D & B NYC Marathon Champions

Congratulations to all the Duffy & Bracken patients who participated in the 2013 ING NYC Marathon. 

We are proud of all of your hard work and dedication. 

Thanks for allowing us to help you get ready for the race!

Finish time 3:39:00

Mile 18 and still smiling

Finish time 5:22:45

D & B therapist C. Shante Cofield, DPT finished in 3:55:51

 

 

 

Great Expectations: How To Pick A Physical Therapist

As a physical therapist, all too often I have new patients come in who tell me that they’ve tried physical therapy in the past for six, seven, eight plus months, with basically nothing to show for it. The two questions I always ask these patients are: “What did they do with you?” and “Did you think that what they were doing was helping?” While I don’t expect patients to remember every detail of their PT regimens, they should be able to say with confidence whether or not they felt that PT helped them. For those of you reading this who can align yourselves with the plights of those poorly-served PT patients, I’d like to offer you these few pointers to help ensure that your next PT encounter doesn’t leave you feeling like all you’ve managed to accomplish is throwing a few dollars at that high insurance copay or deductible.

Your physical therapist should be:

1. Present – Your physical therapist should BE PRESENT. If your therapist is spending 5 minutes with you then passing you on to an aide or trainer never to be seen again, it’s time to look for a new physical therapist.

2. Hands-on – While physical therapy does emphasize exercise and therapeutic activities, the manual techniques employed by your therapist can greatly help accelerate your healing process or correct dysfunction that could lead to injury down the road. If the physical therapy that you’re used to centers around ultrasound, heat packs, and stim, (electrical stimulation) with the therapist basically spending three minutes giving you a bad massage, it’s time to look for a new physical therapist.

3. Approachable and Informative – Too scared to ask your therapist why they have given you a specific exercise or why they are using a specific manual technique? You shouldn’t be. While the busy schedule of a physical therapist does not afford them the opportunity to spend hours upon hours with each patient, a therapist should be both willing and able to answer any relevant questions asked (and not asked) by the patient, within the allotted time.

4. Creative – Don’t expect a poetry reading when you go to physical therapy, however, your physical therapist should be able to provide you some variety with your exercises and treatments. If you’re doing the same exact thing at every session, for weeks on end, with no progression and no improvement in your symptoms, it’s time to look for a new physical therapist.

5. Competent – It goes without saying that your therapist should know what they’re doing, however, it is important that you feel confident in their competency. I’m not advocating that you base your physical therapist selection on their pedigree or how many letters they have after their name, but the manner in which they explain things to you, the exercises they prescribe, and the manual techniques they perform should all instill confidence in you that they can help you achieve your goals and improve your symptoms.

Here at Duffy & Bracken each of the physical therapists on staff bring with them all of these characteristics, and many more. However, my intent is not to tout how much better our practice is than others out there. Let this blog simply serve as an informative piece for anyone who has been to PT, is currently attending PT, or is looking for a physical therapist and wants to ensure the quality of services being offered. 

It’s your body. It’s your health. Choose wisely!

   

C. Shante Cofield, PT, DPT, CSCS

Duffy & Bracken Physical Therapy and Wellness

Carmen@duffyandbracken.com

HELP I CAN'T PEE!!!

Here's a testimony from one of our Pelvic Floor patients that was too good to keep to ourselves. 

MY ROAD BACK TO A LIFE

I didn't have a life. That is, not much of one.  Sadly, I'd lost the ability to do many of the things that I enjoyed and that helped make life fun and meaningful. And THAT was because I'd lost the ability to do one of life's most basic tasks...I couldn't pee.

I assume, if you are still reading this, then something similar has happened or is happening, to you.I was in my office when I first realized I couldn't pee. Quite a shock. Quite uncomfortable. Quite a trip to go to the ER and have a catheter installed. That lead to medication to deal with my enlarged prostate that was, apparently, blocking the flow of urine down my urethra. It worked well for many months...until it stopped working well and I was back in the ER. This time my urologist recommended TURP surgery, a laser procedure to reduce the size of the prostate and open things up. Till it could be scheduled I had to wear the catheter. That meant no running, no sports, no working out, difficulty sleeping, occasional discomfort, and walking slowly.

Then I had the surgery and all was well...for about 2 months. And then the same problem returned. My urologist kept saying he didn't understand, the prostate was no longer squeezing on my urethra, it must be that I was doing something wrong, I must be getting too anxious and tightening my sphincter and preventing the urine flow.

So, apparently, it was all my fault for being too anxious. So we tried a few different anti-anxiety medications. I took them and he took the catheter off. And a few days later I couldn't pee and it was back to the ER. After some tests they could find nothing amiss, my urologist recommended redoing the TURP. We did. Nothing got better. By now I was getting recognized on my return visits to the ER.

Life had become nightmarish. I decided to try something different.

I went to another urologist who specialized in difficult cases. He recommended that I learn to self cath when needed. That way I could avoid ER trips and not have to wear a catheter. It was the scariest thing I ever heard of. No way I'd EVER do something like that! But what was the alternative? So I learned it and it was painless and no big deal.

And I told him I wanted to try physical therapy. He agreed and gave me a few names. I called around and that's how I ended up at Duffy and Bracken. Lucky for me!

I began seeing Ann Duffy twice a week. In the evaluation she used a biofeedback mechanism to measure the strength of my Pelvic Floor Muscles. I didn't know I had a Pelvic Floor nor did I know that there were muscles there. Turned out they were extremely weak. She could also measure their ability to relax. Turned out they were not very good at that either. My pelvic floor muscles were under strength and over tense. "You have pelvic floor dysfunction," Ann told me, and traced it back to surgeries I'd had in the area some years ago. She explained that, because the muscles are weak, they had to work extra hard to keep me from being incontinent. As a result they were in a constant state of tension. And that is what lead the muscles to over tighten at the wrong times and prevent me from being able to pee.

We had a theory on what was wrong that went beyond telling me to relax or giving me anti anxiety medications! And that lead to a theory of what would help: Strengthen the pelvic floor muscles and supplement that with relaxation techniques.

So that's what we did. I learned Kegle exercises (though probably not how to spell them correctly) that I did both with Ann and on my own as well as other exercises I could do at home. Using biofeedback we could measure the muscles' strengthening and also see what relaxation techniques worked best for me. We found deep belly breathing did the trick.

Things did not immediately get better. I had to self cath a number of times. Sometimes I felt pretty discouraged and anxious. Ann was encouraging but also action oriented. "What good does getting anxious serve?" she asked once. We got back to the Kegels.

Then things improved significantly! I had a long stretch of feeling fine. When I had a rough few days, Ann quickly figured out the problem...I'd hurt my lower back lifting some boxes I shouldn't have. The muscles there tightened and that caused surrounding muscles to also tighten...including those pelvic floor muscles. So Ann gave me stretches to do and then strengthening exercises for the area. Things have gotten better again.

I think the best thing I can say about my work with Ann at Duffy and Bracken is that it is individually oriented and self empowering. That is, what she did is figure out what was going on with ME and then devise exercises, stretches and relaxation techniques that enable me to vastly improve and, hopefully, remedy the problem. NOT oriented at all (at least in my case) to medications and that is something I think is a very good thing. They almost always have side effects.

Duffy and Bracken is a business and I'm sure Ann is a good business woman. But everyone knows that physical therapy can take a while and that can be expensive and cause people to shy away. But what I found with Ann is that she'll do her best to work with you, to use your insurance, to come up with something fair should the insurance stop helping or be unavailable for whatever reason.

I'm very happy with what I've accomplished with Ann's help. I'm back to my active life. I'm pretty confident that you will improve things, probably greatly, if you work hard and consistently with the folks there.

I'd be happy to talk to you about all this if you think it could be helpful.

Regards, 

Michael Leiman

TAKE YOUR "BACK" TO SCHOOL!

With the school year beginning next week...after a restful summer…..we will be back to a more structured routine!! The trains will be busy with school kids being part of the rush hour commute.

Every year for the past decade, I have observed school kids carrying heavy loads...totally unaware of their posture. As a Spine Specialist, I naturally notice poor posture in others and I must say adults are just as unaware of their posture.

Our sitting world places undue stress on the spine if we are not aware of “ WHERE OUR BODIES ARE IN SPACE”.  Leading unsurprisingly to all sorts of aches, pains, and complaints of back stiffness.

I have coined 3 words to describe the spinal positions:

•   Hammock Spine: this is when we slouch curving our spine to its limit ---that it resembles the shape of a hammock. All structures are being pulled and stretched up to their end point resulting in weakness and loss of stability. E.g. slouched on the couch sound familiar!!!

•  Swagger Spine: this is when the spine sways laterally and does all the work while the rest of the body comes along for the ride. E.g. Walking with packages and doodling sideways

•   Pencil Spine: this is when the spine is so straight and rigid that any movement seems impossible.  E.g. Turning and twisting to look behind is a total body effort

 I’m sure you can identify where you fall in this spectrum. 

If we are all busy doing yoga, pilates, cross fit and gym workouts --- why then does our super strong core still cause low back pain?  The answer is in our individual lack of postural awareness; and this is where the expertise of a skilled PT with a keen sense of observation is invaluable.

Static and dynamic posture determine spinal health…so why not put your “ BACK TO SCHOOL”. Let us teach you how to enhance spinal mobility, spinal strength and spinal wellness.

Duffy and Bracken has partnered with Intelliskin (a performance apparel company) to help build the bridge for patients who struggle with back pain due to years of poor posture. Our postural assessments consist of a total spine evaluation and assessment, corrective exercises and clothing advice to help maintain good spinal posture. 

Contact us today for more information. Isn’t it time that we adults took our BACK to School ---to improve our quality of life!

Renuka Pinto, MPT, PGDR, CSCS, CES

Renuka@duffyandbracken.com

D & B IS NOW IN-NETWORK WITH CIGNA!!

Duffy & Bracken Physical Therapy is pleased to announce that we are now a participating provider with Cigna Healthcare.

We participate in most major insurance plans, in-network as well as out-of-network. If needed, we offer payment plans to our patients and work with them to make treatment possible at a reasonable cost. With many of today's insurance plans, the out-of-network coinsurance can cost the patient the same (or even less) as the in-network co-payment.

We know that understanding your benefits and/or coverage can get tricky. Our experienced billing staff is committed to working with you and addressing all of your insurance concerns. 

Below is a list of the most popular HMO, PPO, POS insurance plans that we work with, both in- and out-of-network. If your insurance is not listed, do not hesitate to contact us. We will do everything possible to work with your plan.

United Health Care
Empire Blue Cross Blue Shield
Oxford Health Plan
Cigna
Empire Plan (MPN)
Medicare
Workers Compensation
No Fault
Federal Employee PPO
Mt. Sinai- NYU H.S.M.C.M.N.
Anthem
1199
Horizon NY & NJ

Sex & Your Pelvic Floor!

Did you know that physical therapy can help your sex life??

Duffy & Bracken, PT has a unique specialty called Pelvic Floor Physical Therapy that can benefit both men and women. There are very few physical therapy clinics that specialize in this and Duffy & Bracken was one of the first to do so. Not to mention, we now have 20 years experience in this area. 

Painful sex is NOT normal!! Many people experience ongoing pain during sex, and the longer they let this go on, the more chronic and stubborn it may become. We all know that a woman’s first sexual experience is often painful because the hymen, which is very sensitive may still be intact. Anything from tampons to GYN exams (with a speculum) or physical activity before intercourse may have widened the hymen. However, some women are unable to use tampons or have sex due to extreme sensitivity, pelvic muscle spasm or nerve pain-neuralgia. Fear-avoidance also adds to this problem since fear acts like cement to pain and makes it difficult to overcome. Understandably, everyone is afraid of pain but understanding where the pain is and why it’s there, in addition to learning techniques to decrease it; can slowly stretch the vaginal opening allowing you to have pain free intercourse. This process can be quite quick if you do your homework, and usually resolved in 6 to 12 visits or sometimes even less! Even chronic cases sometimes resolve quickly especially if you work at it with your therapist.  

Pelvic Floor conditions do not only affect women. Men who have pain with ejaculation may have painful or trigger points in their pelvic floor muscle (PFM) that can be treated with retraining and massaging of the muscle. Additionally, getting education that explains 'pain' can aid in reducing the fear and hopelessness that sometimes accompanies pelvic pain.

Pelvic pain and dysfunction may also cause urinary and bowel problems or vice versa since the pelvic floor controls voiding. Poor posture and muscular skeletal problems involving the back, pelvis, sacrum, coccyx (tailbone) and hips, can also be a cause or a result of pelvic dysfunction - or as we like to say the 'culprit or the victim.' 

Likewise, women may experience pelvic pain during or after menopause as we lose estrogen and the pelvic floor muscle thins and atrophies (muscle gets smaller). Men lose testosterone around age 60 and sexual dysfunction may accompany this. Strengthening the pelvic floor muscle can help keep and sustain erection plus improve orgasm for both men and women.

There are many reasons to keep the pelvic floor muscle healthy including: pain free sex, better orgasm, and improved sexual stamina. Not to mention, a healthy pelvic floor also prevents: prolapse (the bladder and cervix can fall out of the vagina), incontinence (leaking of urine or feces), and flatulence (gas). It also improves posture and results in a flatter stomach, as the pelvic floor muscle works together with the transverse abdominis (which holds the belly flat).   

Medical terms used to describe these problems include: pelvic floor dysfunction, dyspareunia, levator ani spasm, vulvodynia, vulvar vestibulitis, vaginismus, and erectile dysfunction. These conditions may accompany: coccydynia, low back, sacroiliac or hip diagnosis, urinary or bowel frequency, constipation or irritable bowel or bladder disorder, interstitial cystitis, and post-partum scars from tearing during childbirth.

Let us help you with these very personal problems today. So get a move on receiving help or recommending anyone you know to a specialized PT. We will make you feel comfortable in more ways than one!

Ann Duffy, M.A., P.T.

Owner & Pelvic Floor Expert

Ready, Set, Go The Distance Injury Free!

 

Are you preparing for a marathon, half marathon, 10k or 5k? Let the experts at Duffy & Bracken help you get ready for your race with our Marathon Training Program. We have put together a dynamic team of therapists to help our patients prepare for their race as well as prevent injuries.

Here at Duffy & Bracken our therapists want to see you perform at your best, so they have arranged an incredible package to get you ready for your chosen race. Since every individual has special needs and are at different fitness levels, we give you the option of choosing three out of the four available sessions. You have the power to decide what sessions you would benefit the most from based on your areas of strength and weakness.

Marathon Package Session 1:  “The Rub Down”
This 50-minute massage will utilize both deep tissue and medical massage techniques to restore your optimal performance. Physical Therapist Johann Howard helps to reduce pain, facilitate increased range of motion and improve tissue quality.

Marathon Package Session 2: “Body Fuel”
This 20-minute session will include tips on performance eating, proper hydration as well as suggestions on the finest supplements such as; gels, chews and recovery drinks. You will receive nutritional advice from physical therapist and avid runner, C. Shante Cofield. Since Shante is always training for her next race, she knows where you’re coming from. She’ll provide support, motivation and recommendations on informational reading about running.

Marathon Package Session 3: “It’s a Marathon Not a Sprint”
This 30-minute session will start by assessing your current training program. It will include a gait analysis, running stride and lower extremity mechanics evaluation. For optimal running the session will include core training and lower extremity strength training. Internationally trained therapist, Renuka Pinto, has been working with professional athletes for over a decade, so she won’t have a problem whipping you into shape. She’s our foot expert, so she will also make shoe and socks recommendations based on your individual foot type and running style.

Marathon Package Session 4: “The Finish Line”
This 20-minute post-marathon session will evaluate you after the race. It will include both corrective exercises for common running injuries as well as preventative exercises to avoid future injuries. Our therapists will be here to patch you back up and get you into a treatment plan if needed.

For just $250 we help prepare you for your most successful race yet. Whether it’s your very first race or you’re a veteran, we can help you cross the finish line injury free.

Call the office to reserve your sessions today!

Kieffer Pearce
Director of PR & Marketing
212-402-5430