By Deb Matsuura

To Dream the Impossible Dream: My Journey to Japan

Lifelong Learning Hawaii-Japan Oct 2016

Guest Blogger: Art Lum, P.T., co-owner of Fukuji & Lum

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[two_third_last] Lifelong Learning Hawaii-Japan logo: The symbol marking the beginning of this Hawaii-Japan relationship was the Enso – a hand drawn open circle allowing for movement and development. [/two_third_last]

The recent historic visit by Japanese Prime Minister Shinzo Abe with President Barack Obama to Pearl Harbor on December 27, 2016 brought back memories of an extraordinary work experience I had in Japan. Following three years of planning, the Fukuji & Lum team and fellow physical therapy colleagues from Japan created a series of courses titled ‘Best Physical Therapy Practice’.

The first of a four part series of courses was conducted, on October 22nd and 23rd, 2016 at Kuwana East Medical Center, Mie prefecture, Japan. The course introduced an integration of the respiratory, neurological, and musculoskeletal systems for lifelong physical therapy care.

On October 22nd, at 9 a.m., my heart beat began to rise as the first slide presented the Hawaiian flag alongside the Japan flag – the Rising Sun. Pictures of my professional membership cards, the American Physical Therapy Association (APTA) and the Hawaii Physical Therapy Association (HAPTA) were shared along with my Master of Arts degree diploma in Physical Therapy from Stanford University ’84. The journey had begun.

The objectives of the course were:

  1. To introduce the Annual Musculoskeletal Examination
  2. To teach manual assessment and treatment techniques integrating the system approach
  3. To teach postural and neuromuscular rehabilitation techniques
  4. To introduce a unique physical therapy model
  5. To build a relationship between physical therapists from Hawaii and Japan

[one_half] Bringing unity to this special grouping was the donning of the lime-green colored class t-shirt. The made-only-in-Hawaii sky blue colored wording and the white-brushed Enso brought smiles, enthusiasm, and cheer. We were now ready to begin our journey together, open for learning and sharing; as professionals, classmates, and friends. [/one_half]

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There were two staff therapists from the Kuwana East Medical Center who played a pivotal role in making the course a tremendous success. Rie Takakura, P.T., who works part time at the medical center and is on-call with us at Fukuji & Lum was instrumental in ‘making it happen’. She designed the manual, translating every page and served as the course assistant. Her dream of advancing physical therapy in her hometown and community in Japan had begun and was now in process.

Takashi Maruyama, P.T., Manager of the Rehabilitation Department at the Kuwana East Medical Center was a gracious host and facilitator. Takashi-san went beyond the call to create an optimal learning environment. Arranging the manpower for setup and take down and taking the leadership in accommodating the group needs and wants. He monitored the pulse of the class and acknowledged we were on the right pace. His hospitality went beyond the call in driving the F&L contingent to a nearby famous Garden saving time and ‘stress’ in confronting bus and train schedules.

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The class was made up of a diverse group of professionals. Recent graduates, a professor of Biomechanics, and veteran PTs. Several had been trained in the U.S.A. and were familiar with the Paris and Sahrmann System. The majority enjoyed the ‘active’ learning atmosphere, hands-on manual therapy skill training, and patient demonstrations.IMG_3589

The introduction of the Annual Musculoskeletal Examination served as the blueprint, outlining strategies for clinical decision making in addressing the six major areas:

  1. Breathing – respiratory system.
  2. Posture – attaining a position that allows optimal performance, both static and dynamic. Adding efficiency, balance, and preparedness in anticipation for integrating a purposeful movement.
  3. Locomotion. From walking to striding.
  4. Reaching. The optimal use of the upper quarter, grounded and energized by the lower quarter and trunk, for daily function.
  5. Spine mobility. Turning on the transverse plane; head, neck, torso, pelvis, and hip for safety and energy transfer.
  6. Fulfillment in life. Doing things that you have always enjoyed doing (traveling, gardening, taking long walks, skiing, yoga etc.).

The unique physical therapy model (UPTM) which was also introduced to the group has evolved over my past 32 years in practice, as a clinician. I am grateful for my colleagues and indebted to my mentors. My deceased father, Chew Mung Lum, embraced his physician career of 50 years.  My elder brothers, Steven Lum, MD and David Lum, Esq., and brother-in-law Robert Wo, Jr, are exemplary role models; as business owners serving their respective communities. The faculty members of the Stanford PT School, Professor David Auxter, and Erl Pettman, PT,MCSP,MCPA,FCAMT, one of four founding members of NAIOMT, most influenced my clinician hat, passion for teaching, and lifelong learning.

Referring to the historic visit; Governor David Ige writes, “Hawaii’s relationship with Japan is more than business, more than friendship. It is about family”. Words cannot describe the emotions exchanged at our first meeting on those two days in October of 2016. Rie, Takashi and I believe that we have planted the seed to growing our Hawaii-Japan relationship, building a connection that will help the world of physical therapy prosper. Together, we are committed to lifelong learning; for the goodness and well being of our patients and the lifelong care of our communities.

In awesome wonder and gratitude, I look forward to what’s ahead in 2017. Part Two: Best Physical Therapy Practice. April 15, 16. Osaka Rehabilitation University, Japan.

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Happy at Work
By Deb Matsuura

HOW IS YOUR POSTURE?

Tami Patrick, a Physical Therapy student from Andrews University spent 8 weeks with our therapists in the Kailua clinic learning and working with patients in an orthopedic outpatient setting. While with us, she gave an inservice to the staff on POSTURE. Her presentation definitely reminded us to sit properly and stand correctly as we go about our daily activities.

What is Posture?

  • Posture: a position of a person’s body when standing or sitting.

Who cares?

  • Good posture contributes to good appearance; the person with good posture projects poise, confidence, and dignity.
  • The discs between the spinal segments become less resilient and give in more readily to external forces, such as gravity and body weight. 45 degrees of cervical flexion doubles the weight your neck has to carry!
  • Muscles become less flexible and weaker.
  • In addition, poor posture can affect the position and function of your vital organs, particularly those in the abdominal region. You can imagine as you compress your organs they lose blood flow slowly but over time will give you some organ dysfunction. Constipation anyone?

Why am I like this??

  • Ligaments: We hang out on our ligaments when our muscles get tired, putting us in a “slouched” position.
  • Lifestyles usually become more sedentary. Sitting at work or school for long periods of time shortens various muscles, which results in the body being pulled into poor postural positions, and stretches and weakens other muscles, which allows the body to slump.

What is ideal posture?

  • Ideal standing plumb line posture: bisects the ear, bisects the shoulder joint, runs down the bodies of the lumbar vertebrae, bisects the greater trochanter of the femur, runs just behind the center of the knee, runs just in front of the center of the ankle.
  • In this alignment the abdominal and hip extensors and the lumbar and hip flexor muscles are in perfect opposition to one another. The former group tilting the pelvis posteriorly (to the back) and the latter tilting it anteriorly (to the the front) resulting in a neutral pelvic position. According to Kendall and Kendall, muscles are most relaxed and less contracted in the ideal posture.

Exercises
Standing:

  • Stand with back against a wall, heels about 3” from the wall and feet about 6” apart weight evenly distributed.
  • Place arms at sides, palms forward
  • Keep ankles straight and knees facing forward
  • Keep low back close to the wall
  • Straighten the upper back, lifting the chest and bringing shoulders back against the wall
  • Bring head back to touch the wall while keeping the chin tucked in
  • Pull up and in with the muscles in the lower abdomen, trying to flatten the abdomen
  • Hold for 10 seconds breathing normally
  • Relax and repeat 3 to 4 times
  • Perform 3 times a day for optimum results

posture
Sitting:

  • Sit in a straight back armless chair, with both feet flat on the floor and back resting against the chair
  • Place arms at your sides, palms forward
  • Straighten the upper back, lifting the chest
  • Bring shoulders back against the chair
  • Hold the head erect
  • Pull up and in with the muscles in the lower abdomen, trying to flatten the abdomen
  • Hold position for about 10 seconds, breathing normally and keeping the rest of the body relaxed
  • Relax your abdominal muscles and repeat 3 to 4 times
  • Repeat entire exercise at least 3 times a day

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Tips

  • Sit with back firmly against chair, with chair low enough so feet are on the floor with knees slightly higher than hips
  • Keep your head up and avoid leaning forward: by keeping your chair close in to the desk you can help maintain this position.
  • Sleep on a firm mattress and use a pillow under your head just big enough to maintain the normal cervical—neck—curve. Avoid use of over- sized or several pillows.
  • Exercise regularly; exercise promotes strong and flexible muscles that keep you upright in a proper postural position.
Happy at Work
By Deb Matsuura

Performance Plus Program

At Fukuji and Lum Physical Therapy Associates, we challenge ourselves to deliver fun, happiness, and compassion in serving our patients and the community. In doing so, we strive to support those in need of a higher quality of life, as a family. For 20 years, we have served the community in need of physical therapy, but have also branched out to address another need: maintenance after physical therapy. Thus, the Performance Plus Program (PPP) was created to help patients maintain and improve upon their levels of fitness after physical therapy is completed, and no prescription is necessary. The program is also offered to community members that want to improve on their fitness levels and achieve goals they never thought possible. 

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Here is a testimonial from one of our regular PPP clients at our WORC clinic who asked to remain anonymous.

    “I was in a fitness quandary. I quit the fitness club after 5 years. I was tired of fighting for the treadmill and bikes and didn’t want to compete with the jocks for the other machines. Everyone there seemed to have his or her own fitness agenda. My hairdresser spoke of the Fukuji & Lum YWCA location. She raved about the physical therapy she received there, and had continued with an exercise program after being discharged.

    I was not in need of physical therapy, but Fukuji & Lum did offer a Performance Plus Program, primarily for PT clients interested in continuing their therapy with an exercise regimen. So, I signed up for my first 8 sessions. My goals were to improve my strength and improve my conditioning. I was told I was in poor to fair condition; so much for the fitness club routine.

    Today, 2 years later and starting my third year, I have completed 200 visits; my health profile has improved and I am able to do exercises I never thought possible. The staff teaches me the correct way to do the exercises; always offering helpful tips to improve my technique and correcting my mistakes. The staff pushes me to do more so I can continue to improve.

    My overall health has improved; my doctor is happy; I’ve lost weight; gained muscle and toned my body. I’d say that I fixed my fitness quandary.”

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That testimonial is typical of a lot of our PPP clientele. No more fighting over equipment, as everyone is scheduled at flexible times to accommodate for overcrowding. Our land-based Performance Plus Programs are offered at our Honolulu clinic located in the Kuakini Physician’s Tower and WORC location in Kaneohe, and is also open to high school students with parental consent. We have also expanded our program to include an Aquatic Therapy Performance Plus Program, located at the Kokokahi YWCA. For questions or more information about our programs, please call our Honolulu Clinic at (808)521-4922 or our WORC clinic at (808)234-5353.

Happy at Work
By Deb Matsuura

Connor: My Co-Op Experience in Hawaii

 

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We are so fortunate in Hawaii to be blessed with such rich culture, beauty and love. Sometimes it takes others to remind us of how much we have as you listen to them reflect on their experiences in Hawaii.
It never seems to amaze me that the Co-op students, like Connor and Victoria, have such transformative experiences in Hawaii. I often forget how young these students are and how such an experience can set them up for not only a successful professional career, but a different perspective of life.

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For Connor, his stay in Hawaii was a life changing experience. He wrote to us about the opportunities he had to learn not only about physical therapy but the Hawaiian culture. It was a pleasure to get to know him during his brief stay and I wish him the best in his future endeavors as he continues on his path to become a PT.

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After moving back to Boston and settling into another semester of classes at Northeastern University, I look back at my six months in Hawaii, working at Fukuji & Lum Physical Therapy, with nothing but fond memories. It hasn’t even been a month, but I already miss the people, the sights, the weather, and the aloha spirit. Although I am sad it had to come to an end, I am forever grateful for the opportunity to work for such an inspiring company in such an incredible place. This experience taught me countless life lessons both in and out of the clinic.

My flight to Hawaii was my first flight alone and my first time traveling. I boarded the flight feeling equal parts excited and anxious. I was traveling to an island 5,000 miles away to live and work with people I had never met before. My worries quickly dissipated as I met Mark at the airport and was introduced to my host and the beauty of Kaneohe Bay. I still have vivid memories of my first morning in Hawaii; waking up to the sunrise and kayaking out into the bay.

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My first few days at W.O.R.C. were overwhelming, but I instantly knew I was surrounded by a team of positive, hardworking, knowledgeable, and caring staff. Mark, Woody, Jessie, Stacey, Ross, Lisa, Talon, and Ryan were all more than welcoming and helpful. My coworkers and patients did not take long to show me the true meaning of aloha. Working at F&L’s W.O.R.C. clinic was a unique experience.

From Graston to smashing, I was constantly learning new information and techniques that I wouldn’t have seen elsewhere. It was evident that I was not the only student in the room, as all of my coworkers were trying to become better therapists each and every day. This value on education and striving to be the best you can be, is what makes the F&L team so special.

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During my six months there, F&L went through some changes that opened up even more opportunities for me to grow as a future therapist. I saw Woody leave to start his own practice, which brought Jamie and Janie to W.O.R.C, exposing me to even more therapist styles and knowledge. F&L also hired Nicole, their first ever occupational therapist. I really enjoyed the inter-professional collaboration as patients transitioned from therapy to work hardening & conditioning.

Outside of W.O.R.C., F&L greatly expanded their aquatic therapy program. I was lucky enough to have the opportunity to work alongside Rachel, Joy, Jocelyn, Deb, Wes, Billy, and a fellow Northeastern student Victoria. Coming from the clinic, I once again had so much to learn. I was constantly impressed by the variety of patients benefiting from aquatic therapy, and the creativity of the therapists to accommodate each patient’s needs. The F&L team exposed me to so many different aspects of my future career and taught me that physical therapy and caring for patients is about more than just what you learn in a classroom.

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Of course, while in Hawaii, I did much more than just work for six months. The state of Hawaii is a one of the most unique and beautiful places. I was so lucky to spend my weekends at places like Lanikai, Waikiki, Mokapu’u, the North Shore, Volcanic Rock Gym in Kailua, and many more. Whether I was hiking mountains, kayaking around islands, learning to surf, climbing rock walls, or jumping off waterfalls, every day in Hawaii was a memorable adventure.

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I was also fortunate enough to take some time off from work to see the islands of Hawaii, Maui, and Kauai. I saw some of the most breath-taking views at Kilauea, Haleakala, Lahaina, Hana, Waimea Canyon, and the Napali Coast and experienced the thrills of swimming through underground lava caves, flying in a helicopter, and snorkeling with honu and tako.

The people and experiences of Hawaii opened my mind to so much and became a part of who I am. I cannot thank everyone at F&L and everyone else I met along the way enough. Despite the distance from my home, I have countless life-long friends in Hawaii who made me a part of their ohana. It’s not a matter of if, but when I return, I look forward to seeing you all again.

Aloha and Mahalo!
Connor Pokorney

Connor Falls

Mark's Blog
By Deb Matsuura

HAPPY DISNEY HALLOWEEN!

Throughout the month of October, Fukuji and Lum staff members showed off their Physical Therapy Month spirit by dressing up “Disney” style each week. From Lion King Day (animal print), Monster U (college spirit), Mad Hatter Day (crazy hats) and  Tweedle Dee and Dum Day (twins), Disney Adventure Day (Disney characters). Check out our FB or IG @fukujiandlum page for more Disney Halloween photos.

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Happy at Work
By Deb Matsuura

October is Physical Therapy Month

7 Myths About Physical Therapy by the APTA

People everywhere are experiencing the transformative effect physical therapy can have on their daily lives. In fact, as experts in the way the body moves, physical therapists help people of all ages and abilities reduce pain, improve or restore mobility, and stay active and fit throughout life. But there are some common misconceptions that often discourage people from visiting a physical therapist.

It’s time to debunk 7 common myths about physical therapy:

1. Myth: I need a referral to see a physical therapist.

Fact: A recent survey by the American Physical Therapy Association (APTA) revealed 70% of people think a referral or prescription is required for evaluation by a physical therapist. However, all 50 states and the District of Columbia (DC) allow patients to be evaluated by a physical therapist without a physician’s prior referral. In addition, 48 states and DC allow for some form of treatment or intervention without a physician referral or prescription (Oklahoma and Michigan being the exception). Beginning November 1, 2014, patients in Oklahoma will be able to seek treatment from a physical therapist without a physician referral. On January 1, 2015, patients in Michigan will be able to do so, as well. Some states have restrictions about the treatment a physical therapist can provide without a physician referral. Check out APTA’s direct access summary chart (.pdf) to see the restrictions in your state.

2. Myth: Physical therapy is painful.

Fact: Physical therapists seek to minimize your pain and discomfort—including chronic or long-term pain. They work within your pain threshold to help you heal, and restore movement and function. The survey found that although 71% of people who have never visited a physical therapist think physical therapy is painful, that number significantly decreases among patients who have seen a physical therapist in the past year.

3. Myth: Physical therapy is only for injuries and accidents.

Fact: Physical therapists do a lot more than just stretch or strengthen weak muscles after an injury or surgery. They are skilled at evaluating and diagnosing potential problems before they lead to more serious injuries or disabling conditions—from carpal tunnel syndrome and frozen shoulder, to chronic headaches and lower back pain, to name a few.

4. Myth: Any health care professional can perform physical therapy.

Fact: Although 42% of consumers know that physical therapy can only be performed by a licensed physical therapist, 37% still believe other health care professionals can also administer physical therapy. Many physical therapists also pursue board certification in specific areas such as neurology, orthopedics, sports, or women’s health, for example.

5. Myth: Physical therapy isn’t covered by insurance.

Fact: Most insurance policies cover some form of physical therapy. Beyond insurance coverage, physical therapy has proven to reduce costs by helping people avoid unnecessary imaging scans, surgery, or prescription drugs. Physical therapy can also lower costs by helping patients avoid falls or by addressing conditions before they become chronic.

6. Myth: Surgery is my only option.

Fact: In many cases, physical therapy has been shown to be as effective as surgery in treating a wide range of conditions—from rotator cuff tears and degenerative disk disease, to meniscal tears and some forms of knee osteoarthritis. Those who have recently seen a physical therapist know this to be true, with 79% believing physical therapy can provide an alternative to surgery.

7. Myth: I can do physical therapy myself.

Fact: Your participation is key to a successful treatment plan, but every patient still needs the expert care and guidance of a licensed physical therapist. Your therapist will leverage his or her specialized education, clinical expertise, and the latest available evidence to evaluate your needs and make a diagnosis before creating an individualized plan of care.

 

Happy at Work
By Deb Matsuura

Kaneohe Clinic now at Kokokahi YWCA

Our Clinic has moved!! 
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But we’re still here in Kaneohe!

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The Kaneohe Clinic has been a familiar sight as passersby have recognized the F&L sign on the corner of Kamehameha Hwy and Pua Inia Street for the past 16 years. Recently, the company had been looking into moving to a new location to better serve our patients and the community and was fortunate to find a space at the Kokokahi YWCA, just minutes away from the old clinic.
On June 30th, the new clinic opened it’s doors. It will provide the same therapy services as well as our W.O.R.C. and Aquatic programs, also located on the YWCA campus. We are extremely proud to call this clinic our “new home” as most of the renovations were done by the F&L staff. With many hands and hours put into the project, the staff worked hard to build a customized space that best fit the needs of our patients.

Come visit us Monday thru Friday, on the lower level of Atherton Hall at Kokokahi YWCA in Kaneohe. 

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Happy at Work
By Deb Matsuura

Arthritis Walk for a Cure 2014

The F&L Ohana walked the Walk this past Sunday at the State Capitol in support of the Arthritis Foundation and all those who suffer from some form of Arthritis.  It has been quite some time since our company has participated in this event and we were quite impressed how much the Arthritis Foundation has grown as an organization and how the number of supporters has increased significantly.

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As mentioned in our previous blog, arthritis affects many people of all ages in Hawaii. Those who become patients of F&L are provided with therapy to treat their arthritic symptoms such as pain or stiffness. At times, surgery is required and orthopedic surgeons will refer patients to us who have had joint replacements.

One of the well-known orthopedic surgeons on the island, Dr. Stuart Wakatsuki who recently passed away, was always in full support of the Arthritis Foundation and the Walk for a Cure events. On the day of the walk, F&L along with the Arthritis Foundation honored Dr. Wakatsuki for his exceptional work and contributions he made to his patients and the community. Art Lum, P.T. gave an emotional speech and a  trumpeter played a memorable song to all those who have passed on and left a legacy for us to carry on. Everyone wore a lime green (Dr. W’s favorite color) wristband as we walked the 3-mile path.

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F&L staff and their families had a fun time and look forward to many more walks.

Happy at Work
By Deb Matsuura

Aquatic Physical Therapy For Arthritis

Did you know that Arthritis affects 1 out of 5 families in Hawaii? That’s about 79,000 adults and over 1200 keiki who suffer from some form of Arthritis here in the islands. Many of us are familiar with one of the more common forms of Arthritis called Osteoarthritis (OA), found mostly in knees, hips and hands. The Arthritis Foundation defines OA as, ” the breakdown of cartilage (the part of a joint that cushions the ends of the bones and allows easy movement) and as it deteriorates, bones begin to rub against one another.”

Someone with OA may have difficulty making specific movements when using a joint as it can cause pain and stiffness.  When OA starts to affect one’s daily activities, Physical Therapy can play a vital role in decreasing pain and improving movement. Patients with OA can be prescribed therapy to treat their arthritic symptoms. F&L offers various types of therapy programs for patients with Arthritis, but the Aquatic Therapy program is especially designed to provide patients a comfortable setting where they can perform exercises in the water, resulting in less stress on the joints. Click Aquatic Therapy program for more information.

Let’s get you back to doing the things you love and enjoy doing!

Get the Facts on Arthritis:

Myth #1: Arthritis is just minor aches and pains associated with getting older.
Fact: Arthritis is actually a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions that can affect people of all ages, races and genders.

Myth #2: Arthritis is not a serious health problem.
Fact: Arthritis places a growing burden on the health care and economic systems in this country.

Myth #3: People with arthritis should avoid exercising.
Fact: Exercise is a valuable tool in the fight against arthritis.

Mark's Blog
By Deb Matsuura

Caregiver Workshop #1 – Caregiver Safety Tips

Many family members in Hawaii are now assuming the role of caregiver for their loved one. They are often burdened by the overwhelming responsibilities of care giving and many times forget about taking care of themselves.

Here at F&L, our therapists have seen an increasing number of patients being treated for injuries they obtained when caring for a loved one. We saw a need to equip our patients and their families with the tools needed to safely carry out the tasks involved in caregiving and decided to host a series of workshops.

In February, our Kailua therapists hosted their first workshop for caregivers and families on Caregiver Safety Tips on Feb. 15th and included training on the following:

1. Safe Mobility – ambulation (and with assistive devices)
2. Proper Techniques for Transfers (bed, bath, car, chair)
3. Fall prevention
Our workshop attendees were pleased with the knowledge gained, and were eager to begin utilizing their newly learned skills.  We plan to continue our workshops on a quarterly basis, please stay tuned for more details.
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The role of the caregiver has recently been in the media, with the recent Star Advertiser article regarding caregiver support legislation.  Senate Bill 2264 serves to support and recognize the role of the caregiver.

Happy at Work