CASE STUDY BLOG SERIES

How does integrated health actually work? That is a very common question from new and prospective patients. Join us for a multi-part blog series, written by our experienced providers, exploring integrative care at Jade Integrated Health. Learn about real people, whose lives have been changed by collaborative medicine. First up, physical therapist and co-owner, Nancy Charlebois MSPT, LMT and therapeutic yoga instructor, Julia Redman E-RYT and their work with patient, Maddie.

How does physical therapy, acupuncture and yoga work hand-in hand at Jade?  We are happy to share a patient success story of how combined modalities help a patient recover quickly and pursue a healthy post-Jade lifestyle!

Maddie arrived at Jade Integrated Health seeking physical therapy for low back pain.  It turns out that her pain was due to a condition called spondylolisthesis, where one vertebra in the low back slips out of place onto the vertebra below it.  Her job required her to sit for long periods of time and she had limited access to a sit-stand desk.  Additionally, her pain was interfering with her ability to do every day activities, such as washing dishes, and severely limited her ability to exercise.  Her goals were to reduce back pain to be able to exercise regularly and find some alternatives to be more comfortable at work.

Her course of physical therapy started with conservative core stabilization exercises while also receiving acupuncture for pain management.  Between physical therapy exercises, soft tissue work in physical therapy and acupuncture, she quickly had pain relief for 1-2 days at a time.  The physical therapist also worked with the patient and her employer on recommendations to reduce her low back strain. This included access to a sit-stand desk, a headset so that she could move around while on the phone and brief movement or position change breaks 2x/hour.  

As Maddie’s pain was consistently diminished from a 7/10 to a 3/10 over the course of 3-4 weeks, we started working on more challenging stabilization exercises and discussions about moving into yoga therapy.  When she was ready, the physical therapist spoke with the yoga therapist regarding her diagnosis, progress and what she should focus on or avoid in yoga.  In Maddie’s case, she needed to avoid low back extension as this could aggravate the spondylolisthesis.  As she began yoga therapy, the goal was for her to progress in key areas of flexibility, strength and to develop a home yoga practice that she could continue post-therapy to stay strong and explore more rigorous exercise, if she chose, with lesser risk of injury.  

In her yoga sessions, Maddie practiced keeping her pelvis and spine neutral with the help of core integration. Then, from that foundation of stability, added movements and postures that would help with mobility and flexibility. The sequencing choices were based on the information received from the physical therapist, and the types of exercises she had been doing during her physical therapy sessions. After practicing the yoga sequence in a 1-on-1 session, Maddie brought the sequence home to help establish a sustainable home routine. This gave her the opportunity to practice yoga on her own while minimizing the likelihood of aggravating her spondylolisthesis. She made noticeable progress over her three yoga sessions, and it was clear she had practiced throughout the week.

Maddie seemed to benefit greatly from this integrated approach of physical therapy, acupuncture, and yoga. She showed great interest in continuing yoga, at home and potentially in group settings. With a diagnosis of spondylolisthesis, the realistic goals are for the patient to continue with exercise to minimize the mechanical issues and pain in the low back.  When Maddie was discharged, her pain levels were 0-1/10, she was consistently doing yoga at home, functioning well at home and work, and considering yoga and group exercise classes. Well done Maddie!