I Don't Know You From Adam…

Head, Shoulders, Knees, and Toes

May 16th, 2010

Subjective:

My girls both watched the Wiggles when they were little. Well, Noelle still does but she’s not quite 4 yet. Olivia doesn’t watch them, purposely; however, if Noelle has them on, she won’t get up and leave the room. The Wiggles can be annoying –I’ll be the first to say that. I got sick of them when Olivia watched them all the time, but I still like them better than Dora. Jeff was my favorite Wiggle. He’s the one in the purple shirt who likes to sleep a lot. Kind of like me. Maybe he’s narcoleptic. As I remember, Jenny liked Anthony. Mainly, I think, because he has rhythm. Olivia liked Anthony when she would watch them on TV, but when we went to see the Wiggles in Little Rock, the only one she cared about was Murray. She screamed, “Look at me, Murray! Look at me!” throughout the show. Some of the Wiggles’ songs are catchy, some are annoying as can be and beg to be made fun of. They used several songs I knew from when I was little, but they have original stuff too. Their version of the song “Taba Naba” will stay with me all day long if I hear it (I’ve jinxed myself by typing that). Something about that song and it’s tropical vibe reminds me of Jimmy Buffett. While doing the bath the other night, I was trying to teach Noelle to bathe herself by singing “Head, Shoulders, Knees, and Toes”, one of the Wiggles “greatest hits”. As we sang that, something clicked to me: this is what I do professionally all day long. Not bathe people, but work with their head, shoulders, knees, and toes.

Objective:

Physical therapists are the musculoskeletal specialists. Our field is based on the treatment of the body’s dysfunctions via use of the muscles, bones, and joints. One of the new emerging fields of our practice is the prevention of these same dysfunctions. The chorus of “Head, Shoulders, Knees, and Toes” precisely names the parts of the body that we treat.

“Head, shoulders, knees, and toes (knees and toes); Eyes and ears, mouth and nose…”

Nose? Yes, the nose. No, it’s not common and we don’t ever get anyone specifically for this issue but it’s not uncommon for me to treat someone with sinus problems. Sinus issues often cause headaches. For years I’ve done some hands-on treatments for opening up sinuses. There are some pressure points on the face near the eyes and to the side of the nose that will open up your sinuses and allow you to breath for a while after pressure is applied. That’s what we did for years. The cold laser that we got last fall will open up nasal passages pretty quickly. It wasn’t uncommon to see the therapists in Carson Physical Therapy self-medicating with the laser during the “cold and flu” season back in the fall. The laser allowed about 4 hours –by my reckoning– of relief and breathing.

Eyes. Okay, this is an indirect treatment, but, I have to give this speech to about one person per week. Last week I actually got to give it to an eye doctor! Computer monitors and bifocals don’t mix. Wearing bifocals while sitting at a computer causes you to hold the head cocked back so to speak, so that the eyes can focus through the bifocal portion of the lens. This backward bent position of the neck pinches nerves and compresses discs in the neck. I see lots of neck pain clients with this as a contributing factor in their problems. Solution: when doing computer work, wear reading glasses, not bifocals! You will get neck related issues from this.

Mouth. TMJ issues abound. Clicking jaws, mouths that open too much or not enough. Physical therapy has it covered. It’s a joint like any other in the body with muscles, bone, and ligaments and responds therapy just like the rest of the body.

Head, shoulders, knees, and toes. I’ll get to toes in a minute. The first 3, that’s what people think about when they hear “physical therapy”. Headaches. Neck problems. Shoulders that hurt and don’t work right. Knees that creak and are worn-out and hurt every single step. I’m not minimizing this portion, this is 95% of what I do.

But toes….. In Stripes, Bill Murray says that an “Army without leaders is like a foot without a big toe.” The Big Toe is essential to so many things that we do.Without a big toe, your balance is messed up. If the big toe doesn’t work right, you don’t walk correctly. If the big toe doesn’t dorsiflex (bend up away from the ground) you will end up with back pain because of how it affects your gait, your walking pattern. So, I stretch out Big Toes.

Assessment

Physical therapy treats the whole body. When I say that I mean that we treat this part and that part. But we also treat the body as a whole. Look back at that last section on the Big Toe: if it doesn’t work right, you end up with back problems. An elbow issue can become a neck issue. A neck issue can become a knee issue. It’s like picking verses out of the Bible to study. Yes that verse says something particular that God wants us to know, but taken out of context from the verses around it, the intended message can be missed.

Plan

Soon Noelle will outgrow the Wiggles. She’ll be able to bathe herself. But the “Head, Shoulders, Knees, and Toes” song will probably stay in my mind for several years. My recommendation to you: Remember physical therapy with any type of movement dysfunction. Many times there is a simple solution to what’s going on in your life. Just like a simple children’s song. Tonight, I might watch Stripes. Or maybe I’ll watch Raising Arizona. Who knows?

APC

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