Tag Archives: Exercise

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

1. Decreasing Cartilage Loss in Osteoarthritis
Written by the Therapy Team at The Jackson Clinics Physical Therapy – Northern Virginia

Although some over-the-counter nutritional supplements have been advertised as capable of rebuilding cartilage in arthritic joints, the claims most often do not stand up under scientific scrutiny. Read more

2. Treating Degenerative Meniscus Tears
Written by the Therapy Team at The Jackson Clinics Physical Therapy – Northern Virginia

During the aging process, the fibrous cartilage between the thighbone (femur) and the shinbone (tibia) within the knee can degenerate and become prone to tearing. Read more

3. Five Stretching Tips Before You Workout
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

As temperatures start to warm up, many of you will start to hit the streets, trails, and parks to exercise outdoors. Read more

Guidelines to Prevent Throwing Injuries

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In this third intallment of our series to prevent throwing injuries, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


INTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high up on a doorway and face away from door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the ceiling. Rotate from your shoulder bringing your hand forward while keeping your arm parallel to the floor and your elbow bent to 90 degrees.


EXTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high on a doorway and face toward the door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the door. Rotate from your shoulder bringing your hand away from the door while keeping your arm parallel to the floor and your elbow bent to 90 degrees.


SHOULDER INTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising closest to the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand toward your stomach while keeping the elbow bent to 90 degrees.


SHOULDER EXTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising furthest from the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand away from your stomach while keeping the elbow bent to 90 degrees.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

whiplash

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

thinking healthy

2. What You Eat Affects Inflammation and Healing
Written by Meghan Russo, PTA at the Center for Physical Rehabilitation – Grand Rapids, MI

Did you know that many foods can decrease or increase inflammation and help to decrease pain? Read more

running couple

3. Tips for Beginner Runners
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

If you think running is not for you – think again. Read more

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

overtraining

Are You Overtraining?

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Maintaining a rigorous workout schedule without allowing enough time for the body to recover, often leads to what is known as overtraining. Not only is an athlete at a higher risk for injury but overtraining can manifest itself in several other ways.

WHAT CAN CAUSE OVERTRAINING
• Sudden increase in exercise frequency
• Intensity or duration of training sessions
• Not allowing your body adequate recovery
• The length of time you have been training

SIGNS AND SYMPTOMS OF OVERTRAINING
• Persistent muscle soreness
• Elevated resting heart rate.
• Increased susceptibility to infections.
• Increased incidence of injuries.
• Irritability
• Depression
• Loss of motivation
• Insomnia
• Stop noticing progress towards training goals
• Becoming restless and losing focus
• Feeling sluggish all day

HOW TO AVOID OVERTRAINING
• Get enough sleep – this is the time when your body is able to heal the most
• Proper nutrition- get plenty of protein, fats and carbs
• Monitor stress levels

leg press

Exercise Smartly:
• Find a balance and avoid workouts that are too intense for you
• Progress workouts slowly

Allow Proper Recovery Time Between Workout Sessions:
Take one or two days between workout sessions or alternate intensity levels for each workout

Stay Active On Off Days:
• Try a less intense mode of exercise (Active Rest)
• Yoga, stretching, or foam rolling can be done on these days

Information provided by the Center for Physical Rehabilitation – Grand Rapids, MI
To learn more about the Center for Physical Rehabilitation click here.

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

1. Exercise after Knee Replacement Surgery
Written by the Therapy Team at Cornerstone Physical Therapy – Gahanna, OH

If you’ve been undergoing treatment for knee arthritis and haven’t gotten any pain relief yet, your doctor may recommend a total knee replacement surgery. Read more

2. Low Back Pain and Sciatica Workshop
Written by the Therapy Team at Oregon Spine & Physical Therapy – Eugene, OR

If you are suffering with chronic back pain or sciatica and you’re looking for some help… why don’t you start by attending one of our Educational Workshops so you can make a better, more educated and more informed decision about your options to ease it. Read more

3. Inflammation and Your Diet
Written by Cheryl Schwieters, Physical Therapist Assistant at the Center for Physical Rehabilitation – Grand Rapids, MI

Throughout the day the body is constantly being bombarded with substances that can trigger inflammation. Read more

bike fit

Does Your Bike Fit?

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There is a misconception that only competitive cyclists benefit from bike fittings. The truth is that anyone that rides a bike on a consistent basis should ride a bike that fits them properly. Granted, competitive cyclists are looking for every advantage with respect to power and performance. However, fitness and recreational riders can gain the same benefits while also improving comfort and reducing the risk of on-the-bike injuries. Often, a few basic changes to a bike can make a significant difference with respect to comfort, power, endurance and overall performance. In this blog we briefly examine some of the key areas that must be considered to ensure a proper bike fit.

THINGS TO LOOK FOR

Frame Size
Obviously, not all frames are created equal. Frame geometry can vary dramatically depending on material, the manufacturer and overall design. Head tube angles, seat tube angles, top tube length, wheel base, etc. are all factors which contribute to how a bike handles and rides. This is where test riding a bike will pay dividends. For example, having a steep head angle may sound like a good idea to achieve a responsive ride. However, you may find it a bit unnerving on a steep, fast descent or even when you try to take your hands off the bar to eat or drink. With regard to mountain bikes, different suspension and wheel size options also affect the way a bike handles and rides. All are personal preferences that should match your intended use.

For general fit, most manufacturers will have measurements that you can take on yourself to help you decide which frame size will likely be best for you. However, you may also fall within the acceptable range for two different frame sizes. In that case, there is no substitute for going to a shop that carries the bikes and riding them both. In all likelihood, you will quickly feel the difference and easily decide which will work best for you. If you are leaning toward the larger of the two sizes, make sure to check the stand over height before laying your cash on the counter. Keep in mind that your primary concern with respect to frame size is the fit from the waist down. Reach is obviously important as well. However, most upper body adjustment can be achieved by varying bars or stem length/angle assuming the length of the top tube is appropriate.

Crank Arm Length
This is one area where people seem to be content to accept a length simply because that particular crank arm is what they have been told is standard or best. The truth is that many bikes come equipped with crank arms that are too long for the prospective rider. Even when told they should have a shorter crank arm, some feel that if they can push it, they will be a stronger, more powerful rider. This can be a foolish mindset as this can result in knee and/or back problems. Of course, there are also occasions where the crank arms may not be long enough. In this instance, the rider is likely giving away potential power and performance. When deciding on an appropriate crank arm length, we are usually talking about millimeters of difference. However, there are specifications for crank arm length typically based on inseam length and/or seat height.

Cleat Alignment
Pedal choice as well as cleat adjustment are vital components of bike fit. Proper cleat alignment is the starting point for overall fit and essentially aligns the position of the foot in relation to the spindle of the pedal and the crank arm. It can also be one of the most difficult aspects of fit to get accurately established. This is true primarily because it is hard to align your cleat when it is mounted to your shoe which is on your foot and clipped into the pedal. Furthermore, most modern pedal/cleat combinations allow for considerable adjustment with respect to float, rotation, fore and aft, and side-to-side. Equally important is the shoe. People often buy soft cycling shoes that are comfortable on and off the bike. Although these shoes may be more comfortable for walking, you are giving up considerable force production and performance on the bike. Furthermore, on long bike rides, these softer shoes can result in “hot spots” and foot fatigue. Cycling shoes don’t need to be uncomfortable. However, when you are riding a bike, wear the shoe that is made for the job.

Seat Adjustment
This is another area that results in much debate. Do you go higher for better force generation or lower for better control on descents? Once again, improper seat height can result in pain or injury. It can also significantly limit your performance. For most riders, seat height and saddle setback (fore/aft positioning) is crucial for comfort and performance. This is the area where the biggest abuse of the law of averages has befallen bike fit. Seat adjustment is often based on averages and equations. Unfortunately, this is rarely the correct position. Much better than averages are measured angles with the rider on the bike which results in a more exacting fit.

Stem Length/Bar Height
Fitting stem length and bar height should be based on alignment, posture, comfort and performance. These factors can have a great effect on your back, neck, shoulders and wrists.

You may be saying to yourself, “Then tell me how my bike should be set up.” The fact is that an accurate fit cannot be done without looking at the individual on their bike. Many bike fits are based on measurements such as inseam, reach, trunk length, etc. which are then plugged into a variety of equations. Adjustments to the bike are then made according to the resulting numbers. The problem is that these equations often vary and are based on averages. Most of us aren’t average. We all have differing body composition and physique. Strength, flexibility, experience and orthopedic issues all play into proper bike fit. Proper fit must be done with the rider on the bike looking at specific measures and alignments.

Ultimately, a good bike fit is well worth the money and can go a long way toward improving comfort on the bike, improving your performance, and reducing the risk of injury. There are obviously many approaches and “schools of thought” when it comes to bike fit. The point here is that the most accurate fits are accomplished by evaluating you on your bike. Remember, depending on your effort and ability, cycling can be a very intense form of exercise. However, that doesn’t mean you have to hurt. If you have pain on the bike, something is typically wrong. More often than not, the problem can be addressed by improving fit. The bottom line is that you want to be sure the bike you ride is fit specifically to you. You should never be forced to fit yourself to the bike.

Written by Michael Choate, MSPT, USA Cycling Certified Coach at North Lake Physical Therapy & Rehabilitation in Portland, Oregon.

North Lake Physical Therapy & Rehabilitation clinics use progressive techniques and technologies to stay on the forefront in their field. OTheir staff is committed to providing patients with advanced healing techniques. To learn more about them click here.

Throwing Injuries

Guidelines to Prevent Throwing Injuries

In this monthly series, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


PUSH UPS
Start on your stomach with your hands below your shoulders. Maintain a straight line from your ankles, through your hips, to the shoulders. Extend your elbows pushing your stomach away from the floor.


BICEP CURL
Begin seated with your elbow extended and palm facing forward. Bend the elbow as far up as you can without flexing your shoulder or rotating your wrist.


TRICEP DIP
Find two even surfaces to support your upper body with your elbows bent (a chair with arm rests works well). Extend your elbows pushing your body up toward the ceiling. Lower slowly.


OVERHEAD TRICEP EXTENSION
With your shoulder in full flexion overhead, hold a weight in your hand with your elbow bent behind your head. Straighten your elbow toward the ceiling without changing the angle of your shoulder.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

weight loss

Weight Loss: What Are Your Options?

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The prevalence of obesity has increased steadily in Western cultures over the past century, particularly during the last several decades. In fact, most health professionals agree that we are in the midst of an obesity epidemic in the United States.

Being overweight is closely linked to many very serious health conditions. It is a significant risk factor for coronary artery disease (CAD), stroke, high blood pressure, high cholesterol, high triglycerides, low levels of HDL (high-density lipoprotein—the “good” cholesterol), and type 2 diabetes. Fortunately, even modest reductions in weight can help reduce the risk or improve these conditions. Plus, practicing the behavioral changes of a healthier diet and regular exercise may actually reduce these risk factors whether weight loss occurs or not.

Energy Balance: The Simple Principle of Weight Loss
Scientists often explain weight loss quite simply in terms of the energy balance equation: energy in versus energy out. To lose weight, you must consume fewer calories than you burn or, in reverse, you must burn more calories than you consume.

This is, of course, easier said than done. But no matter what weight loss methods you may employ—diet, exercise, medications, supplements, surgery, therapy, group support—the principle of energy balance is unavoidable. In fact, experts from both traditional and nontraditional disciplines agree that to achieve and maintain weight loss you must make changes in your diet and activity level to favorably affect the balance of the energy equation.

Using Strategies to Get Started
Getting started is often the most difficult part of losing weight. Any changes you make in your eating and exercising behaviors must become habitual, which takes time. In addition, carrying extra weight, no matter how much, can affect how you feel about yourself psychologically, sometimes making it more difficult to take the necessary steps to begin to change.

The following 5 strategies are crucial to successful weight loss and can help to overcome some of these barriers:

• Set and commit to realistic goals and monitor your progress toward achieving these goals
• Slowly modify your eating and exercise behaviors, as well as habits influencing both
• Examine and restructure unrealistic, negative thoughts, or expectations
Reduce stress
• Develop a network of social support and information

weight_loss

Looking at Weight Loss Aids
There is a great deal of interest in whether prescription medications or supplements can facilitate weight loss. Some medications suppress appetite by interfering with brain chemicals that affect mood and appetite. Others reduce fat absorption from the gut. Here are examples of medications that may be recommended for weight loss:

• Diethylpropion
• Lorcaserin
• Orlistat
• Phendimetrazine
• Phentermine—can be taken alone or in combination with another medication

Some studies have supported the use of these medications when combined with lifestyle changes. For example, as part of a review of weight loss drugs, researchers analyzed 15 trials involving almost 10,000 people who were either taking orlistat or placebo. Compared to the placebo group, those taking orlistat had a higher chance of achieving a 5% or 10% weight loss. These types of medications, though, are usually prescribed only for people who are severely obese when other methods of weight loss have not worked. Accordingly, these medications are not without side effects or potential adverse events and should only be used with careful monitoring by your doctor.

The same goes for dietary supplements. Supplements do not undergo the same rigorous approval process as drugs. That being said, certain supplements may provide weight loss benefits since they may contain similar mechanisms of action as drugs. Along the same line, some of the same risks and side effects may be present, as well, which is why you should talk to your doctor before taking any over-the-counter weight loss products.

Also, be sure you know what is in diet medications and supplements. Some medications and supplements that were used in the past have been pulled from the market as it was found that the dangers of taking them were higher than the benefits. Whenever you are considering taking a diet supplement, know exactly what is in the product and share this information with your doctor.

The question is: when should you consider taking these weight loss aids? While it depends on your overall health and medical history, the best approach may be a conservative one. For example, adopt lifestyle changes for 6-12 months before trying a drug or supplement. Your doctor can give you guidance as to which weight loss options you should try first.

by Jackie Hart, MD

RESOURCES:
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:
Dietitians of Canada
http://www.dietitians.ca

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

REFERENCES:
Choosing a safe and successful weight-loss program. National Institute of Diabetes and Digestive and Kidney Disorders. Available at: http://www.niddk.nih.gov/health-information/health-topics/weight-control/choosing-safe-successful-weight-loss-program/Pages/choosing-safe-successful-weight-loss-program.aspx. Updated December 2012. Accessed January 14, 2016.

Diets for weight loss. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed January 14, 2016.

Obesity in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed January 14, 2016.

Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007;335(7631):1194-1199.

Weight loss medications for obesity in adults. Available at: http://www.ebscohost.com/dynamed. Updated October 7, 2015. Accessed January 14, 2016.

7/6/2009 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Seo DC, Sa J. A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults. Prev Med. 2008;47(6):573-582.

10/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food and Drug Administration. Meridia (sibutramine): market withdrawal due to risk of serious cardiovascular events. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Updated Sepember 9, 2013. Accessed January 14, 2016.

Last reviewed July 2016 by Michael Woods, MD Last Updated: 1/14/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

2. Early Intervention is the Key to Success
Written by Ben Eggleston, PTA at the Center for Physical Rehabilitation – Grand Rapids, MI

The relationship between longevity of symptoms and healing time is of reciprocal proportion? Read more

3. Overtraining Doesn’t Help, It Hurts 
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

Working to achieve a sports or fitness goal can drive many people to overtrain in an effort to get stronger, better, faster. Read more