimize the risk of injury, so ensure you’re close to a wall or sturdy object for support if needed.

Secondly, engage in cross-training. This entails exercising in ways beyond just playing pickleball to prevent muscle imbalances. Incorporate fundamental exercises such as squats, lunges, and core strengthening exercises into your routine. Strengthening your legs and core can offer better support for the dynamic movements in pickleball, reducing the risk of lower extremity injuries. Additionally, include flexibility exercises, such as pre- and post-play stretching, to enhance joint mobility and decrease the likelihood of strains or sprains.

Third, focus on proper footwear. Many slips, trips, and falls in pickleball can be attributed to inadequate footwear. Ensure that you wear supportive, non-slip shoes with good traction on the court. Make sure your shoes fit well and provide stability for lateral movements, as pickleball involves quick side-to-side actions that can strain your ankles and feet.

It’s important to listen to your body and not push yourself too hard, especially if you’re new to the sport or returning after a break. Start with a proper warm-up, including light cardiovascular activity and dynamic stretching, to prepare your muscles for the demands of the game.

If you experience any discomfort or pain, don’t ignore it. Addressing minor issues early on can prevent them from becoming more serious injuries. Consider consulting with us at Rye Physical Therapy for personalized advice and exercises tailored to your specific needs!

References:

1. Casals M, Jimenez S, Caparros T, Martínez-Gallego R, Baiget E. Scoping review and quality of studies on the epidemiology of pickleball injuries. Apunts Sports Medicine. 2023;58(217):100403. doi:10.1016/j.apunsm.2023.100403

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We are very excited to announce the opening of Rye Physical Therapy! For years, many of our Hampton Physcial Therapy Rye patients have asked us to bring our services closer to make their rehab care more convenient. So, when we saw the opportunity to open at this fabuous location, we knew it would be ideal!  We finally pulled the trigger and opened our doors on November 1^st at Airfield Place, 6 Airfield Dr Rye, NH – off Rt 1 (formally the Rye Airfield Skate Park). This beautiful facility has been completely renovated to include many Health oriented businesses.

Rye Physical Therapy will be run and operated by Hampton PT’s very own Shane Johnston. Shane and Kate Serodio are co-owners in this new venture.  Shane has been treating and healing patients for over 4 years at Hampton PT and is very excited for this amazing opportunity.  Shane will continue to provide the same great services we have here at Hampton PT such as Manual therapy, Dry Needling, Graston Technique®, Spinal Manipulations, Vestibular Rehab, post operative rehab, balance and fall prevention training and much more.

The family of businesses at AIRFIELD PLACE include; FlightHouse Gym – a full-service gym (formally MaxEdge Fitness), New England Pickleball, Rinse Recovery Spa, Flow House, The Hanger, as well as Engrain Café.  Within these businesses you will have access to Pickleball; Group Fitness classes, Pilates, yoga; an open Gym, Childcare services; and The Hangar is a coworking space.  Rinse Recovery will give you access to the most recent recovery technology available!  They will have a contrast room featuring a large traditional sauna, 3 infrared, and two Morozko Forge Cold Plunges to maximize the benefits of heat therapy, cold therapy, and contrast therapy.  This space will also have other recovery tools such Red Light therapy panels, Therabody Massagers, PEMF mats, etc.

We could not imagine a better location for Rye PT!

Stop by or give us call to schedule your Free Discovery Visit!

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Do you have pain in your shoulder and have no idea what could be causing it? Shoulder pain is actually one of the most common reasons people seek out physical therapy. Often times, the rotator cuff is the culprit. The rotator cuff is a group of four muscles: the infraspinatus, supraspinatus, subscapularis and teres minor. Together, these muscles provide stability for the shoulder joint as well as perform rotation of the shoulder. It is a very important muscle group that often wears down over time. The older we get, the more at risk we are for a rotator cuff tear whether it’s from overuse or a traumatic injury.

If you are diagnosed with a rotator cuff tear, physical therapy is typically the first line of treatment to work on improving the strength and stability of the shoulder complex. Often times, physical therapy is enough to regain normal function and allow for painless shoulder function. However, depending on the thickness of the tear and number of tendons involved, surgery may be needed. Maybe you’ve gotten to the point where you’ve tried PT and the next step is surgery. You’ve heard dozens of horror stories and are wondering what to expect… keep reading!

The surgical procedure to repair the rotator cuff is typically an arthroscopic surgery with very small incisions. The surgeon will insert an arthroscope, a small camera, which displays the picture onto a television screen and guides the surgeon through the repair. This is typically done as an outpatient procedure and is the least invasive surgical option. The complexity of the repair process will depend on whether the tear is a partial or full tear. If it is a partial tear, the area will be trimmed or smoothed, known as debridement. If it is a full thickness tear, the tendon will need to be reattached to the humeral head. The surgical incisions will be closed with stitches which will usually be removed around week two post-operative at your first follow up visit.

So you’ve gotten through the actual surgery, now what? You will typically be fitted to a sling and will go to your first physical therapy appointment two days post-operative. The sling is usually worn 24/7 for 4-6 weeks and provides protection for your arm while the tendons heal. During your first physical therapy visit, your therapist will remove the surgical dressing and evaluate the passive range of motion of your shoulder joint. Passive range of motion means your therapist will be moving your arm so your tendons and muscles are not contracting, potentially damaging the tendon repair. Each surgeon and protocol varies to some degree but the first few weeks of therapy will consist of your therapist stretching your shoulder passively.  The first few weeks of stretching are essential to restore the range of motion of your shoulder. One complication that can occur following surgery is adhesive capsulitis also known as frozen shoulder. This happens when the joint capsule “freezes” and tightens up, usually a result of your shoulder being immobilized in the sling all day. With adhesive capsulitis, restoring full range of motion can be very painful and take much longer. You might feel like you’re not doing much those first few weeks of therapy but being consistent with attendance and allowing your therapist to stretch the joint is essential to ensure full range of motion after surgery.

After the first few weeks of passive stretching, typically around week six, you can begin active range of motion and lifting weight equivalent to a coffee cup. Active range of motion means you are contracting your muscles to move your arm. You are no longer relying on your therapist to perform the motion. Your therapist will guide you through some gentle initial exercises and then begin to add in resistance for strengthening beginning around week 8-12. Together, you and your therapist will work to get you back to full strength and stability allowing your shoulder to withstand daily activities, work duties or athletics. The full rehab process can take 4-6 months or even longer so be patient with the process! Please don’t hesitate to reach out to us for any further questions or concerns regarding a rotator cuff repair.

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BY Dylan Chisholm, PT, DPT, cert. DN, cert. VRS

Many people will attain medical professionals, including physical therapists, for spinal manipulations for their acute or chronic lower back, neck or mid back pain in hopes of alleviating their ongoing pain or related dysfunction. These manipulations, or “adjustments”, often produce loud, cracking noises that allow for the body’s natural receptors to reset, giving better alignment and thus assisting in reducing overall pain in the spine. However, many are unaware that physical therapists are also capable of manipulating, or “cracking”, various other joints of the body, including the hips, wrists, elbows, knees and ankles. This is known as extremity manipulations with the goal of reducing pain and allowing you to get back to doing the activities you love. The purpose of this blog is to educate you on various diagnosis and pain patterns that extremity manipulations can assist with along with various other physical therapy interventions.

One of the most common diagnoses that physical therapists see daily is osteoarthritis (OA), often in the hip, knee and ankle. Osteoarthritis is generally a degenerative process of the joint which can be very debilitating and painful for many patients. Hip OA will often clinically show as pain that can be along the front of the hip as well as into the groin. This pain is commonly seen due to extra compression into the hip that produces a “bone on bone” effect over time. The hip manipulation is a technique used to quickly decompress the joint and allow for fluids inside of the hip to better flow in and out of the joint, which provides nutrients and healing properties that can alleviate pain and make your walking tolerance better.

Knee OA can present as having increased stiffness and achiness into your knee especially with walking long distances, stairs and getting out of the car. The cartilage and menisci of your knee that provide a “cushion” for the knee bones over time will break down, causing the dreaded “bone on bone” and thus leading to increased pain and difficulty performing daily activities. Performing a quick knee manipulation can allow for the receptors of your knee to reset, which can assist in reducing pain and improve Range of Motion (ROM) and balance at the joint.

Many patients will at some point sprain their ankle, which can cause significant instability, swelling and pain at the ankle and can be a long-term problem if ankle sprains occur frequently over time. Due to progressive ankle OA, our calf muscles will also become tighter, which reduces the ability for us to pull our foot off the ground and clear the toes when we are walking, which can cause trips and falls. A manipulation of the ankle can help to reduce pain and improve the ability for the joints to move, which can help with walking and most daily activities.

Extremity manipulations are an important aspect of physical therapy treatment that is often overlooked but can be a game changer when it comes to reducing pain and improving function. This technique along with various other interventions that physical therapists perform, including soft tissue mobility, functional strengthening, dry needling, joint mobilizations and balance training can improve your quality of life and get you back to doing the things you love.

If you experience daily pain into your hips, knees and ankles and wish to get back to walking more with less pain, give Rye Physical Therapy a call and schedule with one of our highly skilled and trained physical therapists today!

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Proper posture is something most of us struggle with. For as long as I can remember, my mom used to frequently remind me to stand up straight with my shoulders back. As a kid I never understood the importance of good posture. However, maintaining good posture has a lot more benefits than just looking better! What exactly is posture? It’s our bodies alignment/positioning in relation to gravity. Gravity is constantly exerting force on our body regardless of what position we are in. Proper posture places the body in position so that no area is overstressed, decreasing susceptibility to pain and injury. It applies to standing, sitting and laying down. Good posture will place the body in a position in which our body weight is balanced throughout our spine and lower extremities, decreasing stress on muscles and ligaments.

Some of the benefits of good posture include improved breathing, decreased spine and shoulder pain and decreased headaches.

Breathing: When it comes to breathing, being in a forward slouched posture affects our lung’s ability to fully expand as the muscles in the front of the chest begin to shorten. Sitting up straight with the shoulders back can improve our bodies oxygen intake! Oxygen is very important in all cellular processes in our body and can help to improve energy and healing.

Back Pain: Back pain is another big culprit of poor posture. While maintaining good posture, our body should be in a neutral position so none of the muscles or ligaments are being overwork, shortened or excessively lengthening. The postural muscles should be in an optimal muscle position to work correctly, expending the least amount of energy. If we are constantly in a poor postural position, changes will occur to the spine and musculature overtime including changes to the blood vessels, nerves and ligaments. This will disrupt our body from performing with correct biomechanics increasing the chances of injury and spinal wear down over time.

Headaches: Most people with poor posture operate in a position in which the head sits forward. Your head is equivalent to the weight of a bowling ball so when the head is positioned forward, the muscles must work much harder to keep your head positioned on your spine! This increased stress placed on the muscles within the neck and upper back causes them to tighten. When the muscles tighten, headaches can occur.

Shoulder pain: It’s one of the most common things us PTs treat! Improving posture will decrease the risk of shoulder pain and dysfunction. Majority of people will allow their shoulders to roll forward which occurs most often in a seated position. This forward roll decreases the space within the shoulder joint. It also causes the front muscles to shorten while the back muscles will lengthen. Decreasing the space within the shoulder joint alters the shoulders normal biomechanics and can cause pinching of several soft tissue structures leading to pain and increased risk of injury.

So, what exactly does proper posture look like? When looking at yourself from the side, your body should follow your head. All your major weight bearing joints should be in line with your ear. Imagine a line going from your head to your feet. Your shoulders, hips, knees and middle of ankle should be right in line with the middle of your ear. You should also have a slight curve within your low back.

Maintaining good posture can be difficult to do and rather fatiguing. You might notice a burning sensation in your upper back after a while when you try to maintain correct posture. This is due to the fact the postural muscles are endurance muscles. Not only do they need to be strong, but they also need endurance to avoid resorting back to the rounded shoulder forward head positioning so many of us are susceptible to. In order to build endurance of the postural muscles, we should perform exercises at a lower weight with high repetition. This will allow those postural muscles to continue to contract over a longer period. Below are several exercises to get you started on improving your posture.

EXERCISES THAT HELP IMPROVE POSTURE:

Rows: While pulling back on the t-band, squeeze your shoulder blades together. Make sure you avoid your shoulders from elevating while you pull. You can perform this exercise with resistance bands or on a cable system. Remember to perform low weight and high resistance. Aim for 30 repetitions and when that becomes a piece of cake, increased the resistance or cable weight.

Prone scapular squeeze with extension: While laying on your stomach, squeeze your shoulder blades together and then elevate your arms a few inches off the table. Lower the arms followed by relaxing the shoulder blades. You can eventually add in dumbbells when you can fly through 30 reps with no fatigue.

Doorway stretch: This is a great exercise to perform to stretch out the anterior chest muscles which often become shortened. You will stand in the doorway with your shoulders and elbows up at 90 degrees. You will then step into the door until you feel a gentle stretch in the front of your chest. Hold each stretch for 30 seconds and perform 3-5 sets.

Bilateral external rotation: To perform, hold T-band in each hand with your palms facing each other and then slowly pull your hands apart. Keep your elbows at your side while you pull. Aim for 30 reps.

Physio Ball Y’s: To perform, lay across physio ball. You will then straighten out your arms and raise them up in line with your head and then lower them back down. Make sure you keep your head in a neutral position. You can add dumb bell weights to make this exercise more difficult when ready. Again, aim for 30 reps.

Give these exercises a try and if you feel you need further help or have any questions or concerns, please don’t hesitate to reach out to us here at Rye Physical Therapy!

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by KATE SERODIO, DPT

It is that time of year again; time to pick your Health insurance plan! The question is, will you opt to stick with your Medicare and Medigap (supplemental Medicare plan that fills in the ‘gaps’) or change to a Medicare Advantage Plan.

The first thing you will want to ask yourself is:

– Do you want to be limited in which providers you can go to?
– Do you travel? Do you reside in another state for any length of time?
– Do you want to have to get a referral to see a provider?
– Do you want to pay a copay each visit or deal with high deductibles?

If you answered No to any of these questions, then a Medicare Advantage plan is most likely not a good fit for you! Recently, we have seen a big increase in the number of Medicare Advantage plans and I wanted to share a story that represents the Physical Therapy experience of many of our Medicare Advantage patients…

Last December, Jenny referred herself to Physical Therapy (PT) for her hip pain that was not getting better after a couple weeks of rest. She had already met her MC insurance deductible of $185 and had a supplemental insurance, which resulted in no cost for her to have PT. She had previously been to PT and was aware that she could come in without a doctor’s referral. She enjoyed the direct access as this saved her a trip from having to see her primary. We treated her for a couple weeks prior to the end of the year. Jenny returned after Jan 1^st for continuation of her PT. She presented her new Medicare advantage card thinking her benefit would be similar to her traditional Medicare plan. Unfortunately, Jenny’s new Medicare Advantage plan now required her to get a referral for therapy. She was frustrated with this change, as she had enjoyed the ability to book directly to PT and other specialists. Her frustration grew larger when she was told she now had a $40 copay for EACH visit! She quickly commented, this Medicare Advantage plan seems more like a disadvantage plan!

As the year of 2021 has continued, we have seen patients like Jenny again and again, making the same comment, “My Advantage Plan seems like a disadvantage from the traditional plan and supplemental plan I previously had”. As a physical therapist, I have been treating patients with Medicare for many years. For years, our patients came in and their plans were very straight forward and easily managed. Until recently, we had nearly a 100% of our patients with traditional MC plans along with supplemental plans. Suddenly, as of 2021 we had approximately 10% of patients change their plans to a Medicare Advantage Plan. We had several patients try to schedule visits directly with PT, however we had to refer them to see their PCP first. NH is a direct access state and you do not need a referral to go to PT, UNLESS your insurance requires it. MC traditional plans do not require this, however most Medicare Advantage plans do. We have also had several patients choosing to not have their PT due to the reoccurring copay costs, which can add up quickly. Unfortunately, this has resulted in many of our patients not getting the care they would have previously received with their traditional plan + supplemental.

Medicare Advantage plans are very similar to the plans that many people previously had when they were working. Medicare Advantage plans are offered by private insurance companies contracted with Medicare and provide at least the same level of coverage that Medicare Part A and Part B provide. Medicare Advantage enrollment is highly concentrated among a small number of firms.

• 44% United Healthcare and Humana
• 15% BCBS affiliates (including Anthem BCBS plans)
• 23% (CVS Health, Kaiser Permanente, Centene, and Cigna)

The Benefits of Medicare Advantage Plan:

– Medicare Advantage plans include everything that the original MC offers, with the exception of hospice care, and can offer additional benefits such as dental benefits, vision, and wellness programs. Some may cover prescription. Many enjoy a bundled plan.

– Medicare Advantage plans have lower premiums (However, Medicare Advantage plans often cover fewer expenses than Medigap — often resulting in more out-of-pocket expenses such as deductible, coinsurance and copays with office visits, Therapy services, lab work, surgery, and many others.

– Medicare Advantage plans have a maximum out-of-pocket limit or MOOP. In 2022, the mandatory MOOP for Medicare Advantage is $8,700, although you may find plans choose to set theirs much lower.

Benefits of Medicare Supplemental Plan ‘MEDIGAP’:

– Medigap covers you for any hospital or doctor in the US that accepts Medicare (the majority accept Medicare). 

– No need for prior authorization or a referral from a primary care doctor. Coverage includes the entire U.S., which may be important for those who travel frequently or spend part of the year in a different locale. This option is ideal for those who have particular physicians and hospitals they want to use.

– More security long term. When you first sign up for a Medicare Part A and Part B Medigap, insurance companies are obligated to accept you regardless of your current medical condition. However, if you have opted for a Medicare Advantage plan and then decide to return as your health declines you may not be able to find coverage or you may be charged significantly more due to your medical condition

The main downside of Medigap is that the premiums may be higher than those of Medicare Advantage. If you don’t mind the Medicare Advantage limitations of freedom and if you’re healthy and can predict that you’ll remain that way, then a MC advantage plan may be perfect for you. My primary concern as a provider is when I see people not getting the care they need because they’re worried about the added cost each time they require treatment. Therefore, when it comes to your health, my suggestion would be to have the plan that will add one less stress to your life when you really need it!

To speak with someone in more depth about these options, visit Medicare.gov

Don’t forget, the deadline to choose your plan is December 7^th so don’t delay!

Stay healthy and safe!

Kate

RESOURCES:

https://www.thestreet.com/personal-finance/insurance/health-insurance/medigap-vs-medicare-advantage

https://www.pmgmd.com/health-matters/medicare-facts/facts-about-medicare-advantage-plans/

https://www.investopedia.com/articles/personal-finance/010816/pitfalls-medicare-advantage-plans.asp

https://www.investopedia.com/articles/personal-finance/071014/medigap-vs-medicare-advantage-which-better.asp

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The COVID-19 pandemic has introduced the world to the importance of prevention.  Mask wearing,
social distancing and quarantining have become household norms.  Despite efforts, in the United States nearly 30 million people have contracted the virus with approximately 525,000 deaths. That means there are countless people living in the United States who have survived COVID-19 and are now left with a vast array of long-term side effects from the virus.

The CDC provides us with information regarding common long term side effects from COVID-19 including;
Fatigue
Shortness of Breath
Joint Pain and Muscle Aches
Headaches

Your Hampton Physical Therapist can be an ally in your recovery from the long-term effects of COVID-19.

Physical therapists are specialists and experts of movement as it relates to quality of life.  Your Hampton Physical Therapist can be an ally in your recovery from the long-term effects of COVID-19.  Our PTs specialize in individualized programming including hands on treatments and guidance of activity to optimize patient’s return to their prior level of functioning.  Pain, stiffness, weakness and fatigue are realms in which PTs address every single day.  Although there are many unknowns when it comes to COVID-19, once recovered from the illness, your Physical Therapist can help guide you to a full and healthy return to life prior to the virus.

As it relates to the previously noted side effects PTs will utilize advanced hands-on skills to address musculoskeletal pain focusing on joint mobility and the health of the muscles that are involved.  PTs have advanced understanding of breathing treatments and optimizing the mechanics of breathing including the use of the diaphragm to aid in improving complaints of shortness of breath.  The “COVID fatigue” that many people experience persist and result in weakness, endurance and cardiovascular challenges.  Your PT has the ability to create a tailored program to address specific areas of weakness and safely implement exercise prescription.

As we all hope to return to life as we knew it pre-virus as soon as possible, for those of you who have experienced COVID and may be having some long-lasting side effects. Utilize your PT at Rye Physical Therapy to get you back up and “running”.

Contact us at Rye Physical Therapy at 603-929-2880 for a Free 30 Minute Discovery Visit.

Citation: Long-Term Effects of COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html. Accessed January 8, 2021.

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No one is spared personal hardships during this difficult pandemic. From the fear of contracting the virus to the tough convalescence of those who do, not to mention the devastation of losing a loved one to it. There’s so many new adjustments to deal with, like working from home, or being laid off. Having to home-school kids is a huge challenge too. For those of us ‘essential workers’ it’s been extremely trying as well.

As a business owner, I have experienced the complete shutdown of a non-essential business (Rezilient) as well as the struggle of remaining open as an essential business (Rye Physical Therapy). It’s been nothing but endless hurdles. The struggles of a complete shutdown then reopening is basically like starting a business from scratch. While remaining open during the pandemic with a skeleton crew certainly had its own challenges. From battling with the ever-changing CDC guidelines, to the additional work needed to provide a safe environment, to the laying off /rehiring of staff (with some pushback due to the unemployment stimulus funds they were receiving). Unfortunately, my businesses just aren’t Pandemic Proof.

Sadly, the continued emphasis from patients hasn’t been about how great a service we provide, but instead whether our business is safe and clean and worth the risk. The fear is understandable. Many months into Covid-19 and I still find there is still so much time and energy devoted to this virus, that the true goal of the business has lessened.

As we treat patients and clients daily, there is one other elephant in the room that is hindering us from connecting, yes, the MASK! The mask obviously has its purpose to prevent the spread but it is affecting us on a whole other level, a mental and emotional level. The mask is a constant reminder that we are in a pandemic. When a primary part of a business is about connecting with people, the facial emotional barrier of masks is yet another hurdle that we must overcome.

A huge part of providing a Great service is the ability to connect with people. Whether you’re a greeter, a waitress, a hairdresser, or a doctor you need facial visual input in order to read their reaction to your questions or comments. Their response is what drives the direction of a conversation. The mask in effect, makes you feel as if you’re talking to a wall. Yes, the eyes are expressive, but I’m finding the mouth is what I often check for nonverbal cues as to how my patient is doing. Consequently, this is a huge barrier to business as this is a fundamental of great customer service. What was once transparent is now a guessing game, an added obstacle on top of accomplishing your job.

Since the first day I started wearing a mask back in March while treating patients, I have personally felt less emotion. Perhaps even less empathetic to my patient’s needs. I believe this is because I can’t see their feelings or pain or smile, and I know they can’t see mine, so why bother. The lack of this input easily makes you have less emotion. Not only does this affect the provider but it also affects the client/patient. Research supports this: a BMC randomized control study in 2013 “Effect of facemasks on the empathy and relational continuity” found that “patients perceived doctors who wear masks as less caring and empathetic.”

Another interesting article that supports our struggles with masks and emotions is from Trends Neuroscience Education: “Masked Education? The benefits and burdens of wearing face masks in schools during the current virus pandemic.” This is an interesting article on many levels. One topic they discuss is how the face provides a universal language for communication, in particular, the communication of emotions. The mouth region on a face conveys information that is crucial for smiling, i.e., a positive emotion, which can work as social glue and facilitates positive social cognition and action. Not seeing the bottom half of the face makes it particularly difficult to recognize a mask-wearer’s positive emotions – pleasure, joy, happiness, amusement, sociability, and friendliness – as they are basically communicated by a smiling mouth. Therefore, face masks impair mainly our positive social interactions and our ability to understand, and empathize with one another.

Some other added struggles that the mask unfortunately results in is a muffled voice. Many people with hearing impairment are having an even harder time communicating because of the muffled voice as well as the inability to read lips.
Many people that don’t even have a hearing problem are finding that they suddenly can’t understand anyone. A number of my patients are misinterpreting what I’ve said, its often like we’re playing a game of telephone where the message is completely distorted by the end of the conversation. Who knows how many people I’ve somehow offended!  There are many times that I assume someone didn’t hear me and I go to repeat myself, only to find out that they did hear me but were making a thinking face that I wasn’t able to pick up on. The normal conversation just simply doesn’t flow as it used to or should, leaving a feeling of complete disconnect.

In my line of work, recognizing feelings is extremely important. In a profession where you provide hands on services, you’re no longer able to gauge from their facial expression if you’re physically hurting them. So many cues that we have all become accustomed to are no longer available. The inability to see feelings on someone’s face and the inability to express my own feelings with a smile is a huge hurdle for me and my business.

So, whether you’re a business owner or an employee trying to provide a service, and make sure you’re able to continue to connect with your clients, you need to overcome ‘the mask’. Since March these are some of the things I’ve found useful:

1) Focus on the eyes. Attempt to read theirs and utilize your own when smiling.

2) The mask sometimes feels like the elephant in the room, so just get it out there, and talk about it. Talk about the mask and how it creates a disconnect, people will agree with you and you’ll connect. Having a conversation about how the mask affects your peripheral vision will open up a possible connection. I actually fell off the treatment table because I couldn’t see down. Have the mask be your first thing in common. It will open doors up for further discussions.

Another good topic is talking about all the great things the masks do:

– don’t have to stress about food in your teeth
– if you have bad breath, no one will know
– only need eye make up
– the obvious… less germs spread
– this list hasn’t gotten that long… we all agree it’s short but have a fun time trying to come up with positives-send them my way if you have more 

3) Mask fitting: make sure your mask doesn’t hit your lips, this muffles your voice even more and makes it difficult to hear which will complicate connecting even more.

4) Give people a visual of yourself-perhaps a business card with a picture of yourself. This will allow them to feel more connected as they’ll be able to build a mental image of you

5) Wear a clear fitted mask: A clear mask for you would eliminate ½ of the problem. You’ll still struggle getting visual feedback from them, but you’ll at least be able to smile with them knowing and allow for a connection and better communication. This would also assist with someone who often needs to read lips.

*FYI this is not a shield, these do not provide the level of protection most are seeking.

6) More gestures! Air hugs: I used to give hugs, now I tell them I would love to give them a hug but I suppose an air hug will do. Hand Air Shakes: handshakes are definitely out but an air shake and just a big greeting will do. Thumbs up or head nods, all are useful to connect.

9) Discuss the need to Communicate: if you have a business that you need to know if you’re hurting someone, have a discussion about communicating. Make sure they understand their role is to speak up if they’re not happy.

10) Try harder: you have to simply try harder, dig deeper to connect. Know it and own it.

11) Mask messages – purchase one with a smile on it or a positive quote. Believe it or not, this can be powerful and allow a connection.

12) Encourage people to buy clear masks-this will allow us to feel as normal as we can in the present.

We all need to be resilient. We must accept that this is potentially our new reality and you must figure a way to overcome it. Hurdle after hurdle, whether small or big, we must move forward.
I encourage you to Be Rezilient!

REFERENCE
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3879648/
Trends Neurosci Educ. 2020 Sep; 20: 100138.
Published online 2020 Aug 11. doi: 10.1016/j.tine.2020.100138
PMCID: PMC7417296 Masked education? The benefits and burdens of wearing face masks in schools during the current Corona pandemic
Manfred Spitzer¹

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We realize there are some of you who are out of work and perhaps in need of some help. And there are some of you who are still working who might like to help others during this difficult time. 

Both Rye Physical Therapy locations (Seabrook & Hampton) as well as FUN located at 40 Stickney Terrace, Hampton (provides quality after school programs) are going to leave a donation box just outside our front doors. We have put a few food items in it to get things started and will keep adding as the days progress.

If you would like to GIVE a donation, please bring non perishable goods
(and/or gift cards to support local restaurants) and leave them in the box. 

PLEASE feel free to TAKE some of the items for your family or friends
who are in need of food supplies!

We will keep you all posted on the progression of our little” food bank”.

WHEN we get back to a more “normal” life, if there are food items still available in the boxes, we will donate to our area organizations who supply food items for those in need.

If you need us – we are open and being conscientious of social distancing, sanitizing, and wearing masks. We want to continue to provide care for all our patients.

Feel free to call us at 603-474-2259 or 603-929-2880.

Physical Therapy services are labeled as an essential service. Private practices like ours have been encouraged by our professional association to remain open as a safer alternative to urgent care and emergency room during the Covid-19 crisis. We can assist in evaluating, triaging, and caring for non-emergent musculoskeletal injury. Emergency rooms and urgent care centers must preserve their staff and equipment for real emergency care at this time.

We are strictly following all screening and cleaning measures recommended by the CDC.

Thank you for understanding the severity of the situation and doing your part to keep the community safe.

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As a physical therapist I frequently get asked by people that are dealing with an injury, “well how do I get an appointment with you, do I need a prescription or a referral?”. The world of insurance can be a very confusing thing for the consumer. At Rye Physical Therapy our front office does their best to explain and break down how your individual insurance works before you even start your first visit. We want to make things as easy as possible to get you started in our clinic and provide quality care. Several insurance plans including Medicare and other PPO’s (preferred provider organizations) are considered to be direct access and the state of NH allows for direct access.

Many people don’t know that NH is a direct access state. This means that if you need physical therapy you don’t need a referral from your doctor. You can come in for treatment on your own. So you can refer yourself, just call our clinic and we will schedule you as soon as possible for an evaluation. At Rye Physical Therapy we are all doctors of physical therapy. DPT’s are highly-trained in how to recognize “red flags” and refer out to physicians immediately if needed. DPT’s learned the proper screening tools to deem if you are appropriate for therapy. We will refer you out to a physician for possible diagnostic imaging to rule out a pathology that is not appropriate for therapy. With direct access the APTA enabled PT’s to be the preferred licensed professionals to treat musculoskeletal disorders.

Direct access is a way to save money for not only the insurance company but the consumer as well. Many insurance companies now recognize the cost savings and improved access to care that come with direct access and do not require a referral for payment¹. For example: these savings are evident in the area of low back pain costs. Chronic low back pain is a high cost in the healthcare industry and by getting early access we can save over 50% in cost. If a patient receives PT within 14 days of onset of pain it can minimize the average total cost of care by 50%². That is major savings for the health care industry and for the individual by getting a patient in PT the following day after their injury and starting treatments like dry needling, spinal manipulation, and corrective exercises.

Without the need for a referral the option to choose where you want to go for treatment is much easier. You don’t have to wait to book an appointment with your PCP or an orthopedic doctor which can sometimes take weeks. At Rye Physical Therapy we can typically get patients in within 24 hours of calling, if they have a flexible schedule. We have 2 convenient locations on the Seacoast of NH, located on Route 1 in Hampton and Seabrook, NH. We even offer FREE Discovery Visits! A discovery visit is a free consultation with a therapist for a potential patient to come into the clinic and discuss their current condition and see if physical therapy is something that can help them. Frequently the discovery visit leads to the patient being a formal patient. We have therapists trained in spinal manipulation, dry needling, vestibular rehab, modern strength training, and Graston Technique™ . So it’s that easy to save money and get quality care! Feel free to book an appointment for either a free discovery visit or for your initial evaluation today at 603-474-2259 or 603-929-2880.

REFERENCES:
1. Neil. (n.d.). Direct Access in Practice. Retrieved June 25, 2019, from https://www.apta.org/DirectAccess/

2. Direct Access: The Truth About Seeing a PT First. (2017, May 24). Retrieved June 25, 2019, from https://ptcentral.org/2017/05/direct-access-truth-seeing-pt-first/

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