Dry Needling for Runners

Trigger Point Dry Needling (TDN) is a physical therapy intervention involving a thin filament, similar to an acupuncture needle, that is inserted through the skin targeting and releasing myofascial trigger points in the underlying tissue.

To put it simply, the dry needling increases blood flow and relaxes the muscles, causing the muscle to contract and return to its normal function, stimulating the body’s healing process.

When running, the legs are placed on constant, low-level contraction for a long period of time. This can cause a development of tight tendons and trigger points within the soft tissue.
The use of dry needling releases trigger points, allowing for the tight muscles, tendons, and ligaments to relax, reducing pain and restoring function.

There are several common areas in which runners develop trigger points, including:
• Hip musculature
• Thigh/knee
• Hamstring
• Calf musculature

Cost: Dry needling may be employed as part of an overall maintenance treatment ($20/15minutes) with an additional $10 supply fee.

If you feel you would like to try Dry Needling, schedule a complimentary consult at UBE Physical Therapy and Performance.

4 Exercises to Consider with Shoulder Instability

It is common for your shoulder to feel unstable or loose due to a previous injury where the instability was never fully resolved, and now you are noticing excessive movement in the shoulder with your job or your workouts. It is the job of the rotator cuff to secure the shoulder into the socket so targeting this muscle group is pivotal in improving shoulder stability. The video demonstrates four movements that will help assist you in addressing this issue. You want to work the muscle endurance initially, so aim for a higher rep count and reduce the rep count to address strength once you feel that instability is improved. All exercises should be challenging by the last rep with no pain!

Plank
Weight bearing through the shoulder is a functional way that the rotator cuff is activated. Hold the plank working toward a 2-minute hold and to 2-3 sets. If you need more of a challenge for shoulder stability, try the variations below.

Plank Variation-Shoulder taps
Aim for 15 SLOW taps to each shoulder for 2-3 sets if performed on the floor, and 6-8 taps per shoulder for 2-3 sets if on the wall.

Dips
Start with limited motion aiming for 3 sets of 15

Single Arm Overhead Farmers Carry
Walk for 15-20 yards and back for 3-4 sets

Single Arm Dumbbell Snatch
Start with 3 sets of 12 reps for each shoulder

Again, the aim is to target rotator cuff muscle endurance initially, so start with a weight where you feel fatigued by the last few reps of each set. Once you feel that your stability is improving, move onto phase 2 to work on strengthening. Increase your weight so that you feel fatigued by the last few reps but keep your rep count down to no more than 6-8.

Mix up your summer workout routine with swimming!

0604171421a.jpgSummer is here! If you are going to be near a lake or pool and are looking for something new to mix into your workout routine, try some water exercise.

The water can help in many different ways throughout your workout: 

  • Buoyancy reduces the stress on muscles and joints: more comfortable than land-based workouts.
  • Resistance from the water itself can aid in light strengthening.
  • Aquatic exercise can improve balance and cardiovascular fitness.

Here are just a few exercises you can try in the water:

  1. Jogging/Walking: increasing your overall speed will increase the water resistance/intensity.
  2. Single Leg Balance: Hold for up to 30 seconds at a time to challenge your balance. To increase the intensity, try slowly swinging your arms at your side against the water resistance.
  3. Wall Squat: Stand with your feet shoulder width apart, keep your back flat against the wall, and slide your back down the wall of the pool into a sitting position, then stand back up. Do 2-3 sets of 10 reps.
  4. Kickboard Rows: Using a kickboard or pool noodle partially under the water and arms straight out in front of you, pull the board/noodle close to your chest with elbows by your side, pinch your shoulder blades together, and then return your arms straight out in front of you. Do 2-3 sets of 10 reps.

Most importantly, have fun!

Note: water exercises might not be appropriate for those with the following conditions:

  • Open wounds/skin infection
  • Severe pulmonary condition
  • Severe cardiac precautions
  • Acute fever (fever about 99°F)

 

Unloading your spine for pain relief

Lumbar pain can be complex and multifaceted; therefore, not all exercises and remedies are appropriate for the lumbar pain that you experience.  Often, your body weight contributes to compression in the lumbar spine, either placing stress on the intervertebral disc or impinging on the spinal nerve roots. If you find that lying down alleviates your lumbar pain, then it is likely that your lumbar pain has a “load” component, and unloading the spine can reduce your pain and allow for inflammation reduction. There are many names for this technique; it is often called lumbar self-unloading, self-traction, self-distraction and spinal decompression, but all mean the same thing.

If you think that your back may benefit from spinal unloading, try some of the techniques outlined below. During spinal unloading, it may be difficult to notice the distraction, so it should either feel good or feel like nothing at all. If lumbar unloading worsens your pain, either during or after, you should immediately discontinue the technique and talk with your physical therapist about your symptoms.

If lumbar unloading is helpful, it may be beneficial to try various techniques and see which ones are optimal for you.

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Leaning

Stand facing a sturdy desk, table or countertop. Reverse your grip on the table and bring your body in contact with the side of the table, keeping your feet right under you. Keep your arms straight, with elbows locked, and sink your body weight down, allowing your back to relax.

 

 

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Chair Unloading

Stand between two sturdy chairs, placing your hands on the back of the chair. Keep your arms straight with elbows locked and sink your body weight down, allowing your back to relax.

 

 

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Seated Unloading

Place your hands on the side of the chair or the arm rests, push down into the chair to unload your back, but make sure to avoid lifting your buttocks off the seat. Ensure that you are allowing your lower back to relax.

 

 

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Leg Press

Lie on your back with your knees bent. Gently push against your thighs, making sure to keep your lower back relaxed.

 

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Doorway Push

Lie on the floor with your hips/waist centered in the doorway. Place a stick against the doorframe and push the stick further into the doorframe while allowing your lower back to relax.

 

 

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Hanging Unloading

Grab onto something sturdy overhead – a pull up bar or a sturdy doorframe works great. Sink your body weight down and allow your lower back to relax, thereby allowing your body weight to traction your lower back.

5 Things They Don’t Tell You Before A Joint Replacement

Whether you’re preparing yourself for a total joint replacement, or a loved one is having his/her joint replaced there is always more to learn:

  1. They will get you up the DAY you have surgery: Within minutes to a couple hours after getting up to the medical-surgical floor, an inpatient physical therapist will be in your room to help you learn to walk again. This not only helps you gain confidence, but also helps to prevent blood clots.
  2. There will be pain, and at times it will seem unbearable: The first couple days in the hospital are the most important time stay on top of your pain medication. This will allow you not only to work with therapies to get stronger, but to also help you sleep (which will improve the healing process).
  3. Time to reorganize your house: Throw rugs? Get rid of them (for a little while). Upstairs bedroom? Move downstairs. Cords? Hide them to avoid tripping. You will also learn very quickly the wonders of a raised toilet seat and a ramp to get into the house (if possible).
  4. Total join replacements are not just for geriatric age-range: There are MANY individuals that are MUCH younger that need a joint replacement for diagnoses such as rheumatoid arthritis and hip dysplasia.
  5. The importance of “pre-hab”: It is so important to strengthen the muscles that will be under the knife. The stronger your body is before surgery, the more likely your recovery with be easier. Even if you had surgery on a lower extremity, it is important to strengthen your upper body as well (think walkers/crutches).

Dynamic vs. Static Stretching

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Dynamic vs. Static Stretching

A proper warm-up prepares an athlete for practice or competition and decreases the risk of injury.

An ideal warm-up is specific to the sport or activity, with stretching as is an integral part of any warm-up.

There are two specific types of stretching that one can do: static stretching and dynamic stretching, but the question remains, which type of stretching is best to do before and which would be more beneficial post-exercise/competition?

1. Static stretching requires no voluntary muscular activity.  An external force such as gravity or a partner provides the force to stretch. Static stretching consists of a slow, constant stretch with the end position held for at least 30 sec.

2. Dynamic stretching requires voluntary muscular action, and involves flexibility during sport-specific movements.  Dynamic stretching is like ballistic movements in that it utilizes speed of movement, but avoids bouncing.

Studies have shown that an optimal warm up involves submaximal intensity aerobic activity, large amplitude dynamic stretching, and sport specific dynamic activities.

Studies have also shown that static stretching aids in lengthening the muscles; However, this may be detrimental immediately prior to an event by causing injury or overall poor performance.

As a result, studies have shown that all athletes should include dynamic stretching prior to activity and static stretching post-performance to their overall fitness and wellness for the health and functional benefits associated with increased mobility.

For specific/specialized warmups to your sport or activity, come visit UBE physical therapists and trainers!

Road race season prep 101

Running-Woman_5

As spring approaches, many people are starting to think about the upcoming road race season. Whether you are a recreational, a social, or a serious runner, it is time to think about your preparation for the upcoming races, and if running is not your ideal form of exercise, these considerations may make your preparations less grueling. But before embarking on any sort of training program, you should ask yourself a few questions:

Consider what type of race you plan to run.

If the race involves sizable hills, or is a mountain race, strengthening the glutes and hamstrings is important to give you the acceleration you might need, and to improve your explosive power as well as providing core strengthening for postural stability and stamina throughout the race. Obstacle course races will more likely require full body strengthening and cross-training to negotiate obstacles that require upper body strength. On the other hand, if you plan on taking part in a trail run, balance and stability are of greater importance so you can safely navigate the uneven terrain.

Where is the race located and what is the terrain?

If racing at higher elevations, try to arrive at the race venue a few days early to aid your chances of acclimatizing to the altitude, and stay active during that time to accelerate the process. Terrain will play its part in the run as well. For example, running on sand will require lower leg strengthening and endurance work, while running on concrete is considerably harder on your knees, so strengthening your glutes is a good idea. This will create more pelvic and knee stability to support the joints.

What is your experience level and what are your goals?

If you are running your first 5k, a generalized strength-training program focusing on glute and core strengthening is ideal to stabilize your gait. However, if you run multiple marathons annually, in addition to a generalized strength-training program, a plyometric, speed and agility program will assist with your power and your ability to explode with acceleration when you need to. You will also need to focus on core strengthening for postural stability, and to reduce fatigue on long runs.

Overweight and just starting to run?

Make sure your running intensity and the mileage you cover increases slowly. Some coaches recommend progressing your running program by no more than five to ten percent of your weekly mileage in order to limit any incidence of injury. This may involve intermittent walk-jog intervals to sustain activity for a longer period of time.

General considerations

Any pain you experience when you are running should never continue into the following day, or increase in intensity the day after your workout. If the pain does persist, make sure you address the cause immediately before it affects your running program, or worse, lingers and results in an injury.

Strengthening your rotator cuff

The rotator cuff is comprised of 4 muscles surround our shoulder joints: supraspinatus, infraspinatus, teres minor and subscapularis. These muscles are responsible for maintaining proper joint alignment during daily and recreational activities that involve reaching overhead, out to the side, in front of us and behind us.

Due to the relative smaller size of these muscles they can become injured easily with poor posture, overuse, poor/lack of training or a traumatic injury involving the shoulder.

Here are a few basic exercises to target your rotator cuff muscles, keep your shoulders feeling good and allow you to be the best “you” possible; However, if you have shoulder pain, you should consult your physical therapist or orthopedic doctor before initiating these exercises. External Rotation and internal rotation at neutral: Stand and use a resistance band. Maintain a neutral spine, tight core, and shoulders away from the ears.

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Scapular Retraction with resistance: Begin with arms straight forward in front of you, holding the resistance band in each hand. Draw back the band as you bend your elbows. Keep your elbows near the side of your body and squeeze your shoulder blades together.

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The enigma of low back pain… why nothing seems to help.

It is not uncommon for individuals experiencing low back pain to try to self-treat to address their pain and to hold off seeing their primary care physician or physical therapist. Often, this starts with a Google search on treatments, exercises, or stretches to manage low back pain.

Here is why this can be problematic…

There are a number of potential causes for your low back pain, and unless you are aware of the cause, some of the movements that are recommended may actually be causing more irritation.  In other words, stretches that may be beneficial for someone with a hpt2erniated disc can ultimately exacerbate pain with someone who has spinal stenosis.

To add another layer here, if you have any irritation throughout the sciatic nerve, which often accompanies low back pain, many stretches are going to feel fine while you are doing them, however your night pain will escalate. The same goes with various movements that you do throughout the day that don’t bother you while you are doing them, but make your evening pain worse. Unless you are aware of the movements you should avoid, you will have a hard time getting ahead of your pain.

This is just one of the reasons that we do free consultations for individuals at UBE Physical Therapy. We can assess your movements, and recommend how to proceed with managing your symptoms on your own. If you are still struggling with managing your pain after that, we are here for you.

Trigger Point and Self-Myofascial Release With Lacrosse Ball

At UBE, our goal is to improve joint mechanics for suitable function and restore appropriate length tension relationships of soft tissue. Some of our manual treatment involve trigger point release techniques. Some of our patients can replicate these techniques at home using a tennis or lacrosse ball on the trigger point itself.

Trigger points are “knots” within a taut band of skeletal muscle that is often reactive, tender and irritable when pressure is applied to that area. If the trigger point is chronic, it may or may not be tender to touch and then is called a “latent” trigger point. Trigger points will often refer pain to nearby body regions, particularly if the trigger point is creating dysfunction with daily living.

Below are common applications of lacrosse ball trigger point therapy we teach our patients to overcome their functional obstacles:

 

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PECTORALIS MINOR

The pec minor responds well to using a lacrosse ball on the wall. By placing the ball about 2 inches below the middle of the clavicle, lean your body into the ball on the wall. Hold the ball in that location for a few seconds before moving the ball slightly to the next location.

 

 

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SCAPULAR BORDER

The area between the upper scapula and spine. Trigger points can be addressed with a lacrosse ball to help relax the upper traps that are often used in the activity. The progression would be to add dynamic movement of the arm into flexion overhead and back down to the hip for several reps.

 

 

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GLUTES

There are areas of the deep glutes that respond better to trigger point releasing with a lacrosse ball. While sitting on the floor, place the lacrosse ball toward the tissue near the greater trochanter (hip joint). Hold in this position for 30 seconds each side with light rolling pressure.