Start Your Year With a Wellness 360 Physical Therapist Visit

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Your car needs regular maintenance, so you probably have a mechanic. Your eyes and teeth are important, so you see your optometrist and dentist regularly. You get an annual physical from your family physician. You might even be getting ready to see your accountant to get your yearly income tax done. What about your physical therapist? Do you and your family have one?

If not, you should! Your body is a lot like your car. It’s got multiple systems, all of which are complex, and all of which have to be working well for it to function. Physical therapists are experts in maintaining, diagnosing, and treating the movement system. Like the braking or ignition system in a car, most people only think of the movement system when it’s not working the way it should.

Don’t Neglect Your Movement System
Similar to the systems in your car, problems with your movement system are much easier to deal with if they’re caught and treated early. This prevents small issues from becoming larger ones. For example, if you have a little bit of weakness, and balance that’s not quite up to par, improving those early could prevent a sprained ankle, or a fall and a broken wrist.

An annual movement screen from your physical therapist can find small issues that you may not have noticed with your strength, balance, flexibility, or coordination. Many of these minor issues can be fixed with a few exercises at home, or with just a few visits.

What to Expect
A screen of your movement system is quick and easy. Your annual visit may include:
● A history of your injuries, as well as a health history
● Assessment of your strength, balance, flexibility, and posture
● A review of your movement goals (do you want to run a marathon? Get on and off the
floor easily when playing with your grandkids?)
● A review and update of your exercise program

Schedule your Wellness 360 Physical Therapist visit today!

Your Physical Therapist Can Help Your Keep Your Resolution

scrabble resolutions

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As one year comes to a close and another begins, people begin to set goals and make
resolutions. Losing weight, getting to the gym more often or getting into “better shape” are all common. Each of these require increasing your amount of physical activity. More activity is great for your health, energy levels, sleep, and mood. However, ramping up your activity level too quickly after a holiday season of eating, drinking and being merry can lead to pain, injury and disappointment if your body isn’t ready for it.

Your physical therapist is an expert in human movement, and can help you safely reach your fitness goals. People think of PTs as the person to see after an injury, but a visit before you change your activity level could prevent injury in the first place. An evaluation by your physical therapist will include assessment of your strength, range of motion, and functional movement patterns – think jumping, running, squatting, carrying. Some physical therapists even use a standardized assessment, such as the Functional Movement Screen.

Most common injuries from new fitness routines are caused by underlying weakness, range of motion deficits, or compensatory movement patterns, which your physical therapist will identify during your assessment and before you are injured. They can then prescribe exercises or movements to address the issues found and et you safely moving into the New Year!

The other common way people are  injured while working towards their resolution is with overtraining, or doing too much too soon. Physical therapists are also experts in exercise prescription and program design. Your physical therapist can help you create a routine specific to your needs and goals that will progress appropriately and keep you out of trouble.

Don’t wait to see your physical therapist until after you’re injured. In this case, it’s true that an ounce of prevention is worth a pound of cure! Seeing your physical therapist before you start on your resolution can keep you on track, injury free, and help you reach your goals for the New Year!

Schedule your annual physical therapist exam or learn more here!

What’s a Movement Diagnosis?

prescription-padMedical diagnoses don’t need much of an introduction;  you get one from your doctor when you are sick.  Examples would be influenza, diabetes, or hypertension. They describe the underlying problem that is causing your symptoms.

When people feel sick, they know they need to go to the doctor and find out what’s going on to get treated. Do we treat movement the same way? If you have pain when you move, cannot do things you used to be able to – like get on and off the floor easily – or cannot do things you want to do – like go for a bike ride or pick up a grandchild – then you need to get a movement diagnosis!

A movement diagnosis does the same thing as a medical diagnosis; it describes what’s causing your difficulty with movement. Some examples would be difficulty standing from a chair secondary to decreased force production or scapular downward rotation pattern.  Diagnoses set the roadmap for treatment, so getting them right is crucial. Human movement is complex and is influenced by more than just your muscles and joints. According to the American Physical Therapy Association, movement is impacted by the following systems:

● Endocrine
● Nervous
● Cardiovascular
● Pulmonary
● Integumentary
● Musculoskeletal

Because of the complexity and interplay between these components of the movement system, establishing an accurate movement diagnosis can be challenging. Physical therapists are experts in human movement with doctoral level training and should be your first stop for movement issues.

Not only can a physical therapist provide an accurate movement diagnosis, they will also design a treatment plan to correct the underlying issues and help get you moving well again!
References:
http://www.neuropt.org/docs/default-source/default-document-library/movement-systemdiagnosis-in-neurologic-physical-therapy-where-are-we.pdf?sfvrsn=0
https://journals.lww.com/jnpt/FullText/2018/04000/White_Paper__Movement_System_Diagnose
s_in.9.aspx
http://www.apta.org/MovementSystem/
http://www.apta.org/MovementSystem/Template

Redefining Human Potential

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By Ake Paramadilok, PT, DPT

October 12th, 2019 marked an historic day in the world of marathon running and athletic achievement. Eliud Kipchoge, the reigning 2016 Olympic marathon champion and current marathon world record holder from Kenya, redefined human potential once again by running a sub-two-hour marathon in Vienna, Austria. Kipchoge completed the 26.2 mile run in 1 hour 59 minutes 40 seconds, making him the fastest human to ever run a marathon and the first to break the elusive 2-hour barrier.

During the run, Kipchoge wore a pair of unreleased Nike running shoes that have become a hot topic as of late. At first glance, they seemed to be the third iteration of Nike’s highly sought after Vaporfly 4%, which were named for their ability to increase running efficiency by 4%. These shoes were first introduced in conjunction with Kipchoge’s first attempt to break the 2-hour marathon record in 2017.

Since that time, the second generation, Nike ZoomX Vaporfly Next%, has hit the market and are flying off retail shelves. Independent scientific studies confirm that these shoes help you run faster, along with a plethora of professional and amateur YouTube reviews. In fact, almost every single elite runner lined up at the start line at the start of this weekend’s Chicago Marathon, was wearing either the Nike Vaporfly 4% or ZoomX Vaporfly Next%.

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So, what is the hype about? How do these shoes improve your running efficiency?

Before this question can be answered, let’s briefly journey into the world of running biomechanics. In its simplest form, running is essentially repetitive jumping from one leg to another with the purpose of traveling forward as quickly as possible. Each time the foot lands, the muscles in the legs contract to control our landing and transfer energy to the ground in order to propel our bodies forward into the next stride. The force created against the ground as we land and push off is called the “ground reaction force”.

Studies have shown that the larger the ground reaction force a runner generates, the faster they will run. However, the ground reaction force generated is only a percentage of the total energy we put into generating it due to energy losses that occur with each foot strike in the form of deformation, heat and sound. The Nike Vaporfly 4% and its successors are designed to improve the energy transfer from the runner to the ground by minimizing energy losses due to deformation. This allows the runner to generate higher ground reaction forces and speed for similar effort, or increased running efficiency.

There are two main features that allow the shoe to accomplish this to such an unprecedented magnitude. First, the ZoomX foam used to construct the sole is designed to not only be effective at absorbing impact as you land, but to also return more energy as you push off (imagine bouncing against an exercise ball rather than into beanbag chair). Second, the shoe has a carbon fiber plate embedded within the sole. As a runner’s weight rolls from the mid-foot to their toes, the plate deflects slightly and stores energy like a leaf spring. As the foot comes up and the runner pushes off, the carbon plate unloads and provides additional propulsion. While subtle, these two features enhance the runner’s ability to transfer energy to the ground, resulting in an approximately 4% improvement in running efficiency.

So, are these shoes right for you? Well, there are many other factors that need to be considered when buying a new running shoe, and if you run regularly, you should have your running biomechanics analyzed to understand what type of shoe would be best for optimizing your running efficiency and supporting your musculoskeletal health. Also consider your goals — a casual runner might be better off in a more entry-level shoe, replaced twice as often when compared with the cost of the Nike Vaporfly!  If you are interested in a running analysis, please visit us at PhysioPartners!

Dr. Ake Paramadilok is a physical therapist at PhysioPartners.

References:

https://www.runnersworld.com/uk/gear/shoes/a29455211/eliud-kipchoge-nike-shoes/

https://link.springer.com/article/10.1007/s40279-017-0811-2 

https://www.chicagotribune.com/sports/chicago-marathon/ct-chicago-marathon-womens-race-20191013-lsfb7swaajbpphtqd4p2pdzpwa-story.html

 

Using Mindfulness to Ease Pain

calm daylight evening grass

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By Mary Schuster, PT, DPT

Whether we like it or not, fall is here, which means it’s the perfect time to reset good routines to round out the last few months of the year. Summer provided time to soak up the sunshine and fresh air outdoors, but you might notice a shift in your physical and mental energy as the fall months progress. How can you keep your body and mind healthy as the seasons change? September is the perfect time to start a mindfulness practice — something you can do indoors, anytime and anywhere. Mindfulness practices have dominated the conversation lately, especially in regard to their impact on easing pain.

What Is Mindfulness?

Mindfulness is the ability to be fully present and aware of your surroundings. It is a non-judgemental awareness of what you are experiencing in the present moment. Mindfulness doesn’t require training or meditation, although practicing meditation can help you to become more mindful because it gives you something to focus on. There is growing evidence showing that mindfulness-based meditation can help ease pain and restore a healthy connection between the body and mind.

How To Get Started

Many people think they do not have time for a mindfulness practice, but even a few minutes a day can make positive changes. Additionally, it has been shown that one week of meditation training for mindfulness can reduce the intensity of pain. The easiest way to get started is with a mindful breathing exercise.

  1. Sit in a quiet space in a comfortable position.
  2. Close your eyes and notice how you are breathing. Is it fast or slow? Take a few breaths to become aware of your natural breathing pattern.
  3. Now focus more on your breathing. Try to inhale for 3 seconds and exhale for 5 seconds.
  4. Do this for 1-3 minutes and notice how your body feels afterwards. As you become more comfortable, increase the amount of time to 5, 10 or 15 minutes.

For more on breathing, check out our recent blog post Just Breathe!

Multiple apps and guided meditations can help support you in your new mindfulness practice.  Calm, Headspace and Insight Timer are popular apps that offer free meditations available for all levels.

Mind & Body Exercise

Another way to practice mindfulness is through mind and body exercises, such as Pilates and Yoga. These classes are rooted in principles to help you move intentionally and mindfully. Many Pilates and Yoga classes are designed to help you create focus and awareness as you connect your breath and movement together. Gentle, mindful movement is important to keep all the tissues of your body healthy and moving together. Considering scheduling a private Pilates session or joining the group Pilates Mat class!

Dr. Mary Schuster is a physical therapist at PhysioPartners.  She can be reached at maryschuster@physiopartners.com.

References

Zeidan F., Vago D.; Mindfulness meditation-based pain relief: a mechanistic approach; Annals of the New York Academy of Science, 2016

www.mindful.org

Why Do My Muscles Hurt After Exercise?

man raising his right arm

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Getting to the Bottom of Delayed Onset Muscles Soreness

By Katrina Sholeen, PT, DPT

 Whether you know it or not, you are probably familiar with the feeling of delayed onset muscle soreness, also known as “DOMS”. To athletes, weekend warriors or even people with physically demanding jobs, sore muscles may seem routine. However, if you’ve only recently started exercising, made changes to the type or intensity of your exercise, or even took up a large gardening project over the summer, it may feel unexpected and unwelcome. This soreness is normal, but knowing what to expect beforehand and how to manage it can help to keep you on track with your fitness goals! 

What Causes DOMS?

 Delayed Onset Muscle Soreness occurs following starting an exercise program that is new to your body due to microtrauma and irritation to the muscle tissue at the microscopic level, which causes inflammation and soreness that is greatest at 24-48 hours after the exercise before resolving on its own. This results stiffness and can temporarily reduce your strength and flexibility. This initial soreness will get better on its own, usually within 48-72 hours. As your body adapts to the new exercise and becomes stronger, the soreness will also occur less frequently. DOMS has been found to be more common after eccentric exercise, which involves a slow, controlled lowering after the “lift” phase of the exercise. This type of exercise is commonly recommended by physical therapists because of the functional training benefits, which is why you may feel sore even if it didn’t feel like a “hard” workout.

What Can I Do About It?

Time has been shown to be the only cure for DOMS, so it is important to build rest and recovery time into your schedule when starting a new program. In this case, rest does not have to mean lying down or avoiding activity.  “Active rest” includes light exercise such as walking or even just exercising a different area of the body.  For example, you can work on strengthening your arms when your legs are sore. Other treatments like foam roller exercises, massage therapy and the use of gentle compression garments have been shown to help manage the soreness, but they will not resolve it altogether. The use of heat and ice to improve soreness has also been debated, with many studies showing favor to one, both, or neither to reduce symptoms of DOMS.

 Recognizing the difference between soreness and pain is important if you are either recovering from an injury of if DOMS is a new experience for you. Though DOMS causes a dull, achy, sore or stiff sensation, it should never cause sharp, intense pain.  If you are currently seeing a physical therapist, DOMS should feel different than the pain that led to you seeking care. If the soreness lasts longer than the typical 48-72 hour recovery period, it may indicate that the exercise was too challenging and needs modification, so be sure to mention lasting soreness to your physical therapist or trainer so they can adjust your exercises to be a good fit for you and your current fitness level!

Unfortunately, delayed onset muscle soreness is a normal part of starting a new exercise routine, but it is also a sign that your body is adapting and getting stronger along the way!

 

References:

Gregory E. P. Pearcey, David J. Bradbury-Squires, Jon-Erik Kawamoto, Eric J. Drinkwater, David G. Behm, and Duane C. Button (2015) Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures. Journal of Athletic Training: January 2015, Vol. 50, No. 1, pp. 5-13.

Petrofsky, JS, Khowailed, IA, Lee, H, Berk, L, Bains, GS, Akerkar, S, Shah, J, Al-Dabbak, F, and Laymon, MS. Cold vs. heat after exercise—is there a clear winner for muscle soreness. J Strength Cond Res 29(11): 3245–3252, 2015

Petrofsky, Jerrold Scott et al. “The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness.” Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 27 4 (2017): 329-337 .

Do You Know Your Movement Vital Signs?

black and white blood pressure blood pressure monitor close up

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Most people think of heart rate or blood pressure when they think of vital signs. It is common to use numbers to quantify health and risk of disease. The American Heart Association encourages people to “know their numbers” referring to blood pressure, blood cholesterol, blood glucose, and weight. However, research is now showing the importance of moving properly for health. Let’s take a look at some of the numbers you can use to quantify your movement health:

Walking Speed
Walking speed has been called the “sixth vital sign” in medical literature recently. It is easy to measure, and takes into account strength, balance, coordination, confidence, cardiovascular fitness, tolerance to activity, and a whole host of other factors. It has also been shown to be predictive of future hospitalizations, functional decline, and overall mortality. Normal walking speed is considered to be 1.2 to 1.4 meters per second.

Push Ups
Push ups are popular to build strength, but a recent study found that they can show us a lot about your heart too. Researchers found that men who could do 40 or more consecutive push ups were at a 96% lower risk for cardiovascular disease than were men who could do less than 10. The push up test was also more useful in predicting future cardiovascular disease than aerobic capacity measured on a treadmill.

Grip Strength
Hand grip strength has been shown to be strongly correlated with health. The stronger your hand grip is, the less likely you are to suffer from cardiovascular disease, respiratory disease, COPD, and all types of cancer. In the study, muscle weakness was defined as grip strength <26 kg for men and <16 kg for women. Grip strength below these numbers was highly correlated with an increase in disease.

Standing From the Floor
If you can’t easily get down on the floor and back up your health might be in trouble, according to a study that looked at more than 2,000 people. The study asked people to go from standing to sitting on the floor and back up with as little support as needed. They found that if you need to use more than one hand to get up and down from the floor that you were 2 to 5 times more likely to die in the next 7 years than someone who can do it with just one hand, or even better, no hands at all.

Moving well is obviously important to overall health and longer life. These tests can give a snapshot of how you’re doing. If you’re having trouble with any of them, considering seeing a movement specialist – your physical therapist.