The Importance of Exercise As We Age

The Importance of Exercise As We Age

by | Dec 4, 2024 | Healthcare

Exercise is important at every age. Babies need to crawl and walk and reach the rest of their motor milestones. Children need to climb and run and jump and play. Teenagers need to play sports or compete. Adults need to exercise for health and longevity. Older adults need it to sustain a longer and quality life. 

A big problem in this world is the “coddling” of the older generation. Traditionally, as adults approach retirement in their 60’s and 70’s, we’ve encouraged them to step back and enjoy the fruits of their labor. Relax more, stop doing yard work, be careful trying to get on the floor with the grandkids. This ideology has set the older generation back a decade of function. One of the most important principles of connective tissue function (muscle, bone, tendons etc) and our central nervous system function (controls everything) is that if you stop using it, you will lose it. Atrophy to our muscles, bones and nervous system are so important as we age.

WE HAVE TO CONTINUE TO DO HARD THINGS. 

Older people should primarily focus on strength training and power. A critical and often overlooked element of decline is not just the lack of ability to produce force (strength), but rather how quickly one can produce force. The biggest risks in the older generations are falls. One of the biggest reasons that they have falls is lack of sufficient ability to react quickly to a stimulus (like loss of balance). They need to prepare for the most vulnerable situations by practicing quick movements.

Just to highlight some key data related to falls:

The mortality rate (death rate) is 17-25% for a hip fracture associated with a fall. Those who are 50 or older have a 3x greater likelihood for mortality than those under 50. 

Fall prevention is far more than balance training. If we have capable muscles that are strong and can move fast, the likelihood of falls reduces by incredible margins. And, worst case scenario, if you do have a fall, the stronger bones won’t break. 

We need to keep encouraging the older generation to do hard stuff for their health!!!

Stop Fearing The Barbell

Stop Fearing The Barbell

by | Nov 18, 2024 | Healthcare, Training

Getting stronger is very simple. Do stuff that’s hard enough for a long enough period of time and you will build strength. We will see muscular changes, bone changes, connective tissue changes and central nervous system changes as you do hard enough stuff over time. Lifting heavy things to get stronger has been around for centuries. But in the last few decades we’ve seen a shift in perception where many people will blame heavy things for the reason they are hurt or injured (or how it will inevitably cause injury). This couldn’t be further from the truth. Strong things don’t break. Weak things vulnerable. It’s as simple as that. I still hear so much negative commentary around heavy lifting or heavy impact activities (running, jumping) that talk about how bad they can be for your joints. I’m here to help put an end to these ideas. They’re wrong for so many reasons. There is far greater evidence out there saying that a joint exposed to these high forces over time have BETTER cartilage preservation and joint health than those that do not. We must stop fearing the things like running, jumping, and lifting heavy. The negative discussion surrounding things that stress the body continues to permeate our culture. The worst culprits, in many ways, are health care providers! So many doctors, physical therapists, chiropractors, masseuses etc. perpetuate these lies without showing any evidence. And, naturally, if the “educated” are willing to spread nonsense, of course the general public is going to believe it. We all agree that the healthiest individuals are typically the ones that train the hardest and eat the best. The stress to our system is far more advantageous than it is disruptive.

It’s not uncommon to see weightlifters get injured. Bench pressers often complain of shoulder pain, squatters deal with a lot of hip and low back pain, deadlifters might experience some low back pain. And for some reason we’ve decided to assume that because these things happen, lifting weights is bad for us or makes us more injury prone. Weightlifting, contrary to popular belief, has one of the lower injury rates of all sports. And, maybe most importantly, the injuries we see in weightlifting are typically under our control (ie you did too many reps, too much weight, poor mechanics etc.). Very rarely so we see any acute trauma in recreational weightlifting that requires major surgery or intervention. There is far more likelihood that you will get injured from NOT lifting heavy than lifting heavy (as long as you train appropriately). Be smart, train hard, and understand that pain is a normal part of the process at times. But good training will significantly reduce the probability for and severity of injury. Don’t be scared of working hard. Be smart, be confident, and push your limits.

Hamstring Tendonitis

Hamstring Tendonitis

by | Oct 23, 2024 | Healthcare

Do you have hamstring tendonitis? You are not alone. Upwards of 33% of athletes 16-25 experience a hamstring injury. If you’re an athlete then it’s likely you’ve either pulled your hamstring or worked through pain in the back of your leg at some point. 

The hamstring is a group of four long, strong muscles that cross two joints, the knee and the hip. This is important to know because flaws with one or both of those joints can often be what creates the problem in the first place. A tendonitis, or inflammation of the tendon, typically presents with pain at the buttock or back of the knee (the two places where the muscle attaches). Tendonitis usually develops from 1 of 3 factors:

  1. Overuse – some element in your training or sport was progressed with too much intensity, too much volume, not enough rest, or was progressed too quickly
  1. Biomechanical – faulty hip or knee mechanics during an activity that cause excess work or pull on the hamstring tendons
  1. Trauma – kicking a soccer ball, sprinting or decelerating, jumping are all common activities that may create a single moment of high force that the hamstring muscle and tendon are not prepared for

Each of these three factors are treated differently. For an overuse injury, we have to determine what was wrong with the training that got us here. But inevitably solving the problem is going to entail a reduction in training frequency, intensity, or volume in order to build up slower. A biomechanical problem at the hip or knee would likely need some mobility adjustments added into the program, some form tweaks, some short term modifications of however the sport or exercise is being done, or some combination of all of these. Lastly, for trauma, we would need to focus primarily on absolute rest and recovery for a few weeks and then slowly integrate a hamstring training protocol to tolerance.

If you’re dealing with a hamstring injury, come see us either in person or for a virtual appointment to create a custom plan for how you can treat your hamstring tendonitis and get back to participating in the activities you love.

Exercises For Knee Pain

Exercises For Knee Pain

by | Sep 25, 2024 | Healthcare

What are some exercises we can do for knee pain? First, we have to get to the root of the problem. Where is the pain located? Is it in the front of the knee, the back of the knee, the inside, the outside? 

We should then ask if the pain came on acutely or came on gradually. Was there any incident that caused the pain? For example, did you have any trauma where you fell on it, twisted it, heard a pop etc. If this is the case and it’s less than 10 days from the injury, we should be cautious in our approach and probably prioritize rest and low level exercises or movement. Conversely, if the pain came on gradually with no obvious cause, we should determine if you’re fairly sedentary or active. Sedentary individuals most likely have pain due to lack of movement or they were exposed to more stress than usual and should probably begin a training regiment of some sorts. Active individuals are more likely prone to an overuse injury or mechanical problem.

As you can see, coming up with the right formula and exercises for knee pain can vary greatly based off of your activity level, the acuteness of the injury, and if there was any trauma. But let’s assume that your injury has been there for a few weeks, your knee pain has either stayed the same for a while or has only mildly improved. It’s probably time for you to start moving and trying something. Disclaimer: the process and exercises below are just a guide, please book an in person or a virtual appointment with us for a more specific plan to reduce the probability and likelihood for aggravating an injury.

Exercise Progression:

Please perform these exercises IN ORDER. Each exercise progression is designed to either increase positional intensity or load to different structures around the knee. If the exercise feels completely pain free, please move on to the next exercise. If something hurts but improves the more you do, please continue to move forward. If something hurts a lot, or gets worse as you do them more then please stop and try training the exercises below the level that hurt for 3-4 days and then try again. For example, if #1-4 all feel fine, progress to #5. If #5 hurts a little but then feels better the more you do them, continue to move on to #6. If you have pain at #5 that doesn’t improve or gets worse, STOP here and practice #’s 1-4 for a few days before retrying to see if #5 now feels better.

  1. Walking 
  2. Glute bridges (2 legs) 
  3. Single leg glute bridges 
  4. Half Squat
  5. Full Range of Motion Bodyweight Squat
  6. Loaded Squat
  7. Lunge
  8. Lateral Lunge
  9. Loaded Lunge
  10. Loaded Lateral Lunge
  11. Two Footed Jump
  12. Single Leg Jump
  13. Jog
  14. Sprint

Follow the directions above explicitly. If you find yourself stuck at a certain level for greater than a week or it is only bothering with very specific positions, please schedule an appointment with us.

For video instructions for the above exercises, please see the YouTube channel here.

Training With Pain or Injury: Prevention vs Response

Training With Pain or Injury: Prevention vs Response

by | Sep 17, 2024 | Healthcare, Training

How do we go about training with pain or injury? We often over-complicate the process. There are only two things we can control in our body:

1. How well we prepare

2. How well we respond

If we look at diet as an example, we prepare the best we can by eating nutrient dense, well rounded, healthy meals. Most people know that we have a better chance for a healthy body the more regularly we prepare with healthy eating. When we have GI distress or heartburn or inflammation, we then need to make the necessary response by making certain accommodations (ie eliminating fatty, fried, processed foods if we get heartburn, taking some medicine). 

With regards to injury, all we can do is prepare our body as best we can and, when a tissue fails (pain or a tear), shift our focus to recovery. TRAINING IS THE SOLUTION FOR BOTH. The better you prepare your body with strength training, joint mobility, cardiovascular health etc, the better prepared you are to avoid pain and injury. When we have pain or injury, we respond with an adjustment in our training, but rarely remove training altogether. We may lighten the weight, we may move through a partial range of motion instead of a full range, we may reduce the reps or sets. Rarely is absolute rest the correct response. Modification is typically much better for healing. Even acute or traumatic injuries need input and load (lower levels) in order to heal effectively.

We often spend too much time focusing on things outside of what we can actually control. Things like:

Our anatomy is at fault – “I have flat arches”, “I have one leg longer than the other”, “I have a back that is out of alignment”

Or

Our posture is at fault – “My head is too far forward”, “My back is too flat or too rounded”, “I sit the wrong way or I sleep the wrong way”

We have the power to make things move better and the power to make them stronger or more resilient. But we can’t change our anatomy (without surgery) and we can’t really make permanent changes to our posture, nor do we have to (I’ll post more on this later because I  know this is a big and controversial topic). Spend more time preparing your body to move better and get stronger. Ultimately, those are the only things we can actually control day in and day out that can directly impact our likelihood for injury and our daily experience. Focus less of your attention on the flaws that we can’t change. It’s unproductive and inefficient. Create the best version of yourself in spite of the flaws you have. Don’t worry about what you cannot change. Life and pain alike become much simpler when we accept the fact that everyone has pain, and the best way to treat it is to prevent it as best as you can through good quality training. Let us help you to establish a healthy preventative program that will help you to move better and get stronger, the things you can actually change in your body. 

Plantar Fasciitis Physical Therapy. What Can We Do?

Plantar Fasciitis Physical Therapy. What Can We Do?

by | Sep 4, 2024 | Healthcare

Millions of people suffer from plantar fasciitis each year. About 1 in 10 people will be affected in their lifetime. It is one of the toughest injuries we treat as physical therapists. It tends to be extremely painful, become exacerbated quite easily, and last for many months. It also has a high recurrence rate, meaning after it’s gotten better, it’s more prone to coming back again. 

What is plantar fasciitis? It is an inflammation of the plantar fascia in the bottom of the foot. The plantar fascia is a thick band of connective tissue that attaches from the heel (calcaneus) to the midfoot (metatarsals). The significance of this hard connective tissue is that it has a strong role in shock absorption in the bottom of the foot, especially during running and jumping. It is also responsible for maintaining the arch in our foot during the loading phase of standing, walking or running. Because of its role in absorbing forces through the foot, athletes and runners can be susceptible to overuse or trauma that can irritate it.

But like many injuries, they can be more complicated than a simple inflammatory response that typically gets better with rest, ice and a deloading period. What else can cause foot pain? Some other potential foot related pain could be: bone spurs, loose body (floating piece of cartilage), neuropathy, sciatica (or other nerve related referred pain from the low back or leg), bone bruise, growth related issues (like Sever’s disease) and many others.

So what can we do about it? Do we have options for plantar fasciitis physical therapy? The answer is yes, we can treat it. But it’s important to note that there are many different possible sources of the pain and therefore treatment options may be ineffective or even worsen symptoms. Common treatment options include stretching of the ankle, foot, calf and big toe, lacrosse ball or golf ball rolling the bottom of the feet, icing, resting, and potentially orthotics. Combined, these can be very effective tools. The one I would advise NOT to do early on in a truly inflammatory condition is to beat it up with a lacrosse ball or golf ball. I’ve never understood the logic here and it rarely helps. When something is irritated, we shouldn’t be beating it up while also trying to rest it. It’s counterintuitive. But stretching, icing, and deloading are really good first steps.

In addition to some gentle stretching, icing, and deloading, I like to institute a heel lift into the shoe. This is temporary in order to help us unload stress to the bottom of the feet. What else can we do when these things don’t help? The next steps would involve increasing the load tolerance of the plantar fascia through a progressive loading program. Make the foot stronger over time with gradual introduction of more and more stress. Simultaneously, we should be looking up the chain for other possible sources of this pain. We can look at the low back, the pelvis, the hips, the lower leg etc for other possible causes of referred pain that often get missed or undiagnosed. Lastly, if continuing to struggle, we should seek out an orthopedist for imaging to rule out a more serious pathology.

Plantar Fasciitis is a very difficult injury to treat. Begin with conservative measures for a few weeks (rest, ice, heel lift, gentle stretching). If not getting better, begin a progressive strengthening program and also look for other potential sources of referred pain besides assuming the plantar fascia is the issue. Lastly, seek medical help to rule out more serious problems.

Check out our physical therapy services and let us help!

References:

Trojian, T., & Tucker, A. (n.d.). Plantar Fasciitis. AAFP. https://www.aafp.org/pubs/afp/issues/2019/0615/p744.html#:~:text=Plantar%20fasciitis%20is%20a%20common,the%20condition%20is%20not%20inflammatory.