Author Archives: Restore Motion

Is this Backpack Too Large?

What to look for in a Backpack:

Wide, padded shoulder straps distribute the weight over a larger area around the shoulders. This avoids that “cutting into the shoulders” feeling.
Chest and waist straps also help distribute the load of the pack. Use of a chest strap (and/or waist strap) decreases load that would completely weigh on the shoulders if it were not used.
Padded back cushions the load as it rests on the back. Some backpacks feature no padding directly over the spine – This is favorable because it creates a comfortable “cut out” for the spine bones. It decreases load contact directly over the “spinous processes” of the bones.
Multiple compartments even out the load and are preferable to one large cavernous compartment. It makes retrieving items easier as they don’t all fall into one single “pit” of the pack.

Consider the size of the backpack wearer—the overall length of the backpack should not go below the waist of the wearer. Appropriately sizing the shoulder straps to distribute weight evenly over both shoulders and using the chest or waist strap can help the pack sit at the waist of the wearer.

Wear the pack with both shoulder straps not just one strap over one shoulder—Really! Wearing the pack on one side contributes to neck, shoulder and hip strain in addition to back pain.

Avoid filling the pack too full. It is too full if the wearer has to lean forward to bear the weight. This can contribute to bad posture and back pain. Full packs can cause havoc when the wearer turns and unknowingly knocks into people or priceless artwork.

Rolling packs have their advantages and disadvantages as well:

Some school lockers aren’t big enough to accommodate the rolling packs.
Need to be carried over stairs or rough terrain.
May be a trip hazard.

When using a rolling pack remember to switch arms frequently and to engage core/abdominal muscles to balance the strain on the body.

Written by: Miriam Graham, PT

MAPP: Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain

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Malassezia spp. Skin Microbiome. https://skinmicrobiome.wordpress.com/tag/malassezia/

MAPP (Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain) Finds That Fungus In Urine Might Be Linked to Urgency and Pain.

One of the most promising lines of research in urology today is the study of the biome, the diverse population of bacteria and fungi that live harmoniously in the human body. In previous MAPP Research Network studies, IC patients were found to have high levels of candida/fungi in their urine during flares (1). Another found that IC patients are deficient in some important bacteria in our bowel while having higher levels of other harmful bacteria (2). This latest MAPP Research Network study now links changes in fungal communities with the symptoms of urinary urgency and pain (3).

Researchers obtained urine specimens from 12 IC patients, 17 Over Active Bladder (OAB) patients and 14 patients without urinary symptoms. DNA was extracted, deep sequenced and compared to multiple fungal sequence databases. They found that patients with more severe symptoms, regardless of the symptom type, had decreased fungal diversity. Individual symptoms were associated with distinctive species of fungi. Patients with severe bladder pain had altered levels of Malassezia spp. composition while patients struggling with incontinence were inversely correlated with Wickerhamomyces spp.

The researchers concluded that the urinary microbiome is altered inpatients struggling with lower urinary tract symptoms, and that the loss of diversity in the microbiome correlated with worsening symptoms. Specific fungal patterns were found in patients with the symptoms of bladder pain and urinary urgency but interestingly this did not correlate with a diagnosis or medical condition. The researchers concluded, “These results suggest the intriguing possibility that particular microbial patterns maybe associated with specific symptoms, not necessarily diagnoses. This could lead to new diagnostic and treatment algorithms for patients struggling with lower urinary tract symptoms.” Clearly, there is a need for greater testing for fungi in urine screening. Bacteria may not be the root problem in some patients. It is time to consider the roll of fungus in bladder dysfunction.

Adapted from Jill Osborne 8/10/17 Interstitial Cystitis Network Blog, Research https://www.ic-network.com/mapp-research-network-study-finds-fungus-urine-might-linked-urinary-urgency-pain/

References:

Osborne J. Could IC Flares Be Caused By Candida – New research study finds higher rates of candida rather than bacteria during IC flares. IC Optimist Winter 2016.
https://www.ic-network.com/could-flares-be-caused-by-candida/
Osborne J. The DIPP Mystery – Why are IC patients deficient in some good bacteria. IC Optimist Summer 2016.
https://www.ic-network.com/dipp-mystery-ic-patients-deficient-bacteria-gut/
Journal of Urology, April 2017 Abstract MP29-10 Alterations in the Urinary Fungal Mycobiome in Patients with Bladder Pain and Urinary Urgency
https://www.ic-network.com/mapp-research-network-study-finds-fungus-urine-might-linked-urinary-urgency-pain/

Ursula Sukinik, Doula and Entrepreneur of Birth You Desire

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Ursula is not only a certified childbirth educator, but is also a birth doula, a birth assistant, a doula trainer, and a mother of two teenage boys. Known for her easy laughter, radiant energy and knowledge of the birthing woman; to say that she is an inspiration is an understatement.

She is a true believer in honoring women’s bodies and the natural process, Ursula not only inspires her students to better understand how choices affect well-being, but she takes the mind-body connection to a whole new level with her practice as a birth worker. Ursula has personally worked with thousands of women during the birthing process.

With this passion, she owns and runs Birth You Desire where you can find a list of doula training, childbirth classes, TENS rentals, workshops and speaking engagements in the DC Metro area as well as choose a doula to support you at your birth.

Ursula’s sons are going to college this fall University of Pittsburg & St Mary’s College of MD. She loves German Shepard dogs and her current dog’s name is Ohana Koa (called Koa, ko-ko, or when bad… Ko-ko loco). She is an avid gardener & hiker in her spare time.

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Our Restore Motion Friend, Ursula Sukinik, doula and entrepreneur of Birth You Desire, suggests how to stack the deck for an uneventful vaginal delivery. Adapted from her BYD blog below, are 10 easy ways to avoid and reduce your cesarean risk.

Prepare yourself. Take a comprehensive childbirth class, learn your choices.
Practice good body mechanics through out your pregnancy.
Have a supportive and educated labor partner. Your partner is your anchor. No matter how wonderful your birth team is they cannot replace the love and security you have from your partner.
Let baby come when they are ready, avoid unnecessary inductions and subsequent interventions.
Build a tool kit of coping methods and practice them. Relaxation is the cornerstone to spontaneous birth.
Labor at home as long as possible with provider permission when applicable.
Avoid continuous monitoring when at your birth place if possible. If continuous monitoring is necessary ask for a wireless monitoring to facilitate coping skills.
Use medications and interventions wisely. There are many tools for labor and they all have their place.
Labor upright and change positions frequently whenever possible. An active mother is an active baby.
Consider hiring a professional Doula to assist you in your birth.

Adapted from intellectual property of Ursula Sabia Sukinik/Birth You Desire. Used with permission. Do not reproduce or distribute without written permission from owner. Copyright 2011. All rights reserved.

Pilates and Your Game

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PILATES AND YOUR GAME
The Pilates principles of core stabilization address posture, breathing, muscle performance and motor control. Pilates sessions break down faulty movement patterns, and enable the practitioner to work on new movement strategies. Pilates can be integrated into any rehab phase, from the most acute to advanced sport-specific training.

Q: What is Pilates and how do you say it?
A: Pilates (pronounced Pi-La-Tees) in named after Joseph Pilates who first devised the exercise program during the Second World War. Pilates is a form of exercise that concentrates on the “core” or trunk area, including the stomach and low back, promoting strength and flexibility in a controlled manner. People who do Pilates often describe themselves as getting “longer and leaner”.

Q: I have some friends who do Pilates mat classes and others who do it on equipment. Is there a difference?
A: Pilates can be done on a mat or the floor, but it can also utilize equipment called reformers that resemble a table with different springs and attachments that alter resistance. There are many different pieces of equipment that are now being used in a Pilates program.

Q: Is it better to take classes or do private lessons?
A: Pilates is a very specific form of exercise, and it is best taught on an individual basis initially. Progressing into small group classes can then be done. Of greatest importance is learning from a highly-qualified Pilates instructor.

Q: Would doing Pilates regularly improve my sports performance?
A: Many people think that powerful tennis strokes come from the arms and shoulders. This is untrue. The power comes from proper weight transfer and rotation of the trunk and hips region. A strong “core” will certainly help the tennis game, and Pilates is an excellent form of exercise for the core region. Pilates can also be made “sport specific” by doing arm and leg movements whilst keeping the trunk stable. In fact, many of the top professional players are now incorporating Pilates into their fitness program to improve their game.

Q: Will I become more flexible and be able to move better?
A: Quite possibly, and in addition to strengthening, Pilates also increases flexibility and will improve any sporting performance. It will even carry over to your golf game!

Q: I have a chronic back problem, is Pilates a good idea?
A: Pilates can be extremely effective for back pain patients. We have seen tremendous results with our caseload of patients, and it is a low impact form of exercise that can be undertaken by people with many different physical conditions. If you already suffer from an ailment, make sure that your Pilates instructor understands the condition and teaches you appropriately.

Written by: Reshma Rathod
Picture from: www.premapilatesbarre.com

Postpartum Pelvic Health: Vol. 1.

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During pregnancy and delivery, natural changes occur that impact your pelvic floor and abdominal wall. These changes can cause pain and discomfort for many women during pregnancy and/or after delivery. Childbirth takes a toll on our bodies regardless of the method of delivery.

The toll of postural changes and weight gain on the body can lead to conditions such has back pain, abdominal separation (diastasis recti abdominis), urinary urgency and leakage. It is a misconstrued notion that these symptoms are normal because they are common. Common is not the same as normal. Many women need assistance treating these symptoms so they do not deal with life-long consequences. The good news is therapists at Restore Motion are skilled in treating both pre and postpartum symptoms.

Physical therapy can help pregnant women be strong and fit while decreasing complications during delivery and improving the birth experience. Physical Therapy can also assist postpartum women in regaining their pre-pregnancy body.

Lowell Weiner, D.D.S., F.A.G.D.

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Dr. Lowell Weiner is board certified Dentist practicing through National Intergrated Health Associates. His interests and studies in Holistic health started in 1969, when he first became interested in how jaw and tooth problems affected swallowing, snoring, breathing, the sinuses and the rest of the body’s total compensating mechanisms from head to toe. Dr Weiner has served either as a consultant, faculty or staff at various universities in the area. He has limited his practice to sleep apnea and dental sleep issues, cranio mandibular dysfunction. He has served as an expert witness and is frequently asked to give second opinions for unusual complex dental medical treatments. The educational and treatment areas on which Dr. Weiner has placed special emphasis are sleep apnea, snoring, the infection and integration of the teeth, head, neck and shoulder with the rest of the body, both as a cause and result of acute and chronic problems.

Outside of work, Dr. Weiner started a fencing club at the University of Maryland and he enjoys cooking.

Reshma taught Muscle Energy Technique to Women’s Tennis Association Physical Therapists and Miriam taught Sex Therapy U at the Chicago School of Professional Psychology in D.C.

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Reshma and Miriam dedicated time to help others in their professional development in January and February. Reshma taught a nearly full day webinar to physical therapists of the Women’s Tennis Association (WTA) February 4^th. The topic was Muscle Energy Technique (MET), an osteopathic manipulation technique where the action of a muscle is used to improve joint range of motion and the ability of muscle to fire. Reshma and Miriam started their study about and using MET in the 1990’s at Michigan State University School of Osteopathic Medicine CME. Reshma is one of a hand full of primary health providers in the world for the WTA!

Miriam also spent February 4^th teaching for Sex Therapy U at the Chicago School of Professional Psychology in downtown Washington, DC. The topic was Women, Sex and Therapy: Ongoing Sexual Pleasure and Couples Interventions for Healing – Treating Pelvic Floor Issues with PT and Sex Therapy. She presented various issues that affect pelvic floor and sexual function and how physical therapy can help those dysfunctions. The students got to practice breathing into the pelvic floor, and using racquet balls to roll out muscular trigger points in the legs and back and tips to help their patients understand pelvic floor function. They also learned ways to help their clients experience and explore communication through touch.

The staff of Restore Motion is planning to offer a pelvic floor and manual therapy continuing education course for Physical Therapy CEUs in the near future – “watch this space.”

Visceral Mobilization

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People don’t think of their internal organs, or viscera, much within the context of physical therapy, however visceral mobility is vital for comfortable and smooth functional mobility. Our viscera are protected by the ribcage and muscular abdominal wall. They are held in place by a system of ligaments and are contained within a fluid filled sack called the peritoneum. The viscera need to be able to slide and glide over each other to allow movement of the diaphragm during breathing. When we inhale, the powerful diaphragm muscle moves down. The liver, stomach and other organs need to slide down out of the way when the diaphragm descends to allow the lungs to fill with air. When we exhale, the diaphragm and internal organs slide back up. Restoring, or improving, visceral mobility is important for normal body function. If the viscera loose mobility because of disease, inflammation or postural restriction, the result can be pain, decreased functional mobility or decreased organ function. Luckily, manual therapy to restore visceral mobility is comfortable and effective. Think about visceral mobility next time you reach to pick something up off of the floor. If your organs couldn’t slide and glide over each other, you wouldn’t be able to bend to reach the floor or breathe easily.

Safe Pain Management: Choose Physical Therapy

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Avoid Addictive Opioids. Choose Physical Therapy for Safe Pain Management.

No one wants to live in pain. But no one should put their health at risk in an effort to be pain free.

Since 1999, Americans have increasingly been prescribed opioids—painkillers like Vicodin, OxyContin, Opana, and methodone, and combination drugs like Percocet. According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the United States, even though “there has not been an overall change in the amount of pain that Americans report.”

In some situations, dosed appropriately, prescription opioids are an appropriate part of medical treatment. However, opioid risks include depression, overdose, and addiction, plus withdrawal symptoms when stopping use. And people addicted to prescription opioids are 40 times more likely to become addicted to heroin. As of 2014, the CDC estimates that 52 people die each day in the United States as a result of prescription opioid overdose.

In addition, Americans are creatively saving and sharing prescription opioids at alarming rates. These saved and/or shared drugs are now getting in the hands of our children. Our children are not traditionally popping pills but masking the drugs in various ways. Drug-laced lollipops are the latest in the drug culture. This has been reported by high school students in our area. The lollipops are apparently laced with strong levels of painkillers. This new drug delivery method should raise concern and awareness about the dangers of prescription opioids. Consumers and prescribers are encouraged to choose safer alternatives to prescription opioids.

The Centers for Disease Control and Prevention (CDC) is urging health care providers to reduce the use of opioids in favor of safe alternatives like physical therapy.

Don’t just mask the pain. Treat it.

Choose physical therapy to manage your pain without the risks and side effects of opioids.

Written by: Reshma Rathod, PT

Bone Up (get the facts) on Bones

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Most of us know very little about our bones- they are hidden and not painful until we break one!

So let’s start with some anatomical facts and bone up (get the facts) on bones:

At birth we have 300 immature bones; some of these join up; adults have 206 bones.
The human hand has 27 bones; the face has 14.
The longest bone in the body is the femur (thigh bone) which is about 1/4 of your height.
Did you know that humans and giraffes have the same number of bones in their necks?

During our lifetime, our bones are in a continual cycle of breaking down and rebuilding. Bone strength represents the integration of bone density and bone quality. Most women will reach their 90% of their bone mass by the age of 18 and their peak bone mass by the age of 30 which emphasizes the importance of bone growth in childhood and adolescence through active and healthy lifestyles. As we age, and especially with hormonal changes associated post-menopause, the living bone tissue reabsorbs at a higher rate than rebuilding.

Bone thinning is classified as osteopenia or osteoporosis. Osteopenia, the less severe of bone weakening, is defined as having between -1 and -2.5 standard deviation of bone mineral density. Osteoporosis, the more severe of bone weakening, is diagnosed as having bone mineral density greater than -2.5 from the standard deviation. The stronger bones we have, the less likely we will fracture in a traumatic incident.

Physical activity can modify bone strength. When gravitation or muscle pull produces strain on the skeleton that is greater than optimal strain, bone formation occurs. In conjunction to other types of interventions, bone loss can be slowed and sometimes reversed. The improvements from exercise are likely from increased bone density and lessened endocrotial bone loss, not an increase in bone size. Women who engaged in a combination of exercise types had an average 3.2% less bone loss at the spine and 1.03% less bone loss at the hip than those who did not exercise.

Consider the following to protect your bones:

Assessment of footwear and/or orthotics and adjustments if necessary.
Review food intake with a doctor/nutritionist to check if you have the essentials for strong bones.
Assessment of the load, type and intensity of your exercise program.
Medical check-up to rule out other potential causes (like thyroid disease or medications that may cause bone loss).
Don’t smoke and keep alcohol and caffeine intake to a minimum (these substances may lower bone density).

Written by: Reshma Rathod, PT