Carl Maronich (Host): Welcome. This is Neighbors Helping Neighbors, the official podcast of Ward Memorial Hospital. I'm Carl Maronich, and with me today is Homer Pique. Homer is a Physical Therapy Assistant at Monahan Physical Therapy at Ward Memorial Hospital. Welcome, Homer.

Homer Pique: Oh good. Good morning, sir.

Host: Today we're going to be talking about recovering, strengthening, and managing pain through physical therapy. So Homer let's get into it. Maybe you could start by telling us a little bit about your role at Monahan's Physical Therapy there at Ward Memorial Hospital.

Homer Pique: My name is Homer Pique. I serve as the Director of Monahan's PT Clinic. I manage the clinic's day-to-day operation. It combines the administrative function, of course, and the hands-on clinical duties to make sure our team delivers excellent service and keeping the clinic efficient and our patients happy and satisfied.

Host: Very good. Now, what type of patients do you typically treat and, and how do you try to personalize that treatment for patients?

Homer Pique: Well, at Monahan's PT Clinic we work with a diverse range of patients, including those recovering from orthopedic injuries, post-surgical rehabilitation, chronic pain conditions and urological disorder. Now each patient, as we all know, will present a different or unique set of challenges. So it begins with a comprehensive evaluation from our evaluating therapist to understand their medical history, physical limitations, personal goals, and from there the treatment plans are being tailored using evidence-based techniques, whether it's a manual technique, therapeutic exercises, modalities, this is to match their specific needs and lifestyle.

Now the plan of care and goals are also reassessed on a timely basis as they progress ensuring that they stay aligned with the recovery and functional goals.

Host: Sure. Now, are there common conditions that physical therapy can help with?

Homer Pique: The common conditions that PT, because it can cover like different condition on a wide range between groups and activity levels. So the most common is the orthopedic conditions. It could be joint replacement, fractures, tendonitis, bursitis, back pain, and neck pain. We also have the neurological disorder, which would include stroke, Parkinson's, multiple sclerosis, or MS, TBI. And sometimes it would coordinate with balance and coordination issues. Mobility functions is also another thing which would entail the gait, fall preventions, muscle weakness, and the conditioning and postural dysfunction.

The last one would be sports related injuries and the chronic pain and inflammatory conditions like arthritis, fibromyalgia, chronic low back pain, and myofacial pain syndrome.

Host: A little bit about the course. So if I have something that's sore, I may go to my primary care provider first, and they, they may then refer and recommend a physical therapy. Is that, right?

Homer Pique: Yes, sir. So what's happening is the primary care physician will give us, or an orthopedic or a specialist would give us an order. And from there we go on with the initial evaluation and the treatment of the patients.

Host: Very good. Now I understand aquatic therapy is something you do as well, is that right?

Homer Pique: Yes sir.

Host: Talk a little bit about that. How does that work?

Homer Pique: So in our facility, Monahan's is lucky to have a pool, which usually has a treadmill under the water. So typically with the properties of the water, like the buoyancy, the reive forces, and the hydrostatic pressure, it acts as a buffer in the joints of the patients, making sure that it has given like a low impact on that one.

So it all starts with the exercises while being immersed in a warm water where the buoyancy dramatically reduces the joint impact as much as 75 to 80%. So imagine a patient's on the chest level water. The water is on the chest level, where if a patient is like a hundred pound, we take out like 75 pounds of that one.

So basically he's just like 25 pounds under the water. And this means that the individual can recover from orthopedic injuries, post-surgical procedures, strokes, or chronic pain earlier than doing it on land exercises such as weights and pulleys.

Host: Interesting. Are there some candidates that are better suited to aquatherapy than others?

Homer Pique: In most cases, the candidates for aquatic therapy would be the post-surgical patients, especially recovering from joint replacement, ligament repairs or spinal surgeries. The water reduces the stress on the joints and allow early mobility. The other one are arthritis patients or chronic joint pain. The buoyancy's pressure eases the painful joint and making more movement, more comfortable and sustainable. Now, for neurological patients, it's usually the stroke and the Parkinson's, or the MS patients. The environment of the water give them a more like a safe and supportive environment that kinda triggers the balance and coordinations. Athletes, also for recovering from injury. It gives them to maintain the cardiovascular fitness, muscle strength, while minimizing re-injury, and especially the older adults that we have Aquatic therapy, as I said, offers low impact. It's a one way of improving mobility, strength, and confidence with the movement.

Host: Yeah, interesting. Now, physical therapy usually comes into play when someone's having pain. Going through the physical therapy process can be painful to a point as well, but that's all trying to make things better. You know, there's no, no gain without a little pain as they say. But you can you talk a little bit about pain management and prevention in terms of physical therapy?

Homer Pique: Usually for pain or what we call is a chronic pain, and usually PT is a critical component in supporting older adults with health and independence particularly in managing chronic pain and improving balance. Well, with PT, it's a multidisciplinary approach. We employ targeted exercises to strengthen supportive muscles.

We give manual techniques to enhance the mobility to reduce the tension in the joints, and we also use like a multimodal approach, like therapeutic modalities. This would decrease the discomfort and promote tissue healing also. And additionally, with PT as far as pain is concerned, we try to educate the patient.

This is a key role in equipping the individual with the practical strategies for pain management and functional movement which would improve the quality of life and sustain autonomy for movements.

Host: Yeah, that sounds great. And we think of PT really as injury recovery. You've had an injury you're trying to recover, but prevention is something else you can help with. Can you talk a little bit about that?

Homer Pique: So PT it's a common notions that PT is only used for people who are injured, but PT itself, it's not just a reactive, but it's also a proactive way of looking at movement. Well, it gives you a powerful tool for preventing injuries and managing chronic conditions and optimizing the movement before the problem arises.

So PT isn't just something you turn into when things go wrong, it's actually making a smart way to stay ahead of the game.

It helps you bounce back after an injury, but it also is a great way of keeping your body moving well, avoiding future issues, and staying strong if you're dealing with a chronic pain condition.

Host: You mentioned a little bit ago balance issues. Maybe you could talk a little bit about the ways that physical therapy can help with balance issues and why that's so important, particularly as we age.

Homer Pique: With the balance issues, the main goal of the PT is to prevent, which is usually fall, which is the most common scenario for this one. With the balance training, we normally starts with the muscles, targeted muscles that could strengthen usually the core and the lower legs or the legs. We also progress with the gait training, which improve the walking patterns and confidence of the patients.

Now, we also give like balance exercises which, which challenge the stability in a safe and controlled ways that would retain the body's response. Now, strengthening training is another part, as we said a while ago. And one more thing, there's a vestibular therapy. Which it involves the being dizzy for quite some period of time, but there's a particular technique that can prevent that from happening or decrease the episodes of dizziness through equilibrium training.

Host: And those balance issues as we talked about, so important as we age to make sure we prevent falls, is really one of the main objectives, is that, isn't that right?

Homer Pique: Yes. That's correct. That's correct. So, that particular scenario, so PT isn't just about exercise. It's about restoring freedom, whether it's a walking without fear, sleeping without pain, or simply enjoying the normal daily activities of a person.

Host: Yeah, that's so, so important. For a rural hospital like Ward Memorial to have full service PT is really important. Talk a little bit about that and why it's so significant, particularly in a rural environment.

Homer Pique: A full service PT department is a strategic asset for a rural hospital like Ward Memorial. It enhances both patient care and community health. By offering comprehensive services on site, it improves access to rehabilitation, it reduces the travel burdens, and it ensures continuity of care.

And this leads to a better clinical outcomes, including reduced readmissions, lower healthcare costs, and improve quality of life, particularly for older adults. So, overall, it plays a vital role in promoting long-term wellness across the community.

Host: So many important things, and maybe you could also talk a little bit about how Ward Memorial's expanded facilities have been able to impact the way you deliver care.

Homer Pique: I would say that at Ward Memorial Hospital, going to the PT clinic isn't just a response to an injury, it's a proactive step toward lifelong wellness. Whether you're recovering from surgery or managing chronic pain, or simply looking to move with more ease, our team would offer a personalized care that meets where you are. You're not just getting the care, you're getting a team that knows your community and understands your needs, and it's committed to helping your tribe close to home.

Host: Now, Homer, what would you tell someone who may be on the fence about whether or not they should start physical therapy?

Homer Pique: I would say you are on the right track. You don't want to get it worse before you go to a doctor or see us. Starting early would really make a big difference for the outcome of the patients.

Host: How do you measure progress fully? I'm sure there's a variety of ways, but how are you measuring progress of a patient?

Homer Pique: Normally we have some scale that we use for this one, especially for balance. So initially the patients would be able to stand for less than two minutes, and you would see the patients would fumble or the patients with swing back and forth. As they progress, they can stand in one leg. The trunk are more in erect positions.

 They can move freely. They can transfer from one chair to the other, and that's for the balance. But for the most cases that we handle, for the orthopedic cases I would suggest they would start here coming as in crutches or walkers. And the progress of this one is that at the end of the prescribed plan of care, they usually walk free from any assistive device.

 It's like being free from the bandage of this wheelchair or assistive devices.

Host: That definitely shows progress. well, Homer Pique, Physical Therapy assistant there at Monahan's Physical Therapy at Ward Memorial Hospital. Thanks so much, and for more information, you can go to wardmemorial.com/podcast.

And if you enjoyed this podcast, please share it on your social channels and check out the entire podcast library for other topics that may be of interest. I'm Carl Maronich and this is Neighbors Helping Neighbors from Ward Memorial Hospital. Thanks for listening.