Tag Archives: Balance

Fall Prevention Physical Therapy

Physical Therapy for Balance & Fall Prevention

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“Falls are the leading cause of injury death for Americans 65 years or older. Each year, about 35–40% of adults 65 and older fall at least once.”
— Center for Disease Control

Physical Therapy for Fall Prevention
Physical therapy fall prevention programs are tailored around each individual’s needs. The length of the program is dependent on the severity of the symptoms and the goals of each individual. Most patients will follow a gradual path of three distinct phases. After an initial evaluation to determine needs and goals of patient and we will set up treatment plan with patient input. The first phase typically includes therapeutic interventions designated to decrease symptoms and the establishment of a Home Exercise Program (HEP). We will then Continue the use of therapeutic interventions with the addition of ADL modifications, and energy conservation techniques. Finally we will continue the program until the patient’s goals are met.

The main objectives in a fall prevention program are to:

  • Increase independence with Activities of Daily Living (ADLs)
  • Increase independence with functional mobility
  • Decrease fall risk
  • Prevent future fall
  • Increase safety

Pain Relief
Our PTandMe licensed physical therapists are skilled in helping patients significantly reduce the risk of falls so that seniors can continue to age independently. If you or someone you know may benefit from a fall prevention program – call a clinic near you today and see what options are available for you! To find a PTandMe partnering location in your area click here.

crossfit

The Skinny on CrossFit

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If you find going to a new gym nerve-wracking, joining a CrossFit gym might be downright terrifying. Walking into the warehouse-like gym and seeing people flipping tires while loud music pumps out of the stereo system and primal grunts and screams reverberate off the walls can be intimidating. Just take a deep breath, slip on your sneakers, grab your water bottle, and get ready to change your life completely.

Created by Gary Glassman, CrossFit is a high-intensity strength and conditioning program. It uses functional movements and varied workouts to help people lose weight, build muscle, and live healthier lives. While every CrossFit trainer is certified and able to adapt workouts to your needs, it is important that you consult your physician about any pre-existing conditions before beginning a new workout regime.

If you are nervous about going to your first CrossFit class, you can rest easy knowing it probably will not be very intense. Before you can participate in the daily workouts, you need to complete the Foundation Training. This is where you will learn the proper form and technique for the nine fundamental movements. Once you feel comfortable with these movements you can join the masses.

You first week at a Crossfit gym (typically called a “Box”) will be like your first week at a new school. There will be new friends to make, lots of questions to ask, and new skills to learn. You won’t be doing advanced moves in the beginning but you will still be working hard and will find yourself sore and tired by the end of the week.

Each class consists of a 15-minute warm-up, followed by 15 minutes of skill work. This is a great opportunity to improve on a move you are struggling with, or tackle an exercise you are nervous about in the Workout of the Day (WOD). After the skill work segment, you will move on to the WOD. The amount of time to complete a workout varies depending on the objective. Sometimes you will be racing against the clock, while other times you will be aiming for a timed personal best. A cool-down will round out your workout.

10 Components of CrossFit

Doing CrossFit is a full mind and body experience. There are 10 specific elements of physical fitness you will practice during each workout. Your overall fitness level will be determined based on your competency in all these domains.

  • Cardiovascular and Respiratory
  • Stamina
  • Strength
  • Flexibility
  • Power
  • Speed
  • Coordination
  • Agility
  • Balance
  •  Accuracy

 

Building Blocks of CrossFit
There are nine foundational movements every new CrossFit member must understand and master to ensure they get the most out of their workout and avoid injury. The three basic movements are: Squats, Presses, and Lifts. These movements increase in difficulty from Level 1 to Level 3. Once an athlete is comfortable with the form and technique associated with an exercise, they can progress to the next level.

Squats
The first movement you will learn when you join a CrossFit gym is an air squat. This basic movement is the foundation for the next two levels of squats. Squats are excellent lower-body exercises that engage your hamstrings, glutes, and quadriceps. As you progress through the three levels of squats, you will also begin to engage your upper body and core, making the squat a full-body workout.

Level 1 – Air Squat:

  • Stand with your knees shoulder-width apart and your toes angled out at approximately 10 degrees.
  • Keep your back, shoulders, and core tight.
  • Extend your arms out in front of you.
  • Press your hamstrings back and down.
  • As you lower yourself to the ground, press your knees out.
  • At the lowest point of the movement, your hips should be lower than the crease in your knees.
  • Press up through your hamstrings and glutes to return to the starting position.
  • Rest your hands at your side.

Level 2 – Front Squat:

  • Begin in the same stance as for an air squat.
  • Hold a bar in front rack position. (Rack position: Rest the bar on your shoulders across your chest. Your elbows should be up and your triceps parallel to the floor. Loosely grip the bar at slightly wider than shoulder width, with palms facing the ceiling.)
  • Once you are comfortable holding the bar, complete the same downward movement executed in an air squat.

Level 3 – Overhead Squat:

  • Begin in the same stance as for an air squat.
  • Hold a bar over your head with your palms facing forward.
  • Elbows should be locked and your wrist and forearms aligned (no bend or flexion).
  • Complete the same downward movement executed in an air squat.
  • Keep your chest up and eyes forward during this movement. If you feel like you are leaning too far forward you might be compromising the exercise. Reduce your weight and continue.

Presses
Presses are fantastic for targeting and toning your upper body. They will engage your arms, shoulders, back, and, depending on what level you are on, your legs. As with squats, there are three levels of press.

Level 1 – Shoulder Press:

  • Stand with your feet hip-width apart and eyes looking forward.
  • Rest the bar across the front of your shoulders, gripping it slightly wider than shoulder width.
  • Use a hook grip to secure your hands around the bar. (Hook Grip: Cross your middle finger and index finger over your thumb.)
  • Press the bar upwards.
  • As the bar moves straight up, only your head should move back to allow the bar to travel in front of your face.
  • At the top of the movement your arms should be fully extended above your head with elbows locked.
  • Follow the same line to lower the bar back to the starting position.

Level 2 – Push Press:

  • Hold the bar in the same position as for a shoulder press.
  • Keep your torso upright and your core engaged, and slightly lower your body by bending your knees.
  • Explosively straighten your knees and use the momentum in the movement to press the bar above your head.
  • Arms should be fully extended with locked elbows at the top of the movement.
  • Lower the bar back to starting position.

Level 3 – Push Jerk:

  • Hold the bar in the same position as for a shoulder press.
  • Lower your body into a quarter-squat position.
  • Perform a vertical jump.
  • When you are in the air, press the bar above your head.
  • Land with your feet in the exact same spot they took off from and with a slight bend in your knees.
  • Finish the movement by fully extending your hips and knees.
  • Return the bar to your shoulders.

Lifts
The three progressive lifts in CrossFit engage your entire body. These full body movements allow you to make the most out of any workout. If you are short on time, incorporate these exercises into your routine to torch calories and burn muscle.

Level 1 – Deadlift:

  • Place the bar in front of you and stand with your feet hip-width apart.
  • Bend forward at the hips, bending your knees slightly, and grip the bar at a point that is wider than hip-width.
  • The bar should be in contact with your shins and your shoulders should be slightly ahead of it.
  • Keep a flat back as you lower your glutes and pull up on the bar (arms should not bend).
  • Straighten your back and legs while lifting the bar in a vertical line up your body.
  • When the bar passes your knees, fully extend your hips forward.

Level 2 – Sumo Deadlift High Pull:

  • Use a wide stance for this movement.
  • With your hands narrowly apart (about two fist-widths), grip the barbell in front of you with your palms facing down.
  • Keep your arms straight and chest up while you slightly bend your knees into a quarter-squat.
  • Explosively stand up and shrug your shoulders, pulling the bar up in a vertical line.
  • By the time your hips are fully extended, your elbows should be above the bar pointing up and your hands should be aligned with your shoulders.
  • Slowly lower the bar back to the ground by reversing this movement to complete the repetition.

Level 3 – Medicine Ball Clean:

  • Swap out the barbell for a medicine ball.
  • Squat down over the ball.
  • Keep your chest up and gaze ahead.
  • Keep your arms straight and grab the ball on opposite sides.
  • Explode up, shrug your shoulders, and slip your body under the ball so that it lands in front of your face.
  • Catch the ball at the bottom of a front squat with your hips below your knee joints.
  • Complete the movement by standing up with your arms remaining bent, and the ball in front of your face.

WOD are you Talking About?
It’s no secret that CrossFit has a lingo of its own. If you’ve ever heard someone talking about CrossFit, you might wonder what language they are speaking and why they hate their friends Josh and Nancy so much. While they might be talking about a person, it is more likely your CrossFit friends are discussing a tough workout they just did. Each WOD is given a name. WODs are usually named after women (in the same way storms are, because they are so intense they leave you feeling like you were hit by a hurricane) or after fallen war heroes. Here are two notorious WODs that people love to trash.

Six Benefits of CrossFit
CrossFit is a tough workout, you can’t deny that. But, if you are willing to take a shot and get your sweat on, you will reap the rewards. Here are just a few of the many benefits CrossFit will have on your health and life.

The best thing to do if you are considering joining a CrossFit gym is to stop by and check one out. They have certified coaches on site who will be more than willing to answer your questions and put your fears to rest. Who knows, you could be the next breakout star at the CrossFit games!

Total Knee Replacement Prehab: Move to Improve Your Outcomes

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Many people with arthritis favor their joints over time in an effort to relieve pain and thus become weaker in their leg muscles or lose range of motion. However, the better shape you are in before surgery the better your results will be after surgery so it is important to strengthen your leg muscles and work on your range of motion. Before surgery your physical therapist will teach you appropriate exercises to help improve strength, range of motion, and balance. They will also teach you how to walk with an appropriate assistive device such as a walker or cane in the immediate post operative recovery period. Finally, they will discuss precautions and advise you in a few short term home adaptations such as removing loose rugs to help make your recovery easier and safer.

Prehab Goals
• Develop an exercise program with your PT to help you
• Improve strength
• Improve range of motion
• Improve balance
• Gait training — Review walking with an appropriate assistive device such as a walker or cane in the immediate post operative recovery period
• Discuss precautions and review a few short term home adaptations that can help make your recovery easier and safer

walker lady

Pre Surgery Exercise Plan
Make every effort to begin these exercises as early as possible before your surgery. Only do what you are able to do without increasing your pain. It is important for you not to exacerbate your pain prior to surgery. Ice packs for 15 minutes following your exercises may be helpful to reduce any soreness in your knee.

This information was written by STAR Physical Therapy, an outpatient physical therapy group with 60 locations in Tennessee, offering more than 15 comprehensive specialty services. STAR Physical Therapy was established in 1997 with one clinic and one mission – to serve. Today, they’ve grown to offer that direct service in more than 60 clinics. While they’ve grown, one thing that has not changed is their commitment to you, their communities, and their employees. For more information click here.

More about knee replacements and physical therapy can be found here:

total knee replacement

postoperative physical therapy

Postoperative Physical Therapy

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Postoperative physical therapy after a Total Hip Replacement is essential to your recovery. Your physical therapist will follow your physician’s protocol and will focus on range of motion exercises, progressive strengthening exercises, gait training, balance training, and activity specific training to meet your specific needs. Modalities such as ice and e-stim may be used to help reduce discomfort and swelling. It is very important to complete your home exercise program as directed by your physical therapist and physician.

RANGE OF MOTION EXERCISES
Swelling and pain can make you move your knee less. Your physical therapist can teach you safe and effective exercises to restore the range of motion to your knee so that you can perform your daily activities.

STRENGTHENING EXERCISES
Weakness of the muscles of the thigh and lower leg is typical after surgery. Your physical therapist can determine the best strengthening exercises for you with the goal of no longer needing a cane or walker to walk.

post op

BALANCE TRAINING
Specialized training exercises can help your muscles “learn” to adapt to changes in your world such as uneven or rocky ground. When you are able to put your full weight on your knee without pain, your physical therapist may add agility exercises so that you can safely and quickly change directions or make quick stops or starts. They may use a balance board that will challenge your balance and knee control. These exercises will be safe and fun.

GAIT TRAINING
Your physical therapist will work with you in retraining your gait following your surgery using appropriate assistive devices such as a walker or cane. They will make sure that you will be able to safely and confidently go up and down stairs, negotiate curbs, and inclines, etc.

ACTIVITY SPECIFIC TRAINING
Depending on the requirements or your job or the type of recreational activities you enjoy, your physical therapist will tailor your program so that you can meet your specific demands.

This article about postoperative physical therapy was written by STAR Physical Therapy, an outpatient physical therapy group with over sixty locations in Tennessee. Established in 1997 with one clinic and one mission – to serve. Today, they have grown to offer that direct service in more than 60 clinics, and while they’ve grown, one thing that has not changed is their commitment to you, their communities, and their employees. For more information click here.

start exercising

Seniors: It’s Never Too Late to Start Exercising

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For years, older people have attributed their aches, pains, and illnesses to the normal aging process. Age is often used as a reason to avoid exercise. But a regular exercise program, regardless of your age, can improve the quality of your life and help you avoid illness, including heart disease, stroke, and diabetes. As always, you should consult with your doctor before starting any exercise program.

WHAT WE KNOW
Most people know that with age, come certain physiological changes. Studies show that we lose the following as we age:
• Lean muscle tissue—Most of us will lose muscle mass as we get older. We usually hit our peak muscle mass early—around age 20—and begin losing muscle mass thereafter.
• Aerobic capacity—The aerobic capacity is the ability of the heart and the body to deliver and use oxygen efficiently. Changes in the heart and decrease in muscle tissue decrease aerobic capacity.
• Balance—As we age, our ability to balance decreases, making falls and injuries more likely. The loss of muscle is a major contributor to losses on balance.
• Flexibility—Our joints and tendons lose some of their range of motion with age, making it difficult to bend and move around comfortably.
• Bone density—Most of us reach our peak bone density around age 20. After that, bones can become gradually thinner and weaker, which can lead to osteoporosis.

Fortunately, regular exercise can help delay some of these changes and give you the energy you need to do everyday activities like walking, shopping, and playing with your grandchildren. Exercise may even help decrease depression and stress, improve mood and self-esteem, and postpone age-related cognitive decline.

Even if you have never exercised before, you can start now. It is what you are doing now that you can change—not what you have been doing all your life.

By adding endurance, strength, flexibility, and balance training into your routine, you will be healthier, happier, and more energetic.

senior push ups

ENDURANCE
Decades ago, doctors rarely recommended aerobic exercise for older people. But we now know that most people can safely do moderate exercises. Studies have shown that doing aerobic exercise just a few days a week can bring significant improvements in endurance.

Aim to get 30 minutes of moderate exercise—such as brisk walking, bicycling, or swimming—at least 5 days a week. You do not have to do 30 minutes at once—you can break these sessions up into two 15-minute sessions or three 10-minute sessions. Moderate exercise will cause your heart rate to rise and your breathing to be slightly elevated, but you should still be able to carry on a conversation.

STRENGTH
It is not just aging that makes people lose muscle. One of the main reasons older people lose muscle mass is that they stop exercising and doing everyday activities that build muscle.

Building stronger muscles can help protect your joints, strengthen your bones, improve your balance, reduce the likelihood of falls, and make it easier for you to move around in general. Even small changes in your muscle size and strength—ones that you cannot even see—will make things like walking quickly across the street and getting up out of a chair easier to do.

Aim to do strength exercises (eg, weight lifting) every other day, or at least twice a week. For each exercise, do three sets of 8-12 repetitions.

FLEXIBILITY
Increasing your overall activity level and doing stretching exercises can markedly improve your flexibility.

To improve the flexibility—or range of motion—of your joints, incorporate bending and stretching exercises into your routine. A good time to do your flexibility exercises is after your strength training routine. This is because you muscles will already be warmed up. Examples of exercises that you may enjoy include Tai chi, yoga, Pilates, and exercises that you do in the water.

By regularly stretching, you will be able to move around easier. You may also feel less stressed, and your posture will improve.

BALANCE
Just becoming more physically active will improve your balance and decrease your risk of falling. If you add some basic balancing exercises to your exercise routine, you will begin feeling more stable on your feet. Balance exercises can be done just about anywhere and usually require no more equipment than a chair.

Keep in mind that if you are having severe problems with balance, it might be due to a medical condition. In this case, talk to your doctor who can assess the situation.

GETTING STARTED
To avoid injury, start slowly. Add one or two sessions a week at first and progress from there as you begin to feel stronger. A doctor, certified physical trainer, or other health professional, can help you develop a program that will be both safe and effective. Check with your local fitness or community center, which may offer exercise classes designed especially for older adults. Check with your doctor if you are planning to participate in vigorous activities.

Remember, it is never too late to start exercising. The sooner you start, the sooner you will start feeling healthier, more energetic, and less stressed.

by Mary Calvagna, MS

RESOURCES:
American Heart Association
http://www.heart.org

The President’s Council on Physical Fitness, Sports, and Nutrition
http://www.fitness.gov

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

Effects of aging. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00191. Updated September 2009. Accessed April 4, 2016.

Exercise and physical activity: your everyday guide from the National Institute on Aging. National Institute on Aging website. Available at: http://www.nia.nih.gov/health/publication/exercise-physical-activity-your-everyday-guide-national-institute-aging-1. Updated February 16, 2016. Accessed April 4, 2016.

Physical activity: glossary of terms. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nccdphp/dnpa/physical/terms/index.htm#Moderate. Updated June 10, 2015. Accessed on April 4, 2016.

Last reviewed April 2016 by Michael Woods, MD  Last Updated: 5/8/2014

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Fall Prevention Programs Can Keep You On Your Feet!

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One in every three adults 65 and older fall each year in the United States – WWW.CDC.GOV

The numbers are staggering. Apparently not only does the eyesight go, but balance along with it. The two could be seen as going hand in hand since the worse your vision gets, the more likely you are to bump into or trip on something unnoticed. Fear not worried reader. Physical therapy may not improve vision, but it does improve the ability to manage and reduce the likelihood of a fall and even more importantly, a resulting hip fracture.

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