Dave Talks About Osteoarthritis and Joint Replacements With Fellow Physical Therapist Maria Petrongolo

Dave Anselmo: [00:04:06] So it’s been a great experience. I’m really you fit in perfectly for us. And we couldn’t be happier when you came on. I must say, you’re a great person as well as a great physical therapist. And the patients obviously echo that sentiment there for us. So let’s put everything out here for numbers for our callers today. We really wanna get as many calls as we can. Well, anyone has any questions. Maybe had physical therapy or have you guys been hurt or in pain? Give it a course. Give us a call. And asked the question. We might be able to help you in reference to give me a direction of what you may need to get physical therapy or get help, or if you even want to call and just tell your story about what physical therapy has done for you. Here’s the number. The number is 856-626-0400. This show has been brought to you by Cross Keys Physical Therapy. We have two locations to serve you. One in our Pennsville location, 181 North Broadway and a second in Washington Township at 150 Fries Mill Road Building, 600 Suite 1 University Executive office. Or you could also locate us on our website at www.CrossKeysPhysicalTherapy.com where you can get directions and phone numbers to both of our locations. So let’s take a break and we’re right back. And let’s talk about joint replacements. So we’re right back.

COMMERCIAL: [00:05:26] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure a prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every means. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They dress back neck athletic, orthopedic and joint replacement rehabilitation therapy and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck, nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away. Participates in a broad spectrum of insurance plans. Date 856-374-3707 in Washington Township and 856-678-8000 in Pennsville.

Dave Anselmo: [00:06:39] And we’re back. Welcome to the Cross Keys Physical Therapy show. We’re going to talk a little bit about joint replacements. We see a lot of different places from the knee replacements, hip replacements, shoulder replacements, ankle replacements, just to mention a few. So, yeah, what are some of the signs and symptoms that one may begin to have that may indicate that they may need joint replacement?

Maria Petrongolo: [00:07:00] So number one, Dave, is pain, right? That’s always the number one complaint we’re hearing when someone’s coming into us. So pain mainly that’s limiting any kind of function. So impairing our walking, our ability to get up the chair, you know, get dressed, get out of bed or anything like that, that impairs our normal day to day activities resulting from that pain will have stiffness, you know. Well, decreased or range of motion, not as much mobility with our normal activity. So that’s going to be number one that we’re going to hear, obviously.

Dave Anselmo: [00:07:32] Yeah, definitely no reason why people even have to have total replacements just because they are in so much pain and they just can’t take it any longer. And people have a tendency, obviously, to push it back as long as they possibly can to have a joint replacement, because the word out there is that these replacements only lasted anywhere from 15, if you’re really lucky, 20 years. And it all depends on how they work and how much they work and how much they press and stress they do, what kind of activities they have. So they’re more apt to push it back as much as they can. And I think that’s where we’ll talk a little bit later and show why we, where we run into some problems with some of these people in reference to getting the rehab because they wait so long for that. I like this. Talk a little about some of the best options for patients following having a joint replacement.

Maria Petrongolo: [00:08:22] The biggest option a lot of people will be referred to is a home PT is a great option, especially if this is your first joint replacement. You’re not really sure what to expect. Someone, a physical therapist will come into your actual home just to really help with your day to day function, how you are going to get dressed, get up out of a chair, walk around your house, use an assisted device just to be as independent as possible, really

Dave Anselmo: [00:08:49] How to get in and out of shower or how to get it off the toilet. All these things are really important because these people have no idea they’re in pain. They have more like they have a lot of taping and straps around them that they can’t move to well. So it’s really important that they have that talent that gives them the comfort to give them the understanding. But ultimately, for me, I mean, I see more and more of these patients that feel comfortable with these things or had physical therapy before and understand what their movement will be and around the house. But the limitations are and have been through that. And some of these people now are just avoiding that and say, hey, listen, give me a day of that just to recover. And they’re coming into outpatient physical therapy a lot faster, I think, because I think we’re able to be a little more aggressive in reference to getting these joints moving. And I think it’s really important that they understand that they have that option of doing that as well.

Maria Petrongolo: [00:09:43] Definitely. And, you know, especially like you said, if they kind of know, you know, say it’s their, you know, very soon after their first replacement or if they’ve done it in the past, they kind of know what to expect, things like that. And they know how to function more so in their home. It’s great to get into an outpatient as soon as possible, not even just for us to work with them, but just to get out of the house. Overall quality life, just so you’re not, you know, feeling like you’re staying in a house just so you’re getting interaction. Just something simple like that, but

Dave Anselmo: [00:10:13] Very true, you know, let’s face it, having a joint replacement can be a major shock to your body. And things can go wrong. I mean, sometimes during the surgery, I mean, some things go wrong. And these patients have a rejected replacement or they get infections and so on, so forth. And I think that’s where it’s really important to have someone that has experience in these situations, have seen multiple joint replacements as a physical therapist and know the signs and symptoms and and know how to make the adjustment in reference to maybe when you send a patient better that this is possible because this patient’s having an infection. And we want to adjust that as fast as possible. We don’t just continue because it will get worse or, you know, we know how to do that. Maybe it’s a little bit of irritation and we know how to handle that. So it’s really important that you get involved. And when you’re having a joint replacement to a physical therapy, a facility that has experience in treating people with joint replacements. So if you are having one, you know something, if you have a specific facility, want to go to make sure you call ahead and ask the facility if they have experience in treating patients with total joint replacements.

Maria Petrongolo: [00:11:16] Yeah. And we’re even getting most of the time, sometimes the same days, sometimes the next day, joint replacements coming into therapy. And really that’s the best thing is to get it to move. And just really movement is medicine and all in all facets of life. So getting there as soon as possible is huge, actually.

Dave Anselmo: [00:11:32] Absolutely. Absolutely. I mean, obviously, last week we had a caller and she was a patient of ours, she had come to us, she had four replacements within a one year period of time, and the fact was, it was the first one she had home care and she had some problems. And that’s what really was that. She got frustrated with it. And she wasn’t she wasn’t progressing as she should. She wanted to. She gave you a lot more stiffness, a lot more swelling. And so she cut it out and said, hey, I can get an outpatient. So she came to us right away. And guess what? Next three. She wasn’t even an outpatient. She didn’t have home care. She came right to us a day after surgery. So it was pretty effective in that I was pretty amazed how quickly she was able to rehab. So I think that it’s really important that people know that that is an option for them if they feel comfortable with it, obviously. But we are obviously nicely talked about how important home care is. And I think you do need to have that at first. If you have no idea what you’re doing, you need to have that. So don’t like that. I’m not trying to talk about it. I’m just saying, if you have had that and you know what you’re doing, you don’t have to have that. If you know what you’re doing, you feel comfortable with it. You can come to physical therapy the day after. It’s not really an option of yours.

Maria Petrongolo: [00:12:40] Yeah, it’s you know, we are here to advocate for you overall, of course. But, you know, we also want you to advocate for yourself. And that’s why we’re going here, to just let you know that that is an option, that you’re able to kind of, you know, take things in your own hands and really think, you know, I think I need this and really advocate for yourself and push for that, because that’s an option for you. And some people might not realize that they think, OK, this is what my doctor is saying I maybe should do. I’ll just do it and not really think about it or you know what I mean? Or everything’s very overwhelming after having a surgery. We understand that. So there’s a lot of things going on. But, you know, we’re here to kind of tell you that, you know, you have the power as well.

Dave Anselmo: [00:13:18] That’s what we do. We’re here to help you in any facet that we can. So once again, let me get the numbers out again for the callers. Anyone who has a problem like we’re talking about has as a pain really doesn’t know what’s going on. And maybe they think physical therapy might be an option for them and they’re not really sure. Give us a call if you’d like to talk to you about it and or if you have a story you had with physical therapy. Well, there’s a good well, there’s bad. Please give us a call. We want these people out here to know. I know there’s a lot of people out there now sitting in their cars, driving home from the shore and really thinking, hey, you know, I have this, I have this, and these people call in and will tell their story. Maybe I resonate for some of these people and realize, hey, that sounds like me. Maybe physical therapy could help me. And that’s what the show is all about. Really, I really want to get out there and educate as many people as we can about what physical therapy is and how we can help them. So please give us a call. The number, again, 856-626-0400. So, OK, Maria, let’s go home and we’re doing well. Just talk a little bit about the sort of places that I see a lot of people once again coming into from PT following an injury replacement for six or seven months after having a replacement, who did not have physical therapy and especially total hip replacements that we are mainly talking about that. Why do you think that is happening and how can we change that?

Maria Petrongolo: [00:14:44] So kind of going off what we said before that a lot of the times patients may not be referred to physical therapy after especially the hip replacements is a big thing. I’ve heard a lot of patients say that they’re prescribed to walk. And that’s mainly their rehab. And we know that walking just in general is not enough. You know, we’re not just walking all day right where we’re sitting down. We’re standing up and we’re doing a lot of things. We’re not just on our feet, just walking all day. If that were the case, I’d be fine. But we definitely need more strength in order to do our mobility, you know, in order to do all of those hundreds of other activities throughout the day.

Dave Anselmo: [00:15:27] So important. Funny, so funny that you say that, because when you really think about it, it’s simple to think about this. Most of these people are pushing back. They’re the hip replacement. We’re talking right now as long as they possibly can, because once again, as I said earlier, they’re saying they’re being told that it takes 15 years or so and it’s how long it lasts. So now wait as long as you can, you know, push it back because, you know, you don’t want to have to go have the surgery again. And so they’re pushing it back. And the process, what’s happening, these people are getting weaker and weaker and their muscles are getting more atrophy. The joints are becoming more unstable. And just the thought of after having that procedure now, how do they think that these joints are going to take the joint out and put in a new one? What they’re not doing anything with the muscles that tendons and their ligaments as the stability of our joints. We still need that to work. And in order to function, to get the range of motion again, they get them back to normal. Yeah. So just the thought that having a patient has gone walking, I see so many times that these patients and it’s once again six, seven months they come in, usually they’re not coming in for their hip.

Dave Anselmo: [00:16:38] Is he coming in because they have a compensatory problem with their other joint? Now they’re having problems with their name. Now they’re having a problem with their back because they’re walking oddly, because they’re trying to compensate for this, because they can’t walk that way. They want stability. And we have another problem going on. So now we’re working on that other hip. We’re working underneath and working on our back. And guess what? The insurance companies don’t want to hear about that. So it becomes a real problem for us. And this is what I want to educate these people about. Let’s avoid that. That’s that the people who are active with your care when you haven’t told her replacement no matter what. Tell the surgeon, oh, no, no, no, no. I want to have physical therapy. I waited so long. I am weak. I don’t have a problem. I don’t want to, I want to avoid that. Please tell me about physical therapy at that point, don’t give me a prescription. And you can go where you want to go.

Maria Petrongolo: [00:17:25] So I go up, like you said, going up the entire kinetic chain, something your foot can honestly affect even up into your arms. Say that you’re compensating with how you’re doing a squat and or lifting, and then you have to compensate with your arms like it goes up through everything on to the other side. So you know, you really need therapy in order to train yourself properly, not even just not even just strengthening in range of motion, but how to actually coordinate your movements. That’s really important that we can help you with.

Dave Anselmo: [00:17:54] Exactly. And the people come in, they’re scared. They think now the happy patient was a failure. I’m doing worse. I feel like I’m where I was before I had a replacement. But the fact is, no, they’re really not on the fact that they just don’t have the stability they don’t have. And they put themselves into learning new ways of walking and put more stress on other joints, which we need to change. We need to start back again and go over and teach them how to walk again and buy. But first we got to stabilize that joint. That joint will not function unless it’s stable. So I have the pain in the joint because now it’s been replaced. But we don’t have problems with your kinetic chain going forward like we just talked about. So I think that’s a great, important point.

Maria Petrongolo: [00:18:38] And also something that you kind of touched on a little bit is even before the surgery. So even a lot of times, the best thing is for us to do therapy even prior to a replacement. So the better strength and mobility that you have before any kind of surgery or replacement, the better you’re going to be afterwards. If you don’t have that in the beginning, it’s going to be a lot more work for us to get it back to where you want it to be. If it’s if you’re putting it off any more like I know it’s going to.

Dave Anselmo: [00:19:07] Exactly the longer. Exactly. You know as well, I say. And people, welcome to our world. Yeah. OK. Hey, we have a caller, so. Well, listen, welcome to Cross Keys Physical Therapy. If you have a question. Hello, your name, please. Oh, we might have lost that caller store. Hello. Welcome to Cross Keys Physical Therapy. No, we lost them. No problem. OK, so let’s take a quick break and maybe we can get that. Call her back and see what happened.

COMMERCIAL: [00:19:35] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure a prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every means. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They dress back neck athletic, orthopedic and joint replacement rehabilitation therapy and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck, nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away. Participates in a broad spectrum of insurance plans. Date 856-374-3707 in Washington Township and 856-678-8000 in Pennsville.

Dave Anselmo: [00:20:44] And we’re back. Welcome to the Cross Keys Physical Therapy show. My name is David Anselmo. I’m a physical therapist and Hope is the co-host of your show. And I’m here today with Maria Petrongolo, who is our co-host today. She’s a physical therapist or a pencil location. And we’re our callers back. So welcome to the Cross Keys Physical Therapy show. Well, your name, please. Was that something going on with our phone lines yourself? OK, no problem. All right. Well, Maria, let’s continue on the show. Must go on, right? That’s what they say. OK, let’s talk a little bit about physical therapy. We treat many musculoskeletal injuries, but we treat other conditions as well. Would you please talk about some of these other conditions that we talk about that we see that a lot of people don’t even know about?

Maria Petrongolo: [00:21:30] Sure. So number one is something that is very prominent in our population during these times is any kind of heart disease and diabetes that correlate very closely together. So a lot of times people have these conditions themselves, don’t have a specific pain that they’ve had an injury from, but still have, you know, these conditions that do affect their day to day life that they may not think they can come to therapy for. But this really is something that can affect the musculoskeletal system in general. Maybe they just aren’t aware of it, that we can treat that as well.

Dave Anselmo: [00:22:09] That’s the great point. Great point. I think that exercise is a huge part. And what we do, Americans are getting these people back. And I must say that it’s not only exercising in physical therapy. What we try to do is educate your nominee as to getting you better. But what you need to do after you, the physical therapy is just as important. So our exercise program or home exercise program, I should say, is very, very important. And it’s not only during this period of time, but it’s also something that we really, really stress on these patients to do after they leave physical therapy to continue on, to keep them there. Whether we’re joining, they are strong, keep your stability, keep the range of motion back again. And so they can keep themselves going again after you’ve done your physical therapy doesn’t mean you need to stop doing your activities. You’re strengthening exercises. You get involved in either a gym or. Well, we have a transitional program in our facility where our patients are able to join and to come in here and exercise whether or not that gym environment, which they don’t like, but they’re under our supervision as well.

Dave Anselmo: [00:23:09] So we’re here for questions that we can help them with and we can see to make sure they’re doing the exercises properly going forward. So I think that’s really, really important. So that’s part of what we’re trying to say. So. Let’s go. I’m going to go a little bit about and let’s talk about I want to talk a little about arthritis, because it’s so important to me. We have so many people out there that have arthritis. I would like to talk about two risk factors that I believe are major players for developing arthritis. Maybe we can jump in anytime you want. Worrying about something is the first one that I like to talk about as obesity. I think obesity is that excessive body weight that puts unnecessary pressure on and supporting joints. And I mostly see it and really we talk about weight bearing and hips and knees. But the question is always asked to me, does obesity actually cause arthritis or does arthritis cause obesity? I really don’t think the answer really matters. I think excessive body weight can cause a huge effect on all of us if we have it. 

Maria Petrongolo: [00:24:09] For sure, you know, it’s the chicken and the egg. Like which one comes first? Does it really matter? Now you have the symptoms. This is what you know, you have the condition. This is happening so well. We treat you know, we can treat any of that pain, obviously, that you’re having. But we also have to tackle the obesity rate, which is kind of cool in the sense that we have aquatic therapy here, which is awesome because you’re in the pool at your waist that’s taking 50 percent of the compressive forces off the body, which is huge. All of the joints in your body. Say, I think it’s up. If you’re going just the neck and just the head is above water, then it’s 90 percent.

Dave Anselmo: [00:24:44] So it’s that sort of level, 70 percent. So, I mean, you just think about all the things that we could do. And the most important thing I Cross Keys Physical Therapy are therapists in the water with you. So, you know, you’re not just being told to go in the water. I know there are a few facilities in the area that are just going to put you in a tank or and then they have to do stuff. But we’re actually in the water with you and we are stretching you. We’re educating you on what we want you to do. And we’re actually making sure that you’re doing the exercises properly when we’re in the water and we’re touching you and stretching. So it’s very, very important,

Maria Petrongolo: [00:25:13] Very unique in that sense that I guess, you know, kind of how you said. But I’ve been to some, you know, places as well that, you know, they’re outside of the pool and telling you kind of like a class in a sense. But it’s really special that, you know, you’re kind of going in there, teaching them, watching everything they’re doing, you know, and getting that touch, which is very important. Absolutely. Honestly, then just just doing the exercise part of it.

Dave Anselmo: [00:25:37] So let’s not make it let me say this. It is clear that the reduction of body weight. Will greatly help people in all walks of life, especially with those that have arthritis. Let’s say that this is why I, I also say you need to be more aware of not only what you eat, but how much you eat. People have a tendency, just know a lot of food and they keep eating. I often will tell people that you are what you eat. So if you eat really good food and you will, you’ll be good. If you eat like shit, you will eventually feel like shit. And eventually you will look like shit as well. So I mean, pardon my expression. That’s just what I tell people all the time, because it really, really is what it’s like out. So let this be a warning to us all. Now, having said that, that’s very. Let me make myself perfectly clear about this as well. I’m not a nutritionist. I’m a physical therapist. You know, a nutritionist. Use the idea of molecular biology and biochemistry and genetics to understand how nutrition works and affects the human body. So if you are looking for exercise, I mean a diet or something, self-worth, you need to see a nutritionist. I mean, so they will help you best on that. So, yeah,

Maria Petrongolo: [00:26:48] It’s really you know, nutrition is a huge part of it because, you know, we can do the exercise portion, which is obviously extremely important. But, you know, the nutrition side of it, we’re not changing any of our lifestyles that way. That’s you know, we’re only doing half the job there.

Dave Anselmo: [00:27:02] Oh, yeah, definitely. And there’s a lot of factors in weather that do as well. I mean, heart problems, so forth. I mean, there’s a lot of factors that contribute to this. So we really need to make sure you’re seeing the professional. I mean, obviously, I know a lot about history. I’ll give recommendations and so on and so forth. But I don’t want to come off as thinking, thinking the time people think that I am a nutritionist, I am not that. So that’s very important.

Maria Petrongolo: [00:27:25] Yes. And what you’re saying, you know, we were kind of touched on a little bit with heart disease and diabetes. You know, it’s so prevalent in our world today that, you know, these are things that maybe patients don’t understand, that this is, you know, they’re able to talk to their doctors about this and really advocate for themselves. Like we were saying before, that, you know, exercise is really the best medicine for this in addition to nutrition. So, you know, studies have shown you obviously the benefits of physical activity are going to improve, improve your glucose control, which is important with diabetes. It’s going to help with the insulin in your body, the sensitivity of it, just so that you can try and, you know, limit any of that progression of your diabetes, et cetera. So it’s really huge in the sense that people may not realize what exercise can do for you.

Dave Anselmo: [00:28:19] Great. Great point. Thank you very much for mentioning that. This goes back to what we say. Motion is lotion in many ways now in your joints, but also in your heart. And helping you with your diabetes is a huge part in affecting our lives going forward. Yeah. So we have a caller. Hopefully we can get this one in here this time. So call her, please. Thank you. Thank you for calling in your name, please.

George: [00:28:42] My name is George from Williamstown.

Dave Anselmo: [00:28:44] Hey, George, thank you for calling in your question, please.

George: [00:28:47] Yes, I listened to your show last week and a very good show. I had a question about contemplating knee surgery and I was wondering whether there is anything therapy wise that I can do prior to that or whether I would just have to wait until the surgery is completed.

Dave Anselmo: [00:29:05] Good question. Thank you for calling in. George, first of all. Yeah, there are a lot of things, you know, I’ve been doing for 32 years. And I must say over the first 15 years of it, that was a very important thing that surgeons do. Doctors who do, they used to always send the patients to physical therapy for a two week period of time before having the surgery just to get them stronger, to get joint stability, to get you more aware of what we’re going to do after the surgery. So having this physical therapy wouldn’t be a shock to you. So it’s very important. So there are some exercises you could do. I mean, I don’t know your condition. So I really can’t give you everything. But there is a lot you could do if you like to call my office. Well, we so I can go through that with you and give you maybe some diagrams, give you some handouts, and or maybe have you come by and I can demonstrate some of them for you. That would be more like I would like to do this, like make sure you’re doing it properly. I’m no problem with that. Once again, call us that if you’re. We are. Washington Township officers, 856-374-3707. Or if you’re near the Pennsville office, 856-678-8000. Welcome. Thank you for calling in. And a great question. And obviously, I think that there’s a lot of people out there that have that same question. And now the answer is to.

George: [00:30:17] Thank you very much. I appreciate it. Thank you. Thank you, sir.

Dave Anselmo: [00:30:25] All right. Well, next, Maria, we’re moving on. I think that we have a lot of obviously people out there that are having problems right now that really are maybe scared to call in. And I know they’re sitting in their home or driving home from the shore and have questions, and they’re afraid to ask the question, please don’t be afraid to call. Give us a call. We could 856-628-0400Let’s take a break and we’ll be right back.

COMMERCIAL: [00:30:51] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure a prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every means. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They dress back neck athletic, orthopedic and joint replacement rehabilitation therapy and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck, nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away. Participates in a broad spectrum of insurance plans. Date 856-374-3707 in Washington Township and 856-678-8000 in Pennsville.

Dave Anselmo: [00:32:03] Welcome back to the Cross Keys Physical Therapy show. My name is Dave Anselmo. I’m a physical therapist and host of today’s show. Today, I have the honor of having Maria Petrongolo along with me. She’s a physical therapist somewhere, in the Pennsville office. So if you have any call, any questions or calls, please give us a call in and ask any questions you might have about your pain or even what you have thinking about what physical therapy can help you. Please give us a call in or once again. If you have a story to tell. If you had physical therapy before, it doesn’t have to be from Cross Keys Physical Therapy could be another facility. Please call in, tell you a story, tell what physical therapy is done for you. I think there’s a lot of people out there that could probably help with this into what you’re saying. And maybe they’re sitting there saying, I have the same problem and then no physical therapy can help them. So maybe along the way we get another caller. So let’s take this caller. Welcome to the Cross Keys Physical Therapy. Your name, please.

Dominic: [00:32:56] Oh, hi. My name is Dominic. Dave Murray. I just want to say, I think the show is great. But I had a question. Of course I had a question in regards to arthritis. So I am a golfer and arthritis kind of runs in our family. If I play a couple of rounds in subsequent days, I start to get very sore around my hips. Not sure if there’s any specific exercises or what would you guys recommend in that case?

Dave Anselmo: [00:33:27] Well, obviously, it’s normal to feel the soreness, especially for some of these people that have done something that I haven’t been doing as often as you can. I mean, just getting back out there. I always recommend to people, no matter what you do, whether you’re golfing, whether you’re playing basketball, we have to always stretch before you do the activity. It really helps to increase the blood flow into the area, helps to get the joints more loose. Your joints, nerves, you get everything moving together here. But if you don’t stretch and you don’t get loosened up now, it has a tendency to be a little more of a trauma to your joints, a lot more time to your hips, especially as you rotate through the ball and golf. It’s really important to do that. And after 18 holes, it’s going to get there. So I highly recommend that you stretch before you play golf. And I got to say, stretch after you get down to.

Maria Petrongolo: [00:34:14] Yeah, definitely. Because, you know, you have that mobility in the hips is very important. You’re rotating his hips at a pretty high velocity swing through that ball at a good pace. So it’s very important for your body to before going right into swinging, that you have that mobility and you’re kind of warm in your joints up in general. So you’re it’s not kind of a shock to your system that you’re all of a sudden going at those high velocity rotational forces on the hips.

Dave Anselmo: [00:34:39] Right, right. Right. So I can’t necessarily tell you that you have arthritis in your hips there. No, I don’t. I realize that you do. But you probably have a little bit of stiffness coming through, a little bit of soreness from an activity. And now you’re getting back out there. And I really would recommend once again, any time you go out there and make sure you stretch, if you don’t really know what stretches to do prior, I mean, you really can look them up on the net. Obviously, you know, they’ll probably have tons of people telling you what you should do before and after. And if you’re not really sure about that, if you can’t find them. Call our office once again and we’ll give you that information. That’s what we’re here for. And that’s it for the call.

Maria Petrongolo: [00:35:13] Yeah. Yeah. Thanks,

Dominic: [00:35:15] Course. Actually, I had a second part first. And if you don’t mind, no room for after after activities such as a couple of golf rounds. Would you say I would be better or heat afterwards?

Dave Anselmo: [00:35:29] Ok, you when it’s that question.

Maria Petrongolo: [00:35:31] Usually with the whole ice and heat. I will go with ice. If let’s say you’re, you know, feeling if you’re feeling really sore and you feel like you need some ice, that’s usually going to help with some of the pain. And if you have to continue on with some of your activities later on in the day, otherwise I will go more so with the heat. If you’re not having excessive soreness and you know, just because that’ll kind of help with any, you know, increase, improve the blood flow throughout the area rather than sometimes the ice can constrict the blood vessels and kind of delay the healing a little bit. So it kind of depends on the timing. That’s usually what I’ll tell people.

Dave Anselmo: [00:36:07] I go either way, George. But let’s face it, George, you know, after 18 rounds, you’re a little tired. And usually the game plan is to hit the bar afterwards, right? You’re hitting the club afterwards. And while you’re having that drink this afternoon, give me a little bag of ice over here. And so I put on what I got, though. It can’t hurt or help to calm everything down. That’s what I recommend. And I’m sticking to the story.

Dominic: [00:36:33] Sounds like that sounds like great advice and definitely appreciate the recommendations, guys. I’m going to go ahead and do that after my next eighteen hole round. And yeah, I appreciate the feedback.

Dave Anselmo: [00:36:45] Listen, George, thank you for calling in at the show’s all about. And I really appreciate you calling in today and asking your question, because once again, I think there’s people out there that have the same question that are sitting there and don’t know what to do. And now you have to solve that problem?

Maria Petrongolo: [00:37:00] Golf is very prevalent. Oh, very much so. Yeah, especially something that we can continue playing as we age. You know, I see so many patients who are like, I want to get back to golf. That’s like really is a good

Dave Anselmo: [00:37:13] Deal more with people as they retire them and their retirement, as they get their activities now and go out to hit the golf course. And because now they have time to do so. So that was a great call. And I think it’s really important that that was the question. I’m sure tons of people have that question. And now you really helped George to answer that question for a lot of people. So thank you very much for the call. And hopefully you’ll know what to do next time you go.

Maria Petrongolo: [00:37:36] All right. Thanks, Tom. Thanks.

Dominic: [00:37:38] All right. Sounds good. Thank you. You guys have a good one. You, too.

Dave Anselmo: [00:37:40] Thanks. OK, so let’s go forward, Maria. We’re having a good show here. I think that I want to go through the next part. I talked a little bit about the factors of arthritis. Next fact, I want to talk a little bit about being overweight, right. Obesity. Now I want to talk about age. I think age is another factor that people don’t really realize. The research tells us that as the body becomes older, it becomes more susceptible to arthritis. This is a fact. But we should also be asking the question, why is that OK? I believe it is because as we age, most people become less active or should I say, become more lazy. OK. They’re not as active as they’re not running around like they used to be. They’re not working anymore. They’re not running around doing their job, maybe. So what do they do? This is my time to relax. I’ve done my thing. So they go to La-Z-Boy. Right. That’s what they say. By the way, do they have a lazy girl now? I don’t know. I never I don’t know why they call it lazy boy, but I’m confused about that. Maybe maybe a call I can give you can fix that for me on time. And therefore, what happens to our muscular system, it becomes weaker and weaker and weaker, which leads to atrophy. You know, what is atrophy accused of breaking down our muscles and the soft tissues that surround those joints. This will lead to joint compression because the muscles are not no longer strong enough to maintain the space between our two bones and make up the joint. And hence there’s rubbing of these bones together, creating an inflammation in the joint, which we call arthritis. So there it is. That’s really important. I think it’s a real part of the age. Is that a contemplative part about all. And hey, Marie, we got another caller. So welcome to Cross Keys Physical Therapy. Show your name, please.

Anthony: [00:39:35] Anthony. Hey, Anthony,

Dave Anselmo: [00:39:36] Thank you for calling in your question.

Anthony: [00:39:39] Yes, I have a question. I hurt my back. And when I hurt my back, I went to a back specialist and he looked at me and examined it and he told me that, Anthony, you’re back to spare tissues and surgery for you is really, really going to be bad. Try and do something else besides get the surgery done. Now, there’s only a few days until

Dave Anselmo: [00:40:07] It turned into radio. Anthony, I think you’re hearing the reflex, but I thank you for the call. I think I know you get in and we see this quite often when patients come in and they say, hey, listen, the doctor says, my back is too bad to have surgery. My options are limited and sending you to physical therapy is one of my options. What can you do for me? So there’s a lot we could do. Obviously, Anthony, obviously the back is so compressed that now the doctors are afraid to go in there because they’re afraid that they might create some more damage than already created in reference to maybe paralyzed you because your your surgery so in depth into the into the spinal canal that they really don’t want to go in there and touch it. Right. So what we do and what the demands of what we have is Cross Keys Physical Therapy. We have aquatic therapy and aquatic therapies, memory as nicely, talk about it, decompresses the spine. And I think that would be the first place I’d put somewhere like yourself. I’ll bring you in here. I would evaluate your limitations. And my first option would probably be for you to put you in the water, because the water is going to have to decompress you as fast as anything else can. And I think that would be a huge help for you. And then from there, we get you moving and we work on your strengths and work on your stability, work on your flexibility and work on getting you moving again and our efforts to return you back to your activities. Daily living, that’s always been my goal as a physical therapist is to return the patient back to whatever daily activities they are living are as quickly and as safely as possible. And Cross Keys Physical Therapy, we have an advantage in reference to having the required therapy at our at our know to play here. So we’ll help you out. So I’m ready to have anything to say about that.

Maria Petrongolo: [00:41:46] Yeah. Like, you know, we get a lot of patients who have been in the very predicament that you are as well. And, you know, it kind of seems like there’s not much for you to do. You know, exercises maybe that you’ve tried or on land itself is just. You are in pain and you don’t know what to do, exactly which ones will work for you, which ones you need. So it’s nice when we have the pool so that we can really focus on that, strengthening in a relatively pain free, you know, environment with the pool. Just take some of those suppression off the body.

Dave Anselmo: [00:42:15] So it’s exactly right, because sometimes maybe we have patients that come in and say, oh, well, I’ve been to other therapy places and it doesn’t really seem to be helping. One thing they tend to forget basically is that gravity is against us. It’s a downward force. And when you’re standing up and you’re trying to do lame physical therapy, unfortunately, it becomes more painful because you have gravity coming down and you’re trying to do some strengthening exercises in the upright position standing. And there’s just too much stress, the part you can’t handle. So it increases your pain. So the increases are inflammation and therefore, this is not working. And they give up? No, that’s where I think aquatic therapy really is a huge, huge factor in reference to getting you where you need to be a lot faster and a lot safer, definitely.

Maria Petrongolo: [00:42:57] Because even if we you know, we start you out with the pool, we can all obviously our goal is to progress into the land, because that’s where you’re going to be nine times and, you know, throughout your entire day. So it’s just a nice, you know, tool that we have to start just so that we can improve your tolerance to some of those more evocative movements throughout the day. Right.

Dave Anselmo: [00:43:16] Right. Because we’re getting separated in us by an hour. We’re getting you stronger. It stabilizes the joint because let’s face it, the joint is no different than having a joint. The spine is a joint as well. So we want to actually get that separation between your bodies and decrease the pressure on that nerve root and get you started. So obviously, we’ll start there. And as we get you stronger, you’d better be able to handle gravity and will transition you to land. So, Anthony, I really appreciate your phone call today. Thank you very much for the phone call. And once again, I think that that’s going to help a lot of people. And so let’s take a break and we’ll get right back to you. Thank you very much.

COMMERCIAL: [00:43:55] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure a prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every means. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They dress back neck athletic, orthopedic and joint replacement rehabilitation therapy and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck, nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away. Participates in a broad spectrum of insurance plans. Date 856-374-3707 in Washington Township and 856-678-8000 in Pennsville.

Dave Anselmo: [00:45:09] And welcome back to the Cross Keys Physical Therapy show. My name states I’m a physical therapist and owner of Cross Keys Physical Therapy. We’re here today with Miriam Pertongolo, who is a physical therapist, at the Pennsville location. To answer your questions or hear your story. So thank you. Please give us a call. Our number is 856-66-0400. So thank you for calling Cross Keys Physical Therapy. Please give us your name, please.

Elaine: [00:45:39] My name is Elaine. I’m from Pennsville. I wanted to say hello to Maria and Dave.

Maria Petrongolo: [00:45:45] Hi, Elaine. How are you doing?

Elaine: [00:45:48] I’m well, thank you. I just wanted to sing your praises, Maria, for your help. You have really helped me out a lot with my back. And I was listening to your show, and I can tell you that you checked all the boxes. I have arthritis under the weight and I have a back issue. So it’s been like all three, huh? But I do want to thank you for all your help, and I highly recommend your aquatics.

Maria Petrongolo: [00:46:15] Oh, I appreciate it. We appreciate you calling in. It’s great to hear from your family that you’re doing well. You know, really, what we do for you, obviously, is give you some of the tools and education. Yeah, but you’re doing all the hard work and you’re doing the exercises and, you know, keeping up with it. So it’s a testament to you and how hard you’ve worked.

Dave Anselmo: [00:46:33] Well, thank you, Elaine.

Elaine: [00:46:34] It made a big difference. Yes.

Dave Anselmo: [00:46:36] Yeah, there’s a big difference. And I appreciate you calling in. This is something that Maria, I really like to point to as I hear this all the time from your patients, and they appreciate your passion for getting them better. And I want to thank you for that. This is just so you are, Maria.

Maria Petrongolo: [00:46:55] I appreciate you very much as well.

Dave Anselmo: [00:46:57] Elaine, thank you for the phone call. I think we finally got our phone line straightened out here. So I think we’re getting some phone calls in here and we’re having a little problem earlier. I think we got it straightened out. So thank you for hanging in there and staying in on the phone lines and getting in on a phone call and telling your story about Maria. I really appreciate

Maria Petrongolo: [00:47:13] It. Thank you. It’s great to hear from you. Good luck.

Elaine: [00:47:15] And thank you so much. Thank you. 

Dave Anselmo: [00:47:22] Well, I think that once again is a great, great caller. I’m sure that there are a lot. I hear about it all the time, Maria. I mean, it’s no secret that you’re passionate about what you do and helping get the patient better. And I think Cross Keys Physical Therapy and Pennsville is very lucky to have you.

Maria Petrongolo: [00:47:42] I appreciate it. And it’s you know, it’s kind of mirroring what you guys have done. So you guys have been very welcoming to me. And I can see how passionate you all are, all of our co-workers from Pennsville. And also I’ve been to the Washington Township office and worked with our physical therapist there, and everyone’s very passionate about what they do. And really, goal number one is getting the patient back to what they love to do. And so you can definitely tell when you are just either working or coming in as a patient. That’s number one there.

Dave Anselmo: [00:48:09] I think it’s a very I think it’s something that patients have other options. I think it’s really important that there are many physical therapists out there. And I think that you have a choice. You have a choice to go where you like to go. And that’s why we’re here today. You know, first of all, what physical therapists do, how we help people, and they’ll let you know you have a choice on what physical therapy facility you like to go and refer to, because we know nowadays there are a lot of doctors, surgeons that have their own facilities. And unfortunately, they’re going to refer you to their facility for obvious reasons. Well, most of these can be financial reasons. And I think that people need to know that they do have other options. And those options are you have a choice to go where you want to go. If you feel more comfortable or you have an experience, another facility, it doesn’t have to be Cross Keys Physical Therapy. I would like it to be, but it doesn’t have to be, obviously. But you have a choice. All you have to say is, hey, listen, I have another facility where I have experience and all the therapists I feel comfortable with and I would like to see him or her. And they should have no problem send you there or that just the fact that you have a facility that is closer to you is pure fact, that if you have facilities closer to your home, that you’re more prominent there to be able to make those appointments or to get in and you won’t feel or have a problem getting in. So just tell the surgeon or your doctor that, hey, listen, I have a choice and I would like to take that option. So this is something that people don’t realize. They feel like they’re getting kind of bullied. If the doctor says, I don’t need to go here and they just don’t think they have an option. But that’s not that’s not the truth.

Maria Petrongolo: [00:49:37] Yeah, you have your own voice. And, you know, even going to a doctor myself, not that I need any significant medical treatment or anything, but even just, you know, sometimes they’ll say, all right, just go here. And sometimes a lot of people even just hear from patients. They’ll go to that. This is what they tell us, the doctors told us. And it’s more of like a you know, it doesn’t seem as an option. It seems like this is what you have to do. And no matter what, you always have the option, even if it doesn’t seem like it from the doctor. Anyone that is always there, the option you have the power to, you know, back is best for you.

Dave Anselmo: [00:50:15] Back in the day, you really never really questioned the doctor and the doctor said is what it is. Therefore, you know, some people have the same sentiment when they go to a doctor. Doctor says that they don’t realize that, hey, you can talk to your doctor and say, hey, doc, I really don’t agree with that or I really think about it and he’s playing this. Why do I have to just buy stuff that people are a little more, you know, adamant and say, hey, look, this is what I want, and then explaining why you want me to go here, go there. You know, can I go where I want to go? 

Maria Petrongolo: [00:50:41] The explanation is big, because the thing that kind of separates us is that as physical therapists, we’re with the patients, you know, sometimes hours for the week. And we’re we’re really just talking to them more than, you know, a minute or two or so or we’re not you know, we try not to, you know, make anyone feel rushed. We’re spending a lot of time. So it’s very different from doctors. You know, you’ll see them maybe for a couple of minutes every few months, every year sometimes. So, you know, we really then can kind of capture everything that’s going on with you and really figure out what is important to you. So I feel like it’s very special in that sense.

Dave Anselmo: [00:51:18] Yeah, very, very important, because I think we’re all hands on. I mean, we’re all our options. And what we do through our evaluation is we will establish a treatment plan based on what your plans are, what your needs are individually plans, the goals that are developed or what your limitations are and not what the doctor wants you to do in reference to obviously it should be around the same thing. But, you know, obviously what you want. I mean, what is your main complaint? I mean, what are your limitations and what are your goals? And we establish our plan of care based on what the patient wants. And I think that’s really, really important. And I think that’s the sediment that I hear a lot from my patients, that they’re very happy because we do that because their interest is first for us.

Maria Petrongolo: [00:52:03] Yeah, communication is key, you know, and we can kind of like Dave said, how a very encompassing plan of care for you based on if you have other comorbidities, what you want to get. That is specifically if any kind of environmental factors may be at home that change things like there’s so many different factors that go into it rather than just what’s on the paper. So we can kind of geared towards what’s best for you and really individualize your programs.

Dave Anselmo: [00:52:28] It’s very, very important. So thank you very much for your call. So we had a lot of good qualities between George, Dominic and Elaine. But today, I’m going to talk a little more about issues with weather or osteoarthritis. Obviously, this is mainly from previous injury or trauma. This leads to the most common arthritis that we see. I think it is known as osteoarthritis. Osteoarthritis is exactly what it says osteo is, which is the bone and arthritis is what is when the bone breaks down off the joint and the right is the inflammation. So osteoarthritis is just inflammation within the joint caused by the bone fragments coming through right now, also is very common and post serious accident’s trauma to the joint and post surgery. So it’s really important that people realize the signs of osteoarthritis. And let’s go through some of those pain develops slowly and worsens over time. Pain that affects the joints may hurt during or after movement, stiffness. You might notice stiffness in the joints upon waking up in the morning or after being in active tenderness. You’ll get tenderness. You might feel tenderness when you apply light pressure over the joint. You might have lost your flexibility. You might also be able to, you won’t be able to move your joiner’s through a full range of motion when you have osteoarthritis as well.

Dave Anselmo: [00:53:46] That could be one of some severe and grating sensations, sensations. You might hear a popping or cracking sensation when you move the joint with osteoarthritis. These are just some of the things bone spurs you might feel with extra small pieces of bone like hard lumps which can form around the joint. People worry about that when they feel that, well, that’s obviously normal with someone who has osteoarthritis. You see that. And as well, the last thing is swelling. You might experience some swelling around the joint, causing the soft tissue to become inflamed. So these are just some of the signs and symptoms that you might have, osteoarthritis. So if you’re having some of these symptoms, it’s really a good, good possibility of osteoarthritis. And you should go to your family doctor. So, Doctor, hey, listen, I’m having some symptoms that I heard Dave talk about on the radio show, and he recommended that I maybe come in and get physical therapy. So please, hopefully you have any questions. Once again, call in the area code 856-626-0400. And let’s take one more quick break before we run the show. And we’ll get right back to you.

COMMERCIAL: [00:54:49] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure a prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every means. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They dress back neck athletic, orthopedic and joint replacement rehabilitation therapy and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck, nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away. Participates in a broad spectrum of insurance plans. Date 856-374-3707 in Washington Township and 856-678-8000 in Pennsville.

Dave Anselmo: [00:56:00] Welcome back to The Cross Keys Physical Therapy Show. I’m Dave Anselmo, I’m a physical therapist and owner of Cross Keys Physical Therapy. And today we have Maria Petrongolo. She’s a physical therapist and from our Pennsville location. We’re here to take your calls or hear your story. We have a caller on the line. Thank you for calling. May I ask you a question? Hello. Please. Hi.

Donna: [00:56:24] Yes. My name is Donna. Hi, Donna. How are you? Good. I wanted to find out. I had a total hip replacement about two years ago and everything was beautiful. But it seems like when the weather changes, sometimes it gets rainy or anything like that. Sometimes I’ll get a pain like I guess right where the replacement was put in. And it seems like it goes down when I do things I want to call down to my knee, to my ankle. Is there anything that they could recommend to, I guess, try to other than, I guess taking medication, I guess, like I’m on leave or anything like that or there anything that I can do to help with this pain? Because sometimes it feels like a burning throbbing.

Maria Petrongolo: [00:57:17] And so my first question for you also be done on first off, appreciate you calling in. And did you have any physical therapy prior to this?

Donna: [00:57:29] I did work out myself, so I didn’t have anything to do before then. OK, no problem. And then afterwards, I did ask the doctor, do I need anything after? And he said, no, no, no, no.

Dave Anselmo: [00:57:42] And I think that’s what we’re here unfortunately.

Maria Petrongolo: [00:57:45] And that might be something

Donna: [00:57:46] When we get back.

Dave Anselmo: [00:57:48] Yeah, well, unfortunately, you obviously weren’t in the skilled program, so really no exercise you’re doing. It really should have been sent to physical therapy. Unfortunately, you get the thing we got in the show. I really appreciate the phone call. So I had to cut you short. But once again, I want to thank our callers for calling in today. George. Dominic, Elaine, thank you for calling in, Anthony. Thank you for calling in. And it’s a Cross Keys Physical Therapy show. I want to thank Tommy T. for helping provide the show today without telling me the show wouldn’t have been happening. So thank you very much, Tommy T for engineering and for our next show. Thank you very much. I’m Dave and I’m OK. God bless. So our next show. Thank you.