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Is COVID 19 Stressing You Out?

Is COVID 19 Stressing You Out?

Mindfulness Definition: What Is Mindfulness?
By Kari Osborne DPT

As a physical therapist I am used to treating pain. Pain is often viewed as a physical response to injury, but it is very emotional as well. We can feel emotional pain from harm, change, and loss just to name a few. Many of us are experiencing emotional pain due to these and other reasons right now, and just like physical pain, unless it is managed, can turn into a cycle which is difficult to break. 

We have all been impacted by COVID19 in one way or another. Whether it is those working on the frontlines in essential industry, those managing working and schooling kids from home, or those who have lost their jobs. Not only have we experienced change in our work lives, but we have experienced substantial change in our social lives as well. We are social beings not meant to live in solitary which many of us have been asked to do. Before COVID even ramped up here in America feelings of loneliness were on the rise. A report released by Cigna in early 2020 showed greater than 60% of Americans feel lonely, a 13% increase from 2018. Loneliness can have significant effects on our health and has been linked to depression, heart disease, and has even been shown to impact our immune system. It is important that we carefully assess our mental health, and those around us, to help recognize changes that may need addressing. 

Below is a picture depicting the pain cycle. Now I don’t know about you, but I can recognize a few of those descriptors in my current life, fear of the unknown and anxiety just to name a few, so how do we break the cycle and move forward? 

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The first step is recognizing what is going on. Below is a list of symptoms associated with depression (see Table 1). Now there are many different types of depression some more severe than others but what I want to focus on is situational depression. Situational depression is typically short-term and brought on by traumatic or life changing events (ring any bells for you?). Oftentimes, as is our current state, there is not much you can do to change the traumatic event or life change. There are however things you can do to help combat the symptoms and break the cycle. 

Table 1

Symptoms of Situational Depression
Lack of enjoyment in activitiesRegular crying
Constant worrying/anxiousnessDifficulty sleeping
Difficulty focusingTrouble carrying out daily activities
Avoiding social interactionThoughts or attempts at suicide

One of the best things you can do to break the cycle is to increase your activity level. Research has shown that exercise reduces the risk of cardiovascular disease, stroke, and boosts our self-esteem. Research also shows a strong link between exercise and the reduction of stress and depression symptoms. Physical activity increases natural endorphins that make us feel good and boosts our mood. It also increases blood flow which has been shown to increase nerve cell connections in our brain and help us think more clearly. Although it may feel challenging at times it is important that we get up and move. It is recommended that we exercise for 30 minutes a day, but this can be broken up into smaller 10-minute intervals if needed. When combined with Vitamin D (aka sunshine) another natural depression fighter, the results can be exponential. I have found that on days I exercise I feel more motivated, accomplished, and sleep substantially better than days I do not, especially when done outside. If you are worried about managing your kids while trying to exercise get them involved by having them hunt for items while on walks or participate in an online workout with you. If there is an injury or physical ailment holding you back don’t hesitate to contact us as we are happy to help you get back up and moving.

Another way to combat feelings of depression and anxiety is to connect with others. Social connectedness has been shown to improve self-esteem, increase empathy, and even improve our immune system. In a society built on independence and self-reliance it is easy to fall into the idea that we are weak if we ask or help or rely on others, but this is necessary to our genetic make-up. We thrive on social interaction, whether you are introverted like myself and enjoy one-on-one conversations, or whether you are extroverted and love large gatherings. Make it a priority to find someone to connect with and be open with them. If social connectedness is not something you struggle with, make an effort to reach out to those who may have more difficulty than you. You will likely feel an emotional boost through your ability to help someone else.

Here are some other ways to help break the cycle of depression

  • Prayer/Meditation
  • Gardening
  • Serving others
  • Watch or listen to comedy
  • Listen to uplifting music
  • Healthy diet

If you have tried many of these suggestions and still find that you are struggling please reach out to your doctor or care giver. I am no stranger to depression as it has a long history in my family and unfortunately has led to losing loved ones. I myself have fought with anxiety disorder and have required treatment at times to help manage those symptoms. There is nothing to be ashamed about and I strongly encourage you to seek medical help if you are unable to manage your symptoms independently.

We at Flex are thinking of you and wish you all the mental health and physical wellness as we continue through this challenging season.

Click here for COVID19 and NEW E-VISIT information. 

Click here for COVID19 and NEW E-VISIT information. 

Flex Physical Therapy is currently open.

As health care professionals we are committed to providing a safe and healthy environment for our patients, staff, and community during this difficult time. We are following all protocols established by the Centers for Disease Control (CDC), the World Health Organization (WHO), as well as other local and state health agencies. To read more about what we are doing in the clinic including E-visits, please see below.


Flex Physical Therapy is now offering E-visits for our patients that are unable to make it into the clinic due to Covid-19 concerns. If this is something you are interested in, please contact your insurance company to verify if they cover physical therapy E-visits or Telehealth and then contact our office at 425-483-4270 to schedule an appointment.


  1. What is an E-visit? E-visits are non-face-to-face patient initiated digital communication (ie, like skype or facetime, although we are using a HIPAA compliant platform called doxy.me).  You can do this in the privacy of your own home or wherever you are comfortable, as long as you have access. 
  2. What do I need to do? Contact Flex PT and advise you would like to set up an e-visit with your therapist. We will send you an invite via email with a link to the HIPAA secure platform doxy.me. You will just need to click on the link at your scheduled appointment time and the therapist can then start the e-visit. (Please call the office and our staff can assist you if needed)
  3. What equipment do I need? You will need a webcam and microphone to use a computer, or you can use your smart phone or tablet.
  4. Will this cost me anything? As stated above you will want to contact your insurance directly to verify E-visits or telehealth are a covered benefit on your plan (using the codes listed above) The usual physical therapy benefits will apply (ie copays, co-insurance, deductibles -which you can ask your insurance plan about as well). 
  5. What if my plan does not cover it or I do not have insurance? Contact our office directly for information.

 If you have any further questions you contact Catrina at info@flexpt.com or call the office. 


As health care professionals we are committed to providing a safe and healthy environment for our patients, staff, and community during this unprecedented time. 

Completion of your treatment plan is important to a successful recovery. Flex Physical Therapy is open and will continue to serve our patients and community until we are directed otherwise.  We are following all protocols established by the Centers for Disease Control (CDC), the World Health Organization (WHO), as well as, other local and state health agencies. 

Flex PT shares everyone’s concerns about COVID-19 (Coronavirus) and are taking all necessary precautions to maintain a healthy and safe environment in our clinic so you can continue to receive care.

For those of you with an existing appointment, we look forward to seeing you and want to reassure you that our talented and dedicated staff are doing everything we can to promote a safe and healthy visit. 

The best prevention against viruses such as COVID-19 is to wash your hands frequently, do not touch your face, follow proper cough and sneeze protocols. For the well-being of other patients and our staff, you will be asked to notify us right away to reschedule your appointment if you: 

  • Have any symptoms of respiratory illness, including fever, cough or difficulty breathing. 
  • Have been in contact with someone with known or suspected Coronavirus (COVID-19). 
  • Have visited or been in close contact with anyone who has visited in the last 14 days countries/regions that the CDC declares high risk of infection spread. 

Flex Physical Therapy has instituted procedures to ensure preventative measures are taken to provide a safe environment for our patients to access physical therapy. All staff have been educated in these measures: 

  • Screening of all patients prior to each visit 
  • Social distancing -every effort is being made to keep staff and clients 6 feet apart including modifying schedules to reduce patient-to-patient interactions.
  • Staff are wearing masks, clients are encouraged to do so.
  • Continuous disinfection of all common areas including treatment rooms, gym space, door handles, equipment, contact surfaces at the front desk and waiting area
  • Mandatory use of proper hand hygiene among our staff to include frequent hand washing and / or use of alcohol-based sanitizer
  • Proper cough and sneeze etiquette 
  • Providing hand sanitizer for all patients upon entering and leaving the clinic 
  • Staff and patients are asked to stay home when ill 
  • Sanitizing all equipment and surfaces in between each patient

We are waiving any late cancellation fees due to respiratory illnesses. Please give us as much notification as possible (preferably 24 hours) so we can maintain our schedules accordingly.

Our team looks forward to seeing you again soon and hope you and your loved ones remain safe and healthy.  

Body After Baby

Childbirth is an incredible experience and the care of a new child frequently takes priority over the mother’s recovery. Many fail to see the all-encompassing impact of pregnancy and childbirth on a woman’s body. During pregnancy, hormones prepare the body for birth by loosening many of the important ligaments in the back and pelvis, therefore decreasing stability. These changes matched with abdominal wall expansion often have an impact on symptoms. Sciatica and low back pain experienced during pregnancy can even continue post birth.
Thankfully there is action that can be taken, both during pregnancy and after, to help keep the body happy. Gentle strengthening and stretching exercises during pregnancy can improve stability and prevent the likelihood of pain or injury. Following birth, these exercises can be progressed to reduce separation of the abdominal wall and promote a tight core preparing the body to return to previously enjoyed activities such as weight lifting or Pilates.

Text Neck

A recent study conducted by IDC1 found that 4 out of 5 individuals reach for their phones within 5 minutes of waking and then keep it with them for all but 2 hours a day. In this tech savvy world we find ourselves looking down at our mobile devices more and more frequently and now our bodies are starting to pay for it.
When we look down at our mobile devices our head moves forward, shoulders round, and muscles tense; and for every inch that your head moves forward it feels like an extra 10lbs to your neck muscles! This can eventually take its toll on our bodies and cause symptoms such as headaches, neck aches, and even on occasion, numbness/tingling in our hands.
How do we prevent text neck, you ask? Simple changes such as holding your mobile device at eye level, moving your shoulders back, and keeping your ears over your shoulders can all help to decrease strain on your neck. If you’re experiencing any of these symptoms you may want to consult with your physical therapist.

1. http://www.nu.nl/files/IDC-Facebook%20Always%20Connected%20%281%29.pdf

What is the Graston Technique®?

The Graston Technique® effectively breaks down scar tissue and reduces inflammation that causes pain and restricted mobility. Used by therapists, the stainless steel instruments comb over and “catch” on fibrotic tissue, which immediately identifies areas of restriction. The instruments enable clinicians to treat soft tissue lesions with the depth, pressure and specificity necessary to affect the condition at the site of the pain, as well as following the kinetic chain to find and treat the cause. Once the tissue dysfunction has been identified, the instruments break up the scar tissue so it can be absorbed by the body. For more information, see the Graston Technique® website: http://www.grastontechnique.com/AboutUs.html

The Benefits of Taping for Sports Injuries

Wednesday, January 08, 2014  – by Stop Sports Injuries

Kinesiotaping has been around for more than 25 years assisting the sports medicine practitioner in the areas of pain management, sports performance, physical therapy and athletic training.  This taping method was designed to facilitate the body’s natural healing process while allowing support and stability to the muscles and joints without restricting the body’s range of motion.  The tape was designed with a texture and elasticity, close to the tissue of the human body.  There are 3 main taping techniques recognized in North America.  These techniques are:
White Athletic Taping
This is the most common technique. The white tape is extremely rigid and usually requires pre-wrap prior to application.

It is used for both acute and preventative measures and if left on for an extended period of time, may cause skin irritation, due to moisture entrapment and muscular compression.  There is little to no rehabilitative benefit gained from this tape.
McConnell Taping
This technique is a bracing or supportative measure using a super-rigid, cotton mesh highly adhesive tape.  It is most commonly used in knee conditions, shoulder dislocations, and back, foot, and hip impingement syndromes.

It may be left on for an extended period of time without causing skin irritation (<18 hours).  This technique may affect the biomechanics of the patient.
Kinesio Taping
This technique is  therapeutic in nature, offering the patient or athlete both the support  and rehabilitative properties of the affected area. This technique uses a  specifically designed tape that will allow the body’s full range of  motion.  Because there is no compression to the skin and its light to  the touch, this tape can be worn over a three to five day period.  The  tape works with the body’s lymphatic system to increase both blood and  lymph circulation in order to rehabilitate and relieve pain to the  affected area.  This technique is used for virtually all clinical  conditions.
Be sure to speak with your athletic trainer or  sports medicine professional to determine the best taping technique for a  given issue/condition.

For more information visit www.sportsmed.org.

A New Breed of Knee Injury in Young Athletes

Here is an interesting article I came across that talks about this trend we are seeing in our young athletes. Worth a read.
Sometimes physicians will notice a medical trend well before science confirms its existence. That has been the case with injuries to the anterior cruciate ligament, the main ligament that stabilizes the knee joint, in young athletes. “Doctors who treat kids have all been saying over and over that the numbers of A.C.L. tears are going up dramatically,” says Dr. J. Todd Lawrence, an orthopedic surgeon and pediatric sports medicine specialist at the Children’s Hospital of Philadelphia. But surprisingly little firm data has confirmed that hunch.
So, for a study presented this month at the annual conference of the American Academy of Pediatrics in Boston, Dr. Lawrence and his colleagues parsed emergency room records of pre-adolescent youngsters treated at Children’s Hospital, looking for A.C.L. tears, as well as tears of the meniscus, the small pillows of cartilage that help to cushion the knee bones.
They also checked for fractures of the tibial spine, a fingerling spit of bone that extends from the tibia, or shinbone, to which the A.C.L. attaches. In prepubescent children whose skeletons are still growing, the slender tibial spine can be weaker than the tissues of the A.C.L. and break under the pressures of hard twisting or planting of the knee, even as the A.C.L. remains intact. “There was a time when the tibial spine fracture was the knee injury of childhood,” Dr. Lawrence says. “Twenty years ago, medical textbooks usually included a statement saying that kids did not tear their A.C.L., that they fractured the tibial spine instead.”
But when the researchers examined the pediatric hospital records, from 1999 through early this year, they found only 155 tibial spine fractures, while there were 914 confirmed A.C.L. tears and 996 meniscus tears. More important, while the incidence of tibial spine fractures increased at a rate of about 1 percent per year during that period, the incidence of A.C.L. tears increased by more than 11 percent per year. The difference almost certainly was not a result of better equipment leading to better diagnoses of A.C.L. tears, Dr. Lawrence says. “Even in 1999, M.R.I. technology was quite good,” so it was possible for physicians to differentiate between the injuries.
Which means that increasingly large numbers of young athletes, both boys and girls, are now suffering an injury to which doctors once thought they were almost immune.
Why? Scientists still aren’t sure, and that question was outside the scope of the current analysis. But Dr. Lawrence, a pediatric orthopedic surgeon who treats many of the afflicted young athletes, is willing to speculate. “I think it’s primarily because kids are out there trying to emulate professional athletes,” he says. “You see these very young athletes playing sports at an extremely intense, competitive level. Kids didn’t play at that level 20 years ago. They didn’t play one sport year-round.” As a consequence, their knees never had to withstand the kinds of repeated twists, sprints, loads and hard hits that young players now regularly absorb, he says.
Most of the A.C.L. tears that were treated at Children’s Hospital and picked up by this study, Dr. Lawrence points out, also involved a simultaneous meniscus tear, an indication of just how much wrenching and grinding the knee had undergone. Injury patterns have changed, he continues, because childhood sports have changed. “There’s a developmental soccer team here” in Philadelphia, he says, “for U-6 players,” meaning a competitive, select team for 4- and 5-year-olds. “When I heard that, I said, are you kidding me?”
The long-term effects of sports-related A.C.L. and meniscus tears in youngsters remain largely unknown, in part because such injuries were so rare decades ago. But there are indications that the consequences could be calamitous.
Recent studies of adult Swedish soccer players who tore an A.C.L. found that, within 12 to 14 years after the injury, 51 percent of the female players and 41 percent of the men had developed severe arthritis in the injured knee. The same time frame could have an injured 10-year-old dealing with a severely arthritic knee before he or she is 25. Meanwhile, many athletes who return to sports after an A.C.L. tear report that they don’t play as well, according to a new study of 500 Australian athletes, and a third of the athletes in that study did not return to any activity afterward.
“It’s definitely not a minor injury,” Dr. Lawrence says, “and it’s not something you want to see in a child.”
Whether anything can be done to lessen the toll on young knees, though, is uncertain, he and other researchers say. Knee injury prevention programs, including those that teach balance and proper landing techniques, have shown some utility in reducing the incidence of A.C.L. tears, especially in girls. But the programs are relatively new and have not been universally successful, in part, perhaps, because they can make some young athletes overly self-conscious, as an interesting review article published earlier this year suggests. In teaching children to think overtly about how to plant a leg or bend a knee while maintaining balance, some youngsters may become less fluid in their movement, more ungainly — and potentially ripe for injury, the review’s authors speculate.
A better solution would probably be to stop assuming that children can train like miniature Ronaldos or Kobe Bryants. “A lot of what we see in our injury data is almost certainly due to a statistical measure called exposure hours,” Dr. Lawrence says. “The more you do a risky activity at a high level, the more likely you are to get hurt.” His advice? “Encourage kids to play multiple sports and not to do any one sport year-round, and especially not when they’re 5 or 6, or even 9 or 10. They’re kids. Let them play and have fun, like kids.”