Today Dave Answers The Nagging Question “What’s the difference between Osteoarthritis and Rheumatoid Arthritis?”

Courtney: [00:02:01] All right. Thank you, Dave. It’s an honor to be here. I’m just very honored that you let me take this platform to speak about Cross Keys Physical Therapy. I am a graduate of Stockton’s doctor of physical therapy program. I graduated in 2018. Prior to that, I got a bachelor’s in biology and prior to that I have an associate’s degree in biomedical science. I have been working at Cross Keys Physical Therapy for a little over three years now and it has been such a joy. I love all our patients. I love working with you and it’s a great time.

Dave Anselmo: [00:02:35] I appreciate that. Obviously, everyone can hear that you’re passionate about what you do and that’s what makes you as great as you are. Helping our patients talk about nothing but the best about you. Thank you. It’s very obvious the show is brought to you by Cross Keys Physical Therapy. We have two locations to serve you. One in Pennsville, New Jersey at 181 North Broadway, the second in Washington Township at 151 Fries Mill Road at University Executive campus. If you also just check us out on our website, CrossKeysPhysicalTherapy.com, or you can call us at the Washington Township office, which is (856) 374-3707 or in the Pennsville office, which is (856) 678-8000. Well, I just want to put it out there for people to call in. The number to call in is area code (856) 696-0092. I hope people call in and ask the questions because I think it’s really important that there’s a lot of people I know out there right now that are in a lot of pain and just don’t know what to do. I know directions have been told by their doctor or their friends that you have arthritis and don’t know what to do. It can’t do anything about it to live with it. I really, truly believe that that’s further from the truth. And I think the platform for this is to tell people what physical therapists can do to help them out, not only arthritis, but multiple types of injuries they have. So let’s get started with that. Once again, people call area code (856) 696-0092. So let’s get started. Let’s get right into some of the questions, if you don’t mind, Courtney, let’s talk a little bit about arthritis. The two most common things we talk about are rheumatoid arthritis and osteoarthritis. Can you explain a little bit what the difference between the two are?

Courtney: [00:04:20] Yes. So their differences begin with what actually causes them. So osteoarthritis is more commonly occurring later in life after years of mechanical wear and tear on the cartilage, which lines and crushing your joints, rheumatoid arthritis, which occurs at any age. Typically, we do see it in the younger and younger patient population. It is an actual autoimmune disease, which is your body’s immune system attacking your joints. Osteoarthritis tends to develop gradually over several years as your joint cartilage wears away and then eventually the bones of your joint will rub against each other and contrast the pain and stiffness of rheumatoid arthritis developed and worsens over several weeks or a few months. And in some cases, joint pain isn’t the first sign of that rheumatoid arthritis. It may be flu-like symptoms such as fatigue, fever, weakness and minor joint aches.

Dave Anselmo: [00:05:19] Thank you very much. Very good. A little bit about rheumatoid arthritis. It can affect all people, all different ages. So it’s not confined to one sex. However, RA does tend to be more prevalent in females. Oh, we have a caller. So thank you for calling my ask. Who’s calling in your question, please.

John: [00:05:40] Yeah, my name is John and I heard you talk about arthritis and I have had arthritis for about 10 years now. And I’m just wondering if you have aquatic therapy, because I go to a doctor and I keep getting needles in my fingers and my wrist and I still have it. I still can’t move properly. And I just heard you and Courtney talking about arthritis. And I was just wondering about aquatic therapy. Would that help me?

Dave Anselmo: [00:06:17] Well, thank you, John, for calling in. First of all, that’s a great question, because that’s exactly what we do have an aquatic therapy center at our facility, which is a we have a 80 by 40 foot pool, which is a 94 degrees, which is therapeutic temperature, in which we do put our patients in the water with the physical therapists. We go in the water with the patients, which is very helpful. Now, arthritis. Courtney I think aquatic therapy is so effective with arthritis.

Courtney: [00:06:45] Absolutely. The water allows it to have a low impact on the joints and also helps with that inflammation and swelling with the buoyancy of the water. It will help push that fluid back to the heart and help with circulation. Our pool is actually a saltwater pool. It’s heated to ninety four degrees. It’s a therapeutic temperature that increases blood flow and circulation, which is great for soft tissue extensibility. And like you said, we’re we’re skilled physical therapists in the water with you and we are able to stretch you so that warm water is loosening up your joints, loosening up your your soft tissue and allows for greater flexibility and movement, allows for patients to strengthen throughout their full range of movement. So when you’re in a lot of pain, a lot of people cannot even lift their joints against gravity. And, you know, that’s so true.

Dave Anselmo: [00:07:34] So true. So, John, there’s your answer. We absolutely do aquatic therapy and we have it at both our locations and our Washington Township office at 151 Fries Mill Road, where in the university executive campus suite 1, building 600, I think will be very helpful for you. So just give us a call, whatever office you’re close to, a Washington Township office is the area code (856) 374-3707. Or if you’re closer to the Pennsville office (856) 678-8000. So please give us a call schedule or just go to our website with CrossKeysPhysicalTherapy.com and check us out or numbers everything on our location, even directions are on the website. So check us out. And thanks for the phone call, John.

Courtney: [00:08:21] Yeah, thank you, John.

John: [00:08:22] Yeah, because I can’t even open a bottle or anything. I try to open a bottle and my wrist hurts, my fingers hurt and I just can’t do things the way I used to do it.

Dave Anselmo: [00:08:33] Well, the good thing about Cross Keys, John, I got to tell you, is our physical therapist. We get in the pool with the patients. So we do a lot of manual techniques just like we do on land. We do it in the water. So it’s very effective. We’ll do our stretching well into whatever we like. As according to you, nice to explain. With the salt water pool, there’s buoyancy and it’s going to help you because it’s ninety four degrees. So you’re increasing the blood flow. We’ll do our stretching right in the water with you. And it’s very effective with all types of arthritis. Well, what type of joints. Your hips, your knees, your hands, your shoulders. It’s a fact that we know when you’re in the water. Waist level would decrease in the compressive forces by 50 percent. We go up to the shoulder to shoulder level and decrease by 70 percent. Then we get to the neck. We’re decreasing the compressive forces by 90 percent. So you’re basically weightless and you could just imagine the effectiveness we could do in that water. So thanks for the phone call. And I think it’s really important that a lot of people are listening and can hear that because they really don’t know much about aqua therapy. Courtney. So I think that was a great call.

Courtney: [00:09:30] Yeah. Thank you, John. That was a great question.

John: [00:09:32] Thank you. And you’ll be getting a call soon. Thank you very much.

Dave Anselmo: [00:09:36] Thank you, John. Bye bye.

John: [00:09:38] Bye bye.

Dave Anselmo: [00:09:39] Courtney, let’s talk a little about different things. As you know, there’s a lot of people who ask me questions like what can possibly be some of the causes for arthritis and some of the things that I talk a lot about, about obesity. And if you think about obesity, it necessarily does obesity affect arthritis or is it why is this causing obesity? Because they can’t move. That’s a controversial question, but near the fact that it definitely has an effect on arthritis.

Courtney: [00:10:05] Yeah, I would absolutely say so. We are weight bearing creatures. So the more weight we have on our joints, the greater load that they are going to take. So obviously, honestly, we have been getting scripts. I got a recent referral for a patient that had a diagnosis of obesity and she came in to see me and her goal, you know, we always ask our patient, what are your goals? Because it’s important that we’re working towards the same goals with our patients. I mean, it could be something as simple as walking their daughter down a wedding aisle or going on a walk with their dog. So I always ask what their goals are. And her goal was to lose 50 pounds. And obesity is a real, real issue for poor joint damage.

Dave Anselmo: [00:10:50] And that’s a key point. You just said, of course, you’re going to get a full evaluation from a skilled physical therapist doing that evaluation. That’s so important. We ask you what your goals are and we customize our physical therapy program based on what your needs are. And I would not know whether they think your needs are right, exactly what the doctor thinks. We really look at what you need and we base it on what you want from us. So I think it’s really important. So next thing, let’s talk a little bit. I think also a big part with arthritis is age. I think with people as they get older, the less active this leads to atrophy of a muscular system, and it can lead to the muscles lacking the support for the joints, which I think was a huge part because it helps to to break down the muscles and it helps to the muscles don’t get supported. They don’t get strong. They don’t have the separations in joints because atrophy occurs. And now that was bone against bone. And we know bone against bone. You have inflammation, which is arthritis.

Courtney: [00:11:53] Yes. Also not muscle weakness around the fact that when you no longer have that support of the joint from the muscles above and below that specific joint, and sometimes we say specifically with the knees, we actually see deform joints. So we’ll actually see something called genu varum from Genu recurvatum and that is either knock me or it will be bow-leggedness. And this is the common term. And a lot of times that structure then affects the whole kinetic chain, affects their hip and affects your ankle. So we’re not just treating one joint. When a patient comes in with arthritis, we’re treating the whole body and all the muscle imbalances that they come with that specific joint.

Dave Anselmo: [00:12:30] Great, great point, Courtney. And obviously, like I mentioned earlier, you’re a skilled physical therapist and you can see that you’re looking at these things through the evaluation. You’re looking at the patient as a whole. You’re not just looking at the diagnosis. They came in with such and such. And just look at that. We understand the fact that it’s the whole kinetic chain. I mean, you realize that when someone comes in, I mean, when the foot hits the ground, everything changes. So if they’re having problems with the feet, we’re going to see that and realize how that affects the joints going outward. It’s not addressed and it can cause other problems. You can continue to treat the symptoms on and on and on and on. But the problem will never go away unless you treat the patient for what we see. Absolutely. Yeah. So that’s a great point. Let’s take a break right now. The callers, you want to give a call in the number here is (856) 696-0092 to call in. As you question or tell your story, if you have a story about what physical therapy has done for you in the past, but it doesn’t have to be at Cross Keys Physical Therapy, could have been another facility. Please call and tell your story, because there’s going to be a lot of people out there right now that are afraid to call in or just listen. And I think it could really be helpful for those patients that they understand what physical therapy can do for them. So let’s let’s take the commercial

COMMERCIAL: [00:13:47] Cross Keys Physical Therapy and Sports Medicine Center and celebrating 30 years of excellence. Our programs are designed to ensure 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 need Cross Keys Physical Therapy. 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 crutches. Physical therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville Help. Only a phone call away participates in a broad spectrum of insurance plans: eight five six three seven four thirty seven 07 in Washington Township and eight five six six seven eight eight thousand in Pennsville.

Dave Anselmo: [00:14:51] Welcome back to the Cross Keys Physical Therapy. We’re here today with Courtney Kane, physical therapist of the Washington Township Office. And I’m Dave Anselmo, physical therapist. I currently go to both offices at the Washington Township office and Pennsville office. So you can see me, either one of those offices. You just gotta call the offices and make your schedule, your appointment at the Washington Township office the number is (856) 374-3707 or at the Pennsville office is (856) 678-8000. We really never got to answer the question because we had callers about the signs and symptoms of RA and osteoarthritis. So you want to do them.

Courtney: [00:15:28] Sure. So we can start with osteoarthritis first. Great. So typical symptoms of osteoarthritis that you may be experiencing or you may know someone that has arthritis in our experience and our patients that we see. So typically they have obvious joint pain. This pain can range from an aching pain to a burning sensation to a sharp pain. Osteoarthritis primarily affects your knees, your hips, the spine, hands, feet, it can arise, and other joints as well. You typically have stiffness in the morning. So morning stiffness is a big hallmark sign for osteoarthritis. And typically this pain, the stiffness goes away with active movement. So throughout your day, you may feel like, hey, I feel a little better, my knee feels a little looser. We kind of touch a little bit on this with muscle weakness around the affected joint. This is very common for the knee and hip fracture. And then you will have reduced range of motion with osteoarthritis and loss of that joint use. And this occurs as arthritis severity progresses. And then a lot of people say it all the time. When I evaluate a patient with arthritis in my knee, cracks, pops or clicks and my medical term for everyone listening is called crepitus. That is a normal degenerative response that bone is no longer congruent. So the slide and glide mechanism of your joint mechanics is no longer functioning like it should. So you’re going to get a little rigid in there and it’s going to start to crack, pop, I always ask the patient, is it a sharp and painful crack? And typically what do they say? Yeah, no, it’s not typically sharp.

Dave Anselmo: [00:17:08] Very common and people panic about it, but it’s really important to balance. I mean, a lot of times that patella also glides back and forth and it’s hitting on the condyle. So it’s common to see that. Well, that’s the reason why you need to come to physical therapy, because we need to get that balance in the musculature. This so that patella glides normally in the groove. Really, really important. It’s a little bit more I got stopped a little bit in between talking to you about how RA tends to be more prevalent in females as a woman. It’s thought also to be three times more likely to suffer with RA than in man. Pretty amazing. I mean, you see that. So you see more women. Also juvenile rheumatoid arthritis. This is a form of our is basically the same as an adult version, and it is the most common form of arthritis found in children. It’s quite interesting. People don’t know about that. So your child has been having problems. They might have juvenile arthritis, rheumatoid arthritis, and it’s just an adult form of RA. And they can be affected in any joints in the body. So don’t panic when you see that there’s people who need to know that your kid can have it as well. So be it. Be alert. And if you see something going on with the symptoms that Courtney just nicely mentioned. So go to your doctor, get it checked out. Yeah.

Courtney: [00:18:19] So I’ll follow up with that. With rheumatoid arthritis, the symptoms are included with that. So you will see pain, stiffness and swelling in the joint. Most commonly these are the joints of the hands, the feet, your wrist, your elbows, the knees and ankles. Typically it’s bilateral. So typically we will see patients if they have right knee pain and left knee pain, that’s a red flag to us. It’s typically not that it will be more systemic. So we’re thinking of rheumatoid arthritis and you will see inflammation with rheumatoid arthritis and osteoarthritis, but significant inflammation with rheumatoid arthritis. And this inflammation can actually lead to permanent, irreversible joint damage if it’s not handled. So it’s very important to see our skilled physical therapist. With that inflammatory process to calm things down, we have certain modalities that we can use specifically at our facility, we use a lot of electrical stem, moist, hot packs, cold packs, ultrasounds that help with this inflammation to calm everything down for for your joint to prevent this irreversible joint damage. Do not think you have to live in pain. There are people like Dave and I who are very passionate about helping other people with their joint pain to improve their quality of life. And the last thing I want to touch on is typically with rheumatoid arthritis. We will see bumps or nodules on the joint, typically in the elbows or the hands, like the knuckles you will see like a deformity there of the extra calcium.

Dave Anselmo: [00:19:47] Very common, very common. People panic about that as well. But that’s a common sign and something that you will get from rheumatoid arthritis. So if you have any of these symptoms, the point is mostly just going over. Call in. Call and ask questions. And if you’re really scared to do that, I highly recommend you go see your family physician and ask him to do a blood work up on you and check it out and see what’s going on. And that I think Cross Keys Physical Therapy can help you in any way. Just ask for a referral. Will take care. We have another caller, Courtney. So welcome to Cross Keys Physical Therapy. Your question, please.

Pat: [00:20:23] Hi, my name is Pat. Hi. How are you? Good. How are you? Thanks for calling in. Oh, please. Thanks for being there for people and myself in particular. So I don’t actually have a question because you guys help me out in every way that I need when I come to the Washington Township facility. But I just wanted to make a comment and I hope and pray that people are listening and that still, you know, take what I say seriously. I just wanted to tell a little bit about my story.

Dave Anselmo: [00:21:02] That’s what this is about.

Pat: [00:21:04] Ok, so I started a couple of months ago, and when I first came there, I was at a point in my life where I thought, I’m too young to not have a quality of life that I feel like I should. I’m 60 years old. I’m looking at 80 year old’s who are functioning better than myself. But thanks to you guys, I’m able to function in a way where I haven’t been able to for years. I am being treated through my doctors who referred me to you for fibromyalgia. And I don’t know if anybody knows, you know, if everybody knows about that. But it is painful at times and it’s like a deterioration of, you know, mobility and all that you have. So since then, I’ve been able to, you know, walk, go without pain for long periods of time and do things, like I said. And one of the things that helps, I think, is because not only do you guys treat my body physically, but you treat me mentally, emotionally. And where you’re training me, you’re teaching me about what’s happening to my body and how to correct it. So I just wanted to say to people that feel like there’s no hope because there’s a lot of people out there that are in pain and feel like they can’t go places and do things that there is.

Pat: [00:22:42] It’s a wonderful facility. I look forward to it three times a week like it’s a barbecue or a party or something. Everyone you come in contact with is so friendly. I’ve met new friends there who we see each other outside of physical therapy. Now, Courtney and Dave and the rest of the staff are tremendous. They make you feel like they’re your own family. They you know, they make you feel like they really are interested in you, which you can tell. And that makes a big difference in your rehabilitation as well. So the newfound love of family that I have there, I just feel great. And I would hope that people would come there and see there’s one thing that there’s a saying to taste and see how good the Lord is. I just wish people would come there and see how good that place is and the difference that they can make in your life. You just need to come and see. And I thought, you know, some people might think, oh, they’re paying her to say all that. No, they are not paying me. What they’ve done is they’ve helped my body to heal my body, and that’s more than payment enough for me. So I would encourage people to come there. And see that there is a better life.

Dave Anselmo: [00:24:09] Thank you so much for the phone call. Obviously, you’re that exact type of patient that we talk about every time when we really are passionate about what we do. And I think that you just acknowledge that because we really are all therapists. Courtney’s exceptional. We love what we do. And the purpose of it became what we want to do because we want to help people. Yes. And I think that that’s just what your story resonates to, you know, makes us feel good, you know, for the phone call may still go for what we do. But, you know, thank you. Thank you so much for calling in. You know, I appreciate it.

Pat: [00:24:44] And thank you guys for being there for helping me and being so compassionate about what you did. And you can clearly see it. Well, like I said, it makes a difference.

Dave Anselmo: [00:24:55] Well, thank you so much again for your phone call, because I think, like you said, there’s a lot of people out there that are just like yourself, that don’t take the don’t take the step to get better. Don’t know what physical therapy could do for them. And you just say that hopefully that will convince a lot of people to make the move, get out of the chair, go see the doctor and get sent to Cross Keys Physical Therapy, because we really, really want to help as many people as we can. And the proof is in the fact that people like yourself to call in. Thank you for the phone call and I will.

Pat: [00:25:24] Thank you again. Thanks.

Dave Anselmo: [00:25:26] See you next week.

Pat: [00:25:28] All right.

Dave Anselmo: [00:25:29] We have another caller, Courtney. So also welcome to Cross Keys Physical Therapy. Your name, please, Calvin Becan.

Calvin: [00:25:37] Hey, Calvin, how are you doing?

Courtney: [00:25:38] Hi, Calvin.

Calvin: [00:25:40] How are you doing, Courtney?

Courtney: [00:25:41] I’m doing great.

Dave Anselmo: [00:25:45] What do you need? You have a question for your story?

Calvin: [00:25:49] No, I’ve got a comment pretty much. Right. You know, I’ve been going to therapy for, I don’t know, about three months, maybe. Great. And originally I went and I worked for back pain, OK? And I couldn’t stand up for five minutes. Wow. I happened to sit down. This turned out, you know, to all the therapy, you know, the help Courtney and the guys there, I’m able to stand up a lot longer. Matter of fact, some days I don’t even feel the pain.

Dave Anselmo: [00:26:33] That’s it.

Calvin: [00:26:34] It’s not 100 percent. Yes, but I still get in there and I’m able to move around a little longer and, you know, stand up a little longer, you know. So I really appreciate what the guys have done there.

Dave Anselmo: [00:26:53] It’s what sounds like Courtney is doing a great job with it.

Courtney: [00:26:57] Obviously, we still have our work cut out for us.

Calvin: [00:27:00] Very, very caring that I have to say that. They are very caring and concerned.

Dave Anselmo: [00:27:06] Well, that’s that’s important. Thank you. Thank you. That’s a fact. Is that, you know, what we say all the time is, you know, you take this, you took the step, you took the step of coming into getting physical therapy. And you’re lucky enough that, you know, you got to meet Courtney. And Courtney is doing a great job with the sounds that way. But I tell people all the time it’s about what you do as well. So thank you for your time in which you took the step to come in to get physical therapy. And that’s a huge part. And then it sounds like, you know, you obviously got to do your part. You got to do your home exercise with sounds like you’re doing. And it sounds like you’re on the right track record.

Courtney: [00:27:39] Having worked very hard. You work very hard during our sessions, Calvin, and it’s a credit to you. I just prescribe everything and you have to do it all. So you do a lot when you’re with me. So that’s a testament to you of what you do when you’re there.

Dave Anselmo: [00:27:55] That’s an important point. I mean, like I said, we do what we can do in the office, but it’s also the fact that we try to educate people on what you could do at home as well. And that’s a big part in helping you progress a little bit faster when you do your home exercises as Courtney’s right. It sounds like you’re doing that. And it’s important that people understand that, that they need to do their part as well. We do the best we can. But if you just come into therapy and just something that we do, that’s not enough. You need the home exercise as well. So it sounds like you’re a big contributor to that. And I think that that sounds like you’re doing a great job, Courtney. You’re doing a great job with Calvin. Thank you for the phone call.

Courtney: [00:28:30] So thank you, Calvin.

Calvin: [00:28:31] Oh, thank you. Thank you.

Courtney: [00:28:33] Thank you. Appreciate it.

Speaker4: [00:28:35] Bye.

Dave Anselmo: [00:28:36] Hey, Courtney we’re rolling here, I think we got another caller

Speaker4: [00:28:38] On the line. Yes, you do.

Dave Anselmo: [00:28:40] Welcome to the therapy, Darlene. Hi, Darlene.

Courtney: [00:28:44] Hi. How are you? I’m doing great. How are you?

Darlene: [00:28:47] Good. I just want to say that you guys probably saved my life. I’ve gone to every single doctor and could not even hold my head up. And now I’ve graduated actually live this week with my last time and. I’m just doing great. I’m just doing great. So I went I scratched off each doctor that may have helped me before and just prescribed pills. Now I take two Motrin and do a couple of my exercises. And I feel fine. So I couldn’t even lift my arms up or keep my head up straight.

Dave Anselmo: [00:29:28] Yeah, sounds great. What was it? You have to have a neck problem.

Courtney: [00:29:32] We don’t know about you, Darlene, if I can tell your story a little bit.

Darlene: [00:29:38] Sure.

Courtney: [00:29:38] Of course. Darlene came to me with a severe headache. She was getting a lot of headaches, a lot of neck pain, stiffness, impaired range of motion. I took her in for any of our talks, and asked her goals. And I remember specifically when I was speaking to her in her email, she had to use her hands to support her neck team and talk to me because she had so much instability and weakness that we talked about. She had arthritis in her neck. So she had that weakness that we were speaking of, a symptom of the deep neck flexors and the extensors of her neck. And I noticed this, that she couldn’t really talk without holding her head. And then I remember I put a moist, hot pack on her, which increased blood flow and circulation and stem because she was getting a lot of headaches. So I was trying to just build a patient rapport with her, decrease her pain. And we actually couldn’t even and she wanted I think I had you sitting up, Darlene, I believe. And I had her sitting up and put the hot pack around her and her neck. The weight of our hot pack is not heavy right now. She couldn’t even keep her head up with that hot pack. So I actually put her head against our wall in a chair. So I had to sit up against the wall on the chair.

Darlene: [00:30:47] That’s exactly right.

Dave Anselmo: [00:30:49] Sounds like you waited a long time. It sounds like you’re on your last step there.

Darlene: [00:30:54] So that’s that’s what it was. That’s what it was. I kind of scratched off everything that I thought might be a neurologist, you know, the next doctor. And all they want to do is prescribe pills, pills, pills. And I took them and then they finally were working. And my last thing was physical therapy. And it works wonders. And I wish I would have thought of it before.

Dave Anselmo: [00:31:17] Well, that’s very true. A lot of times doctors, unfortunately, they don’t if they don’t refer for physical therapy, they give you medication, unfortunately all that is doing is really masking your symptoms. And unfortunately, as it matches your symptoms, your instability, your muscles get weaker.

Darlene: [00:31:31] It gets worse. Exactly.

Dave Anselmo: [00:31:33] And you see that quite often. And people really don’t know what to go, what they do. They don’t understand that. That’s what this show’s all about. Yes, we’re here. Physical therapy can help many patients in this situation. And that’s why I’m so glad you called them today and told your story.

Darlene: [00:31:47] And I just want to just say thank you. Thank you. Thank you. Courtney, too. You’ve helped. And I don’t know where I’d be without you guys.

Dave Anselmo: [00:31:56] Oh, well, listen, this is what we do, Courtney feels the same way. We love what we do. And I haven’t worked a day in my life because I truly love what I do.

Darlene: [00:32:05] Oh, it shows. Yeah. It for sure shows from the both of you, you know, you make a rapport with your patients and it just I mean you can tell, you can tell just meeting you. So I appreciate you. I will love you forever. And I know you’re there when they need you.

Dave Anselmo: [00:32:23] Definitely. You know where we’re at. We know where we’re at. So just obviously give us a call and anything you may need.

Darlene: [00:32:31] But I Would definitely, definitely recommend ten doctors or three doctors before I go to physical therapy, just try it out.

Courtney: [00:32:39] Thank you. You agree with that statement, please come to us at Cross Keys Physical Therapy.

Darlene: [00:32:45] No pills don’t take the pills. Try that because it’ll do you the world of good.

Dave Anselmo: [00:32:50] Here we go again, Courtney. We see this. We hear the same story over and over again. Obviously, sometimes there’s so many doctors out there that really don’t utilize physical therapy like they should. Unfortunately, they like to give their medications. And I think that that’s going to take care of the problem. Unfortunately, you can see this happening more and more. And it sounds like this just.

Darlene: [00:33:09] Creates another problem. So I thank you and God bless you both.

Dave Anselmo: [00:33:13] Thank you again.

Courtney: [00:33:15] Ok, thank you. If you need me, I will.

Darlene: [00:33:19] I know. OK, well,

Dave Anselmo: [00:33:21] Let’s take a quick break and the number here to call in is area code 856-696-0092 . So we’re going to take a commercial break and we’ll be right back and talk a little bit about joint replacements so we’ll catch you on the backside.

COMMERCIAL: [00:33:37] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure 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 need. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They address 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 interest with two locations, Washington Township and Pennsville, help is only a phone call away, and participates in a broad spectrum of insurance plans. (856) 374-3707 in Washington Township and (856) 678-8000 in Pennsville.

Dave Anselmo: [00:34:41] Welcome back to Cross Keys Physical Therapy Show. This show is brought to you by Cross Keys Physical Therapy. We have two locations to serve you, one in our location, 181 North Broadway and Pennsville, New Jersey. The second office is in Washington Township, 151 Fries Mill Road, building 600 at the University Executive campus, building 600, Suite one. Or you can just contact us, look at us, look us up on our Cross Keys Physical Therapy. That is CrosskeysPhysicalTherapy.com. Check us out and see what we can do. Oh, we have a phone call already. Welcome to Cross Keys Physical Therapy. Your name, please.

Louie: [00:35:19] Yeah, hi. My name is Louie, calling on behalf of my wife, Cindy. She’s here also. Her situation is. She had our floor two weeks ago today. She fractured her fibula. Yes. And we will have more kinds of situations trying to get some physical help in here for two weeks already and through contact with the nursing service, Bayada. But they haven’t got the paperwork on yet. We’re told that she’s one of those walking boots.

Dave Anselmo: [00:36:00] Ok, so she actually had a diagnosis of a fractured fibula, correct.

Cindy: [00:36:04] I have two fractures in my tibia and fibula. I’m sorry, the bottom part. And I saw two different doctors. I got a second opinion. We’re waiting for PT and OT and in-home care. But my question is, I had a spot developed from the boot rubbing on it. We are on top and I wondered if Neosporin, I do take it off and air it and if I could put Neosporin on it and then how tight do you actually want the boot? Neither doctor really told me that they just put it on and I have no directions. A black boot. I’m not allowed to put any pressure on it. Right.

Dave Anselmo: [00:36:56] Well, thanks for the call. We get answers together. Yeah, no problem. You know, boots should not be uncomfortable. First of all. I mean, if it’s rubbing against you and causing friction, then it’s not fitting you properly. You need to be fitted properly. These will be reset up. So whether you need any more cushioning around the side, the pressure really should be coming, taking off at the upper part of the leg. So you’re really not putting any pressure on that distal fibula. Doesn’t know who’s listening. The fibula is the lateral part of the bone. The lower extremity gets down into the ankle joint. So it’s very painful because if you’re fractured in two places, weight bearing is really important. And the purpose of that boot is that you could stand up and walk without putting any pressure on it and you can get around without causing any more pressure on that distal fibula and let it continue to heal. But it doesn’t sound like that’s what’s happening to you.

Cindy: [00:37:46] They said two weeks to stay off of it and then try to put weight bearing on it. But if it has pain, which it does when I lift it, and up and down, like exercising it. Right.

Courtney: [00:38:02] Are they speaking of surgery? Like, did the s word come up that you might need surgery?

Cindy: [00:38:06] No, none at all.

Courtney: [00:38:07] OK, that’s good.

Dave Anselmo: [00:38:09] Might be a perfect person for the aquatic therapy program, obviously, because we put people just like yourself in there in the pool because it’s buoyant. So you’re going into an environment where you’re going to be buoyant. I mean, you’re going to be weightless going in the water. We put your waist level, you’re fifty percent less weight bearing. You’ll be able to start working on putting some weight bearing on that without really putting any pressure on that joint. You continue to maintain your musculature down in the area and your leg and then your ankle and continue to pass and strengthen the exercise. We’re really putting any stress on that fracture. So that might be something we want to talk to your doctor about. But to be your family doctor or your surgeon in reference to just give him a heads up, say, hey, listen, you know, I heard about this therapy. Is there something that could help me? Yeah.

Courtney: [00:38:58] And look at Cross Keys Physical Therapy, because definitely if you sound like they want you non weight bearing for two weeks to allow some healing in. Off pressure, but when not two weeks is up, you should definitely call one of our offices either in Pennsville or Washington Township because not many offices have aquatic therapy, right, Dave?

Dave Anselmo: [00:39:15] No, not many at all. I mean, and if they do have therapy and some of the hospitals over there, but it’s not the same. And obviously the physical therapist, a lot of times sitting outside the pool, they’re not actually going in the water with the patients and doing any manual technique with them or stretching them, which is I think is an ultimate very, very important for you to do. So I said, are you close to any one of our facilities? By the way,

Cindy: [00:39:38] You said Washington Township and where?

Dave Anselmo: [00:39:40] Pennsville

Cindy: [00:39:42] Were in Laurel Springs, which is near Voorhees,

Courtney: [00:39:46] Washington Township.

Dave Anselmo: [00:39:47] Washington is not far from that. You’re about fifteen minutes away from that. So we’re not really that far. Check us out on the Web, on the Web site, obviously, CrossKeysPhysicalTherapy.com And look at those who tell you our locations will give you the address and I will give you a little map. So check us out. And obviously, like I said, I would definitely after the two weeks are up, I would suggest that call and see if you get a prescription from your doctor or your surgeon in reference to getting you over to Cross Keys Physical Therapy. And we’ll take care of it.

Courtney: [00:40:14] That for you. And our second part was that you have a little more than it sounds like a little pressure point from that mal-fitting, but definitely on it. If you haven’t already called your primary, I would just I don’t know, or the ortho wherever you last went. I would. I would. Obviously, it’s more fitting because the pressure is not where it’s supposed to be right now, like Dave said. So I would like you to put like a triple antibiotic on there to help and keep it covered because you don’t want it to get opened and then continue to get the pressure on. And then possibly infection can start, especially with the heat sweating.

Dave Anselmo: [00:40:47] I think it will definitely help. But obviously there’s a problem with the thinning of that business. And even though you’re putting this on, if you continue to go back in a boot, you’re going to have the friction occurring over and over again. So we need to change the cause of the friction. Right. So let’s look into that. Obviously, let your doctor know what’s going on and maybe either he’ll take a look at it or we could take a look at it for you and see if we can make some adjustments in that for you. Well, might this be a little bit? We might need to put a little cushioning in different spots a bit. You align a little better and take the pressure point off that area, which is causing the friction. Right. So we’ll walk to help you any way you can.

Cindy: [00:41:22] I ask you one more question? About blood clots.

[00:41:23] Sure.

Courtney: [00:41:25] Yes, blood clots.

Dave Anselmo: [00:41:27] Yes.

Cindy: [00:41:28] I’m basically I’m heavy I’m 300 pounds, OK? And I can’t put any weight on it for Sunday and Monday. And they had said I could go in and have it look the nurse and said have it looked at I, I get up and get in the wheelchair, I they haven’t brought me a wheelchair so I’m using an old one that’s tires have I have a script that I’m just waiting for them to come out. I want to make sure I sit on the edge of the bed or I do get in the old wheelchair and I do move it up and down in the bed and that sort of thing exercising. But I’m not with the heat and stuff going outside. Is that good enough?

Dave Anselmo: [00:42:21] That’s fine. He said he doesn’t want you to put any weight on for two weeks. So you want to keep moving, you want to get a movement. So you’re doing exactly the right stuff you definitely need to do. Or you want blood thinners, by the way,

Cindy: [00:42:31] Just 81mg aspirin.

Dave Anselmo: [00:42:34] Ok, yeah. You definitely need to go and be on some blood thinners if you, if you have any history of blood clots for sure. So you want to get that, make sure that blood knows the things you don’t want to have a clotting going on there. So. So yeah. Obviously you’re under the care of your physician. He’s aware of all that and he’s taking care of that, putting you on what you need to be on. So but you definitely got to keep that moving. You got to get the blood flowing through there. But it’s you’re doing it right now in a non weight bearing environment. You can keep it moving at the edge of your bed. You’re doing exactly what you need to do. And after two weeks, a lot of things could change for you. So if we can help you out in any way, please give us a call.

Courtney: [00:43:08] And do you know the signs and symptoms of a blood clot just to educate everyone listening? I think it’s a good thing to educate what the signs and symptoms are. A blood clot. Do you know what they are?

Cindy: [00:43:17] Well, he is the only one I really know when I get it. I mean, I think somebody told me pain, but I had pain from the fractures. And I only take so long and I take it once at breakfast and once at dinner.

Courtney: [00:43:37] Ok, I’ll educate everyone on what to sign and symptoms of a blood clot or so what you will look for is you will look for redness. Typically it’s in your calf. You can get blood clots in your arms, but you’re going to look for redness. You’re going to look for temperature. So it will feel warm to touch and you will look for tenderness. So if you squeeze your calf or whatever that redness is, it will be tender. And then the obvious is significant swelling. So you may have significant swelling rather quickly if there is a clot. So it’s it’s. Warmth, redness, tenderness and swelling, there are the symptoms that the main thing, so if you see any of that happening, go strictly you go right to the E.R., don’t mess around with that, but just continue moving like you said you were doing. We appreciate your call and we hope to see you at one of our facilities. It seems like Washington Township would be your best.

Cindy: [00:44:24] Yes, I appreciate that. And I thank you for the call. Thank you.

Courtney: [00:44:31] Good luck with that foot. We hope to see it to help you in your rehab.

Cindy: [00:44:34] Yes. Thank you.

Courtney: [00:44:35] Bye bye.

Dave Anselmo: [00:44:36] Another caller. And that was great. So let’s go back, Courtney. Let’s get to some of the new things we want to talk about. Oh, here we go. We got another caller. Well, welcome to Cross Keys Physical Therapy. Your name, please.

Laura: [00:44:49] It’s Laura. Hi, Courtney.

Dave Anselmo: [00:44:53] Hi, Laura.

Laura: [00:44:55] Thank you. I just want to talk about my knee replacement two, two and a half years ago, and it started in September of 2008. And I had a knee replacement when everything went well and the hospital was in five days and I decided to go to a rehab facility in Woodbury so my husband can work and not have to wait on me anymore. Right. And I could hear the news about it. And I think this is the place that looked exactly like a country club. And I thought, well, this is for me. And I ended up getting one and a half days of physical therapy. There was never anybody on duty and they wouldn’t even give me. I asked my husband to take in ice packs from home.

Dave Anselmo: [00:45:57] I’m very sorry to hear that.

Laura: [00:45:59] And I ended up getting a blood clot in my good leg, like, It was very painful. I was there for 10 days and then Monday my husband dragged me out of there in a wheelchair and took me to my physician, Philadelphia orthopedic surgeon. And right away. And sure enough, they did an ultrasound. And I had a terrible blood clot, very, very pain that was more painful than the actual surgery.

Courtney: [00:46:37] Mean, that’s great that she mentioned that because something we wanted to touch upon was just how important early mobilizations are. Laura, so it sounds like you went right from surgery to an inpatient stay where you went to a subacute rehab or some type of inpatient stay where they will then work on your range of motion, making sure you’re safe to go home.

Dave Anselmo: [00:46:57] You’re supposed to.

Courtney: [00:46:59] So it sounds like that facility did not. You know, they weren’t very conscientious of getting you open and preventing  your blood clot, which then and I know your history, it delayed your start to outpatient and all of that due to the secondary complications from your knee replacement. But early mobilization is key to replace the can you touch upon how patients have a right to tell their doctor, you know, what they want for their care?

Dave Anselmo: [00:47:26] I think that’s really important. And I think that’s a misnomer here. A lot of patients don’t understand that, don’t realize that. You see a lot of times where patients come in and they say, I wanted to be here a long time ago because I was going to another facility, unfortunately, that was either owned by a physician or orthopedic surgeon and they were told to go there. And unfortunately, the results were not as what they expected. And I mean, so you have a choice. And that’s our voice right here today. We want to let these people know that you have a choice of your rehab. You can go where you want. You just need to call your insurance company, let them know, hey, I want to go to another facility. I’m not happy where I’m at or this is where I want to go. And 99% of the time, they will allow you to go where you want to go, because this is your body and you have a reason why you want to go so long with that situation. What happened over there and the inpatient was a result of what really what people think physical therapy really is? It’s not right. So unfortunately, we got in the wrong spot, wrong place and didn’t get the proper care. And I apologize for that in reference to. But I can guarantee that won’t happen at Cross Keys Physical Therapy.

Laura: [00:48:40] Oh, no.

Dave Anselmo: [00:48:42] So thank you for the phone call and let people know that, you know, these things happen. We’re about ready to talk about total joint replacements, whether it be your knee, your hip, your shoulder, your ankles, that people don’t even know that you can get replaced. It’s always different parts and things that happen. But it’s really important. As you said, early mobilization, early movement is really, really important. And look, get that it makes the joint. Very stiff increase swelling. Yes, you have all kinds of symptoms that we’re going to be talking about very shortly, that people think it’s normal, that it’s not. So we could talk a little about that, but we really appreciate it.

Courtney: [00:49:18] Thank you for calling in and telling your story.

Dave Anselmo: [00:49:23] Of people that thinking that’s been

Laura: [00:49:24] Going on for so long, since 2007, for other other injuries I’ve had. And I won’t go anywhere else other than his.

Dave Anselmo: [00:49:33] Well, I really appreciate your support and your acknowledgement of us today on this radio show, because I hope that it resonates with a lot of people that are sitting in the chairs right now wondering, you know, do I need physical therapy? And if I do, where to go? I really think that it’s important to get a voice out there, that people know that they have a choice on their behalf and it’s important. So thank you so much for the phone call. And we really, really, really appreciate your trust in us. And hopefully, you know, we’ll always be there for you.

Courtney: [00:50:05] Yes. Thanks.

Laura: [00:50:06] Yes, I think I think I thank both of you. Your care.

Dave Anselmo: [00:50:11] Thank you. Thank you for the phone call. Yes.

Courtney: [00:50:14] Have a good one, Laura. Thank you.

Dave Anselmo: [00:50:16] Thank you. Yeah, I think yeah. I think we have another phone call, Courtney. So we’re going to have her own here. Well, welcome to Cross Keys Physical Therapy, Courtney and Dave here. So your question, please.

Nick: [00:50:29] Hi, Dave. My name is Nick.

Dave Anselmo: [00:50:31] Hey, Nick.

Nick: [00:50:32] I’ve been I’ve been I’ve been coming to you for a long time since I had a therapist named Tracy back in the 90s, fell off a ladder, a broken ankle. You and Tracy in that pool really put me back together, man. I gotta tell you. And everybody else especially.

Dave Anselmo: [00:50:55] Oh, thank you. Thank you. Thank you so much, Nick. I remember Nick. I remember you had a real issue with your back. I think you have a lot of compression going on in your back. Did you have a compression fracture, too?

Nick: [00:51:06] And that was from the early 2000s when I fell out of a tree, deer hunting. I have really had a real bad back problem. Now, like, they won’t even do surgery on me because I have so much mobility. They think they’re going to take mobility away if they do surgery. Right. Well, it all contributes to that pool, you and you and your team over there. 

Dave Anselmo: [00:51:34] Well, I really appreciate your confidence in us and giving us the time to have an opportunity to work on you to get you better. And we’ll be talking about, again, the pool really, really, really effective. And we’re one of the only ones in the area that really can do aquatic therapy in our pools. Once again, it’s a saltwater pool. So people are worried about chlorine. There’s no chlorine involved in that. We are saltwater pools, so it’s safe, clean and I see health. Believe it or not, I’m in the pool five days a week. So it’s a joy to go there. I enjoy doing it. So I think it’s important that you tell people about what it’s done for you. And I’m sure there’s people out there that had issues like yours in the back and that really could use aquatic therapy and they’ll know where to go. So I really appreciate your phone call, Nick, and we really appreciate that.

Nick: [00:52:20] Thank you, Dave. Thank you, Courtney.

Courtney: [00:52:22] Well, thanks for calling in.

Dave Anselmo: [00:52:25] You’re welcome, guys. Yes. Well, I think we’re wrapping up here. I think we have a quick commercial we want to take and then we’ll come to a conclusion. All right. Thank you.

COMMERCIAL: [00:52:37] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure 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 need. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They address 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 interest with two locations, Washington Township and Pennsville, help is only a phone call away, and participates in a broad spectrum of insurance plans. (856) 374-3707 in Washington Township and (856) 678-8000 in Pennsville.

Dave Anselmo: [00:53:41] Welcome back. Of course, Cross Keys Physical Therapy Show. You’re here today with Courtney Kane and Dave Anselmo. We want to thank all our callers. Today we come to an end to another great show. Courtney, we thank you so much for coming on with me today and telling your story and showing you’re passionate about helping your patients. Obviously, we saw quite a bit of your call, your patients coming in today and the signs of their appreciation. And we appreciate that as well. I also would like to thank our engineer, Matt, for helping us out behind the scenes without Matt, we wouldn’t have the show wouldn’t be possible. So thank you, Matt, for helping us out, for getting these callers in and out as nice and quickly as you did and smoothly. And it’s really, really been very helpful and pleasant being here today. We are at the radio station at 92.1. And next week we’re going to be doing a show at the Cross Keys Physical Therapy Center in Washington Township. So if you have any questions or anything, you want to even stop by. You’re welcome to do that. We’ll talk about the show every Sunday at five to six. But next week we’re going to be back at the Washington Township location to do the show. So next week, we have Maria Petrongolo. She is a physical therapist at my facility in Pennsville. And she’ll be on, we’ll be taking calls and answering questions about anything we happens, say, have any questions, please lock us in. And what is your next week? Thank you again and God bless. Take care, Bye Bye.

COMMERCIAL: [00:55:45] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure 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 need. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They address 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 interest with two locations, Washington Township and Pennsville, help is only a phone call away, and participates in a broad spectrum of insurance plans. (856) 374-3707 in Washington Township and (856) 678-8000 in Pennsville.