Category Archives: Fitness

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Q & A: Running Injuries

MTA_RunningInjuries

http://marathontrainingacademy.com/running-injuries

Marathon Training Academy

February 11, 2016

Do you want to meet your fitness goals? Avoiding injury is critical! In this podcast interview with Marathon Training Academy, I discuss common running injuries and self-treatment strategies.

RunningInjuryOnCalfRunning injuries! In this episode we invite Dr. Ben Shatto on the podcast and fire away with injury related questions sent in by Academy members.

You will learn when to self-treat an injury versus visiting a physical therapist, how to pick a PT, and great questions and answers about glutes, hamstrings, and muscle imbalances. Lots to love!  Listen to the podcast

Disclaimer: This blog post and podcast are not meant to replace the advice of your doctor/health care provider, or speak to the condition of one particular person but rather give general advice.

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How to Avoid Upper Back Pain when Running

MTA_UpperBackPain

http://marathontrainingacademy.com/upper-back-pain

Marathon Training Academy

January 24, 2016

In this guest post for Marathon Training Academy, you will learn how to improve your posture and thoracic (upper back) mobility while strengthening your upper back postural muscles in order to eliminate pain when running.

Young woman out jogging suffers a muscle injuryImagine how much the average person actually slouches during a day. Slouching during breakfast, then hunched over the kitchen sink to wash dishes, slouching while driving a car, and then slouching while sitting at work or at a school desk. Don’t forget about slouching while texting, watching TV or using the computer. When you are not slouching, you’re bending over to clean or pick up children and/or pets. The list of slouching possibilities is endless!

Now envision your running posture. Does it look any different? Many of us run in a forward head and rounded shoulders position–a slouched posture! Runners experience many of the same aches and pains as their sedentary counter parts. Upper back and neck pain is a common occurrence. The most typical cause is almost always poor posture.  Continue Reading

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7 Strategies to Improve Your Health in 2016

Portrait of a happy fit couple standing over white background

I often hear clients comment, “It’s too late to make a change now. I’m too old!”  Worse yet, so many people actually believe that, but I don’t!  I believe that it is never too late to change.  You are never too old or out of shape to make improvements in your life.  Being healthy and aging well is not a single choice to be made once and then never re-visited.  It is a series of constant choices that add up to a way of living.

Aging well encompasses all of the following aspects of our being: physical, mental, emotional, and spiritual. It also includes the community around us.  This year, choose to make small consistent choices to improve these areas of your life.  This will make all of the difference in aging well.  Each person’s physical journey as he/she ages is different.  Taking consistent and appropriate action now can vastly change future outcomes.

The purpose of The Physical Therapy Advisor web site is to assist you by addressing the physical component in your successful aging journey. My desire is to help you understand how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions in a timely manner so you can reach your optimal health.

7 Strategies to Improve Your Health in 2016:

Walk more!

Walking is one of the most fundamental activities we perform as humans. Research is very clear that frequent movements (like walking) are the key to avoiding many chronic conditions.  Walking lowers your risk of Alzheimer’s disease, heart disease, stroke, and diabetes.  It can lower blood sugar levels when performed directly after meals.  Elevated blood sugar levels are a major contributing factor to excessive internal inflammation which is associated with most chronic illnesses.

Walking as exercise and generally walking more during the day should be considered the first line defense in slowing the aging process and maintaining functional independence.  For more information on the benefits of walking, please refer to Why You Should Walk, Not Run and Why Walking is Critical for Your Health.

Embrace fashion.

The first step in adopting a new healthy behavior is to envision and feel what it would be like as if you had already adopted that new behavior. This allows your brain an opportunity to already feel what it would be like to make a change without fully doing so.  This can be very motivating.  Investing in gadgets or new work out attire, including new walking shoes, can be both motivating and fun.  Get in the mindset of adopting the new behavior.  Envision how you will look and feel once you have made the changes.  Then go for it!

Take control.

There is nothing more important than your health. You have control over most of the aspects in your life that affect your health and well-being.  Take charge, and empower yourself. You must be your greatest advocate.  Western medicine is designed to keep you alive, not to help you thrive.  Taking a passive role in your health is not a wise choice in America’s current health care environment.  Only you are responsible for your health.  Decisions now will determine how successful you age in the future.  For more reasons on why you must take control of your health, please refer to 6 Reasons to Self-Treat and Manage Your Health.

Make the decision.

Research on willpower has shown that it is a finite resource. We actually use up our willpower during the day and have to replenish it daily.  This is why you are more likely to “fall off the wagon” later in the day rather than earlier.  Decide on the change and commit to the decision.  Then implement structure to your day that causes the behavior to be more automatic.  Therefore, eliminating the need to rely solely on willpower.

Maintain your strength.

Although all muscle fibers decline some as you age, the fast twitch (Type II) fibers show the most declines. Some loss of strength is anticipated as you age.  Losing strength to the point of complete debility or loss of mobility and independence is not a normal aging process.  For more information, please refer to 3 Strategies to Start Right Now to Improve Health Span.

Strength training is a critical component to maintaining and growing additional Type II muscle fibers. The stronger you are, the more resistant to injury you are.  You are more likely to maintain proper functional mobility.  Also, strengthening of the core area (the abdominals and back extensors) helps to manage low back pain.  When you subscribe to my e-mail newsletter, you will automatically gain access to my FREE resource, 10 Minutes per Day Low Back Pain Prevention Guide. These specific strengthening exercises will help you to not only prevent low back pain, but self-treat it, too.

Perform high intensity training (HIT).

The research on the effectiveness of HIT continues to grow. Even more impressive are the findings that HIT can be safely performed at any age and with almost every medical condition.  It is now even being implemented in many progressive Cardiopulmonary Rehabilitation Programs, where people are recovering from all kinds of cardiac and pulmonary disorders such as COPD, heart attacks, and heart valve replacements.

Perform your cardio activity in short bursts (ranging from 30-60 seconds at a time) followed by a one to two minute recovery. The 30-60 seconds should be at a high intensity, meaning your rate of perceived exertion (RPE) is high. You should be breathing heavy.  Accommodations can be made for almost any type of medical condition.  For example, HIT may be performed while using a stationary bicycle, an upper body only bicycle, a rowing machine or in the pool.  You can also walk uphill at a quick pace, then stop and rest.  The point is to get your heart rate up, and then bring it back down for a full recovery prior to repeating.

If you feel unsure as to how to safely perform this type of training, please seek the help of a competent cardiopulmonary trained physical therapist or exercise physiologist. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Get started!

Make 2016 your year to make the necessary changes that will empower you to age well. Most importantly, just Get Started!

Also, I would encourage you to check out my Resource Guide. The specific exercise section is full of rehabilitation exercises ranging from low back pain to knee pain.  These .pdf files include photos and detailed descriptions to help you get started.  This list of resources also includes books, products, resources, supplements, topical agents, videos, and web sites that I personally use and recommend to my family, friends, clients, and patients (for use in the clinical setting).

For additional strategies to improve your health, please refer to 15 Strategies to make 2015 Your Healthiest Year Ever.

Which strategy can you implement in order to age well in 2016? Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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My Top 5 Most Popular Posts of 2015!

Top5Postsof16_Collage

Many of us struggle with aches, pains, and/or chronic illnesses. Often we search for answers online, but we find nothing more than hype and confusion. If we engage in the traditional western medicine approach, we discover nothing more than symptoms management and a hurried and rushed experience. Such experiences can leave us jaded and disheartened. I created The Physical Therapy Advisor web site to fill in this gap and to help you understand how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions in a timely manner so you can reach your optimal health.

My Top 5 Most Popular Posts of 2015:

  1. Q & A: How to Increase Hip Strength and Improve Mobility – Maintaining adequate hip and pelvis mobility and strength is an important strategy in avoiding many lower extremity orthopaedic conditions from knee pain to plantar fasciitis.
  2. How to Prevent Shin Splints – Shin splints are typically caused by inflammation in the lower leg anterior muscles known as the anterior tibialis muscle. This is the primary muscle needed to lift your foot. Shin splints are often considered an over use injury. Unfortunately, shin splints are relatively common in runners and dancers.
  3. Why You Should Walk, Not Run – Although controversial and disappointing for some, running isn’t appropriate for everyone. As a physical therapist and runner, I understand why some people cannot and should not take up running as a form of exercise. An existing injury may make it unsafe to run on a regular basis. If you can’t run, don’t worry about it! Many other forms of exercise without repeated impact can help us to keep fit. Walking is a wonderful method of exercise.  Out of all the possible movements we can perform, we’re best at walking! Walking daily can reduce stress, improve circulation and hormone regulation as well as benefit your overall well-being.
  4. Why Walking is Critical for Your Health – Choose walking as an intentional exercise and add it to your daily activities as part of a healthy lifestyle. You will feel better and likely live longer when you incorporate this critical component to aging gracefully and successfully.
  5. Chronic Pain: Is There Hope? – Jerry Henderson’s post on chronic pain was featured in the Guest Perspective. There are many definitions of chronic pain, but one of the most widely accepted is any pain lasting longer than 12 weeks. Experiencing pain for longer than 12 weeks is simply not normal. Physical therapists need to take the lead on being the providers of choice for these types of problems. No one can do it better.

2015 has been a wonderful year! I have featured reader submitted Q & A’s as well as many exercise and training posts. An important focus has been on longevity and healthy aging. I have also addressed chronic disease management by offering specific advice and rehabilitation strategies.

As many of my posts offer specific strategies and recommendations related to longevity and healthy aging, I was interviewed on the popular podcast, The Longevity and Biohacking Show by Jason Hartman.

In my guest posts for the Seniors Blue Book, I offered advice on healthy senior living (specifically on Exercise is an Effective Treatment for Knee Arthritis Pain and Out of Balance?)

In my guest posts for the Marathon Training Academy, I offered specific rehabilitation strategies to treat common running related injuries. This led to a guest appearance on their top rated running podcast as well. Please refer to Marathon Training Academy Podcast Episode #154, The Marathon That Got Away (How to Rehabilitate Achilles Tendinitis).

I am excited to announce an upcoming guide on injury prevention and recovery for runners that I have collaborated on with Trevor and Angie from The Marathon Training Academy.  Please visit https://marathontrainingacademy.clickfunnels.com/optin8252054 for a FREE digital resource, The Runner’s Toolbox, and to stay informed when the guide is available in early 2016!

Looking toward 2016, I will continue to offer free self-treatment advice to help YOU manage common musculoskeletal, neurological, and mobility related conditions in a timely manner. Together we can all learn to age well and reach our optimal health.

Thank you for supporting The Physical Therapy Advisor! I look forward to serving you in 2016!  If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Don’t forget subscribe to my e-mail newsletter! I will send you weekly posts on how to maximize your health, self-treat those annoying orthopaedic injuries, and gracefully age.  To thank you for subscribing, you will automatically gain access to my FREE resource, 10 Minutes per Day Low Back Pain Prevention Guide.

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Why the Squat is Fundamental to Life

Squatting is a fundamental movement. Squatting is one of the first abilities we develop as a child, and it needs to be one of the last ones we lose as we age.  Your ability to perform a squat is fundamental to how you are able to function throughout your life.

Your ability to squat is critical to your ability to function independently. In my experience of working with seniors, there are two main reasons why a person will need additional care and support: 1. The person can no longer safely get from point A to point B (this usually involves walking). 2. The person is no longer able to stand up from a sitting position.  This means he/she cannot get up and down from a chair, a toilet, or even the bed.  If you cannot perform these activities safely and independently, then you will need additional care.

The squat is a critical exercise to maintain mobility and function as we age. For more information, please refer to 7 Reasons Why the Squat is Fundamental to Life.

Do you regularly practice squatting? If not, which modified version of the squat (as demonstrated in the video) can you start implementing?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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How to Self-Treat Posterior Tibialis Pain

MTA_PTTD

http://marathontrainingacademy.com/posterior-tibialis-pain

Marathon Training Academy

December 6, 2015

In this guest post for Marathon Training Academy, you will discover the factors that increase your risk of developing posterior tibial tendon dysfunction (PTTD).  Learn how to recognize the symptoms and how to self-treat this condition so you don’t lose too much time with your training.

FallenArchesThe most common cause of pain along the inside (medial) portion of your ankle when running may also be associated with the most common reason for adult acquired flatfoot.  It’s likely something most of us haven’t ever heard of before.  Posterior tibial tendon dysfunction (PTTD), also known as posterior tibial tendon syndrome or tibialis posterior syndrome, can develop into a tibialis posterior tendon insufficiency which causes a fallen arch.  Continue Reading

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Astronauts Resistance Train and So Should You

Space travel has long been in the hearts and minds of men and women.  The Martian, a bestselling book and recent movie starring Matt Damon, depicts a manned mission to Mars.  (Personally, this is something I hope to see in my lifetime!)  Damon stars as an astronaut who is mistakenly presumed dead and left behind on Mars, and who then fights to survive.  Among the many potential hazards of space travel, one not so well known issue is osteopenia and/or osteoporosis.  The lack of gravity and weight bearing activity causes demineralization and weakness in the bones.  This significantly increases one’s risk of a bone fracture.

In space, bone loss starts within a few days and escalates between 2-5 months.  On earth, it tends to be a more gradual loss.  Bone density tends to peak in a person’s mid-twenties and worsens as a person ages.  Statics conclude that in individuals over 50, one in two women and one in eight men will have an osteoporosis related fracture within their lifetime.

For NASA, learning the causes of space induced osteoporosis and prevention methods is critical to long term space travel and any potential manned mission to Mars.  The treatment for osteoporosis is quite straight forward on earth and taking steps to prevent osteoporosis is critical.  The sooner, the better!  Regardless of age or severity of the condition, it’s never too late to start.

Osteopenia and osteoporosis can occur for many different reasons, but the most common reasons include:

  • Gender. Females are more likely to experience bone loss.
  • Certain ethnic groups. White Anglo-Saxons are more likely to develop these conditions.
  • Smoking.
  • Prior family history.
  • Alcoholism.
  • Medication side effects.
  • Lack of proper nutrition, including vitamin deficits such as low Vitamin D3 levels.
  • Hormonal dysregulation.
  • Lack of weight bearing exercise.
  • Being bed bound. Studies conclude that completely immobilized bones can lose up to 15% of mineral density within three months.
  • Lack of resistance exercise.
  • Certain genetic disorders.
  • Space travel. The lack of gravity and weight bearing activity causes demineralization and weakness in the bones.

Treatment Strategies for Osteopenia and Osteoporosis:

Start Early 

As we age, our bones will normally start losing some bone density and flexibility.  (They become more rigid.)  It’s important to work on optimizing bone density early in life.  Bone density is best developed under 30 years of age.

There are also studies that indicate pregnancy may also help to improve bone density.  This assumes a healthy diet with adequate calcium levels is consumed during the pregnancy and while breastfeeding. 

Weight Training

Weight training is like living on a planet with increased gravity.  Weight training (particularly barbell training) loads the skeleton progressively over time, which can decrease bone loss and increase bone mineral density.  It also positively affects hormones, such as human growth hormone (HGH) and testosterone, needed to improve bone density and muscle strength.  Barbell training is the most effective method due to the progressive load on the skeletal system, and the muscle pull being exerted on the bone, which also stimulates bone formation.

ManDumbbellWeightTraining

Resistance training (other than through barbell training) can also be beneficial.  Since space is an anti-gravity environment, it’s impossible to load the skeleton via weight training.  Astronauts can resistance train by utilizing strong elastic bands and cords.  This allows variations of pushing or pulling exercises that exert a force on the muscle, which stimulates muscle and bone development as well as optimizes vital hormone function.  Depending on the type of exercise, the resistance bands can mimic skeletal loading and gravity.

The key to maintaining and improving bone density is always axial skeletal loading and the associated pull of muscles against the bone during activity (particularly, strenuous activity).  Examples of such exercises include squats, lunges, and dead lifts.

Weight Bearing Activities

This refers to any activity, such as walking, jogging, hiking, climbing stairs, and dancing performed against gravity.  Biking and swimming are examples of exercises that are not weight bearing and therefore, they are not as beneficial for bone development.  In space, nothing is considered a weight bearing activity because of the lack of gravity.  Any attempt of weight bearing activity will need an outside resistive force to accomplish the task until science can actually create an artificial gravity environment.

Vitamin D3

Vitamin D3 is critical to the absorption of calcium, through the intestinal wall, which is important for bone health.  Although calcium is a critical component of bone health, I cannot recommend extra supplementation because of the potential cardiac risks to over supplementation.  A healthy varied diet will typically supply adequate calcium levels (assuming that adequate Vitamin D3 levels are present for absorption and that you are avoiding drinking soda).  Vitamin D3 is also a critical nutrient in maintaining a healthy immune system.

Increase Your Intake of Vitamin K1 and K2

Research indicates that Vitamin K can help to reduce bone loss by helping the body regulate osteoclast function with in the bone.  An osteoclast is a type of bone cell that breaks down bone tissue. These very important cells are integral in maintaining proper bone density and insuring an appropriate amount of calcium in the blood stream.  Without adequate calcium, many critical cell functions can be affected, including heart function.  Both Vitamin K1 and K2 have been proven to reduce the risk of fractures, including hip and vertebral.

Vitamin K, found in green leafy vegetables, has anti-coagulation benefits.  If you take blood thinning medications, your physician will need to know how much you consume on a regular basis.

Avoid Soda

Excessive soda intake (particularly diet soda) has been linked to poor bone density.  The exact cause isn’t entirely clear.  Many theorize that the acidic nature of the soda along with the chemicals and additives cause increased osteoclast activity in the bones.  This releases more calcium into the blood stream in order to help fight the negative effects of soda consumption.  It is clear that too much soda is bad for your health and bones.

Magnesium

Magnesium is a critical component of bone health and health in general.  Magnesium helps the body to regulate calcium levels.  This has a positive effect on bone health and also has been proven to reduce the risk of kidney stones.  I also use magnesium as a sleep and recovery aid.  I consume it at night to help me sleep.  Magnesium can also reduce muscle soreness, cramps, and/or spasms.  You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates.

Most people are deficient in the amount of magnesium they consume on a regular basis.  I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose in 100 mg intervals as needed.  I would caution you that taking too much magnesium can lead to diarrhea.  Mag Glycinate in its oral form is the most highly absorbable.  Although not quite as absorbable, Thorne Research Magnesium Citrate is also a fantastic product.

Stop Smoking

If you smoke, please stop. It not only affects your bone density, but it has negative effects on every other body system. It also increases your risk of cancer and heart disease.

Eat Healthy

Do not eat anything that comes in a package.  A diet with proper vitamins and minerals is not only imperative to preventing osteoporosis, but it is the key to preventing most disease and illness.  Most of our food should be from low sugar fruits and vegetables as well as protein and healthy fats (primarily from plant sources such as avocados and coconut or olive oil).  Any animal fat should be from organic and grass fed animals.  Your body tissue needs nutrients to be able to perform at a high level.

Avoid processed food as much as possible.  Limit sugary food and add more protein and healthy fat in your diet.  Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system.  Adequate protein intake is necessary to support muscle health and development.  A healthy diet equates to healthy bones.

In space, astronauts must eat a healthy diet and get plenty of exercise to prevent disuse osteoporosis.  Similar steps can be taken to prevent osteoporosis on earth.  Maintain a balanced diet rich in calcium, Vitamin D3, Vitamin K, and magnesium.  In order to prevent or alleviate osteoporosis and osteopenia, implement weight bearing exercise and resistance training; a lifestyle free of smoking and alcohol; and regular bone density screenings.  It’s never too late to implement these strategies as you maintain a healthy lifestyle.  For additional information, please refer to Q & A: How to Self-Treat Osteopenia and Q & A: Which Type of Imaging to Use.

Which strategies can you implement in order to prevent and self-treat osteopenia and/or osteoporosis?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Q & A: My Top 5 Tips on How to Self-Treat Osgood-Schlatter Disease

Q.  For the past several months, my 12 year old son has been experiencing pain below his knee cap just to the top of his shinbone. He typically experiences pain when playing soccer or other sports.  The pain goes away when he rests.  It’s getting to the point that it’s hard for him to participate in sports.  He hasn’t had any injuries.  What do you recommend? -Chandra

A.  Thanks for your question, Chandra. I’m sorry to hear about your son’s knee pain.  Unfortunately, it’s a common problem in children (particularly, boys).  The symptoms that you are describing sound like Osgood-Schlatter disease although other potential causes could be Patellar Tendinitis or Patellar Femoral Pain Syndrome. Due to his age, gender, and activity level, it’s most likely Osgood-Schlatter disease.

Osgood-Schlatter disease (OS) is an overuse injury with pain located just below the knee where the patellar tendon ends (inserts) on the Tibial tuberosity. A boney nob may start to develop in this area and usually occurs as the condition progresses.  This occurs due to the excessive stress on the skeletal system during a period of rapid growing combined with stress from activity of the quadriceps muscle pulling on the patellar tendon at its insertion site on the bone.  If a bump forms, don’t worry as it is benign with OS.  It will likely continue to be there as your child ages.  There are typically no long term effects for this condition except for pain over the raised area of bone when kneeling on a hard surface.

OsgoodSchlatter_TibialTuberosity

Risk Factors for Osgood-Schlatter disease include:

  • Boys who are 11-13 years old.
  • Period of rapid skeletal growth.
  • Adolescents who regularly participate in running, jumping, and sports with many cutting or rapid changes in direction.

Symptoms for Osgood-Schlatter disease include:

  • Pain and possible swelling below the knee located near the top of the shinbone.
  • A bump or boney growth on the front of the upper shin at the Tibial tuberosity that is typically painful to touch.
  • Pain with running, jumping, and cutting sports.
  • Decreased pain or no pain at rest.
  • Possible loss of knee range of motion, typically flexion.
  • Possible pain and tightness with quadriceps stretching due to the pull on the patellar tendon.
  • Loss of quadriceps strength which mostly due to pain inhibiting its use.
  • Painful kneeling.

OS typically begins with mild soreness. The condition is typically self-limiting because of pain.  Continuing to push through the pain can cause significant long-lasting pain resulting in limited function.  Early intervention is usually very helpful.

My Top 5 Tips on How to Self-Treat Osgood-Schlatter Disease:

RICE

RICE, which stands for Rest, Ice, Compression, and Elevation.

Rest. In this case, rest would indicate tapering down from your regular exercise activity or any activity that involves running and jumping or that is causing knee pain.

Ice. Apply ice to the painful area–typically the sooner, the better. The rule for icing is to apply ice no more than twenty minutes per hour. Do not place the ice directly against the skin, especially if you are using a gel pack style.  A bag of frozen peas can be ideal.  Individuals with poor circulation or impaired sensation should take particular care when icing.

Compression helps to prevent and decrease swelling. Swelling can cause increased pain and slow the healing response, so limit it as much as possible.  You can utilize a common ACE wrap.  If you have a friend who is medically trained, many different taping techniques can also assist in decreasing swelling.  You may also consider a compression sleeve or garment.

Elevation. If there is swelling, then elevating the leg may be helpful.

If it hurts, don’t do it!

Modify the activity or discontinue it completely. If your knee is hurting when performing your sport or activity whether you are running, jumping or even weight lifting, then discontinue the activity temporarily.  If you are able to modify and perform the exercise or activity pain free, it would be okay to continue in most cases.

Improve your range of motion (ROM).

The primary goal of a rehabilitation program is to regain full pain free ROM for knee flexion (bending) and extension (straightening). This can be accomplished in many ways.  Perform heel slides by lying on your back and sliding your heel toward your buttocks.  Consider using a pole to assist in performing deeps squats.  Another stretch would be to hang onto a pole or a doorframe, and bring your heel toward your buttocks as you perform a quadriceps stretch.

These exercises should only be performed within a mild to moderate amount of discomfort in order to regain full pain free ROM. If you experience muscle tightness and soreness, I recommend using a foam roller to assist with any myofascial symptoms.  To learn how to use a foam roller, please refer to Foam Rolling for Rehabilitation.

Work on strengthening.

The primary goal of a strengthening program is to work on the quadriceps and glutes medius (hip abduction). Weight lifting is an appropriate choice, but you may have to initially limit your range of motion (ROM).  Most of my clients begin on a non-weight bearing program, then progress to partial weight bearing, and eventually, full weight bearing.  The more severe the symptoms, the longer it will take for an individual to progress to more difficult exercises or to increase the resistance (load).

To initiate a physical therapy program, please refer to Osgood-Schlatter Disease Rehabilitation Exercises.  This exercise guide is designed to address the muscles that I find to be the weakest in most individuals.  The exercises are listed from easiest to most challenging and are designed to primarily improve quadriceps and hip strengthening.  Initially, focus on full ROM.

Weight training exercises (with machine weights or free weights) should be geared toward general leg strengthening and may include: squats; leg press; hip abduction machine; step ups; dead lifts; and straight leg dead lifts. If further instruction is needed, search YouTube to watch the proper technique for a specific exercise.  Do not perform any seated knee extension exercises.

Kinesiological taping.

Besides pain relief, the purpose of Kinesiological tape is to provide compression over the Tibial tuberosity and to facilitate additional blood flow to the area. It also provides proprioceptive input which can help the knee during activity.  I have had luck using Kinesio Tape, Rock Tape, and Mummy Tape brands. There are many other useful taping techniques which utilize different forms of tape.  (You could also utilize Spider tape or KT TAPE.) To visually learn how to apply the tape, please refer to Kinesiological Taping for Osgood-Schlatter Disease.  For application and removal tips, please refer to Skin Care with Taping.

How to Prevent Osgood-Schlatter Disease:

Be sure to schedule rest between athletic seasons, athletic events, and higher volume training periods. Rest is a critical factor as an adolescent’s body undergoes physical changes.  OS is typically associated with overtraining/overuse in combination with a rapidly growing skeletal system.  There are times when an adolescent needs to rest.  It’s important not to encourage an adolescent to play sports through the pain without adequate recovery, rest, and if necessary, an evaluation by a qualified physical therapist or physician.

As part of a prevention and cross training strategy, implement the exercises demonstrated in the Osgood-Schlatter Disease Rehabilitation Exercises.  A proper warm up and cool down is critical when performing in an athletic event or a significant training session.

  • Warm up prior to exercise. I recommend that you increase your normal warm up time by at least 10 minutes in order to increase blood flow to the area. This allows better mobility and also promotes healing as movement is necessary to bring in the nutrients. Use a stationary bike or the rower machine initially to get the muscles warm and the knee joint more lubricated. Then work on moving into a deep squat position multiple times as part of the warm up. You may need to hang onto a beam or a pole to take some pressure off of your knee as you move in and out of the squat.
  • Cool down. After performing your exercises, take extra time to cool down and stretch. Use either a stationary bike (at a causal/slower pace) or the rower machine. Both are reduced weight bearing exercises that promote movement and circulation to the knee as well as increasing ROM. This is the perfect time to work through my recommended rehabilitation exercises.

Thank you, Chandra, for your question! I hope these tips will help you assist your son in his recovery and get him back to playing sports as quickly as he is able to without pain!  If the pain continues, please seek additional assistance from a qualified physical therapist or physician.  The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Do you know an adolescent who may be suffering from Osgood-Schlatter disease? If so, please share my recommendations on how to address this common and treatable condition.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

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3 Strategies to Start Right Now to Improve Health Span

You have likely heard about the life span revolution in the media. Many feel we are on the cusp of significantly advancing the length a person can live.  When in fact, the actual average number of years a person is expected to live has been stable or slightly decreasing.  This is entirely due to poor nutrition, lack of physical activity, and environmental factors.  Although the promise of a long life is appealing, one must ask an important question: Is a long life really what you want if there is no quality? Increasing the number of years that you live is not as important as increasing the way you can live those added years.  Spending an extra 5 or 25 years alive, but ill, is a curse not a blessing.

Today’s pharmaceutical giants, who fund much of this research, don’t want you to feel well during this time. Their intentions are likely not altruistic.  Imagine a longer lived population that is chronically ill.  Sounds like a lucrative opportunity, doesn’t it?

Now the good news! There are very simple and scientifically proven techniques that will allow you to improve your health span AND life span.  Health span refers to the period of time during one’s life that you are generally healthy and free from disease.

Physical factors that address health span include strength, balance, flexibility, and endurance. All of these factors affect your mobility during your life.  These same factors all contribute to your body’s physical resiliency.  Maintaining your mobility is critical for all body functions and is fundamental in avoiding chronic illness.

Elderly couple walking through the park hand in hand

3 Strategies to Start Right Now to Improve Health Span:

Weight Training

Weight training (in particular, barbell training) is a critical component in physical resiliency. Lifting appropriately heavy weights is applicable for almost everyone regardless of age and/or present health status. Weight training has positive benefits on: muscle strength; bone density; cardiovascular performance; neurologic performance and adaptability; mental and cognitive function; and proper hormonal regulation.

Barbell training is the most effective method due the progressive load on the skeletal system and the muscle pull which is exerted on the bone. It fights off frailty! It increases your body’s margin for error when illness or injury occurs. With proper guidance and the right exercise prescription/dosage, nearly everyone can improve in strength and benefit from weight training. To quote Mark Rippetoe, “Stronger people are harder to kill than weak people and more useful in general.”

Resistance training (other than through barbell training) can also be beneficial. An example of resistance training would be any type of pushing or pulling exercise that exerts a force on the muscle, which causes it to work harder than it would normally.  The key to all training is that the system must be properly overloaded to produce the desired effect.  Too little and you will not receive a positive benefit.  Too much and you risk injury.  This overload principle must guide all exercise routines if there is to be actual success and benefit from the program.  Although any properly dosed/prescribed form of resistive exercise would be beneficial, the most effective exercises either activate large muscle groups and/or load the skeletal system.  Examples include squats, lunges, and dead lifts.

High Intensity Training (HIT)

High Intensity Training (HIT) or High Intensity Interval Training (HIIT) involves performing short bursts (ranging from 30-60 seconds at a time) of activity followed by a 1-2 minute recovery. The 30-60 seconds should be at a high intensity, meaning that your rate of perceived exertion (RPE) is high and you’re breathing heavy.

The research involving HIT is ever evolving. Thus far, it appears that HIT may provide superior health benefits when compared to almost any other type of exercise. It has significant positive effects on hormone regulation, particularly Human Growth Hormone (HGH). It regulates insulin sensitivity and increases cardiovascular function (VO2 Max). It not only boosts metabolism, but it leads to greater fat loss than traditional forms of exercise.

There is ongoing research on its effects on all forms of chronic disease and illness, including Alzheimer’s disease, dementia, and cardiovascular disease. Preliminary evidence shows that HIT (when performed correctly) leads to superior benefits in much shorter bouts of exercise.

Walking after Meals

Diabetes and metabolic syndrome are major contributors to cardiovascular disease and most neurologic disorders, such as dementia. Heart disease remains the number one killer in men and women today. Regulation of blood sugar and insulin levels is such a critical aspect of being healthy in today’s sedentary, high fructose corn syrup filled lifestyle. Proper blood sugar and insulin regulation should be a primary concern of anyone desiring to live a long healthy life.

Walking after meals has been shown to stabilize blood sugar levels. It’s also an excellent way to boost metabolism and connect with friends and family.  Frequent walking is the most important physical activity a person can engage in.

Although there are many aspects (mental, social, financial, physical, spiritual, and emotional) to address in order to optimize your health span, it is clear that strength training, high intensity training (HIT), and walking after meals is critical in maximizing your health span and aging well.

What are some practical actions that you can take today to improve your health span? Please leave your comments below.

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Inactivity Kills

Physical inactivity is responsible for more than twice as many deaths as obesity. A recent study of both men and women over a 12 year period of time clearly determined that inactivity does indeed lead to an untimely death. Increasing your activity level to 20 minutes a day of brisk walking is enough to significantly reduce your risk of death. This was true in those who were obese and normal weight as indicated in the study.

Other recent research indicates that sitting for more than two hours at a time can significantly lessen your life span. Even if you regularly exercise, sitting for more than two hours a day will still lower your life span. Frequent movement throughout the entire day is critical for your health.

Senior couple in the gym

Research is clear on the topic of activity. We are designed to be mobile. Regular activity has been clearly shown to:

  • Reduce the risk of diabetes.
  • Reduce the risk of heart disease.
  • Prevent Alzheimer’s disease.
  • Improve bone density.
  • Increase and maintain muscle strength, which is strongly correlated to independence in your environment and reducing the risk of falling.
  • Improve and maintain balance, which is critical to reducing the risk of falling.
  • Maintain proper hormone levels.
  • Reduce stress.
  • Increase feelings of well-being.
  • Reduce pain levels.

This is not an exhaustive list of the benefits of regular activity. Exercise and regular activity are critical to maintaining a healthy lifestyle. Frequent activity and movement throughout the day is best. Choose a form of activity and exercise that you enjoy and keep it as part of a lifelong pursuit.

What is your favorite form of exercise? Please leave your comments below.

Looking for relevant senior related resources in your community? The Seniors Blue Book is full of relevant resources for seniors as well as helpful articles on successful aging and elder care.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

(This article first appeared in the Seniors Blue Book, October-December 2015, pages 106 and 107.)