Whole-Body Approach Reveals Cause Of Pain

Physical therapists’ comprehensive evaluation goes beyond patient’s primary complaint.

Tina Konrad

It takes a special kind of person, someone who can keep her wits about her amid the most disturbing circumstances, to do the kind of work that Tina Konrad did during the first three years of her six-year stint in the Navy.

“I worked crash rescue,” says Tina, who joined the Navy in 1975 and went on to join the rescue team at Naval Air Station Jacksonville. “We responded to downed planes, put out the fires, rescued the pilots and, when necessary, secured the pilots’ bodies.

“It was rough work, but I’m very good at not letting things bother me in the moment. When it’s all over, you do have to regroup a little bit, but I’ll say this: That was the most memorable time of my life serving our country.”

After her assignment with crash rescue, Tina moved onto the flight line, where she was part of the crew responsible for prepping jet fighters for their missions and inspecting them for damage afterward. Not long ago, Tina was inspected for damage herself.

A long-time runner who gave up that activity after undergoing knee replacement surgery in 2017, Tina recently found it painfully difficult to walk or even stand for any length of time. A muscle disease called dermatomyositis was at the root of that problem.

As with Tina, 65, dermatomyositis (pronounced der-muh-toe-my-uh-si-tis) typically strikes people between their late 40s and early 60s and causes muscle weakness. In Tina’s case, this manifested mainly in her feet.

“I was diagnosed in 2001, and ever since I’ve had to wear very snug shoes or I’ll lose my balance,” Tina relates. “But when you wear snug shoes and have arthritis, which I do, it aggravates the situation and causes even more problems.”

For Tina, the problem was incessant pain, which made it hard for her to perform everyday tasks, where something as seemingly simple as cooking dinner became a chore. It also forced her to abandon walking as an exercise activity.

“My feet hurt 24/7,” Tina details. “There was a constant ache or soreness in them, and the nerves in my feet would get inflamed, and I’d have this burning sensation on top of all that. It was very painful.”

In seeking medical attention, Tina first visited a podiatrist who treated the pain with cortisone injections. These provided only temporary relief, however, so the podiatrist suggested Tina visit Regional Rehab for a more permanent solution.

Assessing Whole Patient

Regional Rehab is the practice of Charles C. Donley, PT, and Paul Ernandes, PT, PhD. Charles and Paul take the concept of comprehensive care to a new level by looking beyond each patient’s primary complaint and individually evaluating each patient as a whole.

“Once we’ve each completed our individual assessments, we share our findings with each other,” explains Charles, founder of Regional Rehab. “One question we always ask each other is, Do you see anything else here besides the primary complaint that requires our attention?

“What we’re doing is putting our 70-plus years of experience together to ensure that we’re doing everything we can to help each patient in every way possible. Those comprehensive evaluations and collaborations are among the biggest keys to our success.”

In taking this approach with Tina, Charles and Paul discovered that poor posture was a major contributor to her foot pain. It’s a problem they have encountered many times.

“It was a whole-body approach, and that is something no one had ever done for me before.” – Tina

“A lot of times, when someone comes in with foot pain, particularly in the forefoot and around the toes, which was the case with Tina, we look at how that person stands, because poor posture can be a cause of foot pain,” Charles explains.

“Tina was standing with her knee hyperextended. She was bending forward from the waist, and that was putting extra pressure on the front of her feet. To alleviate that pressure, we simply had to correct her upper body posture.”

To achieve that, the Regional Rehab staff supervised a series of pelvic tilt exercises that are designed to strengthen the abdominal muscles. They also stretched out Tina’s calf muscles to increase flexibility in her legs.

The staff also sought to erase some of the damage to Tina’s feet by utilizing two of the practice’s signature tools, the Class IV deep tissue therapeutic laser and the HIVAMAT® 200 deep oscillation device.

The laser uses wavelengths of red and near-infrared light to stimulate the body’s natural ability to heal damaged cells. It releases nitric oxide, which removes congestion and swelling, promotes healing, reduces discomfort and increases blood circulation.

The HIVAMAT creates gentle impulses that relax muscles and penetrate all tissue layers to remove inflammatory byproducts from the cells that cause pain but are not part of the cells’ natural makeup.

“The Class IV laser, in particular, is an impressive and versatile tool,” Charles notes. “We use it for burn and wound patients as well as for all the musculoskeletal issues we typically treat, such as acute, chronic and postoperative pain.”

The Class IV laser and HIVAMAT are part of a protocol that typically includes stretching and balance exercises as well as manual therapy. Tina received about eight weeks of treatment at Regional Rehab, where Charles did one other important thing for her.

Kind, Helpful Environment

Tina, a Navy veteran who has fought a long battle with incessant foot pain, finally found a solution for that pain at Regional Rehab in Spring Hill.

“We also put a lift in Tina’s right shoe because the right side of her pelvis was tilted forward more than the left,” Charles adds. “She got immediate relief and a greater sense of relaxation in both hips from that.”

The combination of pelvic exercises, stretches, and laser and HIVAMAT treatments helped Tina’s pain dissipate after just a couple of visits.

“I started feeling relief pretty quickly after we started, and my feet just got continually better after that,” Tina raves. “During the last two weeks that I underwent treatment at Regional Rehab, I had zero pain in my feet. It was incredible.

“What I really liked is that they didn’t just focus on my feet. They looked at my hips, my posture, everything. It was a whole-body approach, and that is something no one had ever done for me before. All anyone had ever done was look at my feet.

“The other thing I like about Regional Rehab is that it’s a work environment where everyone is extremely kind and very helpful. Everybody there wants you to improve. It’s an environment you don’t see in a lot of places, and I can’t tell you how much I appreciated it.”

© FHCN article by Roy Cummings. Photos courtesy of Tina Konrad. mkb
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    • Regional Rehab

      Regional Rehab's ultimate goal is to enrich people’s lives by helping to enhance their physical and mental well being, creating an atmosphere of quality care and optimum healing with a loving touch.... Read More

    • Charles C. Donley, PT

      Charles C. Donley, PT, is the owner of Regional Rehab. He earned his Bachelor of Science degree in physical therapy, graduating cum laude, from the University of Pittsburgh. He served on the board of the Hernando County United Way, is a d... Read More

    • Paul Ernandes, PT, PhD

      Paul A. Ernandes, PT, PhD, joined Regional Rehab in April 2018. He previously was director of physical therapy at Vitality Physicians and Rehab and spent 10 years as director of rehabilitation at Oak Hill Hospital in Brooksville. He has also ... Read More