To begin physical therapy, ask your doctor to fax a prescription to (615) 343-7645. Please include the patient’s name and contact information, diagnosis, and physical therapy to evaluate and treat.

Contact us!

Vanderbilt Orthopaedic Institute Medical Center East, South Tower, Suite 4200 Nashville, TN 37232-8774 615-343-9284 (Phone) 615-343-7645 (Fax) This information is intended for education of the reader about medical conditions and current treatments. It is not a substitute for examination,diagnosis,and care provided by your physician or a licensed healthcare provider. If you believe that you, your child, or someone you know has the condidtion described herein, please see your healthcare provider. Do not attempt to treat yourself or anyone else without proper medical attention. All rights reserved 2008, Vanderbilt University, Vanderbilt University Medical Center, Vanderbilt Children’s Hospital.

Our Core Purpose

To improve the lives of others through science, education and clinical skill.

Our Core Values • Everything you do must enhance the patient experience, thereby improving the reputation of the Vanderbilt Orthopaedic Institute (VOI). • Work with the highest honor and integrity. • Check your ego at the door. “Team” before “I”--Ask not what VOI can do for you, but what you can do for the Department. • Lead the field of Orthopaedics with research that will improve the practice of the disciplines in our department. • Strive to be leaders in education for care givers, patients, and the community.

• Treat each patient as we would treat our own family.

What Is A Physical Therapist? Physical Therapists are healthcare professionals who evaluate and treat people with healthcare problems resulting from injury or disease. In today’s healthcare system, Physical Therapists are experts in the examination and treatment of musculoskeletal and neuromuscular problems that effect daily functional abilities as well as recreation/sports abilities. Physical Therapists assess joint motion, muscle strength/endurance, and performance of activities required in daily living. The minimum educational requirement is a post-baccalaureate degree from an accredited education program. The majority of programs offer a master’s degree, but a growing number of programs offer the Doctor of Physical Therapy (DPT) degree. Candidates must pass a state administered national exam as well as maintain annual continuing competency/licensure requirements.

What Is A Certified Athletic Trainer? Certified athletic trainers (ATCs) are medical experts in the prevention of athletic injuries; recognition, evaluation and immediate care of athletic injuries; and rehabilitation and reconditioning of athletic injuries. Athletic trainers can help you avoid unnecessary medical treatment and disruption of normal daily life. The American Medical Association recognizes athletic training as an allied health care profession. In addition to athletic injury rehabilitation, Vanderbilt Sports Medicine provides athletic training services for local high schools. The American Medical Association recommends that a certified athletic trainer be in every high school. The minimum educational requirement is a bachelor’s degree and being certified by the NATA Board of Certification (NATABOC). In addition to certification, athletic trainers must meet individual state licensing requirements in a growing number of states.

To begin physical therapy, ask your doctor to fax a prescription to (615) 343-7645. Please include the patient’s name and contact information, diagnosis, and physical therapy to evaluate and treat.

Making your home safe - diagram

Table of Contents What is Osteoporosis? . . . . . . . . . . . . . . . . . . . 2 How Does Physical Therapy Help? . . . . . . . . . 3 Body Mechanics/Back Protection . . . . . . . . . . . 4 Making Your Home Safe . . . . . . . . . . . . . . . . . . 6

For Additional Information: www.NOF.org www.NIH.gov www.APTA.org www.AAOS.org www.NATA.org

National Osteoporosis Foundation National Institute of Health American Physical Therapy Association American Association of Orthopedic Surgeons National Association of Athletic Trainers

©1997 APTA 8

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What is Osteoporosis? Osteoporosis is a disease that causes bones to become thin, weak and easy to break. It can be related to family history, diet, medications and lack of physical activity. Any bone can be affected; however, the bones that break the most frequently are the hips, spine and wrists. Bone fractures are painful and can be the source of permanent loss of function and disability.

WHO GETS OSTEOPOROSIS? Both men and women can develop osteoporosis; but women are four times more likely to develop it.

FACTORS THAT AFFECT STRONG BONES 1. Adequate intake of Calcium and Vitamin D are necessary for strong bones. 2. Physical activity including weight bearing activities (walking, running, dancing) will help to improve bone strength. 3. Reduction of hazards in your home that may cause you to fall. 4. Certain medications can weaken bones. Your doctor will inform you of the risks and benefits of all your medications. 5. Maintenance of a healthy weight. Being underweight increases the risk of bone loss and fractures. 6. Smoking and heavy alcohol use are detrimental to your over all health and increase your risk for broken bones.

Making Your Home Safe KITCHEN • Every day items (pots, pans, cleaning supplies) should be kept within easy reach to avoid bending or stooping. • The floor should be made of a nonslip material. • If using a mat at the sink, be sure it has a rubber backing. • Use long handled “grabbers” to reach lightweight items on upper shelves. • Avoid using step stools or ladders to reach items on upper shelves. LIVING ROOM • Area rugs should be secured with non-skid padding and furniture. Avoid throw rugs on carpet or hardwood floors. • Furniture should be arranged to allow wide walkways. • Chairs and sofas should be tall enough to permit easy sitting and standing without effort. STAIRS • Railings on both sides are a must. • Step surfaces should not be slippery. • Items should not be stored on the stairs. • Bright nonskid tape should be used to mark the beginning and end of the stairs. IN GENERAL • Always wear properly fitting footwear with nonskid rubber or crepe soles. • Do not use ladders or step stools. If you must use one, have another person watch you. Avoid the top step. • While cleaning the house, try to keep your upper body straight. Do not twist from the torso. Bend from the knees, not from the waist. When vacuuming or mopping, bend your knees and rock front and back instead of bending over.

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Making Your Home Safe

How Does Physical Therapy Help? Your Initial Physical Therapy Visit:

FALL PREVENTION THROUGHOUT THE HOUSEHOLD, CHECK THAT THE FOLLOWING ARE IN WORKING ORDER: • Flooring and carpeting are in good condition and without obstacles that may cause tripping or falling. • Lighting is bright and non-glare. Install light switches at the entrance and exit of each room. • Nightlights are placed throughout the house, especially on stairs and along routes between the bedroom and bathroom. • Telephones are positioned to avoid having to hurry to answer a ringing phone. Install extensions or place cordless phones in as many rooms as possible • Electric cords are hidden and tacked down onto baseboards. • Pets should not lay or sleep near a person’s feet or at the bedside. • No unsecured runners or pieces of carpet on the floor BATHROOM • Install grab rails by the tub, shower and toilet. • Use non-skid carpeting and mats • A sliding glass door at the tub is NOT secure enough to prevent a fall. BEDROOM • Bedside table is present for placement of glasses, lamps and telephones. • Before getting out of bed, sit on the side of the bed for a minute or two before standing to avoid dizziness.

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Your first physical therapy visit will be for an evaluation with a physical therapist (PT). The PT will ask you for information about your past medical history as well as your present injury. After taking your history, the PT will perform an evaluation. This exam will look at your strength and range of motion, as well as address problems with walking, movement, and daily care activities. If you have had a recent fracture, your therapist will focus on pain control and improving range of motion, strength, and function. If you have not sustained a fracture, your therapy will proceed directly to strengthening exercises, improvement of posture and balance. You will be given exercises and/or stretches to begin working on your program at home. The PT will let you know how often to perform your exercises at home and how many times per week you will need to come to therapy.

Home Exercise Program: In addition to the stretches and/or strengthening exercises you will do at home, the PT will also give you tips for posture and body positioning. Your PT will discuss how and when to perform these activities. In many cases you will be given printed pictures and instructions for these exercises. They will also give you instructions on how to “Fall Proof” your home. As your therapy continues, you may be given new activities which will build on or replace your original program. It is very important that you follow all instructions, as your home exercise program is an important piece of your overall therapy.

How Does Exercise Help? Bones are living organs which are alive with cells and body fluids. They can be renewed and grow stronger with a good diet and physical activity. It is important to establish a moderate exercise routine that can be maintained and be incorporated into your daily life.

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Body Mechanics Back protection and good body mechanics are ways to decrease spinal loads. There are many ways to protect your back from stress and injury. For example:

Body Mechanics • Avoid prolonged sitting postures. Get up every 30 minutes to stretch and walk around to increase circulation.

• Avoid forward bending as much as possible. Repetitive forward bending puts pressure on the spine. Using a “reacher” (a device used to extend your reach) will allow you to pick up objects without bending forward.

• When standing, you can decrease stress on the back by putting one foot up on a step for a few minutes at a time, then alternate with the other foot.

• Carry loads close to the body to decrease stress on your spine.

• When sleeping, position yourself on your side with your back straight and a pillow between your knees. Stomach sleeping is not recommended because it puts undue stress on your neck.

• When you must pick up an item off the floor, start by facing the object. Keep your back straight, tighten you stomach muscles and squat down. You may need to hold onto a solid piece of furniture to help lower and raise yourself if your legs aren’t strong enough to squat down.

• Keep your abdominals activated by pulling your stomach in toward your spine.

• Never twist your back when carrying a load. Keep the item close to your body and take steps with your legs to change directions instead of twisting. • Avoid a slumped sitting posture. Use a low back support if needed to keep your spine as straight as possible. Sit with your knees level with your hips.

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