Physical Therapy FIRST

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Set up an appointment to see the doctor, wait a few weeks, see doctor, get referred to physical therapy, wait another few weeks, THEN see a PT.

Wouldn’t it be easier to just get straight in to see your physical therapist?

You can!

Many are unaware that instead of going straight to the doctor for an injury, you can go straight to a physical therapist first.

Not only will you cut out the waiting period, but often, physical therapy is used as a means of conservative treatment before other options are explored. Instead of immediately turning to prescription drugs or invasive surgery for treatment, your physical therapist can trial more conservative modalities, hands on work, and strengthening exercises to help lead you towards health and healing.

Here are just a couple of reasons why physical therapists should be the first step:
• Weight training and bone health with osteoporosis/osteopenia
• Physical therapy during cancer treatment
• Pre-surgical rehabilitation
• Avoiding surgery: Strengthening of supporting muscles may help to avoid going under the knife.


Is your child’s backpack too heavy?


Some of the backpacks that kids bring home today seemingly weigh more than the kid themselves. These heavy backpacks can lead to pain and soreness, progressing towards musculoskeletal issues in the future if not addressed.

Some signs that may mean the backpack is too heavy are:

  • Pain between the shoulder blades when wearing the backpack
  • Indentations or red markings on the shoulders
  • Complains of tingling and/or numbness in the hands or arms

Here are a few key components on backpacks to consider, preventing these problems from occurring:

  • Fit: The base of the backpack should rest centered in the middle of the back. Both shoulder straps should always be worn on top of the shoulder as well as under the arms, with the arms having the ability to freely move.
    • Avoid the backpack sagging down to hips/buttocks.
  • Weight: The backpack should not weigh more than 10% of the student’s bodyweight.
    • While it is important to be prepared for classes, being judicious with what is placed in the backpack each day is important.
  • Structure: The ideal backpack would have padded shoulder straps with hip and/or sternum straps to equally distribute weight as well as prevent frequent movement/friction of the backpack.

Low back and core stabilization

Low back pain is the most common musculoskeletal diagnoses and cause of activity limitation and work absence in the U.S. Here are 3 exercises (with variation) that may help reduce your risk of injuring your lower back.

Bird Dog: This exercise requires a lot of balance and core strength, improving trunk and back muscles.
Start with just an arm raise and then progress to leg lift. Once those movements become easy, alternate arm/leg (as shown below).


Dead Bug: This exercise (with variations for increased progression) assist with activation of spinal stabilizers. With all variations of dead bug, the spine and pelvis are in a neutral position with the abdominals braced.

The first version consists of pushing your lumbar spine into the ground, bringing your arms and legs straight up into the air, and holding that position. Start with 10 seconds and increase up to 30 seconds.


Once the first version of dead bug becomes too easy, you can progress the exercise by alternating arm and leg extension (as shown below). Continue to focus on your spine and pelvis in a neutral position with the abdominals braced.


The final progression is using a loop band (placed around your feet).


Bend your knees 90 degrees and bring your arms straight up. Alternating arm and leg extension (as shown below), focusing on your spine and pelvis in a neutral position with the abdominals braced.



Plank pull down: Start in a high plank position holding the end of a band in each hand with the band stabilized/anchored in the middle. Focus on your spine and pelvis in a neutral position with the abdominals braced. While stabilizing on a single arm, pull the band in the opposite arm back (into the position of your front pocket). Alternate arms and repeat 5-10 times each arm.




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!

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.

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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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.




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.





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.




Leg Press

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





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.






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


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


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.