Running Tips For the Dog Days of Summer

As the temperature rises and beach season approaches we see more and more runners come into the office. Not all complain of the same issue but most boil down to the same root causes, poor running form. You might think to yourself, “I know how to run! You just go out there and run!” Although running may seem intuitive there is more to it than you might think. Here are a few things you should look out for:

1.       

• Wear the right shoes: So many people don’t understand that footwear is of the utmost importance. Get yourself fitted for the correct shoes at places like…

a  .     Road Runner Sports - http://www.roadrunnersports.com

b.      Jack Rabbit - http://jackrabbitsports.com      

      

These stores will be able to fit you for the proper shoe for your foot and your running level

• Heel – Toe is wrong: Traditionally we think we should be running on our heels but actually you shouldn’t. Running heel to toe actually puts a large amount of force on the shins and the lower leg and can possibly lead to “shin splints” or knee problems. You should land on your mid-foot or slightly behind the balls of your feet.
  
•  Running not jumping: There should be very little vertical movement with proper stride length. Next time you take a run, pass by a store front and look at how much your head bobs up and down, I think you’ll be surprised.
  
• Running surface: Running on asphalt and concrete all the time will eventually take its toll on your knees, hips and back. Change up your running surface every now and then. Try running on a soft track or grass every now and then.
  
• Treadmills are not always good: Running on treadmills all the time can sometimes lead to alterations in stride length, poor body mechanics and poor posture. This is mostly due to the fact that treadmills do half of the work for you by propelling your body. 

Hopefully these tips are helpful! But if you are currently in pain because of your running get assessed by a qualified PT or specialist. Happy running everyone!

David Kwon, PT, DPT, CSCS

SNOW SNOW SNOW!!!

As the northeast has been slammed with snow this winter, I have seen an increase in patients coming in with snow removal related injuries. Obviously snow doesn’t remove itself (unless you live in an apartment building) thus snow removal is necessary. Shoveling snow is an extremely strenuous activity that could lead to several injuries.

Possible Injuries:

•           Strained back muscles
•           Herniated discs
•           Impingements syndrome
•           Bone fractures (from falls)
•           Torn rotator cuffs
•           Shoulder strains
•           Wrist and hand ligament tears
•           Neck strains

With all the possible injuries that can occur with shoveling there are some very simple tips a physical therapist can use to help avoid injuries.

TIPS:

Know your limits! You may think you can move two tons of snow at once but maybe it’s not necessary. Take breaks and avoid long bouts of shoveling at a time. Over loading your muscles for a prolonged period will almost always lead to injury. During breaks make sure you rehydrate and eat something. Dehydration and hunger will lead to weakened muscles and injury.

“Lift with your legs!” When shoveling you must first remember that your legs are stronger than your arms.

     Step 1: When lifting that heavy shovel full of snow first use your legs to push the shovel.

     Step 2: Before lifting re-grip hands so that one hand is closer to the actual shovel.

     Step 3: Get the shovel close to your body.

     Step 4: TIGHTEN YOUR STOMACH! This is the most overlooked step. When you tighten you stomach       you stabilize your “core” this will protect your back.

     Step 5: Lift the shovel parallel to the ground keeping the snow as close to your body as you can. This will  decrease the torque on your back.

Avoid throwing snow. Walk snow over to where you want to put it. Throwing snow will almost always end in shoulder injuries.

BEST WAY TO AVOID INJURY! Hire someone else to do it! But if you can’t, please follow these guidelines. 

New Year Resolution… MORE PAIN!

As the clock strikes 12 on December 31^st, millions of people around the globe make resolutions to “lose weight” and to “get back into shape”. With this resolution come a few dangers that everyone should be aware of.  

Did you know? According to some sources there are more gym related injuries in the first month of January than all other months combined?

Common Mistakes that lead to injury

Being too aggressive: It is possible that injuries are prevalent in the month of January because people will be too aggressive when they return to exercises.

TIP: If you have not worked out in a few weeks (months or years!), progress your exercises. Start out slowly and don’t expect to be able to lift as much as you did when you stopped working out.

Your body requires a few weeks of consistent exercise and activity before your body is “re-educated”, meaning, that the mind and the body must accommodate for this new level of activity. Being too aggressive at the start of therapy could lead to injury simply because your body is not “used to it”.

Not warming up: When first starting any exercise it is imperative to “warm up”. Warming up increase peripheral blood flow to extremities (e.g. Legs, hands, arms) and increases tissue extensibility (ability to stretch). Imagine that your body is a car on an icy winter day. You have to warm your car up before you redline it! Same goes for your body.

TIP: Brisk walking on the treadmill for 10 mins, should be sufficient. If you are not sweating slightly after your warm-up, you did not warm up! If you are performing upper extremity exercises try a row machine.

Not stretching: Stretching is not only one of the most neglected activities; it is also the most incorrectly performed activities. Stretching should be performed after a warm up. Stretching should be specific to the body part that is being exercised that day. Stretches should last at least 15 seconds.

TIP: Do not bounce during stretching activities. There are little sensors in your muscles that detect rapid stretching, which compensate and increase muscle contraction. When you bounce and stretch (as seen in many Jane Fonda work outs) you can activate these sensors, meaning you are essentially making your muscles tighter!

Hopefully 2011 will be a healthier, stronger, injury free year for all of you! Good luck!

PT Frequently Asked Questions (FAQ):

When people come into my clinic there are some common questions that people ask. Being that Maven Clinics are all found inside gyms, we get a few questions that other clinic may not hear that often. Here are a few examples.


PT Frequently Asked Questions: 

1. When do I know that I need therapy?
Usually I recommend that patients receive therapy when their injury (or condition) is inhibiting their normal daily activities such as walking, sleeping, running, exercising, cooking, driving. Often times people will ignore their problems until it starts to interfere with their everyday life, which leads to the next question.

2. My pain isn't stopping me from my normal activity but it still bothers me, do I need therapy?
Yes! Why live your life in pain?? Prevent the injury from getting worse, get treatment so that you can move on with your life. Pain is a signal from your body that something is wrong. It is usually a good idea not to ignore signs, like a red light at an intersection. Consider pain a big red light for your body.

3. Do I need a prescription? I don't have time to go back to my doctor.
Depends, most of the time no, you don't need it. But certain plans DO require it, but 90% of insurance plans in NJ DO NOT require a prescription. NJ is a Direct Access state, which means it is legal to go straight to a PT without a prescription. Medicare patients, unfortunately, DO need a prescription.. sorry!

4. What exercises or machines can I use out here that wont hurt me? How do I use them? (One of those MAVEN only questions)
That really depends on what you are looking to gain from the exercises and how you are performing the exercises. All MAVEN PT's are either CSCS (Certified Strength and Conditioning Specialists) or in the process of being certified, so we are a great resource for you. Also we will be having a....

INJURY FREE RESISTANCE TRAINING WORKSHOP
700 Palisadium Dr.
Cliffside Park, NJ 07010
Dance Studio 1
January 15th, 2011
12:30PM - 1:30 PM

The seminar will be taught by Taylor Lee DPT, CSCS. With over 10 years of training and fitness experience! The seminar will be fun and interactive and is absolutely free! Come and bring your friends!

What is spinal stenosis?

Spinal stenosis is one of the most common conditions that effect the older population. Spinal stenosis is a narrowing of the spinal canal that causes pinching of the spinal cord. The spine is comprised of bones call vertebrae. The vertebrae are like bricks that make a pillar (the spine). 

This pillar keeps your body upright and is the foundation of your skeletal system. The spine also protects your spinal cord. Most of you know that your spinal cord carries your nerves which carry information such as pain from your body to the brain.  Over time, the part of the vertebrae that encases the spinal cord becomes narrower and with eventually begins to compress on the cord itself. This results in pain and possibility numbness and tingling in one or both legs.  

Signs of spinal stenosis:

1.  Pain with back extension activities (leaning back).
2. Standing is more painful than sitting.
3.  Pain goes away with sitting or lying down.
4. Pain and/or numbness extends down legs, most of the time into both legs.
5. Pain relief medications are not effective.

Treatment for spinal stenosis:

1. Conservative treatment: NSAIDS (Tylenol, Aspirin, ice)
2. Changing sleeping positions – Sleeping on side.
3. Medical treatment – Surgery, medications, injections.
4. Physical therapy – Therapist will teach core strengthening, postural control, body mechanics and pain management with manual therapy. 

Spinal stenosis is a difficult thing to treat but there are some patients that respond very well with treatment. The therapist and the patient must work hard together to return the patient to his/her normal life. 

PRP = PED?

Listening to the radio the other day (on Mike and Mike ESPN 1050), Tiger Woods was being interviewed about his connection to Dr. Galea. As some of you may know, Dr. Galea was purported to have given performance enhancing drugs (PEDs) to professional athletes a few months ago. Tiger Woods denied any use of performance enhancing drugs but stated that he saw Dr. Galea for PRP or Platelet Rich Plasma therapy.

What is Platelet Rich Plasma?

To answer this question we must first understand platelets. Platelets exist in all human blood and are used to “clot” blood. Without platelets in your blood, a little cut would end in extensive blood loss and possibly death. People with impaired platelet aggregation have a condition called hemophilia. The important part of platelets, in regards to PRP, is that platelets also cause cell growth. This cell growth is necessary for healing a wound and to eventually close the wound. Platelet Rich Plasma is relatively new and innovative technique used by physicians to treat chronic and lingering injuries. The mechanism behind this technique is injection of platelets into the site of the injury which causes cell growth and repair. Recent research is mixed but some show significant improvements in the rate of healing.

This technique is usually used on people with long standing chronic issues that were not successfully treated with conservative therapy. Conditions such as tennis elbow, plantar fasciitis and Achilles tendonitis can be treated with PRP. PRP, however, is not a full proof procedure that is somewhat invasive. Minor conditions, such as these, can also be treated with simple physical therapy. PRP is performed by physicians usually in an outpatient setting mostly when physical therapy has was not successful.

So if PRP a Performance enhancing drug?

No, PRP is used just to increase the rate of healing without any systemic effect. Improvements in performance would be related to a decrease in pain and increase in functional strength. Maybe if PRP enhanced performance Tiger Woods would have won a major this year? 

OW My Tendon Hurts!

Tendinitis

What Exactly is a Tendon?
 Tendons are the tissues which connect muscle to bone. All muscles are connected to bone by a tendon and are integral part of the musculo-skeletal system. Tendons are used by the body much like ropes are. Ropes bare the load of an object in order to move the object through space. If you imagine a man pulling a rope in order to pull a bucket of water out of a well, you can imagine that the “man” as the muscle, the bucket of water as the limb, and the rope as the tendon. The man would never be able to pull the bucket of water out of the well without the rope. Likewise, the body cannot move without its tendons.

What is Tendinitis?
Tendinitis is a fancy word for inflammation of the tendon. Because the tendon is required to take much of the load of the limb it often becomes inflamed. This inflammation can be caused by a wearing away of the tendon or just irritation to the tendon. When dissected from the human body, a healthy tendon should look like a white “shoe lace”. An unhealthy tendon will look like a yellow “frayed” shoe lace. This fraying works well with the rope analogy we used before. As you can imagine repetitive stress along with poor body mechanics, unhealthy lifestyle, and age can wear away at this tendon and cause to be “fray”.

What can be done about it?
As a Physical Therapist, I encounter tendinitis everyday! Tendinitis can be easily treated. However, if tendinitis is left untreated and is repeatedly reinjured, it can become Tendinosis. Tendinosis is not just a fraying of the tendon but a progressive death of the tendon. Think of it this way, imagine the rope the man was using to pull up his bucket is grating against a rock, at the edge of the well. The rope begins to fray and begins to weaken. What do you think will happen to the rope if nothing is done about the progressive weakening of the rope? You guessed it! Rupture isn’t the only risk with tendinosis. Calcification of the tendon is also a possibility. Both of these outcome require much more than just physical therapy.

I don’t mean to scare you out there. Tendinitis is not a serious condition, but if left untreated and ignored it can become a big problem. Especially for those of you that are active in sport or life, tendinitis can keep you on the sidelines. Who knows when you are going to need to pull a bucket of water out of a well anyway!