Balance: What is it Really and How Do I Improve It?

Published at January 29, 2019October 15, 2019 In Category Balance, Physical Therapy Tags: balance exercises, balance training, exercises to improve balance, somatosensory, vestibular system

By Kurt Gilbertson, DPT, XPS
Therapydia Lake Oswego Physical Therapist

If you’re reading this, then there’s a good chance that you’ve been told to improve your balance. You may be thinking to yourself: how did I get bad balance? Don’t I balance everyday? Where do I start?

Today, I’d like to (hopefully) simplify balance for you and answer some questions you may have, such as: Why do I tend to trip in the dark? Or, why do I veer left when looking right? To begin, let’s look at the balance system as a whole.

The balance system has three components: Visual, Vestibular and Somatosensory

Visual: This is the most obvious component in that you know that your balance is worse with your eyes closed or when it’s dark. This is because when your eyes are open, your brain relies on the information you see. It begins to interpret and integrate what is perceived into its own reality of space (balance). This means that when you’re relying on your sight to keep your balance, you will immediately sway once it is taken away. In a perfect world, your balance system would be able to maintain itself without visual input but how could it if it’s never been trained to do so? So, let’s train it. Luckily, training is as easy as performing this simple test:

If balance is a worry, please stand next to something secure and hold on if need be.

Everything done with eyes closed. You should be able to complete level 5 five times without falling over.

Do 1 -> 5 as you can for the test. The treatment is the level you fail at or the level under failure depending on how hard the the above test was.

1. Widebase
2. Narrow Base
3. Tandem
4. Single Leg
5. 5 Second Alternating March

When babies develop, the stimulus of movement guides their visual field development. The more they move, the more they see and interact with new depths of field. As we develop further, we tend to rely on the visual field to guide our movement, often so that our vision can begin to override other senses (vestibular, proprioception), which is why we tend to sway when balancing with our eyes closed.

Vestibular: This system is growing in public knowledge—unfortunately due to vertigo and increasing falls among the elderly population—but it can be confusing so lets make things easier by looking at the anatomy of the ear first:

Inside your ear are two systems: Cochlear (hearing) and Vestibular (equilibrium). Equilibrium is the sense of balance, feeling level or equal on both sides. In the above picture, locate the semicircular canals which stimulate the vestibular nerve. See how there are three? There are also three planes of movements. Remember the X/Y/Z axis in algebra? (Cue the great algebra memories) Those three axes are the three planes of those canals which are designed to stimulate your brain, via the vestibular nerve, to signal to your brain that you’re standing upright or you’re laying down or you’re looking left/right.

Refer to the picture below: these canals are filled with fluid that moves when your head moves, which then moves sensory receptors in your inner ear: calcium crystals and hair cells which communicate with the brain. The brain is the CEO and knows which canal is up/down, left/ right, and it decides to orient your mind and the rest of your senses to where you are facing. Those struggling with vertigo have hair cell stimuli telling them something that the rest of the senses disagree with, creating the dizziness and nausea symptoms. For those curious of vertigo (BPPV) and these crystals, view this video.

Now, onto how this influences your balance. If you stay in a small amount of positions without challenging your brain to interpret vestibular stimuli, it becomes maladaptive to vestibular stimuli. Which is fancy talk for when I look left, I sway and fall right.

The small amount of positions are typically sitting, standing and laying down while looking in the direction we are facing. Hardly ever do we move where we aren’t looking because we rely on the eyes. The vestibular stimulus always follows behind the visual stimulus, until it doesn’t, and then we lose balance. Let’s make that simple again by testing.

If balance is a worry, please stand next to something secure and hold on if need be. If you have prior history of neck or shoulder pain with head movements, start slow and contact a Therapydia physical therapist.

Everything done with eyes open. Head Turns and Head Nods stimulate the vestibular system. The faster you move your head the harder it is so start slow.
You should be able to complete level 4 five times (L/R & Up/Down) without falling over.

Do 1 -> 4 as you can for the test. The treatment is the level you fail at or the level under failure depending on how hard the the above test was.

1. Widebase
2. Narrow Base
3. Tandem
4. Single Leg

Luckily again, the test is the training.

Somatosensory: Somato = body. Sensory = physical perception. Somatosensory is your body’s physical awareness to stimulus. In regards to balance it has two components: proprioception and exteroception. The former being (per)ception of internal positioning and the latter being (per)ception of external stimuli. Both create the body’s awareness of itself in space, i.e spatial awareness. This is largely influenced by your sensory nerves especially in your feet of which there are millions of them that are constantly talking to your brain about temperature/ pressure/heat (extero) and movement on surfaces (proprio). We tend to spend most of our waking time in shoes which limits how much our feet sense the outside (external) world. We also tend to not move our bodies outside of comfortable positions so the proprioceptive awareness isn’t challenged and it begins to decrease.

Well, that got a bit confusing right? As long as you understand that what you are sensing is talking to your brain and if you limit the amount of time sensing new things, the body will react adversely to new stimuli. Let’s make it more simple by showing you how to improve the somatosensory system for balance which can be done through the movement (proprioceptive) component. See the test below.

If balance is a worry, please stand next to something secure and hold on if need be.

Remember the somatosensory system is challenged by different surfaces you are on. So this one incorporates the same positions (wide > narrow > tandem > single leg) as able but the challenge is increased by harder surfaces to balance on.

Start with a pillow at home, and at the gym there will be balancing pads, discs, and a BOSU. For those trying to do the disc or BOSU hold on first and please be careful. It gets wobbly!

You should be able to complete level 4 holding 60 seconds without falling over.

Do 1 -> 4 as you can for the test. The treatment is the level you fail at or the level under failure depending on how hard the above test was.

1. Widebase
2. Narrow Base
3. Tandem
4. Single Leg

And again, the test is the training.

Once a majority of the above trainings get easy, it’s much more fun to incorporate all them together.
Try these below. Have some fun with it but be safe. 🙂

1. Leg Movements (Eyes Open / Eyes Closed)

2. Leg Ball Circles (Eyes Open / Eyes Closed)

3. Arm Ball Circles (Eyes Open / Eyes Closed)

4. Ball Throws

If you read through this again you’ll see two common themes: Challenge Yourself and Use It or Lose It. Don’t rely on your eyes to determine 100% of what your perceiving, let your feet do some talking, and move with purpose in ways you’re not used to. You’ll be amazed at how quickly balance improves when it is properly challenged. If left unchallenged, don’t be surprised that your balance slowly deteriorates because why should it be good at something that it is never asked to do?

Youth Sport Specialization: How Much is too Much?

Published at December 21, 2018October 14, 2019 In Category Athletes Tags: Kids, Training, Youth Athletes, Youth Baseball, Youth Soccer, Youth Sports

Youth Soccer Baseball Kids Sports Playing Young Athletes

A researcher on the consequences of single sport specialization said it best: “A culture [in America] has been created in which the definition of success in youth sports is defined not by laying the foundation for a healthy lifestyle, but rather the attainment of ‘elite’ status.” (1)

Hard to hear, right? But it’s true. Whether you’re a parent or grandparent, a coach, sports fan or maybe even an athlete yourself, surely you’ve noticed a shift in youth sports over recent years. Gone are the days of pick-up games and kids getting into physical activities for fun. How often do you see kids shooting hoops in the driveway anymore? How many student-athletes are playing 2-3 different sports throughout the year, not playing for a club team and actually taking summer off from any competitive sport? It’s rare. And the shift from sports specialization at a young age is unfortunately leading to a drastic increase in sports-related injuries.

Although a standardized definition of sports specialization has not been developed, the term implies year-round intensive training in a single sport at the exclusion of other sports. (2)

Calculating the Risk

Here’s a quick survey to categorize the level of sports specialization:

Q: Can you pick a main sport?
Q: Did you quit other sports to focus on a main sport OR have you only ever played one sport?
Q: Do you train more than 8 months a year in your main sport?

If you answered ‘yes’ to all three questions, you’re in the high specialization group. Although these questions don’t necessarily capture all of the information needed to determine accurate specialization, it can give some insight into whether an athlete may be susceptible to the risks, which we’ll go into later.

So, how much of one sport is too much? While there’s no set number that can be applied to all youth, recent studies have shown that athletes who played their primary sport greater than 8 months of the year were more likely to report an overuse injury. (3) Additionally, athletes who played one sport for more hours per week than their age were more likely to report both overuse and acute injuries. (4) More hours played can increase repetitive stress on the body and lead to microtrauma. This is not only true for athletes but for anyone who performs a higher than optimal volume of movement. Growing athletes are even more vulnerable to injury because of certain areas of the body that are weak and not fully developed (i.e. the sites where tendons and ligaments attach to the bones, and bone growth plates). This is why variability of movement by playing different sports, along with adequate rest, is extremely important in youth athletes.

The Benefits of Being a Well-Rounded Athlete

Multiple physician associations across the country agree that there are both physical and psychosocial risks to early sport specialization. (5) Despite this information, why is approximately 1 of every 2 parents encouraging their children to specialize in a single sport? (6) Are they hoping their athlete will get a scholarship and play at the collegiate level? Based on data reported by the NCAA during the 2013-2014 academic year, of the 7 million high school student-athletes across all sports in America, only 6% went on to participate in NCAA athletics (Division I, II, or III). (7) Do we mention this to discourage someone from playing sport(s)? Of course not; physical activity is beneficial to overall health and both team and individual sports can teach us great skills that last a lifetime. We’re presenting the data so that expectations are consistent with reality. It is becoming more common for college recruits to seek out talented and well-rounded athletes versus an elite soccer/basketball.etc. player. So, with the chances of competing at the next level being less than favorable and the increased potential of causing physical, mental and emotional harm to our youth athletes’ bodies through early sport specialization, is it really worth it? What if there were substantially more long-term benefits to playing multiple sports, including playing at the college level.

Contrary to popular belief, a 2016 study found that the majority of NCAA Division I athletes did not specialize in high school. (8) Another study concluded that players participating in other physical activities beyond their primary sport decreased their risk of injury by 61%. (9) Multi-sport athletes were also 2.5 times more likely to have good control, defined by jumping mechanics and agility tests, compared to single-sport athletes. (10) Kids that play multiple sports are also more likely to continue playing sports through their adolescence due to the decreased likelihood of suffering from burnout.

Play Longer and Stronger

Of course, physical activity is beneficial for overall health throughout the lifespan. What can you do to minimize the physical and/or psychosocial risks of sports specialization? Try these tips to keep our youth happy, healthy and playing the sports they love for longer:

) Can you imagine how that would shift the culture of youth sports in America?

• Participate in more than one sport/activity throughout the year.

• Play your primary sport <8 months out of the year to reduce the risk of injury.

and

practice).

• Have an off-season! Professional athletes don’t compete year-round, so why should our youth?

prepare your body

for the demands of the game, such as strength training and plyometrics.

Common Skiing and Snowboarding Injuries: A Slippery Slope

Published at December 12, 2018October 15, 2019 In Category Physical Therapy, Snowboard Tags: ankle sprain, concussion, skiing, Snowboard, winter sports, wrist injury

snowboard skiing knee injury ski skiing injuries snowboarding injuries physical therapy portland

Who hasn’t been watching Shaun White dominate the Winter Olympics since 2006, or Chloe Kim slay her back-to-back 1080 in the 2018 Olympics to win gold? It makes a person excited for this delightfully chilly time of year; ‘Tis the season for winter sports! Cold weather activities, like skiing or snowboarding, are not only dominated by those who absolutely shred, they’re also (unfortunately) chock full of injury risks.

Skiers and snowboarders experience different types of injuries due to a number of factors like experience level, physical preparation and proper equipment. While concussions are common in both camps, skiing tends to result in more knee and lower extremity injuries due to the twisting and turning motion during the falls. Contrary to that, upper body injuries are generally more prevalent among snowboarders as a result of falling on their outstretched hands. Ankle injuries are also frequent because snowboarding boots are typically softer than ski boots, allowing more room for the foot and ankle to move around. Experience plays a role as well. Approximately 1 out of every 4 snowboarding injuries occurs on the first day of the season and 50% of total injuries happen during a boarder’s first season. Due to the high volume of falls during the learning process, beginner snowboarders tend to suffer more wrist and ankle injuries. As they become more confident and falls become less frequent, so do these injuries. Once the snowboarder progresses in skill and begins experimenting with jumps or backcountry, head and spine injuries become more prominent.

Those who participate in these sports should always wear protective gear like helmets or gloves but these won’t completely protect the wearer from injury. While there is no guaranteed way to avoid getting hurt, below are a few commonly injured areas along with steps you can take to minimize injury risk and best prepare yourself for the slopes.

Ankle Injuries

Lower extremity injuries are becoming less frequent due to improvements in boots and binding technology. Still, due to softer boots, outer leg ankle fractures are still common. The difficulty to pick up on this particular injury with imaging means that there should be a high level of suspicion even when X-ray findings are negative, especially if an ankle sprain is present. Signs to look for are persistent pain, difficulty putting weight on the leg/foot, limitations in motion and failure to improve with appropriate management. These injuries are most commonly seen with aerial stunt landings after over rotation. The unfortunate truth about ankle sprains is that once you suffer one, you’re much more likely to injure that ankle again. Ankle Physical Therapy can help you properly strengthen and heal to help you build the skills necessary to prevent future injury.

Wrist Injuries

Making up an increasing proportion of injuries due to the lessening frequency of ankle injuries, the wrist is now the most commonly injured area. As newer snowboarders fall and brace themselves for impact, their arms are outstretched to lessen the fall, which can result in a fracture of one of the many bones in the wrist or hand. A good way to prevent this injury as a beginner would be to wear wrist guards, or to fall on the forearm with fists closed and elbows bent.

Head Injuries

Helmets are being made to look much more appealing and are now designed with less obstructions to hearing or vision. Not wearing a helmet causes a significantly increased risk for concussion or skull fracture with either falling backwards or catching an edge after a jump. Skiers are more likely to experience a concussion, while snowboarders are more likely to experience a severe form of a traumatic brain injury which can in some cases result in death. If a mild head injury is suspected, an experienced physical therapist can assess and treat the concussion symptoms. If a more severe traumatic brain injury is suspected, a more thorough examination and treatment plan involving your physician, including physical therapy, may be needed.

In Summary

Snowboarding is an incredible way to experience some of the most beautiful and majestic mountains around the world. While shredding the gnar can be a rewarding experience, it is not uncommon to experience an injury in the first season. Injuries can never be 100% prevented, but they can be minimized with protective equipment, balance training and sport-specific strength training. If you have questions about how you can minimize a skiing or snowboarding related injury, or if you currently have pain during these winter activities, please contact us. Our goal is to help you get back on the mountain safely and quickly!

–Nathan Redington, DPT, Therapydia Beaverton

Do You Stretch Correctly?

Published at November 17, 2018March 4, 2019 In Category Physical Therapy Tags: Dynamic Stretch, Static Stretch, Warm up

Stretching Warm up Physical Therapy Portland Oregon Dynamic Stretching Static Stretching

Why do muscles sometimes feel stiff and tight? We’ve all experienced soreness in muscles or joints after sitting for a long period of time but what is muscle “tightness” referring to? We can either have passively or actively “tight”’ muscles. Passively, muscles can be adaptively shortened due to scarring or from maintaining prolonged positions; and actively, muscles can be shortened due to spasms or from contraction. Whether the cause is passive or active, you may be experiencing limited range of motion which can lead to muscle imbalances.

Choosing the right technique to stretch can make a big difference depending on the result you want to achieve. There are three types of stretches you can perform: Static, Dynamic and Pre-Contraction. Each of these different stretches can improve different aspects of your daily life or your sports performance.

Static stretching, or sustaining a hold at end range, has been shown to be very effective at lengthening the tissue with a recommended 3-4 sets of 30 seconds holds. While static stretching is effective to improve muscle and tendon length, it can have a negative impact on sports performance prior to activities. Static stretching can lower the maximal strength (for a short period of time) that the muscle can generate, as well as lower performance in running and jumping before and during a sporting event! The rate of perceived exertion can also increase that a runner has while performing the run.

Dynamic stretching, on the other hand, is also highly effective at improving overall range of motion and improving muscle and tendon length. But unlike static stretching, dynamic stretching has been shown to improve muscle performance, as well as running and jumping before and during sports.

Pre-contraction stretching is the third type of stretching. This is not as common but it gives the most immediate improvement. A pre-contraction stretch is similar to a static stretch, but is not a sustained hold for 30 seconds. The stretch is broken up into a contraction phase of the opposite muscle being stretched and a short static stretch of the tight muscle. For example, if I wanted to stretch my hamstring I would activate the quadricep and then stretch the hamstring. There is an alternation between contracting the opposite muscle and stretching the tight muscle in 3 phases of 10-20 sec contractions. (5 sec contraction + 5 sec relaxation and stretch + repeated 2 more times).

The big takeaway is this:

Static Stretches are a great way to improve and maintain muscle length over a long period of time. Perform these after a sporting event or workout.
Dynamic Stretches are recommended for warm up prior to working out / exercising to maximize strength and performance. These stretches also “prime” the muscles to run faster, jump farther and contract stronger.
Pre-contraction Stretches are most helpful to see immediate or acute changes which can then be transitioned to a static stretch over time.

Now, time to give it a shot! Below are a few static and dynamic stretches to help and improve your performance.

Static Hip Stretches

Perform 2-3 sets for each, holding for 30 seconds.

Standing Quadriceps Stretch

Where You’ll Feel It: Thigh and Hip Flexor
Stand on your right leg, grab your ankle and pull your foot towards your buttock. Make sure that your knee is underneath or behind your hip and not in front of it. Don’t let your back arch.

Standing Hamstring Stretch

Where You’ll Feel It: Hamstrings
Prop your foot on a chair or a step. Slowly lean forward until you feel a stretch behind your thigh. Bend through your hips, not your back.

Runners Stretch

Where You’ll Feel It: Calves
Stand with both hands against the wall. Place one leg in front and your other leg straight behind you with your toes pointed slightly inward. Press into the wall and drive your heel into the ground.

Kneeling Hip Flexor Stretch

Where You’ll Feel It: Hip Flexors and Quadriceps
Begin in a half kneeling position. While maintaining an upright position, perform a posterior pelvic tilt (tuck your tailbone underneath) to engage your core. Shift your hips slightly forward until you feel a stretch. Slightly shift your pelvis/hip forward until increased stretch is felt.

Piriformis Stretch

Where You’ll Feel It: Gluts and Inner Thigh
Start lying down with one leg bent and your foot flat on the floor. Cross the other leg over your knee. Gently push the knee of the crossed leg forward. For a greater stretch, grasp the thigh of the bent leg and pull towards the chest.

Dynamic Hip Stretches

High Knee Running

Engage your core by lightly bringing your belly button closer to the spine. Drive your knee upward as high as possible.

Butt Kicker

Stand with your feet shoulder width apart. Kick your leg backward, concentrate on driving the heel toward the buttocks and back to the ground as fast as possible. Maintain a quick, yet steady tempo.

Hip Internal Rotation

Move your knee up and outward to the side, slowly rotate your hip inward and back down.

Hip External Rotation

Life your knee up towards waistline, slowly rotate your hips outward and back down.

Lunge with Trunk Rotation

Step forward into a lunge and then rotate your arms and trunk to the forward foot side.

Windmills

Kick one leg to the opposite hand, try to keep both knees straight.

Preparing for Your Next 5K: Tips From a PT

Published at November 13, 2018October 15, 2019 In Category Physical Therapy, Run Tags: 5k, run, Training

Fall is upon us and with holiday runs right around the corner, Therapydia physical therapist Jodie McGinlay, DPT, weighs in with her top five things to keep in mind as you prepare for this year’s Turkey Trot, Holiday Hustle, Fun Run or any of the numerous other festively-themed 5Ks, 10Ks and half marathons:

You did it! You made the important first step of signing up for that 5K/10K or maybe even half marathon. Great job! Prior to race day, there are a few things to consider to make the most out of your run, no matter if this is your first race or your tenth. One of the most important things to keep in mind to ensure your success is to go slow and listen to your body. No matter how many races you’ve run, there are many goals to set and accomplish during your pre-race, training period. Remember that injury prevention and maintenance at any phase of the training process is attainable so the fact that you’re reading this prior to your run is great! Here you will find the top five considerations to help you avoid injury and prepare your body to cruise across the finish line on race day.

1. Running Shoes

Take a look at your shoes. Are they more than two years old? Do they squeeze your toes? Do your feet ever feel numb during or after you wear them? If you answered yes to any of these questions, it’s time to check in with your local physical therapist or running shoe store. Unfortunately, shoes are not bulletproof and they need replacing every so often, especially if they are uncomfortable. Your physical therapist can assess your foot mechanics for optimal comfort and recommend a specific brand or running shoe store to visit.

2. The Course

Consider the surface in which you’ll be running on race day. Is the upcoming race hilly? Is it flat? If the race is outside, try to hit the pavement and see how your body handles it. Various surfaces can actually distribute forces through your feet in different ways so you should try to change up the surfaces that you’re training on to prepare (because not all are created equal). Tracks, treadmills, concrete surfaces and trails can all put stresses on the body in their own way. This doesn’t necessarily mean that you should hop out on the trails if your 5K is on pavement, but it may be wise to switch up your training occasionally and skip a treadmill day in favor of some fresh air.

3. Set Your Goals

Are you shooting to complete a personal record or increase your speed for your upcoming race? Try to include some form of cross training to give your program variability. Current physical therapy research suggests 2-3 days a week of resistance training: weights, high intensity interval training, and even plyometrics can increase your run speed and lung capacity for endurance.

If you haven’t been particularly active lately and you’re unsure about where to start, these three exercises are low impact and address specific musculature responsible for ensuring optimal gluteal activation while walking and running. Remember if any exercises create discomfort, please discontinue performing and consult a physical therapist for a formal musculoskeletal assessment.

Exercise 1: Sidelying Clamshell

Lie on your side with the band above your knees. With the knees bent and stacked on each other, lift the top knee up and away—into the resistance band. Try to maintain the hips and shoulders from rocking back or forward. Hold for 5-10 seconds and perform 5 reps for 2-3 sets. You should be feeling this on the outer glut. If you feel it more on the side of your hip (think about where a seam in your pant would start), roll your top hip forward. Work your holds up to 20 seconds.

Exercise 2: Running Man

Stand and balance on one leg. Lean your body forward (keeping your upper body/core in plank position) while you straighten your back leg behind you. Try to hover back leg or tap toe on the ground for balance. Bring the same arm forward into ready position (see picture). March leg up to 90 degrees as you extend your arm back to end position. Perform 2-3 rounds of 5 reps. Work your reps up if you are able to maintain your balance in a smooth and controlled manner.

Exercise 3: Lateral Band Walks

Place elastic band around legs. From easiest to hardest: band above knees, band below knees, band at ankles, band at feet. Lightly bend your knees while you take a step to the side keeping your feet spread about hip distance apart. Keep resistance on band and bring trailing leg towards the other. Try to keep hip distance between feet in order to get the best burn. Remember this is four your hips—you should feel it on the outside glut but will feel quads as well. Try 10 steps down and back. Work up to 20 steps in coming weeks.

4. Fuel the Tank

Hydration + diet + adequate sleep can give your body energy and sustainability through your training period and beyond. Make sure to drink water throughout the day and eat plenty of nutrient rich and high carb energy boosters, including bananas, oats, whole-grain foods, peanut butter, broccoli, Greek yogurts and berries. The consistency with your training program to ensure your body is equipped to run the race from a cardiovascular standpoint can be accelerated by how you’re fueling the tank before and after.

5. Recovery, REcovery, RECOVERY

As you prepare and train for the upcoming race, allow your mind and body some time to cool down. A long week full of runs, resistance training, socializing, work, etc. can take its toll. This could mean taking a hot bath and letting your body relax while you work on incorporating some new recipes and getting a little extra sleep. Cooldowns after a run could mean walking the last ½ mile home instead of the sprint you planned on or simply taking the time to prop your feet up and elevate after moving around all day. However you choose to take it easy after the week, this rest is not only beneficial for your body but for your mental drive to get back out on that next run the following week. Self motivation can sometimes be challenging so I like to incorporate training with a friend or local run club. Consider looking into run clubs or meetups in your area that could make running more enjoyable.

If you feel you need further assistance with training including ramping mileage and/or a customized running program, there are additional resources and education we can provide to ensure optimal performance during your training. Therapydia’s Run Assessment locates any weaknessess or mechnical challenges involved in your running. With a thorough exam of your strength, flexibility, movement patterns and running form, your run analysis will help to ensure your running is more efficient, more enjoyable and most importantly, injury and pain-free. You’ll review the findings with your physical therapist and leave with a custom assessment and exercise training plan. Click here to schedule your Run Assessment today.

Happy running!

Dynamic Warmup for Runners

Published at November 7, 2018October 14, 2019 In Category Run Tags: injury prevention, run, Warmup

Warmup for Runners Injury Prevention Run Warmup Stretch

If you’re a runner, it’s likely that you’ve experienced some sort of discomfort, ache or pain along the way. In fact, it’s been reported that as many as 90% of runners miss training time each year due to injuries. Fortunately, running pains are not necessarily an inevitability.

A good warmup, prior to exercising, loosens up your body and gets the blood flowing, gradually raising your heart rate to make it easier to get into a good rhythm. Dynamic stretching before a run has shown to help with poor posture, faulty running mechanics and injury prevention. It can also work wonders in terms of improving your range of motion. If you experience aches and pains during or after your run, try this warmup to help and combat the likelihood of injury and give yourself a little peace of mind so you can run longer and stronger!

In addition to the suggested exercises, we also offer a Run Assessment to give you more information on your running strengths, weaknesses, and any mechanical challenges involved in allowing running to be more efficient, more enjoyable, and most importantly, injury and pain-free.

Estimated Time: 10 Minutes

Sunrise Stretch

Where You’ll Feel It: Pecs and Mid Back
Lie on your side, bend both knees up toward your chest and place your bottom hand on top of your knees. Place your top arm out in front, reach up toward the ceiling and continue the rotation as far as possible. Hold for 2-3 seconds. Allow your head and chest to follow. Return to the starting position and perform 10 times each side.

Leg Swing

Where You’ll Feel It: Hamstrings and Hip Flexors
Swing your leg forward as high as you can and as far back as you can with controlled speed while keeping your knee straight and trunk upright. Perform 10 times on each leg.

Quad Stretch

Where You’ll Feel It: Thigh and Hip Flexor
Stand on one leg, grab your opposite ankle and pull your foot towards your butt. Keep your standing leg straight and the heel on the floor. Reach overhead with your other arm. Make sure that your bent knee is directly under your hip. (Optional – you can lift your heel and come up onto your toes). Don’t let your back arch. Hold for 3 seconds. Perform 10 times on each side.

Donkey Kick

Where You’ll Feel It: Glutes, Not Your Back!
Place a mini band around your knees. Start on your hands and knees. Align your hands directly under your shoulders and your knees directly under your hips. Engage your core by lightly bringing your belly button closer to the spine. Keep your core engaged and lift the right knee back like a kick. Think about kicking your heel towards the ceiling but avoid arching your back or twisting your hips. Perform 10 times on each side.

Runner’s Side Plank

Where You’ll Feel It: Core and Glutes
Lie on your side with your body and your legs in a straight line (like you are in a toaster slot). Bend the bottom of your knee 90 degrees and keep the top knee straight. Draw your belly button in towards your spine and engage your abs. Lift your hips up towards the ceiling, keeping your elbow stacked underneath your shoulders. While holding the plank position, bend your knee toward your chest and straight out to starting position (mimic running). Perform 10 times on each side.

Runner’s March

Where You’ll Feel It: Glutes
Place a mini band around your ankles. Engage your core by lightly bringing your belly button closer to the spine to maintain neutral lumbar spine. March your knee up to hip level, pause for 1-2 seconds and then return to the starting position. Focus on slow, controlled movement. Drive the standing leg straight by squeezing your gluteal muscles. Perform 10 times on each side.

Side Steps

Where You’ll Feel It: Glutes / Outer Hips
Stand in a semi-squat position with your feet hip width apart and a mini band around your ankles. While always keeping tension in the band, take small steps to the left (Your stance should not be wider than your shoulders at any point). Focus on pushing off the trailing leg vs. reaching with the lead leg. Keep your knees pushed apart and your toes pointed straight forward. Repeat while moving to the right. Perform 10 steps to each side.

If you have any questions or any pain with these exercises, please consult a Therapydia physical therapist.

Back to School: 3 Tips to Avoid Posture Pain and Discomfort

Published at August 21, 2018October 15, 2019 In Category Ergonomics, Physical Therapy Tags: back pain, core strength, good posture, posture, workplace ergonomics

classroom-ergonomics-physical-therapy-posture-pain-discomfort

Summer is nearing the end and that means so long to summertime hiking, biking and swimming, and hello to back to school book reading, screen staring and desk sitting. In the classroom, proper posture can be difficult to maintain. Heavy backpacks, sitting for long periods of time and hunching over computers can all take a toll after a while. Not surprisingly, the harmful effects of poor posture and strength can lead to more serious aches and pains down the road.

Next time you sit down at your desk consider this: Your head carries the most important organ in your body—your brain. The human head weighs on average between 10-11 lbs (that’s the size of a heavy bowling ball!) so it’s important to make sure the head and neck are supported throughout the day in order to avoid pain and dysfunction. The neck is comprised of vertebra, muscles, ligaments, arteries and nerves and it needs to be strong and adaptable to carry that weight around all day long.

Keep these quick tips in mind to ensure that you maintain proper posture throughout the school year. The greater focus placed on strengthening and activating these muscles, the easier it will be for these good postural habits to become second nature!

Tip #1:

When sitting, try to keep your feet on the ground. This keeps your lower back and core in a good position to avoid stress and pressure along the rest of the spine.

Tip #2:

Keep computer screens and reading materials in front of, and level with your eyes. This will help you avoid prolonged bending at the neck as well as reduce eye strain and potential for headaches.

Tip #3:

Position your shoulders in a comfortable resting place when working at a desk or chair with arms. If it feels like your shoulders are up in your ears, that can put a lot of stress on your neck and potentially create problems down the road.

Making these small adjustments in the classroom can be simple and effective. Postural changes can help you avoid injury but remember that sitting posture comes from the combination of muscle strength and activation. If you have any questions, please come see one of our skilled physical therapists so they can better examine you and get you on your way to a successful start of the school year!

What is Yoga?

Published at June 20, 2018December 21, 2018 In Category Yoga Tags: benefits of yoga, meditation, mindfulness, Yoga Exercise, yoga poses, Yoga Workout

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By Kirsten Kupras, DPT

Yoga is more than just a 60 minute class on a yoga mat. Yoga is a workout for the mind. It challenges the narrative, that little voice in the back of your head saying you’re not strong enough, you’re not flexible enough, you’re too tired. Yoga shows you that you CAN.

Bringing awareness to these elements—the breath, the mind-body connection, the sensation of exploring your limits—will translate to other areas of your life. Show up, see what will happen, take a chance rather than being afraid. Taking this approach can have a huge, positive impact on your day-to-day.

That is the real skill: not worrying about what is coming next, what may or may not happen, but teaching yourself to be in the present moment.

Yoga is the ability to sit with yourself during uncomfortable moments, on and off the mat. In a challenging pose, can you breath through the shaking muscles? Concentrate on the feeling NOT the fear.

Moving Meditation

With yoga, we learn to allow the body to breathe into whatever shows up – first in our meditative seat and then into every situation in our lives. Instead of running or reacting when something uncomfortable comes up, can we breathe into the moment and show up on a deeper level? Yoga gives us the opportunity to practice and explore this.

Yoga has the ability to reduce the sympathetic nervous system which is when we are in a stressful flight or fight state. In effect, the parasympathetic can take over which allows healing to improve mental focus, vitality, peace of mind and elevated perspective.

Start with this: Ask yourself this centering questions: What is important now? In this moment?

Get to Know Your PT: Jodie McGinlay, Therapydia Portland Physical Therapist

Published at June 12, 2018June 27, 2018 In Category Physical Therapy

Therapydia Portland physical therapist Jodie McGinlay takes some time to talk about the process of PT, keeping up with the latest health gadgets and the importance of consistency.

“PT is a process and not a product. It takes consistent maintenance to accomplish goals but that doesn’t mean you’ll be in PT forever.”

When did you know that you wanted to be a physical therapist?

I had a good family friend who worked as a physical therapist for the U.S. Ski Team. She worked out of Mt. Hood and got to travel a lot. She inspired me to think outside the box and enjoy what I do.

What is the biggest challenge involved in being a PT?

Keeping up with the latest health-related gadgets.

How do you like to stay active?

I like trying new group classes but enjoy running and resistance training.

What’s your favorite song to get you motivated?

“Jumpin Jumpin” by Destiny’s Child.

What surprised you the most about the physical therapy profession?

How many different settings you can work in as a PT.

Are you currently pursuing any further education/certifications?

I’m working on learning more about new interventions with temporomandibular pain dysfunction.

What do you wish everyone knew about physical therapy?

PT is a process and not a product. It takes consistent maintenance to accomplish goals but that doesn’t mean you’ll be in PT forever.

What’s your go-to breakfast?

Smoothies and coffee.

What is the most important personality trait that a PT must have?

One is hard to say but the ability to adapt communication and teaching styles based on who you’re working with.

What do you do to de-stress/unwind?

Go for walks with friends and be outside in the sun.

Finish this sentence: On Saturday mornings, you can usually find me…

Walking around Laurelhurst park with a coffee.

What is your favorite piece of wellness advice?

Stay consistent even in small doses. Pursue things you like and not things you think you should be doing based on others around you. Motivation in health and wellness is person-specific.

Click here to learn more about Jodie and the other physical therapists at Therapydia Portland.

Get to Know Your PT: Rachel Wilkinson, Therapydia Portland Physical Therapist

Published at May 8, 2018June 11, 2018 In Category Physical Therapy

Physical therapy portland get to know your physical therapist

Therapydia Portland physical therapist Rachel Wilkinson takes some time to talk about her love of food, CrossFit and the importance of adaptability in the PT profession.

“Everything in moderation. Too much or too little of one thing can be detrimental and this applies to all areas of life!”

When did you know that you wanted to be a physical therapist?

I started as a premed major and transitioned to pre-PT when I realized how much more rewarding the PT profession would be in terms of seeing patients regularly and spending quality time as a care provider.

What is the biggest challenge involved in being a PT?

I would have to say educating patients on the scope of our practice: how much we can do for them, but ultimately how we are going to teach them to help themselves.

How do you like to stay active?

My go-to is CrossFit. I love group classes because what is more fun than being social while you work out? I also love to get outside in the summertime and hike.

What’s your favorite song to get you motivated?

“Midnight City” by M83. It really builds and pumps you up!

What surprised you the most about the physical therapist profession?

I would say how few people know the extent of our educational process. The profession has advanced to a Doctorate in the last 5 years and we’ve worked hard to get there!

Are you currently pursuing any further education/certifications?

I am currently finishing a course to provide care and progressions to women returning to fitness. I would like to pursue my Orthopedic Specialty in this upcoming year.

What do you wish everyone knew about physical therapy?

I wish everyone knew how accessible PT was. Most states have direct access, meaning patients can go see a PT directly and without going through their primary care physician first.

What’s your go-to breakfast?

Eggs and sourdough toast with avocado.

What is the most important personality trait that a PT must have?

I would say you need to be adaptable. We work with a wide variety of patients and conditions.

What do you do to de-stress/unwind?

Usually CrossFit and then happy hour in Portland (I’ve got to work off those calories first!). I love the food/beer and wine scene here!

Finish this sentence: On Saturday mornings, you can usually find me…

Sleeping in and then going to our team (or partner) workout followed up by brunch (I like to eat).

What is the best piece of wellness advice?

Everything in moderation. Too much or too little of one thing can be detrimental and this applies to all areas of life!

Click here to learn more about Rachel and the other physical therapists at Therapydia Portland.