Tag Archives: physical therapy

Pilates and Your Game

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

Constipation: What is it and how can physical therapy help?

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According to the National Digestive Diseases Information Clearinghouse, someone is constipated if they have a bowel movement less than 3 times a week. This leaves a large range for what is considered “normal” frequency of defecation, from going three times a day (after every meal) to three times a week.

All of us will likely experience constipation at one time or another in our lives. Constipation just means that our food has spent too long in our colon, so more water than usual has been absorbed from the stool leaving it dry and hard to pass. This can be a frustrating symptom, leading to abdominal bloating, gas, increased pressure on the pelvic floor and surrounding organs and back pain. The best treatment is to be aware of the contributing factors and make daily lifestyle changes as needed.

What can lead to constipation?: Factors that may lead to constipation:

An imbalance in soluble and insoluble fiber intake, or lack of fiber in your diet
Not drinking enough water
Not enough physical activity
Changes in routine (irregular meal intake, traveling, unusual stress)
Ignoring the urge to go to the bathroom
Overuse of laxatives
Pelvic floor muscle dysfunction (we’ll come back to this later in the post)
Sometimes, constipation is a symptom associated with a specific condition such as from suffering a stroke, rectal prolapse, and irritable Bowel Syndrome or IBS. Constipation is common during pregnancy as the abdominal contents must shift and compress to accommodate a growing baby.

Physical therapy for Constipation

Help your pelvic floor muscles relax during defecation

When you go to the bathroom, your pelvic floor muscles should relax to “open the gates” and allow passage of stool and urine. Some people lose this normal coordination if they hold tension in their pelvic floor from life stress, or if they’ve had trauma to the pelvis, back, abdominals, or hips (childbirth and surgery). A pelvic floor physical therapist can help your body re-learn proper pelvic floor muscle coordination with biofeedback, manual therapy, and postural education.

Perform and teach you manual techniques to stimulate movement through your Intestines

In some cases, performing an abdominal massage can stimulate a bowel movement. Your physical therapist can teach you the massage sequence and appropriate amount of pressure. He/she can also perform visceral manipulation, techniques to restore normal movement in your abdominal organs.

Help you become more physically active

Your physical therapist can prescribe exercises to improve your flexibility and strength so that you can be physically active in the community without pain. Establishing a daily exercise routine is an important step in reducing constipation.

Photo: http://static.businessinsider.com/image/550b24a46da8115622cd5ecd/image.jpg

Written by: Claire Agrawal, PT
Edited by: Miriam Graham, PT

Not So Sweet

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Does this sound healthy? Bagel and orange juice for breakfast, turkey sandwich, apple and chips for lunch, that afternoon latte and pasta for dinner. Have you ever thought about how many carbohydrates you eat everyday? The example daily menu tallied up to a grand total of 279 carbohydrates. Optimal daily recommended carb intake depends on many variables such as age, gender, body composition, activity level, and metabolic health, but moderate carbohydrate intake falls between 100-150 carbohydrates/day. However, people who are physically active and have more muscle mass can tolerate more carbs than those who are sedentary. You’re probably asking why you should care about carbohydrates. After all, haven’t we been told to watch the calories and the fat for decades? Those carbohydrates are sugar. Excess sugar consumption has been proven to directly contribute to weight gain. When you eat sugar, your pancreas releases insulin which brings the glucose (from the carbs) into the cells. This glucose is stored as glycogen in our muscle and liver, but if these glycogen stores are already full, the glycogen is stored as fat. In 2012, the British Medical Journal published a study that combed through the literature regarding how body weight and sugar intake were related and indexed over 15,000 potential studies.^[1] Sixty-eight studies made the cut of passing the rigid standards and statistical reliability and they all came to the same conclusion: sugar makes people gain weight.

Sugar also elevates dopamine levels which control the brain’s reward and pleasure centers similar those to drugs such as cocaine, morphine and nicotine. Long-term exposure to sugar lead to a reduction of dopamine levels, causing increased sugar consumption to achieve the same level of reward.

So how are we to get out excessive sugar intake under control? In a study published by international research journal PLOS ONE, found withdrawal from chronic sugar exposure can “result in an imbalance in dopamine levels and can be as difficult as going ‘cold turkey’” from a drug. Hopefully we will not have to resort to drugs to break us from the tight grip sugar has on our taste buds. This summer, opt for water instead of juice and soda, or some string cheese instead of the apple and see if you can see a difference in the way you feel by breaking the sugar habit.

^[1] Te Morenga, Mallard S., Mann, J., “Dietary sugars and body weight: systematic review and meta-analyses of randomized controlled trials and cohort studies,” British Medical Journal (January 2012): 345:e7492.

Written by: Heather West, PT
Edited by: Reshma Rathod, PT

What a Pain in the Neck

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Neck pain is a common reason for doctor visits. It is so common that the topic made it to the Washington Post recently in an article titled “What you need to know about that pain in your neck.”

Here are some facts about neck pain:

A common cause of neck pain is poor posture during work, rest or leisure.
Lifting or carrying heavy objects can strain muscles connecting your arm/shoulder and neck.
Even light weight (or un-weighted) repetitive motions can cause neck pain.
Excessive tension or stress frequently causes us to hold our jaw, neck and shoulders in a way that leads to pain and headaches.
The joints of the neck allow a great deal of motion. That is why necks are vulnerable to injury with trauma.

What you need to know before you go to the doctor:

Majority of neck pain episodes resolve in 2-3 weeks without imaging studies.
The older we are the more likely neck pathology will be seen on imaging studies even on those people without neck pain.
Over the counter analgesics (Acetaminophen, Ibuprofen, Naproxen Sodium) are more effective in treating neck pain than muscle relaxants.
Sleeping with too many pillows or a pillow that is too firm can cause neck pain.

What you can do:

Use heat or cold pack to soothe muscle aches. Use the type that feels best to you.
Decrease unnecessary weight in your handbag, book-bag or briefcase.
Remind yourself to relax your neck, jaw and shoulder muscles while trying to maintain good posture.
Consider Physical Therapy to help improve muscle and joint balance via exercises for your neck and shoulder girdle.
If pain has not resolved in time, or if your pain was caused by trauma, see your physician or urgent care clinic.

Written by: Miriam Graham, PT, DPT
Edited by: Claire Agrawal, PT, DPT

Photo Credit:
http://media2.mindandbodychiro.com.au/wp-content/uploads/2015/01/img-neck-pain-spreading-shoulders-450×600.jpg

Link to Washington Post article:
https://www.washingtonpost.com/national/health-science/what-you-need-to-know-about-that-pain-in-your-neck/2016/04/11/5666e97c-a2a3-11e5-b53d-972e2751f433_story.html

New ACL Surgery May Improve the Lives of Many

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The anterior cruciate ligament (ACL) of the knee is one of four ligaments between the femur and the tibia that helps keep the bones together and stable during movement. Injury to this ligament can lead to knee pain, a feeling of your knee buckling or giving out from under you, and decreased knee range of motion. Spraining or tearing of the ACL is one of the most common knee injuries in humans. Depending on the severity of the injury and the person’s age, physical therapy may be the first treatment option to stabilize the knee. If symptoms do not improve with conservative management, surgery is often considered next.

Currently, the standard surgical technique is called ACL reconstruction and involves removal of the torn ends of the ligament and replacement with a tissue graft. A tissue graft is tissue from another part of the body (usually hamstring tendons) or a cadaver. The tissue graft acts as scaffolding for a new ligament to grown on. Recovery is lengthy and patients are at a higher risk of developing arthritis 15-20 years post surgery (Boston Children’s Hospital).

A new surgery, called “bridge-enhanced ACL repair, or BEAR,” has been developed by Dr. Martha Murray and her team at Boston Children’s Hospital. The technique places stitches and a sponge injected with the patient’s own blood between the ends of the torn ACL to stimulate healing of the original ligament instead of replacing it. Over six-to-eight weeks, the ends of the torn ACL grow into the sponge and reconnect.

There is potential for the BEAR technique to allow quicker recovery of strength after ACL surgery and possibly reduce the long-term risk of arthritis in the injured knee. At this time the surgery is experimental and being performed through clinical trails to determine long term risks and benefits. To learn more about the clinical trials, click here.

Written by: Kristen Bissell
Edited by: Claire Agrawal, PT, DPT

Clinical Trial link:
http://www.childrenshospital.org/centers-and-services/anterior-cruciate-ligament-program/bridge-enhanced-acl-repair-trial

Photo Credit:
http://www.childrenshospital.org/~/media/centers-and-services/departments-and-divisions/sports-medicine-division/bearimage1.ashx?la=en