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SPRING/SUMMER 2013 I VOLUME 4 I ISSUE 1

Y O U R G U I D E T O A H E A LT H I E R B O D Y & M I N D

GOODSHEPHERDREHAB.ORG

Freedom from Headaches D

o you suffer from recurring headaches? You are not alone. An estimated 40 to 50 million Americans suffer from chronic headaches, and about 15 percent of the U.S. population suffers from debilitating migraine headaches. Good Shepherd’s Headache Program offers hope to those who have been unresponsive to traditional headache care. Good Shepherd’s therapists work closely with your medical provider to offer evidence-based therapy that is effective in 80 percent of cases. Symptoms of headaches may include, but are not limited to: migraines (all types), oral facial pain, neck pain, tooth pain, ear fullness/pain, sinus pressure/ pain, sinusitis, visual disturbances, eye dryness and tearing, dizziness, vomiting and nausea. The treatment of headaches starts with a medical diagnostic workup to rule out disease. When all tests are negative, Good Shepherd’s therapists will review a patient’s detailed medical history and perform an examination that will determine if therapy will help reduce or abolish the headaches. Physical therapists at 15 Good Shepherd Physical Therapy sites have been trained in specialized headache therapy techniques. “Most patients will experience a fifty percent reduction in symptoms within one to three sessions,” says Dan Danish, PT, MHS, MTC, manager of Good Shepherd Physical Therapy’s CORE PT site in Bethlehem Township. “The treatment techniques are non-invasive and include simple re-positioning and repetitive movements of the neck and head.” An important part of the therapy is education about changes patients need to make to their activities of daily living, including modifications to their sleeping, reading and working postures. “Good Shepherd’s Headache Program empowers patients to take control of their headaches by showing them what they can do for themselves to prevent them,” adds Danish.

Learn more at www.GoodShepherdRehab.org/headache or call 610-419-2130.


Seniors: Maintenance Therapy Now Covered S

killed therapy, under the guidance of a licensed therapist, can help aging adults maintain function, increase strength and prevent physical decline. For decades, Medicare beneficiaries – particularly those with long-term or debilitating conditions and those needing rehabilitation services – were denied care. That recently changed, and maintenance therapy is now covered by Medicare even if a condition is not likely to improve. “This change reflects what we have long known to be true – that ongoing, skilled intervention can make a world of difference for a patient who suffers from a debilitating, chronic condition,” says Frank Hyland,

Program Conditions treated include:

vice president, Rehabilitation, Good Shepherd Rehabilitation Network. “This ruling is a victory for Medicare patients who want to maintain or improve their current physical condition.” If you or a loved one has been denied Medicare coverage for rehabilitation in the past, it’s time to call one of Good Shepherd Physical Therapy’s 22 outpatient locations and ask for the Stay Strong Program.

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Arthritis Balance/fall risk Degenerative joint disease Multiple sclerosis Parkinson’s disease Physical decline from age Spinal cord injury Spinal stenosis Stroke Traumatic brain injury

Learn more at www.GoodShepherdRehab.org/staystrong or call 1-888-44-REHAB (73422).

Safe Gardening Tips T

his is the time of year when many people spend a lot of time in their yards and gardens. This is also the time of the year when injuries can happen when digging, trimming, raking or moving heavy items like bags of mulch.

“Proper body mechanics should be followed when working with a shovel, wheelbarrow, rake or other gardening tools,” says Good Shepherd physical therapist Natalie Bedio. Here are a few helpful tips to keep you safe while working in your yard or garden:

Pick objects off the ground by bending with your legs, not your waist. When lifting objects, try to keep the object as close to your body as possible to avoid back pain and injuries. The closer to your body, the more stable and easier it is to control the object.

Plan ahead. Determine what you need (tools, gloves, wheelbarrow, etc.), and decide if you need help. Is the job too big for one person?

Avoid twisting your trunk when lifting or carrying. Keep your nose over your toes!

Keep your back straight, and bend your knees when you are lifting, carrying or using a rake or shovel.

If you find yourself sore for a few days after yard work, ask your primary care provider for a physical therapy evaluation. A physical therapist will do an assessment and teach you exercises to keep your body’s core strong, as well as the proper body mechanics of lifting to prevent any injuries.

Learn more at www.GoodShepherdRehab.org/outpatient-rehabilitation or call 1-888-44-REHAB.


Children and Social Skills D

o you remember sitting at the lunch table in high school, sharing the latest gossip with your friends? What did you say during the interview that helped you land your first job? Life’s important milestones require social skills that typically are developed and refined as we age. For most of us, learning social skills, such as how to hold a conversation or understand when it is appropriate to ask a question, came naturally through life experiences and everyday interactions. We picked up on social cues and learned the “rules” for how to act and function in a variety of social settings. But, for children with cognitive and language impairments, these skills don’t come as naturally.

“One of the ‘red flags’ for an autism diagnosis is an inability to interact socially with one’s peers,” says Sarah

Schimpf, M.S., a speech-language pathologist for Good Shepherd’s Pediatrics Program. “Good Shepherd’s outpatient pediatric services include

social skills groups, which address the problems children have when interacting with others. Children are assessed and given specific, individualized goals to help improve their social interactions.” Whether a child has a cognitive or language impairment, motor coordination deficit or issues with overall strength, Good Shepherd has a social skills group that will fit his or her needs. Goals may include: maintaining eye contact; learning to self-monitor responses (not to provide too much or too little information); taking turns; and maintaining topics of conversation. Each session runs for 10 to 16 weeks and is led by trained speechlanguage pathologists, occupational therapists and physical therapists.

Learn more at www.GoodShepherdRehab.org/pediatric-speech-language-therapy or call 610-776-3578.

When Exercising Is a Pain M any people who are new to an exercise program or who are increasing the intensity of their workouts feel a variety of aches and pains. So is this normal? Yes! The pain you are feeling is a process known as delayed-onset muscle soreness (DOMS). This is usually caused by over-stressing a muscle that is not strong enough to meet the demands placed on it and is common after starting a new activity, exercising consecutive days or increasing the intensity of exercise. DOMS causes microscopic tears within the muscle, which causes pain within 24 to 48 hours after the activity. “Generally, pain associated with DOMS peaks 48 hours after exercise and then gradually subsides,” says physical therapist Tom Zeiser, of Good Shepherd Physical Therapy-Macungie. “This is a

sign of your body adapting and should disappear a few days after you do the exercise.” Be sure to warm up slowly and stretch after exercise. Gradually increase the duration or intensity of exercise, and listen to your body. A general ache that isn't in a specific spot and only bothers you when you move in a certain way is most likely due to DOMS. Icing the muscle and anti-inflammatory medications can help alleviate pain. If your pain increases or changes at any time, or something doesn’t look or feel quite right, seek medical treatment. Swelling, irritation or redness may be signs of injury. If you have a medical condition or are unsure about exercising, check with your physician before starting an exercise program.

Learn more at www.GoodShepherdRehab.org/outpatient-rehabilitation or call 1-888-44-REHAB (73422).


What Is Bursitis? B

ursitis causes pain and occurs when bursae – little fluid filled sacs that cushion an area of friction between tissues (such as tendon and bone) – become inflamed. This inflammation, or swelling, makes it difficult, and often painful, to move parts of the body like the joints. If you work at a job or engage in activities that require repetitive motion, the ongoing stress on your joints can make you more susceptible to bursitis. The most common causes of bursitis include: repetitive injuries (throwing a baseball, lifting boxes); direct impact injuries (falls, banging your knee into a table); pre-existing rheumatoid conditions (rheumatoid arthritis, gout); and infection. Bursitis is often found in the following joints: ■

Shoulder: Commonly seen after rotator cuff injuries, bursitis in the shoulder causes a sharp pain in the side or front of the shoulder and makes overhead reaching or lifting very uncomfortable.

Knee: Kneecap swelling and bursitis can be caused by consistent kneeling or even a single blow to the knee. If a patient has suffered a fall, the swelling could last up to 7 to 10 days. This type of bursitis is often seen in people with arthritis.

Hip: Hip bursitis pain can spread to the buttocks or down the leg to the knee. It is caused by aggravated activity and is often worse at night – making it difficult to sleep on the affected side.

“Treatment for bursitis may include relative rest of the affected area,” says Ali Shah, M.D., M.S., of Good Shepherd’s Spine & Joint Center. “To reduce swelling and alleviate pain, apply a bag of ice or frozen vegetables to the area for ten minutes, twice a day.” To know if your pain and discomfort is bursitis, consult with a doctor like Dr. Shah who specializes in physical medicine and rehabilitation.

Learn more at www.GoodShepherdRehab.org/spine-joint-center or call 1-888-44-REHAB (73422).

Regaining Speech After Stroke O

ne of the most frustrating aspects of suffering a stroke is recovering the ability to communicate. The speech language pathologists, who are part of the Good Shepherd Stroke Rehabilitation Program, are experts in helping patients reach their full potential to recover from speech-related problems following a stroke. According to speech-language pathologist Denise Stryker, MA, CCC-SLP/L, communication problems that may result from damage to the brain following a stroke include: ■

Aphasia: Expressive aphasia is the decreased ability to produce language, and receptive aphasia is the decreased ability to understand language. Apraxia and dysarthria: Apraxia of speech affects the voluntary production of speech movements and is not

related to muscle weakness. The patient may have inconsistent production of speech or imprecise ability to produce sounds. Dysarthria is a disorder that is caused by the decreased strength or paralysis of the speech muscles (lips, tongue, cheeks, soft palate). Speech may become less clear with possible changes in pitch, loudness and/or timing.

Dysphagia: Defined as difficulty swallowing, a stroke survivor may experience the following difficulties: chewing food, moving food from the front to the back of the mouth, delayed timing of the swallow initiation, food/liquid sticking in the throat, penetration of food/liquid into the airway and/or aspiration with food/liquid into the lungs. A speech therapist will determine the appropriate diet in which the patient can swallow safely and work with the patient to improve swallowing strength.

During a personalized therapy program at Good Shepherd, a stroke survivor will learn and practice to improve daily physical function, including speech-related issues.

To learn more, visit www.GoodShepherdRehab.org/stroke or call 1-888-44-REHAB (73422).


Specialized Therapy for Performing Artists

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ancers, musicians and other performing artists often are highly dedicated to their craft, and much like athletes, they have grueling practice schedules and incur repetitive and other injuries. Good Shepherd Physical Therapy-Bethlehem/Performing Arts Rehabilitation Center recently opened to meet the unique needs of performing artists. “Conveniently located in Bethlehem, the specialized site has dedicated rehabilitation staff members who understand and cater to the unique needs of performing artists,” says Cathie Dara, PT, DPT, OCS, STC, site manager. FOR DANCERS: A professional dance floor, complete with a ballet barre and full length mirrors. Spacious treatment rooms afford patients the room to practice their routines. FOR MUSICIANS: A piano and a soundproof music room for performers to play their instruments. “Overuse and repetition make performers predisposed to serious injury, so receiving professional help early on

The site’s staff understands the demands of performance and work commitments and will provide therapy to accommodate performance, class and recital schedules. Specialized services offered at the site for performers and the general public include: physical therapy, hand therapy, pain management, Kinesio taping/ splinting and headache rehabilitation.

can make a big difference in recovery,” says Dara, a physical therapist specializing in orthopedics and manual therapy for the treatment of cervical, shoulder and knees injuries and conditions. Physical therapist assistant Margo Clifford Ging is a dance instructor, choreographer and former professional dancer.

rts Performing A ter n Cen Rehabilitatio 800 Eaton Avenue Bethlehem, PA 18017 610-868-2805

Learn more at www.GoodShepherdRehab.org/performingarts or call 610-868-2805.

Straightening Out a Trigger Finger H

ave you ever woken up in the morning with your finger stuck in your palm? Trigger finger is a common hand condition that can be painful and annoying.

Trigger finger involves the tendons in your palm. When a forearm muscle pulls, a tendon causes the finger bones to bend and the finger curls down to the palm. The tendon is held in place by little bridges called “pulleys.” The “trigger” occurs when your tendon becomes caught as it tries to pass under a pulley. This rubbing causes inflammation and fluid accumulation, which can make the finger “click” in the palm or at the middle joint of the finger. Eventually, the finger may start to become stuck, and the condition may worsen until it can no longer move. Treating a trigger finger starts with reducing the inflammation.

“In hand therapy, we create a splint to keep the finger nearly straight overnight and even during the day if clicking or locking are occurring,” says Randy Wolfe, a certified hand therapist and occupational therapist at Good Shepherd Rehabilitation. “We also recommend using an ice cube to massage the palm for 15 to 30 seconds, pausing a few seconds and then repeating. Inflammation may be reduced when ice is used 8 to 10 times over a 4- to 5-minute period.” Another treatment option is an antiinflammatory and pain medication injection into the trigger area. Persistent trigger fingers may require a relatively simple surgery in which the physician releases the pulley.

Learn more at www.GoodShepherdRehab.org/hand-wrist-therapy or call 1-888-44-REHAB (73422).


Non-Profit Org. US POSTAGE PAID Lehigh Valley, PA Permit No. 158 850 South 5th Street Allentown, PA 18103

New President & CEO: John Kristel, MBA, MPT

J

ohn Kristel recently became President & CEO of Good Shepherd Rehabilitation Network, replacing the retiring Sally Gammon, FACHE, who led the organization for more than 16 years. Kristel has more than 10 years of experience in senior leadership healthcare roles. Kristel, who started his career as a physical therapist, joined Good Shepherd after serving as the President & CEO of Carlisle Regional Medical Center and Vice President, Operations, for the Atlantic Division of Health Management Associates. “It is truly an honor to lead Good Shepherd Rehabilitation Network, which has an outstanding reputation for providing high-quality health care and for innovation,” says Kristel, a native of Bucks County, Pennsylvania. “I am impressed by Good Shepherd’s

commitment to its mission and by the dedication of the organization’s staff.” Kristel also will serve as chair of the Good Shepherd Penn Partners’ Board of Directors. Good Shepherd Penn Partners, based in Philadelphia, is a joint venture of Good Shepherd Rehabilitation Network and Penn Medicine. Kristel earned an MBA from Temple University Fox School of Business in Philadelphia and a master’s degree in physical therapy from Drexel University in Philadelphia. He received his bachelor’s degree from Temple University. Kristel, his wife and three children will move to the Lehigh Valley this summer. “I look forward to meeting as many members of the community as possible and learning more about my new home,” says Kristel. “Once settled into my new role at Good Shepherd, I anticipate volunteering in some capacity in the community.”

Follow John on Twitter @GoodShepherdCEO or read his blogs at www.GoodShepherdRehab.org/blog.


Be Well - Summer 2013