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Fitness, with a Side of Dysfunction?

This time of year, many people are focused on fitness so it’s worth taking a look at what fitness really means. The dictionary defines fit as “sound physically and mentally, healthy.” Using that definition, many “fitness” routines fall short of the goal. If you don’t enjoy running and dread every workout, you’re probably falling short of the “sound mentally” portion. Exercise should be enjoyable, reduce stress, and leave you feeling better, not worse.

NO PAIN NO GAIN?
Exercise should also leave you feeling better physically. If you can run a good time in a 5k, but have aches and pains for days after, you’re not “sound physically.” If you are increasing your PR in the squat rack, but your joint pain is increasing right along with it, you’re not “sound physically” either. Sure, some muscle soreness and fatigue after a hard workout is normal. But if you’re having pain that doesn’t go away, sore joints, or trouble moving after exercise, you’re probably developing movement dysfunction along with your fitness.

MOVEMENT DYSFUNCTION
Go back to the dictionary and you’ll find that dysfunction is “impaired or abnormal functioning.” So movement dysfunction is impaired or abnormal movement. When someone has a movement problem like a sore joint, limited range of motion, or strength loss, the brain finds a way to get the body to do what it wants. That usually means moving in a way that is less than optimal. For a while, it works. But eventually it leads to injury. As a concrete example, think of someone who has trouble bending one knee doing squats. When one knee bends further than the other, it will cause one side of the pelvis to drop lower than the other. Now that the pelvis isn’t level, the spine bends towards the high side to stay balanced. When that one side of the pelvis drops lower than the other one, it also usually rotates. Now the spine has to bend to the side and twist to keep you upright. This works for a while, but as weight gets added to the squat, and the repetitions add up so does the risk for a back injury.

PREVENTATIVE MEDICINE
Pain during workouts, or pain and soreness that don’t go away after can be warning signs of a movement dysfunction. If you’re experiencing any of these, your physical therapist is a movement expert who can help. PTs are trained to analyze movement, and figure out the root cause of problems. They can then design a program to treat the cause and correct the abnormal pattern. There is no need to wait until you’re injured to see your physical therapist. In fact, it’s preferable not to. Getting minor problems fixed early means fewer visits to the PT, less pain, and not having your workouts put on hold by injury.

Jaw Pain?

Physical therapy can help individuals suffering from jaw and facial pain associated with the temporomandibular joint (TMJ). The TMJ is one of the most used joints throughout the body, as it is responsible for chewing, talking, and yawning. This joint consists of the temporal bone of the skull and the mandible (jaw bone) and is separated by a small disc that allows the joint to glide properly. However, alterations in the TMJ such as too little or too much movement can result in pain and disability. Jaw pain has also recently been associated with neck pain and headache as well causing an update in the name of the disorder to Temporomandibular dysfunction (TMD) or craniofascial pain. 

TMD can result in the following symptoms: 

  • clicking/popping of the jaw 
  • facial pain 
  • headaches 
  • pain around the ear 
  • pain or discomfort with chewing 
  • locking/catching of the jaw 

TMD can be caused by frequent clenching or grinding of teeth, trauma, and poor posture. Poor posture causes the jaw to be pulled posteriorly due to the attachment of muscles surrounding the joint. As a result, this leads to altered teeth contact, changes in joint space, and increased stress on the muscles responsible for chewing. There is research supporting physical therapy as a treatment to improve jaw pain and function. 

If you are experiencing symptoms that appear to be related to the temporomandibular joint, schedule an appointment at Breakthru Physical Therapy today for an examination! 

Physical Therapists Diagnose Movement “Illnesses”

For people who are sick, going to the doctor and getting a diagnosis is common sense. But who do you see for diagnosis if you’ve got a movement “illness”? If your knee hurts when you go hiking, you can’t get on and off the floor to play with your kids, or you can’t lift things to do your job, who do you see?

Physical therapists are experts in human movement with doctoral level training and should be your first stop for movement issues. After a comprehensive evaluation, a PT will give you a movement diagnosis. Like a medical diagnosis, your movement diagnosis will describe what’s causing your difficulty with movement. Some examples would be difficulty standing from a chair secondary to decreased force production, scapular down rotation syndrome, or lower crossed syndrome. 

Human movement is complex and influenced by many factors, including the pulmonary,nervous, endocrine, cardiovascular, integumentary and musculoskeletal systems. Because of the complexity of the movement system, getting the diagnosis right can be difficult. Physical therapists have extensive training and expertise in human movement and should be your go-to practitioner for movement issues. Getting an accurate diagnosis is important because it sets the road map for treatment. 

Once your movement “illness” is correctly diagnosed, your physical therapist can design the correct treatment plan for your issues. Before you know it, you’ll be back to work or play and moving as well as if not better than before!

 

About The Private Practice Section of the American Physical Therapy Association Founded in 1956, the Private Practice Section of the American Physical Therapy Association champions the success of physical therapist-owned businesses. Our members are leaders and innovators in the health care system. The American Physical Therapy Association (APTA) represents more than 85,000 physical therapists, physical therapist assistants and students of physical therapy nationwide. For more information, please visit www.ppsapta.org.

Monday, September 23rd is Falls Prevention Awareness Day!

Did you know, according to the CDC, at least 3 million older adults visit the ER for fall-related injuries every year?1 Factors such as lower body weakness, difficulty walking, poor balance, and foot pain can all increase a person’s risk of falling, but are preventable with proper rehab therapy.

 

Check out these 5 tips to decrease your chance of falling!

1. Practice Strength and Balance
Strength building programs are key to preventing falls. If a patient’s lower body is weak or in pain, it can negatively effect their balance, leading to a higher risk of falling.
2. Strengthen Spatial Awareness
Many older adults have difficulty performing tasks while remaining mindful of where their body is in relation to other objects or surfaces. This lack of spatial awareness can often result in falls. An effective solution is “dual-task” training, or having your patients practice doing two things at once, like walking while talking, standing on one foot while reaching for an item, or moving while holding an item.2
3. Create an Exercise Routine
Physical activity can improve balance, coordination, and flexibility in your patients. Recommend easy workouts, like walking, swimming, or aerobics to promote exercise without increasing an older adults risk of injury.
4. Adjust Assistive Devices
Assistive devices like canes and walkers are only helpful when they are the correct height for your patient. Make sure that your patients are comfortable with the height of their device and make adjustments if needed.
5. Check for Foot Pain
Foot injuries that heal incorrectly can cause pain and poor balance. If your patient has suffered from a foot injury and is still experiencing pain, they likely have developed restricting scar tissue that is interfering with movement and causing pain. Treat these types of patients with a treatment that is proven to eliminate unwanted scar tissue, like Astym therapy. Astym therapy is proven to remove unwanted scar tissue and regenerate healthy soft tissues, effectively eliminating pain and movement restrictions.

Scoliosis: Things to look out for!

You know your child better than anyone else.

If you notice something different about their posture like one shoulder is higher than the other or a part of their spine seems to be protruding out or curved to the side, schedule a FREE consultation with a Breakthru Schroth Expert.

 

 


 

  • STANDING & FACING YOU:
    • Is one shoulder higher than the other?
    • Is one arm farther away from the body?
    • Are the hips level?
    • BENDING TOWARD YOU:
      • Is one side of the rib cage higher than the other?
      • Is the lower back uneven?
      • Are the hips level?
    • STANDING AND FACING AWAY FROM YOU:
      • Is one shoulder higher than the other?
      • Do the hips look even?
    • BENDING AWAY FROM YOU:
      • Is one side of the rib cage higher than the other?
    • TURNED TO THE SIDE:
      • Does the back look overly rounded?

For questions or concerns, please email us.

#Get PT 1st For Back Pain

Chances are, you or someone you know has had back pain. Each year 15% of the population has their first episode of back pain, and over the course of our lives, 80% of us will have back pain. Even though back pain is common, the medical community does a poor job managing it.  Stories of chronic pain, opioid use, multiple surgeries, and a lifetime of disability are far too common.

Let’s look at some of the common treatments for low back pain and see how they stack up against physical therapy:
Medication Low back pain is the #1 reason for opioid prescription in the US, however in 2106, the CDC recommended against the use of opioids for back pain in favor of “non-drug treatments like physical therapy.”

Imaging

Having an X-ray or MRI for back pain is common, however it’s rarely needed or helpful.
Research has NEVER demonstrated a link between imaging and symptoms. As we age,
degenerative changes on imaging is common.
● 90% of people age 50 to 55 have disc degeneration when imaged, whether they have
symptoms or not
● In 2015 a study that looked at 1,211 MRI scans of people with no pain found that 87.6%
had a disc bulge
● Just getting an image increases the chances that you’ll have surgery by 34%

Surgery

The US has sky high rates for back surgeries – 40% higher than any other country and 5x higher
than the UK. You’d think that with all the back surgeries we do, we’d be pretty good at it but the
outcomes are terrible!

A worker’s comp study looked at 725 people who had spinal fusions VS 725 people who didn’t.
The surgical group had:
● A 1 in 4 chance of a repeat surgery
● A 1 in 3 chance of a major complication
● A 1 in 3 chance of never returning to work again

Physical Therapy

● Current clinical practice guidelines support manual therapy and exercise
● Research proves that early PT lead to better outcomes with lower costs, and decreases the risk of surgery, unnecessary imaging, and use of opioids
● A study of 122,723 people with low back pain who started PT within 14 days found that it decreased the cost to treat back pain by 60%
● Unfortunately only 2% of people with back pain start with PT, and only 7% get to PT within 90 days.

Despite the data showing that PT is the most effective, safest, and lowest cost option to treat low back pain, most people take far too long to get there. Almost every state has direct access, meaning that you can go directly to a physical therapist without a doctor’s referral. If you see your doctor for back pain, and PT isn’t one of the first treatment options, ask for it!

Shoulder Stability in the Overhead Athlete

The shoulder is one of the most complex parts the body. It consists of four separate joints that are linked together by multiple muscles, tendons, and ligaments that provide both mobility and stability to the shoulder. The shoulder is a “ball and socket” joint with the socket portion being shallow and therefore providing very little stability via the bony anatomy. As a result, you have to rely on other structures to keep your arm securely inside the shoulder blade. When your arm is at rest your shoulder is primarily stabilized by the joint capsule that fully encloses both the ball and the socket. During arm movement the stabilization process is much more complex and requires the four muscles of your rotator cuff to fire to maintain proper positioning of your shoulder joint. 

The action of lifting your arm up above your head requires movement from both your shoulder blade and your arm in order to reach your full range of motion. For this movement to be performed correctly, it requires the proper muscle firing patterns in the shoulder complex. Athletes tend to forget about the small stabilizing muscles of the rotator cuff during their workouts and instead focus on the larger muscle groups, i.e. the pecs, deltoids, lats, etc. These big muscle groups, especially the “pushing” muscles which are used frequently in sports, can become overdeveloped in comparison to the small stabilizing muscles and result in injuries from this muscle imbalance. One of the most common issues from a muscle imbalance like this is that the small rotator cuff cannot compete with the larger muscles and is unable to perform its job of providing small rotational movements to the ball part of the joint to prevent it from hitting into the socket during arm movements. 

It is important to remember that the rotator cuff is not only firing during athletic activities, it is also responsible for proper positioning of your arm and shoulder blade while you sit with good posture. Since these muscles are required to fire constantly throughout the day it is important that they are trained in very high repetitions to increase endurance. Increasing the endurance of the rotator cuff during the offseason will also assist in maintaining the integrity of the muscles throughout the season of an overhead athlete. During the season, the rotator cuff experiences plenty of stress through the deceleration portion of throwing or shooting. This repetitive stress causes the rotator cuff to “stretch out” and lose the ability to function at 100%. This is why it is important to remember that overhead sports require full kinetic chain movements for maximum power.  It is vital to keep the core and hips strong and mobile as well in order to decrease the stress placed across the shoulder during the throwing or shooting motion. 

A proper off season strengthening program is necessary to minimize an athlete’s risk of injury and to maximize his or her success during the season. There are various “prehab” shoulder programs available for athletes to follow online, but it is important to remember that not all shoulders are created equally and different sports place different demands on the body. The shoulder must be managed differently while the athlete is in season and after the season to allow for proper recovery of the muscles in the joint. In conclusion, each and every shoulder is created differently and must be managed following specific guidelines catered to each individual. It is crucial to find the correct balance of mobility and stability for the overhead athlete to be able to reach his or her peak performance.

Click HERE to check out a short video of exercises that you can do at home to help improve your shoulder stability!

  • Use a light weight and keep your elbow tight in against your side as you rotate your arm until your palm is parallel to the ground.
  • If you want to challenge your athlete and add core strengthening into the exercise; have them perform this exercise in a side-plank position to increase the difficulty of the exercise by incorporating oblique and glute activation.

By: Dr. Abigail Dingle, PT, DPT, OCS, SCS, CSCS

Getting ‘Back’ to Spring Sports

With warmer weather right around the corner, spring sport athletes are gearing up for their seasons.  The majority of spring sports consist of overhead movement patterns, which require a series of complex movements throughout the body. Thoracic spine, or upper back, rotation is one of the most important components for maintaining a healthy lower back and shoulder throughout the season.

Proper mobility through your thoracic spine allows for the transfer of power from your legs and core. It is easy to compensate for rotational range of motion through your lumbar spine, or lower back. However, if the middle of your back isn’t moving properly it is easy to lose the majority of your strength and power generated by your hips and core for your throwing or shooting motion before it ever reaches your shoulder. If you want to obtain the maximum speed out of your throw or shot, it is vital that you have full rotation through your thoracic spine. 

 

If an athlete is lacking proper rotation through his or her thoracic spine the body will have to find a way to make up for that missing motion somewhere else. Most often the body will “make up” this range of motion in the shoulder. The front of the shoulder is stabilized by a group of ligaments that help to keep the head of the humerus in its proper position against the shoulder blade, or the ball in the socket. These soft tissue structures are prone to stretching out if repeatedly stressed from excessive external rotation of the shoulder. If the ligaments in the front of the shoulder become too loose, additional stress can be placed on the biceps tendon and nerve structures causing irritation or injury for the athlete. 

 

 

 

There are various exercises to address limited rotation through your thoracic spine that can easily be added into your daily routine. One of the most common is called an “Open Book”. To perform this exercise begin by laying on your side with your bottom leg straight, your top leg bent to 90 degrees through your hip and knee, and your arms straight out in front of you. Begin by slowly lifting your top arm and rotating your trunk to bring it towards the floor on the other side of your body. If you have limited motion, you should feel a stretch in the middle of your back. Only go as far as you can without lifting your top knee or arching your back! 

Snow Shoveling Tips

It’s that time of year again! According to the U.S. Consumer Product Safety Commission, more than 158,000 people were treated in emergency rooms, doctors’ offices, and clinics for injuries that happened while shoveling or removing ice and snow manually. Snow shoveling is a common cause for back pain and lumbar injuries, however there are ways to prevent these from occurring. Proper mechanics and technique can help decrease post-shoveling low back pain.

  •    Lift with your legs, not your back:  When shoveling snow we tend to bend forward putting a lot of stress on the lumbar spine, which increases the risk of injury or flare up of low back pain. In order to prevent this, try to squat down by bending at your knees lift the snow using your legs instead of your back.
  •    Turn with your feet: When we twist with our feet planted we are mostly twisting using our low back. A better way to turn with a heavy load is to keep the core tight and lock the arms into your side while pivoting using your feet. Using these mechanics will help decrease load on the spine and help prevent injury.
  •       Grip snow shovel with hands apart: Gripping the shovel with your hands together can create a longer lever arm, which in turn makes it harder to lift the shovel filled with snow. Having one hand toward the handle and one hand further down towards the shovel will improve force distribution and decrease stress on the body while snow shoveling. It will make the pile of snow seem like less than it is.
  •    Take breaks: Muscle fatigue can cause our mechanics to break down, putting us at risk for injury. Be sure to take plenty of breaks in order to keep your muscles in good condition and maintain good mechanics.
  •    Shovel smaller loads of snow: Only shovel a load you can handle while maintaining all the mechanics above. If the load is too heavy and compensations are occurring, your mechanics suffer. When mechanics suffer, the risk for injury increases. Only shovel loads you can handle!

Safe snow shoveling is important to prevent injuries that will affect the ability to participate in daily life. It is important to maintain proper mechanics and decrease risk of injury in order to stay healthy and active throughout the winter.

If you or someone you love are experiencing any aches and/or pains then schedule a FREE Screen with one of our Doctors of Physical Therapy.  No Prescription Necessary!