How to Rehabilitate Achilles Tendinitis

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http://marathontrainingacademy.com/the-marathon-that-got-away

Marathon Training Academy

September 20, 2015

In this podcast, Trevor discusses the difficult decision to not run a race. He chose to avoid risking further injury as he prepares for a more important race in a couple of months. His particular injury and decision provided an opportunity for us to identify the cause of his Achilles tendinitis pain and the different methods he could utilize during his rehabilitation. Listen to the podcast

KinesiologicalTapingForAchillesTendinitisIn this particular episode, I mention several rehabilitation strategies, including utilizing mobility bands and Kinesiological tape.

For specific strategies on how to rehabilitate Achilles tendinitis, please refer to https://www.thephysicaltherapyadvisor.com/MTA.

How to Prevent and Self-Treat Shin Splints

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http://marathontrainingacademy.com/self-treat-shin-splints

Marathon Training Academy

September 12, 2015

In this guest post for Marathon Training Academy, you will discover the common causes for shin splints and learn simple prevention strategies and treatment options to quickly help aid in your recovery.

ShinSplints_Arrows_LandscapeThe term shin splints, also known as an anterior compartment syndrome, refers to pain along the shinbone (tibia), the large bone in the front of your lower leg. Shin splints can be excruciatingly painful to the point that you may struggle to walk or run. They are typically caused by inflammation in the anterior muscle of the lower leg 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 and unfortunately, are relatively common in runners. Discover the common causes for shin splints and implement these strategies to prevent and self-treat shin splints. Continue Reading

Q & A: How to Self-Treat Osteopenia

Q.  I had my annual visit with my physician, and she says that I have osteopenia. She recommended that I start taking calcium and maybe even another prescription to help. Isn’t there a better way to treat this without the use of drugs? -Mary

A.  Thank you, Mary, for this fantastic question! Osteopenia can be a very serious condition and is the precursor to osteoporosis. Osteopenia is defined as lower than normal bone density, but not to the severity of osteoporosis.

Osteopenia and osteoporosis significantly increase your risk of a bone fracture if you fall. When the condition is severe, the fracture can occur spontaneously from normal activities. Nearly 20% of all hip fractures in the elderly will result in death within the first year, and 50% of people will never regain their prior level of function after suffering from a hip fracture. Treating osteopenia and osteoporosis is a critical first step in reducing fractures and maintaining independence as a person ages.

Osteopenia can occur for many different reasons. Risk factors include:

  • Side effects of medications, such as chemotherapy or chronic corticosteroid use
  • Eating disorders
  • Radiation exposure
  • Gender – Females are more likely to experience bone loss.
  • Certain ethnic groups – White Anglo-Saxons are more likely to have thin bones.
  • Smoking
  • Prior family history
  • Alcoholism
  • Chronic soda consumption
  • Having a very thin build
  • Lack of physical activity

Osteopenia and osteoporosis are typically diagnosed via a bone density scan, which is recommended for woman over the age of 65. Depending on the risk factors for both men and women, your physician may order the scan at different times. For more information on a bone density scan, please refer to Q & A: Which Type of Imaging to Use?

Mary, you are correct. There are many options to help manage this condition other than prescription medications. I highly suggest that you speak with your physician about all available treatment options. The following recommendations are helpful in managing and treating osteopenia, but there may be more complicated internal issues affecting your body’s ability to improve bone density. Hormonal imbalances (such as low testosterone), menopause related hormone changes, and thyroid related issues (among others) may affect bone density. All possible hormone regulation issues should be screened for and addressed as you implement the following strategies.

Senior couple in the gym. How to Self-Treat Osteopenia.

How to Self-Treat Osteopenia:

1. Weight Training

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.

Weight training or resistance training (other than through barbell training) can also be beneficial. An example of weight or 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. Although any 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.

2. Weight Bearing Activities

This refers to any activity, such as walking, jogging, and hiking, performed against gravity. Biking and swimming are examples of exercises that are not weight bearing and therefore, they aren’t as beneficial for bone development.

3. Vitamin D

Vitamin D is critical to the absorption of calcium, 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 D levels are present for absorption and that you are avoiding drinking soda).

4. Avoid Soda

Excessive soda intake (particularly diet soda) has been linked to poor bone density. The exact cause isn’t entirely clear. It’s debatable as to whether it’s a sign of an unhealthy lifestyle or that the additives, acids, and artificial sweeteners affect the bone density (but it’s likely both factors). What is clear is that too much soda is bad for your health and bad for your bones.

5. Creatine

Creatine monohydrate is helpful for increasing skeletal muscle size, strength, and power production. Increased muscle strength means increased muscle pull on the bones, which causes them to grow stronger. It may also have the added benefit of a preventative effect for dementia and neurodegenerative diseases. I recommend taking 5 g per day, and I typically consume it in 6-8 week cycles.

6. Magnesium

Magnesium is a critical component of bone health and health in general. 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 as absorbable, Thorne Research Magnesium Citrate and magnesium oxide can also be beneficial.

7. 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.

8. Eat Healthy

Do not eat anything that comes in a package. 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.

9. Avoid Excessive Alcohol Consumption

A moderate amount of alcohol has been shown to have cardiovascular health benefits. Excessive amounts can lead to kidney and liver related issues as well as negatively affect bone density. The general recommendation is to consume no more than 1-2 servings of alcohol per day.

Mary, you should be able to affectively treat osteopenia without prescription medications by implementing these strategies, avoiding known risk factors when possible, and addressing any potential hormonal related issues. Thanks again for the question!

How has osteopenia or osteoporosis affected your life? Which strategies can you implement to improve your condition? 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!

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.

7 Tips on How to Avoid a Heart Attack

Approximately 735,000 Americans have a heart attack every year. Heart disease is the #1 killer in western countries, including the United States, with over 17 million people dying every year due to heart disease worldwide. Most heart attacks are preventable and most risk factors for cardiovascular disease are preventable. Learn how to recognize the possible signs of a heart attack and how to avoid one with the following 7 tips.

Man with chest pain

The cardiovascular system consists of the heart and blood vessels. It is responsible for carrying nutrients and oxygen to the tissues and removing carbon dioxide and other waste out of the cells and tissues. Diseases of the cardiovascular system include the following (this is only a partial list):

  • Heart attack
  • Stroke – cerebral vascular accident (CVA)
  • Arteriosclerosis – hardening of the arteries
  • Coronary artery disease (CAD) – also known as heart disease
  • Heart valve diseases/disorders
  • Heart (cardiac) arrhythmias – abnormal rhythms of your heart rate or beat
  • Heart failure – also known as congestive heart failure (CHF)
  • Hypertension – high blood pressure
  • Peripheral vascular system (PVD) or peripheral artery disease (PAD)

Heart attacks are often associated with men, but cardiovascular disease is actually the leading cause of death in both genders. One out of every two men and one out of every three women will develop heart disease.

Although more men die of heart disease than women, females tend to be underdiagnosed. Once the condition is discovered, it’s often too late to intervene. Nearly 29% of female related death is cardiovascular in nature.

Possible Signs of a Heart Attack:

  • Pain in the left shoulder, pain in the jaw, neck or upper back
  • Dizziness, lightheadedness or fainting spells
  • Shortness of breath
  • Pressure or pain in the chest, typically the left side
  • Nausea and vomiting
  • Sudden sweating
  • Extreme fatigue

Symptoms of a heart attack can be very different among individuals and are typically more subtle in women. If you have any concerns, please seek medical advice immediately. Most importantly, be proactive! The best time to start is prior to an issue occurring.

7 Tips on How to Avoid a Heart Attack:

1. Manage Your Diabetes

If you are diabetic, you are at an increased risk of heart attack and cardiovascular disease. Newer research indicates that sugar and insulin resistance is more of a significant risk factor for cardiovascular disease than excessive saturated fat intake and/or salt. Reduce your carbohydrate (sugar) intake and manage your diabetes. The best and most effective method is through a proper diet and exercise program. For specific strategies on how to improve your health, please refer to 15 Strategies to Make 2015 Your Healthiest Year. 

2. Stop Smoking

Smoking is highly correlated to cardiovascular disease. If you smoke, please make every effort to cut back and then quit. Nearly 20% of all deaths from heart disease are directly related to cigarette smoking.

3. Manage Your High Blood Pressure

High blood pressure makes the heart and cardiovascular system work harder. Over time, this excessive pressure can lead to an enlarged heart (cardiomegaly) as well as damage to the blood vessels in the kidneys and brain. It increases the risk of a heart attack, stroke, and kidney disease. High blood pressure also increases your risk of developing dementia or Alzheimer’s disease.

Acupuncture is proven to be helpful in lowering blood pressure. By applying acupuncture needles at specific sites along the wrist, the forearm or leg, it stimulates the release of opioids, which decreases the heart’s activity and thus, its need for oxygen. In turn, this will lower your blood pressure.

Blood pressure can typically be managed through a healthy diet and regular exercise. For tips on how to get started, please refer to How to Jumpstart a Sedentary Lifestyle and 15 Strategies to Make 2015 Your Healthiest Year.

4. Maintain a Healthy Weight

Obesity is associated with diabetes, high blood pressure, and coronary artery disease. These all increase your risk of developing heart disease. Studies have shown that excess body weight (not including all of the other associated medical conditions) can also lead to heart failure. Even if you are healthy otherwise, being overweight still places you at a greater risk of developing cardiovascular related diseases.

5. Reduce Your Stress

Stress is a normal part of life. Poorly managed stress or excessive stress can lead to emotional, psychological, and physical problems, such as cardiovascular disease and high blood pressure. Regular exercise, massage, yoga, acupuncture, and Tai Chi have all been proven to reduce stress.

6. Improve Your Sleep Quality

Poor sleep is linked to most of the cardiovascular risk factors including: high blood pressure; atherosclerosis; heart failure; heart attacks; stroke; diabetes; and obesity.

Be sure to get as much sleep as you need (typically 7-9 hours at night). Short naps are also an excellent way to get more sleep. I recommend that you read Michael Hyatt’s 6 Strategies to Sleep Soundly, Wake Rested, and Accomplish More.

Acupuncture is also a proven method to help people sleep better and more soundly. It can be used to treat insomnia as well.

7. Sit Less

Sitting for more than two hours at a time is linked to an increased risk of dying from cardiovascular related deaths. Walking daily can reduce stress, improve circulation and hormone regulation as well as benefit your overall well-being. To find out more about starting a walking program, please refer to Why Walking is Critical for Your Health.

Implement these 7 tips to increase your health, avoid cardiovascular related illness, and help you to ultimately age successfully. Proper cardiovascular health will help you to avoid heart attacks and strokes. It will also help you to reduce your risk of other serious medical conditions, such as cancer and dementia.

What steps are you taking to avoid cardiovascular disease and to live healthfully? 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!

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.

Q & A: Which Type of Imaging to Use?

Q.  Your previous post about MRI’s brought up a question I have always wondered. When do you need an MRI versus a CAT Scan versus an X-ray? How do you know which type of imaging you need? -Jeanne

A.  Thanks, Jeanne, for a great follow up question from Q & A: Do I Need an MRI for Low Back Pain? Many different types of imaging, such as an X-ray, CT Scan, and MRI, can be used depending on the situation and the structure being assessed. Let’s go through a quick synopsis of the basics on imaging. In addition, I will review the differences between a bone scan and a bone density scan, which is very important in diagnosing osteoporosis.

close up of male doctor holding x-ray or roentgen image

An X-ray, also known as radiography or a Roentgen ray, is an electromagnetic wave. The images produced show the parts of your body in different shades of black and white. This is because different tissues absorb different amounts of radiation (X-ray). The more radiation absorbed, the whiter it appears on the film. For example, calcium in bones absorbs X-rays the most, so bones appear white. Fat and other soft tissues absorb less and appear gray. Air absorbs the least, so the lungs appear black. If you have any metal implants, they will appear the most white.

X-rays are typically used to examine bones for a fracture or injury. Chest X-rays are often used to quickly spot pneumonia. Mammograms use X-rays to search for breast cancer. Fluoroscopy is a type of live action X-ray in which the results are delivered in real time. This is commonly used during certain types of spinal injections.

A computed tomography CT Scan (also known as a CAT Scan) uses X-rays to produce detailed images of the structures of the body. The CT scanner sends the X-rays through the body part/area being studied by taking very thin slices (images) of the targeted organ or area. They are then grouped back together by a computer to make a comprehensive image. CT Scans are best suited for viewing bone injuries, diagnosing lung and chest problems, and detecting cancer. CT Scans are widely used in Emergency Departments (ED’s) because the scan takes fewer than 5 minutes to perform depending on location of the scan. CT Scans produce more radiation than a typical X-ray or an MRI.

An MRI (Magnetic Resonance Imaging) is best suited for examining soft tissues, such as ligaments and tendons, spinal cord injuries, and brain tumors. Unlike an X-ray or a CT Scan, a MRI can take 30 minutes or more depending on the area and the detail of the scan. Like a CT Scan, the MRI takes images in slices, and then a computer recreates the information to give a comprehensive image. The smaller the slices taken, the more detailed and accurate the image meaning that the scan will take longer and cost more. An MRI typically costs more than a CT Scan. One advantage of an MRI is that it doesn’t use radiation like a CAT Scan.

A bone scan is a nuclear imaging test for looking at specific bone related injuries or disease. One advantage of a bone scan is that it can often discover a problem days to months earlier than a regular X-ray test.

During the scan, a radioactive substance called a “tracer” is injected into a vein in your arm. The tracer travels through your bloodstream and into your bones. Then a special camera takes images of the tracer in your bones. Areas that absorb little or no amount of tracer appear as dark or “cold” spots. This could show a lack of blood supply to the bone or certain types of cancer.

Areas of fast bone growth or repair absorb more tracer and show up as bright or “hot” spots in the images. Hot spots may point to problems such as arthritis, a tumor, a fracture or an infection. The level of detail is not always as good for a bone scan. However, bone scans can be very helpful for your physician in order to gain a proper diagnosis if you are experiencing unexplainable skeletal pain, bone infection or a bone injury that can’t be seen on a standard X-ray.

A bone density scan, also known as a Dual-energy X-ray absorptiometry (DXA, previously DEXA), is not the same as a bone scan. This particular scan measures the density of the bones by using two X-ray beams, each with different energy levels. One beam is high energy while the other is low energy. The amount of X-rays that pass through the bone is measured for each beam. This will vary depending on the thickness of the bone. Based on the difference between the two beams, the bone density can be measured.

The actual radiation exposure is low and typically less than a standard X-ray. A bone density scan is not only quick and safe, but it’s very important in diagnosing osteoporosis, which is the thinning of bones to the point they can become brittle and break. The National Osteoporosis Foundation recommends bone density scans for:

  • Women who are 65 years and older
  • Men who are 70 years and older
  • Those who have broken a bone after the age of 50
  • Women of menopausal age with risk factors for osteoporosis
  • Post-menopausal women under the age of 65 with risk factors for osteoporosis
  • Men between 50-69 years old with risk factors for osteoporosis

Thanks, Jeanne, for the question! The only way you can insure that you are receiving the best possible care for you and your loved ones is to understand more about your body and the medical options available today. Then you can research certain topics more thoroughly and have a complete, straight forward dialog with your medical providers.

I strongly believe that it is critical for all individuals to increase his/her knowledge base on basic medicine, health, fitness, and nutrition. My ultimate goal for The Physical Therapy Advisor is to help you in providing that education. What are your pains? What questions do you have? Please submit them to contact@thePhysicalTherapyAdvisor.com. I look forward to providing you with useful and practical types of “how to” information and to answer your health related questions.  You can achieve optimal health!

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, My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain.

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How to Self-Treat Runner’s Knee

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http://marathontrainingacademy.com/how-to-self-treat-runners-knee

Marathon Training Academy

August 16, 2015

In this guest post for Marathon Training Academy, you will discover the common symptoms and causes for Patellar Femoral Pain Syndrome (PFPS), also known as runner’s knee, and learn how to effectively self-treat and manage this condition.

LacrosseBallForQuadPatellar Femoral Pain Syndrome (PFPS), also known as runner’s knee, is a common running related issue. The sooner you can manage this condition, the easier it will be to recover and eliminate future problems. As part of a quick and thorough method of treatment, first address the biomechanical causes for the pain. Then utilize the following strategies to quickly recover from the pain in order to keep training and running at a high level.  Continue Reading

Q & A: Do I Need an MRI for Low Back Pain?

Rear view of shirtless man with hand on hip over white background

Q.  I have been dealing with low back pain on and off for the past several months. The pain is severe. I cannot participate in my normal exercise activities. In fact, I struggle just getting in or out of my car. My doctor says my X-ray results are fine, but do I need an MRI? -Brad

A.  Thanks, Brad, for the question! I am often asked if an MRI is necessary when someone is experiencing low back pain (LBP). You state that your X-ray results are fine, so that immediately rules out the possibility of certain types of injuries such as a fracture or more chronic conditions like spinal stenosis. Fortunately, most LBP is mechanical–meaning it is from a physical or structural cause and isn’t related to conditions such as fractures, cancer or infections.

The answer to your question is no. An MRI is not needed in a majority of cases of LBP. It is best to diagnosis the cause and the best treatment strategy through a thorough physical assessment because most LBP is mechanical. There is definitely a time and place for an MRI. There are very clear indications when additional follow up such an MRI is necessary. Your physician will take a thorough history and determine if it’s necessary based on your history and examination. (To learn more about the different types of imaging, including an X-ray, CT Scan, and MRI, please refer to Q & A: Which Type of Imaging to Use?)

To safely self-treat your low back pain, first take a moment to assess your symptoms and pain level. What led to your pain and/or injury? Did the pain come on suddenly or slowly? Evaluate the severity of the injury. If you’re experiencing any of the following, please seek immediate medical attention:

  • Loss of bowel/bladder function.
  • Uncontrollable pain. The pain is so severe you cannot function or move.
  • You are losing muscle function or control. The muscles in the legs will no longer work. (This is different than pain preventing the muscle from working.) This sensation of paralysis occurs when the muscles will not actually function.
  • Significant loss of sensation in the leg or groin area. This is not a tingling sensation, but an actual loss of sensation. For example, you cannot feel the toilet paper when you wipe after using the toilet.
  • Numbness, pins and needles or severe pain in the toes or lower leg.
  • Any history of cancer or tumor. The pain did not have a specific and correlated mechanism for injury.
  • Onset of pain without any known mechanism for the injury. (Thoroughly consider your activity. Many times, a slow onset of pain begins several hours after performing an activity.)
  • A high fever or any other symptoms in relation to your low back pain or you generally start to not feel well.

Most LBP will have a directional preference for extension. A majority of injuries occur when performing a forward biased (flexed movement) like chronic slouching or a spinal flexion biased movement. I will discuss an extension biased program because it is by far the most common directional preference. Flexion biased programs are often found in older adults particularly in cases of spinal stenosis.

LowBackPainIn the case of mechanical LBP, you should be able to alter and change your LBP within a short period of time. First, establish a directional preference by identifying a pattern to the pain. Does the pain get worse when you bend over or does it improve? What happens when you repeat this movement? Determine how your pain responds. If it spreads away from the spine and down into the leg, beware that you are moving in the wrong direction.  Stop that particular movement, and instead try moving in the opposite direction. If you were moving into flexion, try extension. If you had trialed extension biased movements, try flexion.

The rule of thumb for movement: If the pain worsens by spreading peripherally down the buttock and into the leg and/or foot, then the condition is worsening. We must stop that activity. If the pain centralizes and returns back toward the spine (even if the pain worsens slightly), then keep moving as the condition is actually improving. For a thorough discussion and an excellent treatment resource, please refer to Treat Your Own Back by Robin A. McKenzie.

In my experience, most episodes of LBP tend to respond better to extension biased movements. If flexion or extension doesn’t help or change the pain in any way, then you may need assistance from a medical provider. I highly suggest seeking a qualified and competent physical therapist who works with clients suffering from LBP. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area. In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to seek your physician’s opinion as well).

Thanks again for the question, Brad, and good luck with resolving your pain! For more self-treatment strategies for low back pain, including specific exercises and recommendations, please refer to the following posts: How to Safely Treat Low Back Pain, 12 Sure Fire Ways to Injure Your Back, and My Top 7 Tips to Prevent Low Back Pain While Traveling.

Don’t let LBP affect your ability to stay active and keep enjoying your favorite activities! Learn how to prevent, self-treat, and manage LBP so you can get back to your daily life and exercise goals more quickly without additional unnecessary and costly medical bills!

AVAILABLE NOW ON AMAZON!

In my book, Treating Low Back Pain during Exercise and Athletics, you will learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP. In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies to eliminate pain and get back to training and exercise sooner.

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Why I CrossFit

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I recently had the unfortunate pleasure of cleaning out my grandparents’ estate after my grandmother passed away. Her house was fairly large and full of furniture. The basement was packed with 4,000+ vinyl records, hundreds of books, and thousands of cassette and VHS tapes. Additionally, old canned food in the cellar and 50+ gallon jugs of water had to be moved upstairs to be discarded. My grandpa and grandma were definitely prepared!

Why do I CrossFit? Because during this three day event, I packed more boxes, moved more heavy objects, and worked myself ragged with only minimal breaks for bathroom use and re-fueling without much complaint. CrossFit has helped me to develop more strength, endurance, and agility than I have had since being a kid! Frankly, I’m more fit now than any other time in my life. (In addition to CrossFit, I still enjoy running a couple of times a week to insure that my long run endurance maintains a good base.)

Not only has CrossFit prepared me with the strength to complete the tasks necessary at my grandparents’ estate sale, but in my experience, CrossFit:

  • Develops my strength and endurance to perform extended periods of yard work in the heat
  • Hones the skills needed to compete in obstacle course races (OCR)
  • Improves my endurance running
  • Prepares me to roll with my jujitsu buddies and not “cardio” tap
  • Improves my hiking
  • Empowers me because I can physically perform any task that I choose to perform
  • Reduces my risk of developing chronic diseases such as heart disease, diabetes, and Alzheimer’s disease

Although the training methods used in CrossFit help to improve strength, endurance, balance, agility, and over all fitness, they are also designed to challenge mental fortitude. Learning to set and push through mini goals is a fundamental skill in life. With every WOD (work out of the day), I strengthen this skill set.

What is CrossFit?

  1. Constantly varied functional movements performed at relatively high intensity. CrossFit incorporates a combination of weightlifting, general fitness and boot camp activities, and an endless amount of activities and exercises to constantly challenge the body in a new way.
  2. 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.
  3. Weight Training. CrossFit has made lifting heavy weights cool again. After spending time in a CrossFit box (gym), participants will quickly realize the need to focus on strength in order to improve on the WODs (work out of the day). Weight training becomes an integral part of the weekly training. The benefits of weight training are long established, but to steal a quote from Mark Rippetoe, “Stronger people are harder to kill than weak people and more useful in general.”
  4. Community. CrossFit has done an amazing job in creating a community of people who desire to improve fitness and maintain the ability to perform physical tasks. The type of people who attend certain gyms will vary, so spend time finding the right community for you.

Why do I CrossFit? CrossFit is an integral part of my training and development. As a physical therapist, I take pride in my profession as I help others accomplish his/her mobility goals. CrossFit roots me in a physical and mental state that allows me to practice what I preach and accomplish my mobility goals whether it’s a hard day of work in the yard or moving 40 boxes of vinyl records out of a basement. Is CrossFit for everyone? No, not really as it is a very intense form of exercise and training. Can we learn something from CrossFit to make our training, health, and fitness more successful? Yes, most definitely!

Do you CrossFit? Why or why not? 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!

15 Tips to Self-Treat Achilles Tendinitis

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http://marathontrainingacademy.com/achilles-tendinitis

Marathon Training Academy

July 26, 2015

In this guest post for Marathon Training Academy, you will discover the common symptoms and causes for Achilles tendinitis and learn how to effectively self-treat and manage this condition.

Fit man gripping his injured calf muscle on a sunny dayAchilles tendinitis tends to affect runners more than any other group or athletic population. There is typically a high correlation to the amount of activity and volume performed in relation to biomechanical abnormalities and training errors which lead to Achilles tendinitis or tendinopathy. The Achilles serves as the conjoined tendon for both calf muscles, the gastrocnemius and soleus muscles. Achilles tendinitis (also called tendonitis) is a serious condition for any athlete as it typically means a significant reduction in training volumes and modification to training routines. A complete stopping of sporting activities may be necessary in severe cases. Learn the potential causative factors for Achilles tendinitis and how to self-treat this condition so you don’t lose too much time with your training. Continue Reading

How to Recover Quickly from a Hamstring Strain/Pull

A hamstring strain, also known as a hamstring pull, is a relatively common injury that can occur in almost any sport: running, CrossFit, ice skating, and weightlifting. The injury typically happens when one of the hamstring muscles (which are located in the posterior or back of the thigh) become overloaded. This causes a strain or small tear of the muscle and a complete tear in severe cases. The pain is typically located in the back of the thigh near the site of injury. This area can range from the back of the knee to the buttock area (specifically near the bones of the pelvis you sit on called the ischium). Discover the factors that increase your risk of straining your hamstring and learn how to self-treat this condition.

HamstringSelfMobilizationUsingaMassageTool

The strain most commonly occurs during running or jumping (in particular during sudden movements or when quickly starting and stopping). However, you could just as easily pull your hamstring while weightlifting or working in the yard. The following factors increase your risk of straining your hamstring:

  • Not warming up prior to exercise
  • Tightness in the hip flexors or quadriceps muscles
  • Weakness in the glutes/buttock muscles

Although hamstring strains are relatively common, they can be very debilitating. Depending on the severity of the sprain, you may have to discontinue your sport. A minor strain is classified as Grade I. Grade I injuries tend to be mild. With proper care and rehabilitation, the healing time can be shortened.

Grade II tears are partial ruptures. Grade II tears can often be rehabilitated, but the time frame for healing is longer.

A complete rupture is classified as a Grade III tear. Grade III tears may require surgical intervention. Severe Grade II and Grade III tears cause impaired muscle function and usually have associated bruising that occurs near the site of injury.

The course of treatment is dependent on the severity of the pain and the location of the injury. I recommend that you seek competent advice from a medical doctor, physical therapist or athletic trainer if you’re experiencing severe pain. A professional can assess the severity of the strain and address how to handle the injury.

Initial Treatment

For the purpose of this discussion, I will address a Grade I or minor Grade II injury. The initial course of treatment following the sprain includes 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 using your hamstrings (bending over, walking uphill, squatting or activities involving hip extension or bending your knee).
  • 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. Many physical therapists or athletic trainers can apply KT Tape, Rock Tape or Mummy Tape for you or you can find application techniques online.
  • Elevation. Compression and elevation may not be fully possible if the injury is located higher into the buttock region. If there is swelling in the lower leg, then elevating the leg may be helpful.

Gentle Movement

During the acute phase, gently move the leg as you can tolerate. Don’t be aggressive with the movement. Walking is usually the best way to keep the area moving. Be sure to keep your steps shorter if you are experiencing pain. You may also try gently floating or walking in a pool as long as the pain does not worsen.

HamstringMobilizationUsingtheFoamRoller

How to Self-Treat a Hamstring Strain/Pull:

  • Mobilize the fascia and muscle tissue. As you progress through the initial acute phase (typically 10 to 14 days), work on restoring normal pain free movement of the leg. Mobility issues and myofascial restrictions are very likely to occur following a hamstring injury. Along with tightness in the hamstring, you are likely to have tightness throughout the lower leg including the buttocks, quadriceps, IT Band or in the deep hip internal or external rotators. You may also have more spine tightness or pain due to altered movement patterns in the lower extremity. I recommend using a foam roller to address tightness in the lower leg. Care should be taken, and don’t roll too aggressively on the site of the injury. To learn how to use a foam roller, please refer to Foam Rolling for Rehabilitation. I also recommend using a Thera-Band Standard Roller Massager, which is very firm and allows for a deep amount of pressure. You may also utilize a tennis or lacrosse ball to mobilize the deeper hip and buttock muscles or to more deeply and aggressively mobilize the restricted areas appropriately. 
  • Stretch. As you progress through your rehabilitation, care should be taken when stretching the hamstring. I tend to utilize both mobilization and gentle stretching to help maintain hamstring and lower leg motion. Don’t let the hamstring become tight and restricted. Hamstring Rehabilitation Exercises demonstrate my recommended stretches, foam rolling, and self-mobilization techniques.
  • Strengthen your glutes, hamstrings, and hip muscles. Weakness in the glutes, hamstrings, and hip muscles is common after injury and was likely a contributing factor to the injury itself. Strengthening of these muscle groups can help avoid future hamstring and even low back pain issues as well as reduce your risk of re-injury. Please refer to Hamstring Rehabilitation Exercises for additional exercises.
  • Hydrate. The human body is primarily made of water, which is critical for all body functions. I highly encourage you to hydrate more frequently during recovery. Adequate water intake is critical as your body attempts to heal and flush out metabolic wastes. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Keep steady supplies of nutrients going to/from the site of the injury. Try to avoid beverages that contain artificial sweeteners or chemicals with names you can’t spell or pronounce. Water is best.
  • Start a supplement. A hamstring strain is typically associated with a specific event and an active inflammatory process typically occurs. I am a supporter of natural supplements and remedies. Many supplements include herbs which are designed to help reduce inflammation and support the healing response. My most recommended supplement to help recover from injury is CapraFlex by Mt. Capra. Essentially, it combines an organic glucosamine and chondroitin supplement with other natural herbs which are designed to reduce inflammation and support healing. CapraFlex can be taken long term or intermittently. Phenocane Natural Pain Management combines the following: Curcumin, an herb that reduces pain and inflammation; boswellia, a natural COX2 inhibitor that also reduces pain and inflammation; DLPA, an amino acid that helps to increase and uphold serotonin levels in the brain; and nattokinase, an enzyme that assists with blood clotting and reduces pain and inflammation. If you are taking blood thinner medication, please consult with your physician prior to taking these supplements.

Return to Activity

As your pain decreases and after your hip and hamstring range of motion has returned to normal, slowly start tapering back into your training routine. During this time, you remain at a higher risk of injury. As you continue working through your rehabilitation and your return to activity, implement the following strategies:

  • Warm up prior to exercise. I recommend that you increase your normal warm up time. You should warm up at least 10 minutes in order to increase blood flow to the area. This allows for better mobility and also prepares the tissues for exercise. You can use a self-massage tool or a foam roller to roll up and down the hamstring as part of your warm up. If you perform hamstring stretches, be mindful that prolonged static stretching before exercise may worsen performance. Warm up exercises may include light jogging, bicycling, rowing or any activity to get the heart rate up and the blood flowing in the lower legs. Be careful when performing any movement that puts the hamstring in a stretched positon with speed or force.
  • Cool down. After performing your exercise or activity, take the extra time to cool down and stretch. Focus on hamstring stretching as well as general lower extremity mobility stretches. Use the same self-massage tools as you did during your warm up.
  • Initially avoid potential high risk activities. As your recovery progresses and you return to activity, initially avoid high risk activities that put the hamstring muscle under heavy load or a very quick load. Progress slowly. If an activity begins to cause pain in the hamstring, don’t push through it. Instead, stop and give your hamstring more time to heal prior to trying it again. You should be pain free before you progress the intensity of the activity or sport. Hamstring pulls have a high likelihood of re-injury if you rush the process.
  • Regain full strength and motion before returning to sport. Before a full return to sport or activity is initiated, you should have full lower leg and hamstring mobility and strength without pain. If you continue to experience soreness or restriction, continue to work on your rehabilitation until the leg and hamstring have returned to normal. Then initiate a full return to activity.

If you’re not experiencing relief after two to three weeks of aggressively managing the symptoms, contact your medical doctor, physical therapist or athletic trainer for an assessment and help in managing the injury. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Has a hamstring strain/pull ever sidelined you? Which treatment was the most effective for you? Additional discussion can help others to manage this condition more effectively. Please leave your comments below.

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