The Do's and Dont's of Stretching

Everyone has engaged in a stretching routine at one time or another and, yet, a lot of questions remain regarding proper technique. Here's a quick run down:

DON'T:

•  Perform static stretching before an activity (such as a runner's stretch, hamstring or quad stretch- where one position is held for a length of time). Static stretches elongate muscle fibers which can cause injury when done on "cold" muscles and can actually decrease your power and speed during the activity. Instead, do a warm up before your activity. For "work-out" type activities, such as running, using the elliptical, or lifting, try walking at a brisk pace a few minutes before the activity, slow lunges, or knee lifts with marching. If you're about to play a sport, practice movements that you will doing frequently during the activity, but in a slower, more controlled pace. This will prime your body to do these actions in a safe, technique-appropriate way during game time.
• Bounce with static stretches! As previously stated, static stretching elongates muscle fibers. If you bounce you're very likely to overstretch the muscle or even tear fibers. 
• Hold your breath. This is known as a val-salva maneuver to health professionals and can wreak havoc on your blood pressure as well as teach you bad habits that you then take into your work out or sport. You are never performing an activity to your true potential if you're holding your breath.

DO:

• Static stretching after your activity. No matter the activity, you just performed numerous contractions which has left your muscle tight and balled up. Even after the activity the muscle fibers remain in some amount of contraction, therefore, we need to elongate them to return them to their normal resting state. This will decrease the likelihood of muscle soreness or spasm. If you're in a time crunch, at least stretch the muscle groups you used most during your activity (ie quads after lunges)
• When performing your static activity, stop at a sensation of a comfortable stretch, NOT PAIN. Pain indicates, or may lead to, possible injury.
• Hold your stretch for 30-60 seconds. 
• Remember to always use good technique. If you're trying to stretch your hamstrings, be sure you're not actually stretching your back!

If you have any questions about stretching or have had repeated injury with your activity despite following these guidelines, see a physical therapist.

Lesley

Weebles wobble, but they don't fall down...

Unlike weebles, we have very complex means for staying upright.  There are three main systems in the body that contribute to our ability to maintain balance.  They are vision, the vestibular system, and joint/muscle receptors.  Vision is obviously important for maintaining balance, but the other two systems have important roles as well.  The vestibular system, located in the inner ears, helps your body know which way is upright and, with vision and joint receptors, if your body is moving and how so (as in rocking on a boat).  Joint receptors, along with receptors in the muscles, tell your brain where the joint is in space and if and how your joint is moving.  Additionally, sensory input from the skin helps us feel the ground and adapt to uneven surfaces.  Processing, integration, and control from brain centers (for instance, the cerebellum, located under the base of the skull in back) play a major role in maintaining balance.  If something goes wrong in any of the systems, balance will be affected and you'll have to rely more on the other systems.

A few practical examples illustrate the contributions of the various systems.  A person who's had a knee replacement has lost joint receptors in the parts of the joint that were removed in surgery.  Sometimes the loss is significant enough that balance is affected because the person can't tell where the joint is in space very well.  People with diabetes often loose sensation in there feet due to nerve damage from the disease.  They are basically walking on two numb feet, which can be especially troublesome with walking on the lawn (which is uneven).  A person who had a blow to the head may find that they are terribly dizzy with changes in position.  This can be due a problem with the sensory apparatus in the inner ear, but is often treatable.

The balance system is really a combination of beautifully interworking systems in the body.  So, next time you take a step without falling down, be glad everything's in working order!
-Karen

Workplace ergonomics

According to The New York Times, the average American spends eight hours in front of a computer a day. The human body is not meant to spend such a large amount of time in one position, however since most jobs, classwork duties, and genres of entertainment are now based around a computer, making that space the least detrimental to your physical well being is a must. Here are a few general rules to follow:

1) Head/neck: the top of you computer monitor should be at directly in front of you at eye level and a comfortable distance away that you can easily see the screen (using computer glasses if needed). If you are doing any type of data entry, place the sheet of paper on an easel at eye level and as close to the computer monitor as possible. Do not place the paper flat on your work surface! It may not seem like much, but continuously looking down at the paper then up at the monitor will place too much tension on your neck. Use a monitor riser or even a phone book to raise monitors up. If using a laptop, place the entire thing on a riser and use a wireless keyboard and mouse.

2) Arms: your elbows should be placed at your sides bent at 90 degrees, typically resting on an arm rest of appropriate height. Your forearms should rest on the work surface with the keyboard so your wrists are not either too flexed or extended. As most standard desks are too high to allow for this, mobile work surface that you can raise and lower should be installed or you can raise your seating surface. Gel wrist supports for the keyboard and/or mouse can be helpful if you're spending numerous hours at the computer but they should be used as a cue to hold your wrist in a neutral position, not relied upon as a true support. Continuous torque on the wrist is the fastest way to develop carpal tunnel symptoms.

3) Back: your low back should be in a neutral position - not arched nor rounded. Your shoulders should be stacked on top of your hips, not hunched over. If your shoulders are hunched, see the two items above. Be wary of lumbar supports, they often put the user in too much of an arched low back.

4) Hips/legs: your knees should be level with your hips and feet flat on the floor. This can be accomplished by lowering your seating surface or purchasing a foot rest (or even a phone book!) of appropriate size.

There are numerous items on the market to help make your workplace more ergonomically friendly. Take a look at an office supply store or online if needed.

Most importantly, TAKE BREAKS! As stated earlier, the human body is not meant to stay in any position for a prolonged period. If needed, set a time every 30-60 minutes and change positions. Each break can be as long or as short as you need it to be, simply getting up for a glass of water makes a huge difference.

If you're having trouble assessing your workplace or continuing to have pain while at this position, come see a physical therapist at CORE Services, Inc. We can simply make a few recommendations as to how you can create a better environment, or assess and treat your pain if needed.

Lesley

What's the noise my joints make?

There are several theories of joint "cracking" noises.  Some people think that "cracking" in the spine is a sign of excessive mobility and lack of muscle control of the joints, which if untreated could lead to arthritis.  Joint noises in the knees, hips, or shoulders is sometimes a sign of injury to the cartilage in those joints, especially if accompanied with locking of the joints.  For other explanations of joint sounds see this site.
-Karen

Three simple strategies to help you lose weight

More than one third of all US adults are obese. All that unnecessary weight can cause significant medical problems like diabetes and heart disease, but it can also have a big impact on your musculoskeletal system. A larger and more protruded abdomen can cause a "sway back" posture putting excess stress on your low back, knees, and ankles. Along with regular exercise, three simple strategies are key to helping you shed some pounds: eat regular meals, journal everything you eat, and bring your own lunch!

Check out this article via cnn.com to find out more.

Eating habits are only part of the struggle. Regular exercise (even walking!) is essential in maintaining a healthy weight and improve overall health! If you are having any pain keeping you from getting out there and staying fit, see a physical therapist at CORE Services, Inc for an evaluation today!

Lesley

Have a headache?

There are multiple types of headaches.  Most people have probably heard of migraines.  These typically involve a throbbing pain with sensitivity to light and noise and may also include upset stomach.  Tension-type headaches are more of a dull ache with the feeling of a band around your head.  Cluster headaches are so called because they occur in groups over a period of time.  For instance, they may occur multiple times in a week and then disappear a while, only to recur later.  Oftentimes cluster headaches are felt only on one side.  Some headaches have more interesting names, like thunderclap headaches, which you can read about here.  Head pain can be caused by trigger points (tight areas in muscle) that refer pain over the top of the head, around the eyes, and other typical patterns.  You can see and example here.  Problems with the jaw joints are sometimes associated with headaches too.  With so many types and causes of headaches it is important to seek help from a medical professional if you experience them.

Karen

Leaking is never normal

Ladies, have you ever been talking with your girlfriend and heard her say "I laughed so hard I peed my pants!"? This phenomena has become so mainstream that many women don't realize that this is a major issue. IT'S NEVER NORMAL TO LEAK! It doesn't matter if you're laughing, lifting something heavy, or "just didn't make it to the bathroom in time." If you leak urine, it's a clear sign that your pelvic floor is not working the way it should. This may be related to a previous injury like an episiotomy (traumatic or surgical) with childbirth or a consequence of another issue like low back pain.

If you have experienced urinary leakage, especially coupled with pelvic pain, rectal pain, constipation, or chronic urinary tract infection, come see the women's health therapist at CORE Services, Inc. Having a simple conversation and looking at your overall posture can give great insight as to what may be going on with your body. In many cases, this problem can be treated externally with exercise and manual therapy. If the problem does not clear with conservative measures, it may be appropriate to do an internal assessment, of course, only if you're comfortable.

Urinary leakage is the number one reason women are admitted to nursing homes, take care of this problem before it's too late!

Lesley