Occupational Therapy…Where Creativity and Compassionate Care Collide

In celebration of Occupational Therapy Month in April, we are celebrating our 17 in-home and outpatient occupational therapists (OT) at RVNAhealth. We sat down with Gigi Weiss, MSPT, RVNAhealth Director of Rehabilitation Services, to talk about RVNAhealth’s own OT team. “Problem solvers…creative strategists…fitting square pegs in round holes…not cookie cutter…thinking outside the box.” These are just a few of the phrases Weiss uses to describe her occupational therapy team and the work they do. Okay, so these OTs sound like pretty interesting people! So, what exactly do they do and why do they need to be so creative? RVNAhealth has tackled this topic before (check out this great video interview by our very own Danielle Taibi, RVNAhealth Home Health Aide Supervisor, Occupational Therapist MOTR/L, CDP). To summarize, occupational therapists focus on addressing an injury, illness, or post-surgery condition that has disrupted a person’s normal activities of daily life (“ADLs”) – activities as basic as eating, bathing, and dressing, for example. They focus not only on helping to rehabilitate the affected area, but they also place tremendous effort on creative and attainable adaptations to enable a patient to have greater independence and function in those daily activities as they recover.

Mrs. McMorran and Christine Cooper, OT/L, practicing skills and adaptations for cooking

Given the focus on activities of daily life, OT goals often focus on reclaiming a patient’s ability to complete basic and fine motor skills needed at home…from dressing oneself and using buttons or zippers, to bathing and personal hygiene, to picking up a utensil, cup, or a pen to write with. In focusing on the goal of accomplishing greater independence, a patient may be taught how to accomplish a task (e.g., buttoning a shirt) in an entirely different way, or recommendations may be made for devices to help make such tasks easier.

We were able to capture the unique art of occupational therapy during a recent visit with RVNAhealth patient, Mrs. Monica McMorran of Ridgefield, and her OT therapist, Christine Cooper, OT/L. Cooper was working on a variety of practical activities to assist Mrs. McMorran with improving her strength as well as how to accomplish many activities around the home. From practicing and discussing best approaches for moving in and out of the shower, to practice time in the kitchen working through techniques for cooking and standing safely at the stove, to the basics of how to use tools to assist with putting on socks and sneakers. When asked what she has appreciated most about OT, Mrs. McMorran’s immediate response was, “It’s practical! And it’s about getting on with living!”

Practicing the use of adaptive equipment for dressing

Echoing the experience we witnessed with Mrs. McMorran’s therapy session, “Occupational therapists are masters of adaptive equipment. Devices such as reachers, sock donners, and foam on utensils or pencils are just a sampling of the toolkit an OT may use to help a patient regain independence,” says Kate Campbell, DPT, RVNAhealth Outpatient Practice Manager. “In addition to adaptive equipment, OTs are also experts at home safety modifications and equipment. Focusing on a patient’s environment – e.g., lighting, floor surfaces, bathroom layout — is just as important to regaining independence as focusing on the patient and their abilities.”

“Occupational therapy is often overlooked, especially for outpatient rehabilitation needs” says Gigi Weiss. “Physicians or Orthopedics tend to be more familiar with physical therapy.” As such, she encourages patients to become their own advocate and ask about occupational therapy when seeking rehabilitation – especially when there is a need and desire to regain ability and independence in basic activities of daily life. All OTs at RVNAhealth have achieved masters or doctorate level degrees in their field and are highly recommended. As

Sarah Triano, OTR/L, works with an outpatient client

one recent patient added, “[My] expectations for OT were very high, but my therapist EXCEEDED them.” Weiss attributes this success to RVNAhealth’s overall unique rehabilitation program. “We offer both occupational therapy and physical therapy services, in-home and at our outpatient facility in Ridgefield. Finding OTs, working alongside PTs, particularly in the outpatient setting is rare. But this enables RVNAhealth’s ability to evaluate and make recommendations to both patient and physician if we feel someone could benefit, for example, from OT rather than physical therapy.”

For more on RVNAhealth’s occupational therapy and other rehabilitation programs, please visit rvnahealth.org or call 203-438-7862.

It All Starts with the Feet

And not all feet were created equal.  Which is exactly why RVNAhealth is now offering custom and semi-custom orthotics.

The importance of a good foundation has long been established.  Be it a skyscraper, a novel, a wedding cake, or an education, it’s that which comes first that provides structure and stability to that which follows.

The human body is no different, with our feet playing a critical role as our foundation. “The fact is,” says Kate Campbell, DPT, Outpatient Practice Manager at RVNAhealth, “the importance of our feet is paramount, yet they are often overlooked — and entirely unappreciated! Each foot is composed of 26 bones, 30 joints, and more than 100 muscles, tendons, and ligaments. From our very first steps, they bear the brunt of every stride and skip, every leap and bound, every stub and twist. Our entire body lies above them, and any imperfection or deformity in the foot invariably impacts the whole body, often manifesting in pain or issues elsewhere.”

Gigi Weiss, MSPT, RVNAhealth Director of Rehabilitation & Wellness continues, “As physical therapists, our goal — our job —is to resolve the pain and issues of our clients and restore them to optimal strength and mobility. Many times, when a client presents with back, hip, or leg pain — and of course, foot pain —the root issue may lie at the foundation, the foot. In these cases, we can only treat their full condition by addressing their feet.”

For this reason, RVNAhealth has added custom and semi-custom orthotics —inserts placed inside the shoes with the purpose of restoring natural foot function and enabling optimal biomechanics — to our Rehabilitation & Wellness service offerings. “Those who already wear orthotics likely understand their value and how they work,” says Campbell. “But for those new to orthotics, we can help you identify if an orthotic is right for you and walk you through the process from start to finish to ensure a successful end result.  Believe me, the right orthotic can be life changing.”

Here’s everything you need to know to get started:

Does RVNAhealth offer a particular brand of orthotics?
RVNAhealth offers Stride™ Orthotics. Stride is based out of Middlebury, CT, and we think they are the best in the business. We are committed to their product which pairs well with our process of capturing and molding the foot in its natural state, not its deformed state. With this approach, and Stride’s products, we can then build an orthotic that compliments the natural foot to optimize balance and alignment.

RVNAhealth offers both semi-custom and custom orthotics, correct? What is the difference?
Custom Orthotics are built entirely ‘from scratch’ beginning with an extensive evaluation and measurements, molding of the foot, and then designing the orthotic based on the patient’s specific needs (for example, shoe-type like sneakers vs. loafers, or to accommodate specific pains or conditions like diabetes, etc.). Semi-custom orthotics begin with a ‘prefabricated’ Stride orthotic and are customized from there to meet your specific needs. Stride offers six prefabricated models based on six different foot types.

Who needs orthotics? How do I know if I need them?
Honestly, everybody with foot pain, knee pain, back pain, flat feet, too-high arches, shin splints, plantar fasciitis, neuromas, you name it, might need orthotics. Tendonitis, ankle sprainers, Achilles’ heel, etc.  If you are uncertain, we can help you with an evaluation/ consultation.

Why would I get orthotics from RVNAhealth rather than a podiatrist office?
RVNAhealth offers orthotics as a specialty service to help resolve and prevent injury. Our methodology takes time and expertise and includes a detailed evaluation with the gold standard of casting methodology. At an RVNAhealth orthotics appointment, we perform a complete treadmill gait analysis; take digital photos of your feet; review old shoes to see wear pattern; evaluate feet in standing and laying (non-weight bearing) positions. We make a plaster of Paris mold of the foot in a perfect gravity-eliminated state, capturing the foot in its natural state, not its deformed state. Orthotics are intended to prevent further change and deformity in the foot — and in some cases are successful in ‘re-training’ the foot back to a healthier state — and our process successfully supports that intent. The RVNAhealth team currently includes two trained Stride Orthotics Specialists, fully educated on the process with ongoing education and training for the whole staff.

How much do RVNAhealth Stride Orthotics cost?
Custom Orthotics cost $450 and semi-custom orthotics cost $150. Both include evaluation, casting, and follow-up fitting until we know they are right. Re-orders of the same orthotics (for multiple pairs of shoe types) do not require an additional evaluation, hence are significantly reduced. (Actual cost depends on type of orthotic, shoe, etc.)

How long do Orthotics last?
Custom orthotics last for several years if you take care of them or “refurbish” them every year or two. Refurbishment means the orthotic liner is temporarily removed, the orthotic is ‘plumped back up’ and returned to its original shape. Refurbishment is sort of like a tune-up for your car. Semi-custom orthotics ($150) do not get re-furbished. They are replaced every year or two, depending on wear. Semi-custom orthotics are good for kids whose feet grow, and first-time orthotics wearers.

Does RVNAhealth accept insurance for orthotics?
No. Some HSAs and Flexible Spending Accounts, however, do reimburse for orthotics.

How long from my casting appointment until I receive my orthotics?
About 4 weeks.

What if they don’t work?
Getting used to your orthotics takes time and we recommend a staggered wearing sequence for the first few weeks once you start your orthotics. If something still isn’t right after two weeks, it needs to be looked at. We have 90 days to get it right and work with the lab to correct.

Might my child need orthotics?
If your feet are problematic, your children will likely have the same issues. Orthotics are also appropriate for children with Osgood-Schlatter disease; patella tendonitis; flat feet; toe walking; in-toeing; knock knees, and many other issues. If you have concerns, call us at 203-438-7862 and we can work together to figure it out.

Volunteer Spotlight – ‘Meet the Anns!’

Like many not-for-profits, RVNAhealth counts on a corps of volunteers to complement our staff with their professional expertise, fresh perspectives, and their good old-fashioned manpower. The RVNAhealth volunteer program offers safe and diverse opportunities for donating time in a way that is purposeful and meaningful for everyday heroes of all ages.  

Meet Ann Harrington 

When did you start volunteering for RVNAhealth?    July 2021

Why did you choose to volunteer for RVNAhealth?   I was interested in helping in the community for an organization that promotes wellness and quality of life

What kinds of things do you do for RVNAhealth? I volunteer in the Rehabilitation & Wellness  Center helping the therapists with equipment set-up, maintaining the gym, greeting and checking in patients, and learning the scheduling system.

What is your favorite part about your role?  The friendly staff and clients, pleasant working environment and the opportunity to learn new skills.

Is RVNAhealth what you expected?  Yes. It is very busy, and you need to multi-task. I gained new appreciation for what the therapists and admin staff do.

Please tell us a little about yourself!  I was born in Buffalo, NY and moved to CT after college to begin working in advertising. I’ve held positions in children’s book publishing and managed health care. My husband Steve and I have 2 children in their 20s.

I volunteered in different organizations while my children were in school. 

Where do you reside?  Ridgefield.

What else do you enjoy doing?  Swimming, theater, walking, traveling, wine-tastings, dogs.

Do you volunteer with any other organizations?  Yes, I am involved in Community Bible Study and Smart Kids with Learning Disabilities.

Meet Anne Gilson

When did you start volunteering for RVNAhealth?    Summer of 2021

Why did you choose to volunteer for RVNAhealth?  My husband had back surgery and RVNAhealth came to our home and helped get him back on his feet.

What kinds of things do you do for RVNAhealth?   Prepare intake folders.

What is your favorite part about your role?  The cheerfulness of the staff.

Is RVNAhealth what you expected?  No, much more. I did not realize all the services offered.

Please tell us a little about yourself!  In the morning, I work at Wooster School in Danbury.

Where do you reside?  Ridgefield since 1988.

What else do you enjoy doing?  I have 3 grown children (all with health insurance). Love reading and traveling.

Do you volunteer with any other organizations?  Daily Bread. 

 

RVNAhealth is infinitely grateful for the support and friendship of Ann Harrington and Anne Gilson. We invite others in the community who are interested in volunteering and supporting our mission to get in touch.   We have assignments big and small!

 

Volunteer Today!

RVNAhealth Unveils Pat’s Path

On Thursday, October 28, RVNAhealth unveiled a distinctive memorial renovation, officially called ‘Pat’s Path,’ in the RVNAhealth Rehabilitation & Wellness Center. The Path is a gift from the Patricia M. and Robert H. Martinsen Foundation and is a tribute to Patricia ‘Pat’ Martinsen who died in 2020.Continue reading

Balance Matters!

Balance is an important part of optimal health, particularly as we age — meaning as we advance past the age of 30.  (Yes, 30!)  And not just equalizing work/life obligations, but physical body balance. Balance is the state of equilibrium when all forces are aligned resulting in optimal posture, muscle control, and spatial orientation.  Much like with lifestyle balance, if our bodies are not properly aligned, undesirable consequences are the result. With normal aging, or following injury, surgery, or any physical stressor, improper balance can result in falls, muscle/strength weakening, and decreased mobility.

Maintaining healthy balance is not difficult and can improve overall movement, enhance joint mobility, and reduce injury risk. According to the Centers for Disease Control, the muscles that keep us upright begin to weaken in our 30s and falls are a leading cause of injury or death in people over age 65. One in three in this age group experience a debilitating fall each year.

Oftentimes, people don’t recognize when their coordination is compromised and the RVNAhealth Rehabilitation & Wellness Center team offers tips for maintaining optimal balance health at every age:

Strengthen core muscles. It doesn’t take a crunch class at the gym to increase core strength (though don’t let us stop you!). Some simple ways to engage core muscles include planks and push-ups (try doing them on the counter if the traditional floor versions are too much. Add an arm lift to the plank if you’re able.

Improve your static balance (your ability to hold our body in a specific position and posture) by standing on one leg. On a flat, stable surface, like while at the sink or on the phone, lift one leg off the floor – even a few inches. Then repeat with the other leg. Do whatever it takes to hold for 30 seconds. Always repeat this exercise more than once. The first time simply wakes up the nervous system, but the second or third round really reiterates the learning and engrains the new pattern.

Walk heel to toe twenty steps forward and twenty steps back to the starting position.  This works on your dynamic balance. Use arms for stabilization, as needed. Then walk on your tippy toes, walk on your heels, walk sideways, and walk BACKWARDS! With caution, please!

Incorporate quality rest. A good night’s sleep improves equilibrium; sleep deprivation can slow the body’s ability to respond, increasing fall and injury risk.

Do Yoga. Regardless of fitness level, yoga is a safe way to improve strength, lengthen muscles, and reduce stress, all which can impact body balance.

Stay hydrated! The Vestibular system in the inner ear relies on a good fluid balance. Being dehydrated can lead to slower reflexes in response to a fall.

Give the brain a good workout.  Yes, the brain plays an important role in body balance because it processes signals from the sensory body systems to aid in movement and balance. Keeping the brain engaged through reading, word/numeric puzzles, other mind-challenging hobbies, listening to music, or trying a new skill can strengthen brain performance which positively affects balance.

If your balance is a concern, contact the RVNAhealth Rehabilitation & Wellness Center at (203) 438-7862 to schedule an evaluation, or attend an upcoming Falls Assessments & Balance Testing program.

Gen Fagan is Back in Action!

It was April 2021 and things were looking up. Spring was on the horizon, and COVID-19 vaccines were beginning to take hold, bringing hope for a return to life as we formerly knew it. But for Genevieve Fagan, known fondly as Gen, life took an unfair turn. Continue reading

Back to Backpacks

It’s almost the time of year when green leaves turn fiery, and days get shorter. Soon the roads will be peppered with the surest sign of summer’s end: school buses. As students prepare to re-enter the classroom — some for the first time in a long time — and families shop for back-to-school supplies, the RVNAhealth Rehabilitation and Wellness Center has tips on how to help kids avoid discomfort and potential injury by considering an oft-overlooked culprit: the backpack.

The American Academy of Pediatrics advises that kids’ full backpack weight should fall between 10-20% of total body weight and one study revealed that the average high schooler’s backpack weighed in at nearly 19lbs. That’s a lot of weight for young people to carry around. Sarah Triano, OTR/L, RVNAhealth Occupational Therapist, shared the following tips to prevent backpack injuries:

Buy the Right Size
The backpack should not exceed the length of a child’s back. If it falls more than 3” below the child’s waist with the straps secured comfortably, it is too large

Consider the Straps
Straps should fit snugly around the shoulders without a large gap; Both straps should be used to balance the weight evenly across the back and chest; and thicker straps are preferable to thin which can cause circulation problems and extremity tingling/numbness

Lift With the Legs
When picking up the backpack up from the floor, bend at the knees and avoid bending at the waist which stresses back, shoulder, and neck muscles

“Wearing a backpack inappropriately won’t necessarily have an impact straight away,” says Triano, “but it will lead to a build-up of postural strain that may result in injury weeks, months, or even years down the road.  That’s why proper usage, plus keeping the weight to a minimum, is important.”

Should injury develop, Triano recommends early intervention as the best course of action. “Without proper treatment, a small strain can quickly become a more complicated situation.” she notes.

For more information, or to schedule an appointment with an RVNAhealth Rehabilitation therapist, call (203) 438-7862 or visit https://rvnahealth.org/services/get-well/rehabilitation-center/

And now for all you history buffs — the origin of the current-day backpack:

A marriage proposal is largely responsible for the modern-day nylon, double-strap, zipped accessory seen at bus stops around the country. Murray Pletz and Skip Yowell, cofounders of a 1960’s, Seattle-based, outdoor gear company, re-developed a pack concept created by Gerry Cunningham of Gerry Outdoors, for a nylon daypack designed for skiers and hikers but neither knew how to sew. Pletz’s girlfriend, Jan Lewis, an unemployed teacher, owned a sewing machine and Pletz offered her more than a partnership in the company if she came onboard. If she accepted Pletz’s marriage proposal, the company would bear her name. In 1969, JanSport was born. Over the next two decades companies like LL Bean joined the competition and by the late 1980s nearly every kid in America sported a backpack for schoolbooks and supplies.

While we’re on the topic of school, read up on Back to School Fuel and how to keep those daily lunches healthy — and interesting.  

 

Get to the Starting Line with RVNAhealth

August 4 2021:  In just over three months time, Andrea McGowan will be standing on the Verrazano-Narrows Bridge in Staten Island, about to embark on one of life’s fascinating journeys: the 26.2-mile New York City Marathon. Between now and then, Andrea will increase her weekly running mileage; conquer distances she has never approached before; and will log hundred of miles on the roads. Andrea is doing the race not only for personal challenge and fun, but to raise funds for Girls on the Run NYC, a not-for-profit organization with a mission near and dear to her heart.

To get to the NYC Marathon starting line feeling her best, it’s Andrea’s job to stay healthy and strong, which is exactly what brought her to RVNAhealth on a recent weekday evening.  Andrea came for a Running Evaluation with RVNAhealth physical therapist, Kate Campbell, DPT.

“I’m so excited to be training for and running the NYC Marathon,” says McGowan. “I feel great right now, and I want to keep it that way. I’ve had shin splints, occasional Achilles tendinitis, and some toe pain in the past, and I want to keep those at bay, so I can enjoy my increased fitness, and relish the race experience.”

“Training for a marathon — or any race for that matter, “says Campbell, “is a true investment of time, energy, and emotion. You want to stand on that starting line confident, strong, and ready to achieve your goal. It’s no fun to race injured or tentative. Our Running Evaluation is an intensive assessment that helps you understand your strengths and vulnerabilities. Andrea is smart to be doing this proactively, so nothing will sideline her training or compromise her race.”

The 90-minute evaluation includes video analysis of running mechanics; strength assessment of muscles related to proper mechanics and injury prevention; flexibility assessment; a foot and shoe analysis; and an individualized home exercise program based on the evaluation results and aligned with personal goals.

Meet Andrea McGowan

Andrea McGowan, at left, with Kate Campbell, DPT

Q:  How many years have you been running?
A:   I have been running for about 10 years, but have competed in other sports my whole life.

Q:  What did you learn in your Running Evaluation with Kate?
A:   I learned so much about my stride; where I should be striking the ground; where my feet should land with regard to my body, and much more! I also learned some great exercises that can help me prevent injuries.

Q: When did it first occur to you that you wanted to run a marathon?
A: After I did my first half-marathon in 2017 (Fairfield Faxon), I think it ignited the idea! I like to push myself and having a goal to work toward really helps my mental health while improving my workouts! I decided to take a gap year before I start medical school in 2022, so now feels like the perfect time!

Q: Do you know what you’ll be focusing on in medical school?
A: I’m interested in working in gastroenterology or women’s health! I truly haven’t decided, but I hope to do research and practice clinically. (By the way, Andrea is going to medical school at the University of Michigan. Go Andrea!)  

Q: How is training going?
A: Training is going well! I look forward to my workouts after I finish my work day. I have been following a training plan that was recommended to me by a few other runners. I am trying to be super intentional with my workouts and also with my recovery. I am increasing my mileage gradually each week.

Q: Do you think you’ll be a multi-marathoner, or ‘retire’ after NYC and move on to other pursuits?
A: I can definitely see myself catching the marathon bug because I like working toward goals! I think it will be a matter of how this one goes and how much time I have in the future.

Q: Can you tell us a little more about Girls on the Run (GOTR)?
A: Absolutely! Girls on the Run NYC is a nonprofit organization that empowers young girls through a transformative running-based curriculum. The program focuses on building skills surrounding connection, confidence, self-esteem, and goal-setting all with the overarching goal of helping girls recognize their limitless potential!  I am so excited to be part of the GOTR NYC Marathon team. In today’s world, girls are constantly greeted with the idea that they are not enough and that they need to change themselves in millions of ways to meet societal ideals. I love that GOTR works to challenge those beliefs and empower girls to be their authentic selves.

To learn more, or schedule an RVNAhealth Running Evaluation, contact rehabcenter@rvnahealth.org, or call 203-438-7862.