Tip of the Month
Written by: Peter Harmeling, MEd, PT, SCS, ATC
Balance is a big deal and for those of us with reasonable balance we take it for granted. Balance declines with age and with this decline comes fear. When this happens you can easily see the compensatory behaviors: looking down at the ground for visual input, the trunk leaning forward slightly, the hips and knees bending too much and the feet spreading apart - all the result of the brain not really trusting the normal balance mechanisms. Balance, like all other physical tasks, improves with practice. There is a simple yet very effective exercise to improve balance: stand on one leg in a doorway using the side of the door jam to steady oneself as needed. Try it for five seconds per leg and try five times on each leg. Then increase it to 10 seconds and pretty soon you will not have to use the door jam at all to steady yourself. Email me with questions or comments, firstname.lastname@example.org. Until then stand tall, work hard and as your balance improves so does your confidence.
SPRING INTO ACTION
Written by: Gloucester PT staff Scott Kulesa and Sheela Zerilli
The weather is warming up outside and people are starting to get more active with outdoor activities. Many of us enjoy getting out and working in our yards and gardens this time of year. However, increased activity can sometimes result in nagging injuries. Many of the things that we enjoy doing require the use of muscles that are not used as often or vigorously over the cold winter months. The repetitive lifting, bending, and pulling motions used with gardening and yard work can often lead to muscle strains or overuse problems such as tendonitis. The lower back and hands/arms are the areas that bear much of the stress associated with these activities. Fortunately, there are some easy exercises that can be done to help reduce the risk of pesky injuries that could prevent you from enjoying fun in the sun over these upcoming spring and summer months.
***All stretches should be done 3 times and held for 15-20 seconds. Never bounce while stretching and always consult your physician prior to doing these exercises if you have any hip or lower back issues.
3. Lower trunk rotations: lie on your back with your knees bent and feet resting on the floor. Let your knees gently rotate towards the floor while keeping your lower back flat on the ground. Repeat this going to the right and the left side.
5. Standing groin stretch: Spread your legs apart and gently lean to one side until you feel a pull on the inner thigh of the leg you are leaning away from.
DO YOU KNOW WHAT TO DO?
Are you plagued by chronic conditions like shin splints, plantar fasciitis, Achilles tendinitis, strained hamstrings and hip flexors, runner's knee, or kneecap pain? Sooner or later these common problems of the legs are going to pay you a visit. When they do you are going to be in trouble: pain, limping, change in workouts, missed athletic seasons, frustration, anger, and general unhappiness!
There are two broad types of injuries: traumatic and overuse. As the name implies traumatic injuries involve "trauma" and are traceable to one instant. The injuries listed above are overuse or "chronic" and usually have a gradual onset and worsen over time. The culprit is inflammation. These injuries are treatable but the treatment is difficult requiring KNOWLEDGE, time, and careful attention all targeting the inflammation. Let us know if we can help you!
Neck extension is bad! This occurs when you look up, when you lean forward to talk with someone or look closely at a computer screen. These activities cause your head to tilt back (extension). This position is tough on your neck especially when held for a prolonged time. It can definitely precipitate neck pain. When sitting try to lean back and use the back of a chair and look straight ahead. Position the computer screen at eye level. Your neck will thank you. Email me with questions or comments. Until then remember-prolonged neck extension will bring on prolonged neck pain!
WITH LOW BACK PAIN IT IS UP TO YOU!
Twenty years ago a very smart orthopedic surgeon rather casually mentioned to me "Pete, until a low back pain patient realizes that they are the one responsible for getting themselves better, not you or me, they are not going to get better." He was referring to non-surgical cases.
Over and over again I see what my friend meant by this. The cause of most low back pain occurs over time - that is we gain weight, our mid-section and lower extremity muscles become weak and inflexible, we become more sedentary in our work and home lives, we get older and our tissue ages and becomes more vulnerable. The structures of the low back become less able to do work. Like a care going faster than it is able eventually the low back will be asked to do more than it can handle and then you get PAIN!
My surgeon buddy wanted me to know that short of surgery, which very few patients need, the patients are the ones who need to shoulder the responsibility of losing weight, stretching and strengthening their muscles, shaping their posture, using good body mechanics and increasing the capacity of their low back to do work (i.e. move, lift, etc against the force of gravity). We therapists can help reduce the acute pain and we can teach good low back exercises BUT we can't do any of these crucial exercises for you. So here's the tip: Realize that care of you low back is really up to you. Health care personnel, like physical therapists, can help you GET YOURSELF BETTER by relieving some of the pain and teaching you what to do and not to do. Let us know if we can help you with your low back.
A BETTER NAME IS GRIPPER’S ELBOW
It’s late spring and I am treating a lot of tennis elbow patients right now. This condition is characterized by inflammation of the tendons on the outside of the elbow and apparently many folks are doing a lot of house and yard work. This is causing the elbow tendons to work beyond their capability and, of course, pain is not far behind.
Though the elbow is where the pain is the real culprit here is not the elbow but the hand and fingers. This condition is caused by over gripping things. When you grip too hard (i.e. grasp heavy objects) and too long (rake leaves all weekend or shovel mulch) the muscles and tendons in the back of your forearm have to lift the wrist backwards and hold it very steady to prep the fingers for gripping. After awhile these muscles controlling your wrist, which attach via tendons to your outside elbow, get pooped out and then inflamed. Tendons have poor blood supply and therefore it is hard to get rid of this inflammation. So here’s the tip. The elbow is the fall guy and the hand is the bad guy. Until you squeeze less progress will be hard to come by.
YOUR NATURAL GIRDLE
I think that the most important muscle group to keep strong is your abdominals. These muscles act as a girdle for your midsection where your upper body and spine connect with your pelvis. Strong abs help protect your low back. Often when people hurt their low back we therapists give them a brace to wear around their midsection to support their injured back. This is nothing more than an artificial set of abdominal muscles which, sadly, are often too weak to do their job.
To work these muscles lie on your back on a carpeted floor or exercise mat, bend your knees and lift your shoulders off the floor a few inches. Don’t sweat it if you can’t come up too far as your abs start working as soon as you lift your shoulders up. Don’t anchor your feet under anything because this will work your hip flexors more than your abs. Start with 10 or so and work up to 50. Don’t push at the beginning. It’s more important to stick with it and never hold your breath when you do these abdominal crunches. If you have osteoporosis, consult with your physician before starting an abdominal strengthening program.
Posture is how you choose to hold your body up against the force of gravity. It’s a big deal especially as a kid where you start to form lifelong habits. Besides affecting your appearance, poor posture can also make life harder for the musculoskeletal system. What I mean by this is that your muscles and joints have to work harder to keep you upright. As you get older this extra work adds up and can cause real pain. The essence of good posture is to stand as tall as you can, don’t look down too much and pull your belly in just a little bit. Give it a try in front of the mirror and see what you think!
Email me with questions or comments. Until then remember that posture is a habit and the more you practice this habit of good posture the more natural it will feel.
A SPECIAL PAIR!
I teach musculoskeletal Anatomy at Gordon College. One of the most interesting things that I cover is the relationship between the shoulder joint and the scapula, or shoulder blade. Your arm is attached to your shoulder blade by a ball and socket joint - the shoulder joint. Your shoulder blade is a flat, triangular bone held onto your ribcage by a bunch of muscles.
Here is the interesting part - when you raise your arm up over your head the shoulder joing is only able to go about two-thirds of the way or (just above the shoulder level) and then it can't go any further. Yet your arm is able to point straight up to the sky. How does it do this? The last one-third of the motion is accomplished by the shoulder blade actually ROTATING around your rib cage once the shoulder joint has reached its end point. When the shoulder blade is finished with its rotation then the arm can wash you hair, hang up a shirt or paint a ceiling. This beautiful synchronization is accomplished by a terrific partnership of the muscles of the shoulder joint as well as the muscles controlling and moving the shoulder blade on the rib cage. Here's the tip. When there is a problem with one of the two, especially for any length of time, then the other one tries to pick up the slack and after a while it may become overworked and injured as it tries to help out its injured partner. So if you have pain in either shoulder joint of shoulder blade muscles don't wait too long to get help or your problem may well double!