Postural Tip of the Week: Knee position when sitting

We want to start updating the blog with regular postural tips; things you can change in your daily posture that can help you achieve and maintain "neutral".  These are not usually big changes - they are little things to try that can make a big difference in keeping those muscles that typically go unused in many people.

Today's tip is in the sitting position.  When sitting, attempt to pull the left knee back behind the right.  When looking down, you should see something that looks like the knee position below:

The key muscle to feel is the left inner thigh.  See if you can keep that on for your entire ride to work, or during your favorite TV show...it's hard work!

Pain in Dancers: When to Act?

Dancing is a sport as much as it is artistic expression.  In my experience, dancers frequently assume they will be injured some time during their dance careers and therefore don't always pay close attention to pain that they feel when they dance.  Remember that pain is your body's way of saying that something is not right.  Just like the sensation of hunger tells you your body needs food; or your heavy eyelids and yawning tell you that your body needs sleep, pain is your body's way of communicating that a body part may be getting too much strain.  Follow these guidelines to know when you should seek help.

• Your pain last longer than two weeks
• Your pain is greater than a 5/10 for less than two weeks
• Pain that you cannot make better with self care (rest, ice, compression, elevation)
• If you have a sense of instability with pain or without (i.e. your ankle keeps giving way and rolling)
• Pain that appears to be getting worse or more frequent (i.e. you used to only feel it when you dance, but now you are starting to feel it even walking around at home)
• Pain that prevents you from dancing or doing certain movements in dance

Remember that pain is a warning sign that your body may need attention.  You will be a stronger, happier, healthier dancer if you get your pain attended to quickly!  

Katy Gamelin, PT

Dancers - Six Ways to Prevent Injury

Dancers are prone to injury due to the intensity and difficulty of the activity.  Below are easy ways of preventing injury.

1. Eat good food.  Good nutrition is key both to keeping your body strong and healthy.  Think of food as fuel for your muscles as you would think of gas for a car. 

2. Drink lots of water.  Dehydration is a big risk for injury.  Our bodies are made up of 60% water!  It helps in food digestion, waste transport, helps us regulate our body temperature.  Without enough water it is easier for you to strain muscle

3. Engage in sufficient warm-up.  This is so important.  Dance is so difficult because one minute you are holding a difficult position for a prolonged period, the next you are leaping or turning quickly across the stage.  Dance uses every aspect of our muscles.  You need to warm up to get them prepared to do all the different activities that are required of you.  Younger dancers especially need sufficient warm up due to the quick growth of bone, and difficulty for muscle length to keep up!

4. Ensure good shoe fit.  It was brought to my attention in New York that so many dancers (even professionals) do not have proper shoe fit or try to over extend the life of their shoes.  Be realistic about how often you need shoes and make sure you get a proper fit.  If you have foot pain, consider the fit of your shoes as a possible source of problem.

5. Engage in gentle cross training. Choose cross training activities that are very different from your dance type.  Ballet dancers, focus on things that require your feet to be straight, get our of turn out (i.e. treadmill, bike, etc.); modern dancers, do something that requires good sneakers, get out of bare feet (treadmill, elliptical); Step dancers, tappers and flamenco dancers, choose an activity that restricts pounding (elliptical, swimming). 

6.  Practice good form in dance and outside of dance.  I can't stress this enough.  Form is everything.  Don't lose sight of the basics.  During warm up is a perfect time to check in on your form, especially at the barre.  When you are not dancing, remember that it will only make you weaker if you are not maintaining good posture. 

Katy Gamelin, PT

Guest Post - Andrea O'Connor- PostureYoga

Ping. I felt it in my right low back just after I moved into a deep backbend. What was that?

At 3 am the next morning, I swung out of bed with unexpected difficulty and found my legs wouldn't  bear my weight.  Managing to stay somewhat upright using the walls for support, I made it to the bathroom floor to breathe and stretch.

That was the beginning of my journey with the torn spinal disk in my low back that changed my life. 

Is this fair? I thought. For the past twelve years, I’ve dedicated myself to the health of bones, muscles and mind through yoga and Gyrotonics.  Yet, in the last nine months, a key yoga teaching has become clear to me in a new way. Life doesn’t operate on the basis of equality, or offer any guarantees or even clarity about right and wrong.  Peace and joy, I learned AGAIN, come from giving up the struggle for “what’s fair” to deal with what is. 

There is a happy ending! Katy and Cindy from Essex PT helped me deal with the excessive right side bending, weak left abs, and other imbalances to transform my experience of breathing and moving. I'm so grateful for their amazing skill, expertise, and healing kindness. As a result of this injury and their care, I'm developing PostureYoga for me and my students! 

This yoga, based on the Postural Restoration approach, helps the body relax through breathing, releases muscle tension, and the spine, hips and shoulders work better. Ahh, the delight! 

Come check out the PostureYoga Flow class on Sunday at the Essex Physical Therapy Marketplace location from 9-10 am. 

Contact andrea@workingwellvt.com if you are interested in the PostureYoga for a Healthy Back classes or the Destress PostureYoga series, coming in October.

Andrea O'Connor

WorkingWell Inc.

www.workingwellvt.com

Barefoot Running - The Craze

The popular book “Born to Run” by Christopher McDougall published in 2011 has been instrumental in having most runners think about trying the “new” style of running and dream of being one of the “super-runners” from the Tarahumara tribe in Mexico. While we are far removed from the high desert regions of Mexico, runners around the world and in our community would enjoy reading this stimulating book. The book is a good read and I would recommend reading the book for the interesting details of these runners and the excitement of running in an Ultra marathon. That being said, the new “craze” of the barefoot  running gives rise to frequent questions that are posed in the clinic, as well as, “What about these shoes that are supposed to make your feet stronger?”  

In the clinic, we as physical therapists can offer numerous suggestions based on what an individual’s evaluation reveals to us.  The postural patterns (muscle weakness and tightness) that your body may have developed running, with or without minimalist shoes, will be evident upon your PT evaluation.  Our treatment approach will be tailored to your specific problem(s) which may include exercises or a new suggestion of footwear. There are reasons for the footwear suggestions that we as PTs promote because of the body’s amazing ability to compensate in recruiting the wrong muscles for walking and running. 

At Essex PT, we like to promote heel control, as well as a “hip strategy vs. an ankle strategy.” Minimalist shoes are unsupportive at the heel, arch and forefoot thus resulting in a foot that hits the ground with no control and subsequently having more muscle groups involved in the walk/run cycle at the ankle vs. the hip. Those of you who have experienced our PT evaluations and treatment plans know that we promote a lot of buttocks/hamstring recruitment on both the left and right hips and left inner thigh recruitment. Thus we are promoting a “hip strategy” approach to correcting faulty postural patterns. Since the minimalist shoes do not fit into the “heel control” shoes, more often than not we as PTs would not recommend these types of shoes to address your body’s postural problems.  We may also gently point out how these shoes could be potentially keeping your body in an undesirable postural pattern. Overall, it is about how your body responds to your treatment plan and the tools (exercises and footwear) you use to correct the body’s dominant postural pattern.

When it comes to making changes in your running style having an assessment of your running gait would be beneficial. Before you make a major change in footwear there are some key things to keep in mind:

• There have been no studies published to date that can show that barefoot running can make the foot muscles stronger or improves your running biomechanics.  
• It has been shown that running barefoot is “different” in regards to the biomechanics of running.  Promoting a more upright posture and thus recruitment of your back muscles.
• There is no evidence that barefoot running reduces injuries other than the blogs and pro barefoot running sites.
• Should you decide to make the transition to barefoot running, several studies do support the need to slowly transition to shoes that have a lower heel height and to prevent metatarsal bone injury.
• Other than the famous Ethiopian runner Abebe Bikala winning the 1960 Olympics in barefeet, when was the last time you saw an elite runner competing in a Marathon without wearing shoes? 

Happy Running!

Jim Cummings, PT

Tip of the Month: Back to School - Backpack Tips!

It's that time of year again - back to school!  (Does anyone remember the Staples commercial "it's the most wonderful time of they year"?  Get me every time!)

This month, we wanted to give some backpack safety tips to keep you or your child from being one of the 7,300 backpack-related injuries that occur annually.  64% of students aged 11-15 report back pain related to heavy backpacks.  This problem doesn't end in adolescence - according to a study by Boston University, approximately 85% of university students report pain associated with backpack usage.  This affects us all - so let's learn how to tackle the problem.

• Lighten up!  Backpacks should only weigh 10-15% of the wearer's body weight.  
• To reduce weight, think about taking only the items that are needed that day.  
• If a locker or cubby is available, use this as much as possible and only carry necessary items.
• Find out if some of the textbooks that are being carried to/from class are available electronically (many are!) or in the library.
• It's all about placement!
• Most backpacks have multiple compartments - use them!  Unexpected shifting in the backpack can cause sudden muscle strain.
• Heaviest items should be placed closest to the back to keep them close to the center of gravity.
• Two straps are better than one!
• There's a reason why backpacks come with two straps - use them!  This helps to more equally distribute the weight.
• Shoulders and necks have many blood vessels and nerves that can cause pain and tingling if to much pressure is applied to one side.  
• Backpack straps should be well padded to prevent them from digging into the shoulder/neck.
• Hip/chest belts also help to distribute the weight more equally.
• Wheeling and Dealing
• While wheeled backpacks are great in theory, there are many things to consider.  Will the bag need to be carried up stairs?  Will it fit in a locker?  How is it going to work in the winter being pulled through the snow?  If the wheels aren't going to be used often, they add extra heft to the bag.
• Adjust!  Wearers are not all created equal (in size!):
• Shoulder straps should be adjusted to allow easy movement of the arms.  The backpack should be easily able to go on and off.  
• The bottom of the back should rest in the curve of the lower back.  It should never rest more than 4 inches below the waistline.  
• The pack should be snug to the back - the more loosely it hangs the more it pulls on the back muscles.

Remember - persistent pain is NEVER normal - contact the office and get it checked out!

Backpacks - That pack is TOO HEAVY!

Tomorrow we are going to post our "tip of the month" - all about backpack safety.  Today, we wanted to review warning signs that a backpack is too heavy - and when to seek medical attention if symptoms persist.

That pack is too heavy!

• Postural changes when the pack is in - leaning forward or increased curve of the low back
• Struggling when putting on or taking off the backpack
• Pain when using the pack
• Tingling/numbness of the arms/hands
• Red marks over the shoulders 

When to seek attention from a medical professional:

• Persistent tingling that does not end quickly after removing the backpack
• Back pain/aching that lasts long after the backpack is removed - back pain is not normal in children!
• Difficulty lifting the bag due to weakness - if the pack only weighs 10-15% of the child's body weight as recommended (spoiler alert!), they should be able to lift the pack without difficulty.  Some strengthening activities could make a big improvement in the child's pain, posture, and abilities.

Inaugural Blog Post!

Here at Essex Physical Therapy, we strive to keep our clients educated on their bodies and movement patterns.  We sometimes joke about when people come in with shoulder pain and tell us they have an injured “rotor cuff” (really a rotator cuff) or how someone who has suffered for years with morning heel/foot pain had no idea that physical therapy could help (and it did...in just a few visits!).  So we got to thinking...what if we could educate people on things related to physical therapy outside of the traditional PT setting?  Abracadabra, our blog was born.  Here were some of our initial ideas:

• THE HIP BONE’S CONNECTED TO THE THIGH BONE:  A series about anatomy, including rotator cuff, fascia, and lumbar discs
• WHAT IS WRONG WITH ME?:  Giving information on a number of common complaints/diseases, including tennis elbow (you don’t have to be a tennis player to get it!), plantar fasciitis, vertigo, osteoporosis, and carpal tunnel and how PT can help
• RESEARCH CORNER:  A quick look at the latest and greatest in physical therapy
• OUR FAVORITES:  A list of some of our staff’s favorite exercises (with some videos and photos included as well, hopefully!)
• TIP OF THE MONTH:  An ongoing series of tips according to the time of year or targeted to a certain population - back to school backpacks, top 3 exercises for soccer, etc.
• POSTURAL POINTERS:  Ever had Estelle sneak up on you at a baseball game and tell you to get off your right leg?  Look here for frequent ideas on how to change your habits and improve your daily postural positions and movement patterns.
• GUEST WHO?:  Guest posts from some of our partners - think yoga, nutrition, Pilates, massage, Reiki, etc.
• And many others, including information from classes we attend, current concerns (concussions!), barefoot running, etc.

Have any more ideas for us? Leave a comment below!