July 24th, 2007 The Importance of a Strong Core Core stabilization, along with proper body mechanics, is a primary fighter against back pain and strains. The majority of Americans have poor abdominal and overall core strength and those who do have the strength typically do not use it to his/her benefit. The prevalence of back pain would be greatly reduced if proper core stabilization was achieved and utilized correctly. To increase core stabilization a rigorous abdominal workout is not the answer. Some abdominal exercises are too intense for the average person and may cause back pain. It is important to start with gentle exercises and progress as your core gets stronger. Everyone will progress at his/her own pace. The most basic abdominal/core stabilization exercise is to simply brace the abdominal muscles, as they do during a cough or sneeze. This may be progressed to a posterior pelvic tilt. This is achieved by lying on your back with your knees comfortably bent with feet on the floor, bed, etc. Perform the abdominal bracing while flattening your low back onto the surface you are lying on. During this your pelvis will tilt backwards; if you were to wear pants with a zipper, the bottom of the zipper would tilt up towards the ceiling. Your buttock does not need to lift off of the floor. As you feel your abdominals getting stronger you must remember to keep them braced (taught) during activities such as doing dishes, getting into and out of a vehicle, hanging clothes, etc. You must make a conscious effort to achieve and maintain proper core stabilization. In doing this you will help decrease and prevent back pain. Erin Stratford, MPT July 6th, 2007 Osteoporosis Osteoporosis is characterised by the loss of calcium and bone tissue in the bones, which makes them susceptible to fracturing (breaking). Around half of all women and one third of men over 60 years have osteoporosis. Women are more susceptible because the hormonal changes of menopause worsen bone loss.
A calcium-rich diet and regular weight-bearing exercise throughout life (particularly during childhood and adolescence) are known to reduce the risk of osteoporosis in later years.
Recent research suggests that people with existing osteoporosis can also benefit from exercise. This is because a sedentary lifestyle encourages the loss of bone mass. Exercising regularly reduces the rate of bone loss and conserves the remaining bone tissue, reducing the risk of fractures.
Most fractures occur due to a fall. Exercise builds muscle strength and can improve balance, which may help reduce the likelihood of falling and thus reduce fractures.
Benefits of exercise
A sedentary lifestyle, poor posture, poor balance and weak muscles increase the risk of fractures. A person with osteoporosis can improve their health with exercise in valuable ways, including: - Reduction of bone loss
- Conservation of remaining bone tissue
- Improved physical fitness
- Improved muscle strength
- Improved reaction time
- Increased mobility
- Better sense of balance and coordination
- Reduced risk of falls
- Reduced risk of bone fractures caused by falls
- Reduced pain.
Deciding on an exercise program
Always consult with your doctor, physical therapist or health care professional before you decide on an exercise program. Factors that need to be considered include: - Your age
- The severity of your osteoporosis
- Current medications
- Your fitness and ability
- Other medical conditions such as rheumatoid arthritis, coeliac disease or liver disease
- Whether bone density or muscle strength and coordination are the main aims of your exercise program.
A combination of aerobic and muscle building exercises is best, together with specific balance exercises.
Recommended exercises
Exercises that are ideal for a person with osteoporosis include: - Walking
- Tai Chi
- Low impact aerobics
- Weight training using free weights such as dumbbells and barbells
- Resistance training using rubber tubes
- Dancing
- Exercises to improve posture, balance and body strength.
Swimming and water exercise
Swimming is not a weight-bearing exercise, because the buoyancy of the water counteracts the effects of gravity. However, swimming will improve cardiovascular fitness and muscle strength. People with severe osteoporosis or kyphosis (hunching of the upper back) who are at high risk of bone fractures may find that swimming is their preferred activity. Water exercise, such as aqua aerobics and hydrotherapy, is also recommended. Consult with your doctor or health care professional.
Exercises to avoid
A person with osteoporosis has weakened bones prone to fracturing. Activities to avoid include: - High impact aerobics or activities
- Any exercise that requires sudden, forceful movement
- Abdominal sit-ups
- Any exercise that requires a twisting motion, such as a golf swing
- Any exercise requiring sudden jolts, stops and starts, such as tennis or squash.
The amount of exercise
The exact amount of exercise required for people with osteoporosis is currently unknown. However, research indicates the following to be beneficial: - 15 minutes to one hour of continuous aerobic activity two to three times per week.
- Strength training (such as weight training with dumbbells, barbells or rubber tubing) twice per week. Each session should include exercises to strengthen the lower limb, trunk and arm muscles. Each exercise should be performed eight to 10 times.
- Balance exercises need to be performed at a level that is challenging to your balance. However, for safety reasons, always make sure you can hold onto something if you overbalance. These exercises should be performed for a few minutes at least twice a week.
- Include stretching exercises to promote flexibility.
Professional advice
Moderate, regular exercise should be considered an essential part of any osteoporosis treatment programme. See your doctor, physical therapist or health care professional for expert guidance. Always start your exercise programme slowly and under medical supervision. Exercise that is too vigorous may increase the risk of fractures. Also, consult your doctor about ways to increase the amount of calcium in your diet, including the use of supplements, and avoid smoking which is bad for bones.
Where to get help - Your doctor
- Physical therapist
Things to remember - Osteoporosis is characterised by the loss of calcium in the bones, which makes them susceptible to fracturing.
- Exercising regularly reduces the rate of bone loss and conserves bone tissue, reducing the risk of fractures.
- Exercise can help reduce the risk of falling.
- Exercise that is too vigorous may increase the risk of fractures.
- See your doctor, physical therapist or health care professional for expert advice.
Kelley Rankin, MPT June 18th, 2007 Little League Shoulder and Elbow It’s baseball season and if your son or daughter play you need to watch out for injuries. Two of the most common are Little League Shoulder and Little League Elbow. These injuries have become more common over the years as adolescents are overusing their throwing arm. The highest risk of injury to adolescent pitchers is due to overuse, pitching with pain, and improper throwing technique. Also throwing curve balls, change ups, and sliders at too early of an age has been shown to increase injury. Repetive throwing creates an excessively strong pull on tendons and ligaments of the elbow and shoulder, which can cause injury. Symptoms for the shoulder include pain, tenderness to touch, may have swelling, and weak and painful throwing. Symptoms for the elbow include pain, restricted movement, locking of elbow, may have swelling, tenderness to touch, pain when throwing, and may have pain when carrying heavy objects or gripping. The Little League Baseball and the American Sports Medicine Institute have come together to create Pitch Counts per day and rest recommendations for adolescents. Injury risk increases by 50% after 75 pitches. You can go too little league.org to find the complete article and more information. · 17-18 years old------------------------------------105 pitches per day · 13-16 years old------------------------------------95 pitches per day · 11-12 years old------------------------------------85 pitches per day · 10& under------------------------------------------75 pitches per day Rest Recommendations for ages 16 and under · 61 pitches or more in one day---------------3 days rest · 41-60 a day-------------------------------------2 days rest · 21-40 a day-------------------------------------1 day rest · 1-20 a day---------------------------------------0 days Many major league scouts and coaches recommend that Little League players throw only fast balls in order to limit damage. Recommendations remain that pitchers should not throw change-ups until 11-12 years, curve balls until 14 years, and sliders until 18 years. So what can you do to help prevent injuries? Follow the recommended rest periods between pitching. If your child complains of pain in shoulder or elbow give them a rest from pitching. If the childs arm is sore the pain should usually go away in 3-4 days. If the pain lasts longer a physician should be contacted. Coaches and parents should watch for signs of an injury or in the throwers pitching stamina. Also make sure your child is instructed in the proper pitching technique. Always stretch your muscles before pitching. If an injury does occur you can rest until pain is gone, apply ice for 15-20 min 4 times a day for several days and you can take medication such as aspirin, ibuprofen, or Tylenol. Just be careful that the medicine doesn’t mask the pain which can lead the athlete to pitch and can cause more injury. Physical Therapy can help to begin proper strengthening exercises. Gradually return to a pitching program given to you by a health care professional or coach. But remember Never Pitch with Pain, you can do more damage and risk serious injury. Holly Peck, PTA Low Back Pain May 14th, 2007 Low back pain (LBP) affects approximately 80% of people in the U.S. LBP has many causes and contributing factors. These range from improper body mechanics, poor posture, lack of core stability, muscle spasms, degenerative disc disease, herniated discs and more. Poor body mechanics is imperative when lifting or bending is required. When you have to pick up an object, small or large, you must bend your knees to prevent the low back from bearing the brunt of the lift. Keeping the knees bent will allow the legs, which are typically much stronger than the low back, to handle the majority of the load. It is important to keep the normal curve in the lumbar spine throughout lifting and daily routines. Correct posture also helps decrease the chance of developing LBP. Many people sit slouched which causes increased stress and strain on the spine. Sitting up straight with proper posture is often difficult to maintain. The use of a lumbar roll can help. This can easily be achieved by rolling a towel into a tube/roll shape and placing it behind the lumbar area while sitting. A lumbar roll can also be purchased. Abdominal strength is key in core stability. Core stability will help alleviate stress/strain on the low back during everyday activities. Abdominal bracing/tightening requires mental reminders until it becomes involuntary. These treatments and life changes just touch the surface of managing LBP. If symptoms are not managed or get worse contact your family physician or call Rankin Physical Therapy, Inc. for additional advice or treatment. Erin Bosley, MPT Rotator Cuff Repair May 7th, 2007 The rotator cuff consists of muscles and tendons that hold the shoulder in place. It is one of the most important parts of the shoulder. The rotator cuff allows a person to lift his/her arm and reach up. An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand or develop over time due to repetitive activities. Aging may also cause rotator cuff degeneration and tears. If the rotator cuff is injured, it may need to be repaired surgically. This may include shaving off bone spurs that are pinching the shoulder, or repairing torn tendons or muscles in the shoulder. The goal of rotator cuff repair surgery is to help restore the function and flexibility of the shoulder and to relieve the pain that cannot be controlled by other treatments. When combined with a good rehabilitation effort, rotator cuff surgery allows people to regain much of the function lost due to a tear or cuff disease. In experienced hands, this procedure can address the restricting scar tissue and roughness that frequently accompany cuff disease. If the quantity and quality of the tissue is good, surgery can help repair the tendon back to the bone from which it has been torn. Rotator cuff surgery can improve the mechanics of the shoulder, but cannot make the joint as good as it was before the cuff tear. In many cases, the tendons and muscles around the shoulder have been weakened from prolonged disuse before the surgery. The tissue may be insufficient for a strong repair. In such cases the mechanics of the shoulder may be improved by carefully smoothing out the cuff area and moving the shoulder immediately after surgery so that new scars are not formed. If the cuff is repaired, it takes months before the tendon is strongly healed to the bone. Physical Therapy will be needed to regain ROM and strength of the surgical repaired shoulder. However, physical therapy will be demanding and continuos rehab to get close to prior level of function may take up to 6 months. The effectiveness of the procedure depends on the health and motivation of the patient, the condition of the shoulder, and the expertise of the surgeon. When performed by an experienced surgeon, rotator cuff surgery usually leads to improved shoulder comfort and function. The greatest improvements are in the ability of the patient to sleep, perform activities of daily living, and engage in non-contact recreational activities. Jason M. Simmons, DPT Aquatic Therapy April 30th, 2007 Aquatic therapy or pool therapy consists of an exercise program that is performed in the water. It is a beneficial form of therapy that is useful for a variety of medical conditions. Aquatic therapy uses the physical properties of water to assist in patient healing and exercise performance. One benefit of aquatic therapy is the buoyancy provided by the water. While submerged in water, buoyancy assists in supporting the weight of the patient. This decreases the amount of weight bearing which reduces the force of stress placed on the joints. This aspect of aquatic therapy is especially useful for patients with arthritis, healing fractured bones, or who are overweight. By decreasing the amount of joint stress it is easier and less painful to perform exercises. The viscosity of water provides an excellent source of resistance that can be easily incorporated into an aquatic therapy exercise program. This resistance allows for muscle strengthening without the need of weights. Using resistance coupled with the water’s buoyancy allows a person to strengthen muscle groups with decreased joint stress that can not be experienced on land. Aquatic therapy also utilizes hydrostatic pressure to decrease swelling and improve joint position awareness. The hydrostatic pressure produces forces perpendicular to the body’s surface. This pressure provides joint positional awareness to the patient. As a result, patient proprioception is improved. This is important for patients who have experienced joint sprains, as when ligaments are torn, our proprioception becomes decreased. The hydrostatic pressure also assists in decreasing joint and soft tissue swelling that results after injury or with arthritic disorders. Lastly, the warmth of the water experience during aquatic therapy assists in relaxing muscles and vasodilates vessels, increasing blood flow to injured areas. Patients with muscle spasms, back pain, and fibromyalgia find this aspect of aquatic therapy especially therapeutic. Kelley Rankin, MPT Plantar Fasciitis April 16, 2007 Spring is here! Runners beware. With warmer weather comes more running and exercise. Many inexperienced runners have a tendency to increase his/her running regimen too quickly, which often results in pain. One common syndrome that occurs due to this is plantar fasciitis. Plantar fasciitis is an overuse syndrome resulting in an inflammation of the plantar fascia. The plantar fascia is found on the bottom of the foot from the heel to the great toe. This is the most common cause of heel pain in runners, but is not limited to only runners. The most common complaint with plantar fasciitis is pain at the inner border of the heel. This pain is often increased when first stepping out of bed in the mornings. It often hurts to push at this area as well. Another painful position is extending the big toe. Common risk factors for plantar fasciitis are repetitive stress (as with running), obesity, tight Achilles tendon, flat feet, high arches and shoes without adequate support. Plantar fasciitis can be treated with ice, anti-inflammatories, rest, stretching and possibly a heel cup. If this syndrome is not self-managed, physical therapy is often the next step. This may include phonophoresis/ultrasound, stretching, orthotics, friction massage, iontophoresis and education. Severe, chronic cases may require further attention from a physician for possible injections and/or occasionally surgery. To avoid plantar fasciitis, don’t increase your walking/running distances too quickly. Wear supportive shoes. Stretch your Achilles tendon/calves. Take an anti-inflammatory (as long as there are no medical contraindications). Use ice initially. If you unfortunately suffer from plantar fasciitis and need assistance in managing it, contact your physician and ask about physical therapy or contact Rankin Physical Therapy, Inc. Erin Bosley, MPT Diabetic Foot Care April 9, 2007 The American Diabetes Association reports that 7% of the population in the United States suffers from Diabetes. They recommend daily checks of blood glucose levels of any individual that has been diagnosed with Diabetes. One of the biggest complications in a patient with Diabetes is amputation. The American Diabetes Association reports that more than 60% of nontraumatic lower-limb amputations occur in people with diabetes. The risk of amputation in an individual with Diabetes is 10 times higher than in an individual without Diabetes. To control your risk of callus, skin breakdown, and possible amputation, there are some simple guidelines that you can follow: 1. Try to keep your feet clean and dry at all times. 2. Perform daily foot inspections. If you are unable to see all surfaces of your foot you may need to ask a family member for assistance or use a mirror placed on the floor. You are looking for any redness, callus or ulcers. If any of these are present, then contact your doctor immediately. 3. Before putting your shoes on each day, check them with your hands for pebbles or any other foreign object. Make this a habit that you check your shoes every single time you put them on. 4. Correct shoe fit is a must. Shoes that fit incorrectly may rub calluses or blisters on your feet which could escalate into a serious problem quickly. 5. NEVER go barefooted. Even a short trip to the bathroom in the middle of the night is too long for you to go barefooted. Socks are not enough protection. The foot should be protected with a shoe or soled slipper at all times. 6. A build up of callus or a blister is your warning sign that there is too much pressure in that particular area. If any problems exist, it is imperative that you contact your doctor immediately. Please do not delay. Do not think that you can handle the problem at home on your own. Do not “wait to see” what happens the next few days. That may be a few days too late to get the treatment that you need to save your foot and leg. Chrystal McDonald, MPT, DPT
Total Knee Replacement March 19,2007 Total knee replacement surgery is considered for individuals whose knee joints have been damaged by progressive arthritis, trauma, or other rare destructive diseases of the joint. The most common reason for knee replacement is severe osteoarthritis of the knee. Regardless of the cause of the damage to the joint, the reason individuals seek a total knee replacement is from increasing pain and stiffness, and a decrease in daily function. A total knee replacement is a surgical procedure whereby the diseased joint is replaced with artificial material. The thigh bone (femur) meets with the lower leg bone (tibia) to form the knee joint. During a total knee replacement, the end of the femur is removed and replaced with a metal shell. The end of the tibia is removed and replaced with a metal/titanium stem. Depending of the condition of the kneecap, a plastic surface can be added to provide increase/better motion of the knee joint. A total knee replacement generally requires 2 to 3 hours or operative time. After surgery, patients are taken to a recovery room for monitoring of vital signs. When stabilized, patients are returned to their hospital room. Physical Therapy is a very important part of rehabilitation and requires full participation and a great work ethic for an optimal outcome. A patient will not return to optimal function just from the surgery alone, physical therapy will be needed to regain ROM, strength, balance, and confidence. Patients can begin physical thearpy 24 to 48 hours after the operation. Some degree of pain, discomfort, stiffness, swelling, and redness can be expected following surgery. A continuous passive motion (CPM) machine is usually attached to the leg during the initial PT evaluation to allow the knee to move constantly through various ranges of motion while the patient relaxes in bed. Patients will start to use a walker or crutches for gait, balance, and confidence. These are usually used for the first 3-6 weeks depending on your progress. Exercises and stair training are incorporated into your program before being discharged from the hospital. It is important for patients to continue in an outpatient physical therapy program along with home exercises for optimal outcome following total knee surgery. Patients will be asked to continue exercising the muscles around the replaced joint to prevent scarring/contractures and to maintain muscle strength and ROM for the purpose of joint stability. Patients will be asked to watch their incisions for any warning signs of infection such as abnormal redness, increasing warmth, swelling, or unusual pain. It will be important to report any injury of the knee to your doctor immediately. Physical Therapy can last anywhere from 2 to 4 months depending on the progress being made. Individuals’ level of activity might need to be modified secondary to the risk of increase stress/strain on the joint. Some individuals might be able to return to their previous level of function but usually intensity of prior activities will probably need to be modified to decrease the risk of injuring your total knee. A second operation can be necessary because of loosening, fracture, or other complications. Re-operations are generally not as successful as the original operation and carry higher risks of complications. A great attitude/work ethic and of course a great physical therapist will be needed to have a successful outcome. You need to be willing to put in a lot of hard work to get the outcome you desire. Jason Simmons, DPT Osteoarthritis March 11, 2007 Do you or someone you know suffer from painful, stiff joints? Have you noticed that it seems worse during the cold summer months? This is likely arthritic pain. Osteoarthritis, or degenerative joint disease is a slow, progressive degeneration of the joints. This can lead to chronic pain and loss of mobility. Osteoarthritis affect a large number of men and women and increases with age. It is often referred to as “wear and tear arthritis.” Mild Osteoarthritis can be managed with pain medication, warm water baths, paraffin wax, and low impact exerting. It is important to stay flexible and strong with a regular exercises program. The stationary bicycle and swimming are good low impact exercises. Paraffin wax is helpful for hand and/foot pain and is an inexpensive investment. Many also report relief with a warm bath or a use of a hot tub. Over the counter medications for pain and inflammation may also be beneficial; although this should be discussed with your physician. There are different levels of severity of Osteoarthritis. Some may be managed independently or by physical therapy; however contact your family physician if you feel you may suffer from Osteoarthritis. Erin Bosley, MPT Five Tips to Help Prevent Back Pain in Office Workers March 5, 2007 Health experts estimate that up to 80% of the population in the U.S. will be affected by back pain at some point in their lives. Listed below are some tips to help keep you in the 20% of people with healthy backs.
1. Watch your posture, especially at work. When at your desk, do you keep your back straight most of the time, or do you continually lean forward at an angle? Sitting hunched over at your desk for extended periods can cause the muscles on the front of your torso to shorten and your back muscles to become weak and stretched out. Over time, office workers with muscle imbalances from a continually slumped posture may develop rounded shoulders and a forward neck posture, leading to chronic back and neck pain.
2. Get regular exercise that uses all of your major muscle groups. Even with the best posture at work, our bodies simply were not designed to be sitting in front of a computer all day. Muscles kept at bent positions for long periods can become contracted and may become difficult to fully extend when doing other tasks. Muscles not used at all can atrophy from inactivity. If you sit at a desk all day long, try to have some form of regular exercise scheduled outside of work to keep your joints lubricated and your muscles moving freely.
3. Try to take regular stretch breaks at your desk. Set a timer to remind you to take a break every 30 minutes, or purchase software with a window that pops up with simple stretches you can do at your desk.
4. Physical Therapy can often identify particular movements and positions that actually lessen or control low back pain. Once identified, the physical therapist may instruct you in those postures and movements that help to alleviate the pain. Physical Therapy can also show you exercises that strengthening your core muscles (muscles of the abdomen and back). These approaches can then be applied to the activities in which you are involved on a daily basis. A physical therapy treatment program that is active in nature and geared toward instructing the patient in self care techniques and back injury prevention are key ingredients in returning a person to a pain-free, active and healthy lifestyle.
5. Maintain a healthy diet and quit smoking. A diet high in calories and fat, combined with an inactive lifestyle, can lead to obesity, which can put stress on the back. By eating right and getting plenty of physical activity, you'll feel better, have more energy, and reduce your risk of developing low back pain and other weight-related diseases, such as coronary heart disease, diabetes, high blood pressure, and stroke. Smoking also greatly increases the risk of suffering from low back pain. In fact, people who smoke are two and half times more likely to develop low back pain than non smokers. Kelley Rankin, MPT SHIN SPLINTS
February 19, 2007
Shin splints occur during the foot strike while running. The foot strike sends a shock wave into the musculoskeletal system which triggers pain. Running on hard surfaces such as concrete and asphalt is really hard on the body. Shin splints refer to a painful condition that occurs along the tibia, a few inches above the ankle to about halfway up the shin. Treatment for shin splints is RICE (rest, ice, compression and elevation). Stretching and strengthening of calf muscles help prevent injury from returning. Always wear comfortable, padded running shoes for shock absorption. Misty Hollinshead, PTA What is BPPV? Februaury 12, 2007 BPPV is an acronym for Benign Paroxysmal Positional Vertigo. It is a pathology of the inner ear, which causes the sufferer of the condition to be very dizzy while in certain positions of the head and/or body. There are simple tests which can be performed in the clinic to determine if a patient’s dizziness is in fact caused by BPPV. The treatment for this condition is also very simple. Most often the dizziness associated with BPPV can be resolved in five or fewer visits. BPPV is an acronym for Benign Paroxysmal Positional Vertigo. It is a pathology of the inner ear, which causes the sufferer of the condition to be very dizzy while in certain positions of the head and/or body. There are simple tests which can be performed in the clinic to determine if a patient’s dizziness is in fact caused by BPPV. The treatment for this condition is also very simple. Most often the dizziness associated with BPPV can be resolved in five or fewer visits. We must keep in mind that there are multiple causes for dizziness. So it must first be confirmed that the dizziness a patient experiences is caused by BPPV before this treatment will work successfully. Dizziness could potentially be caused by some of the following: cardiac disorders, vascular disorders, substance abuse, psychogenic disorders, a hormone imbalance, neurologic disorders, and BPPV. Therefore, we must not be fooled into thinking that any and all dizziness is as simple to treat and abolish as that which is a symptom of BPPV. The inner ear contains three semicircular canals, and these canals send messages to the brain about the position of the head. These canals sense movement through the use of calcium deposits. The specific direction of movement of the calcium deposits is what tells the brain about the location of the head. Now imagine that one of the calcium deposits is in the wrong location… This would cause a confusing message to be sent to the brain about head position, and this is the exact cause of the dizziness associated with BPPV. Through a series of movements provided by your physical therapist the calcium deposit can be relocated back to it’s original position, and then all of the dizziness would stop! There are many reasons why a calcium deposit could be dislodged from its original location. A mis-step off of a sidewalk or stair could jar the body enough to cause movement of a calcium deposit. A fall or motor vehicle accident could definitely provide enough force to dislodge a calcium deposit. An inner ear infection changes the pressure relationship of certain structures of the ear and can cause movement of these calcium deposits. Another cause could be degeneration of the ear over time. The gelatinous mass which houses the calcium deposits can dry out and lose its capability to hold onto the calcium deposits. So, if you have unexplained dizziness which has not been treated as of yet, please contact your family physician or physical therapist with questions. If BPPV is your diagnosis, then you may be only hours or days away from saying good-bye to your dizziness. Chrystal L. McDonald, MPT, DPT Getting Ready For Winter February 3, 2007 As the Eastern Panhandle awaits the first big snow storm of the season it is important to understand how to prevent low back injuries and other complications before stepping outside to battle mother nature. The most important intervention is to speak with your physician and get his/her approval before shoveling. Shoveling places increase stress on the heart and this increase activity should be taken seriously. Back injuries are among the most common injuries resulting from snow shoveling. Many back injuries occur in the morning because the tissue around the spine is not warmed/loosened up after a night of rest and there is an increased fluid pressure of the disc. So before stepping out your door try to warm up with 5-10 minutes of light exercise that will incorporate low back stretching. A simple exercise could be lying on your back and bringing your knees to your chest than dropping your knees from side to side. Also, stretching of the hamstrings will be important. There are also other things to consider while shoveling. Taking frequent breaks and replenishing your body with fluids to prevent dehydration. When shoveling, a 1-2 minute break for every 10-15 minutes is recommended. If your begin to feel dizziness, lightheadedness, or tightness in your chest stop shoveling immediately to rest and/or call 911. Secondly, dressing appropriately by using light and layered water-repellent clothing will provide ventilation and insulation. Be sure to wear gloves and appropriate headwear so your body’s temperature will not decline. Using a technique of lighter loads will decrease stress and strain on your muscles as well as heart. Yes, it might take longer to do this but your body will be thanking you later on as you sit next to the fire sipping hot chocolate. Using a proper lifting technique will be key to prevent injury/complications. Always face towards the object you intend to lift. Bend at the hips/legs not with your back to lift your “light” load. Pushing show will place less stress on your back than lifting so keep this in mind. If you need to lift avoid twisting the back; always pivot your whole body to face the new direction. Keep the heaviest part of the object close to your body instead of out in front. Walk to the new location to dump the snow instead of reaching or tossing. Again, consult your physician/physical therapist before attempting to shovel. Shoveling snow will boost your heart rate and blood pressure. Individuals with poor health including heart problems and high blood pressure should be cautious as well as the elderly population. Individuals should expect “normal” post-exercise muscle soreness that can last 18 to 36 hours. Contact your physician or physical therapist if problems persist. Jason M. Simmons, DPT Osgood Schlatter Disease January 22, 2007 If your child has swelling just below the kneecap, tenderness during or after exercise and pain when contracting the muscles of quadricep it may be a disease called Osgood Schlatter. The disease was named after two physicians in 1903, Dr. Robert Osgood and Dr. Carl Schlatter. It is a condition where the bony protrusion below the knee becomes inflamed, painful and swollen. This disease mostly occurs in boys who are pre-teen (ages 10-16) and going through growth spurts. The patella tendon inserts at the tibial tuberosity and through overuse can tug away at the bone causing inflammation. With repeated trauma, new bone grows back during the healing which causes a bony lump. Treatment consists of the RICE method: Rest, ice, compress and elevate. If pain still occurs, there are braces that will support the tendon. Pain relievers such as aspirin, Advil or Motrin can be used to reduce swelling. Pain and swelling may last for several months. Therapy of ice and strengthening will help as well. Misty Hollinshead, PTAHEADACHES January 12, 2007 Many people have experienced a headache at some point in their lives, likely more often than not. A headache may be a daily occurrence in your life or the life of someone you know. Headaches are caused by a number of different factors. Stress, work demands and set-up, dehydration and cervical (neck) muscle tightness are just a few of the contributors. Stress is a difficult variable to change, but eliminating certain stressful situations and circumstances will help to decrease the onset of a headache. Often times, the way a workstation is set-up will affect the body’s positioning and posture for prolonged periods of time. A computer being placed to the side, too high or too low causes the neck to be held in an awkward position or a chair being set too low for a receptionist causes shoulder elevation while typing. These positional errors often contribute to cervical muscle tightness, which ultimately leads to the dreadful headache. There are three easy neck stretches which will help to decrease the occurrence of intensity of the common headache. These three stretches will primarily help to loosen the upper trapezius, levator scapulae and the scalene muscles when performed correctly. The first stretch for the upper trapezius can be done by bending the head forward, tilting the head to the right shoulder and looking toward the left. These three steps should be performed all together so that the chin is toward the chest, the right ear is toward the right shoulder and the nose is facing toward the left. Switching the movements to the opposite side can stretch the left upper trapezius. The second stretch is for the levator scapulae muscle. This can easily be done by taking the nose toward the opposite armpit. The third stretch is for the scalene muscles. This is done by tilting the head toward each shoulder without any turning of the head. Each stretch should be held for a count of 30-seconds and you should not bounce. By making these simple changes and performing the neck stretches throughout the day, the inconvenience of a headache should be lessened. If this is not self-manageable, speak to your physician about physical therapy. By: Erin Bosley, MPT Exercise Your Worries Away January 1, 2007 Stress of the holiday season and cold winter months can leave all of us feeling the blues, often leading to depression. Seasonal depression, otherwise known as Seasonal Affective Disorder (SAD), is defined as a depression that occurs each year at the same time, usually starting in fall or winter and ending in spring or early summer. Symptoms of SAD include weight gain, fatigue, loss of energy, difficulty concentrating, and increased need for sleep. It is reported that between 4 and 6 percent of the U.S. population suffers from SAD, while 10 to 20 percent may suffer from a milder form of the winter blues. Due to lack of activity, many individuals diagnosed with seasonal depression often experience degeneration in physique, strength, and psychosocial well-being. Recent studies have shown that exercise is essential for one’s physical and mental health. It provides an outlet for releasing negative emotions, such as anger, frustration, and irritability. By stimulating the production of neurochemicals in the brain, it has been clinically proven to affectively lift you out of a depressive state. Examples of physical activity include brisk walking, jogging, swimming, bike riding, stretching, weight training, aerobics, and playing sports. It is recommended that you engage in these forms of activity three to five times a week to receive maximum benefits. Keep in mind that your exercise program should be meaningful and enjoyable to you and should not be strenuous or overexerting. It is important to set reasonable goals and prepare for setbacks and obstacles. Combating seasonal depression involves an equal balance between physical, emotional, and cognitive well-being. Exercise will improve overall health and fitness, increase social interaction, and enable one to engage in purposeful activity. Written By: Kristen Mellott COTA/L |
