Cool Down For What?

young business man use fans to cool down

Cool Down For What? 
Don’t leave your exercise routine hangin’!

Cooling Down – the most underrated and ill performed part of a work out. Most don’t consider it a necessity let alone even part of a work out. In reality, it is equally as crucial as the warm up and main event. A patient at Therapydia Portland had a revelation when we were wrapping up our session last week and felt armed with new knowledge of what a real cool down entailed. He inspired this blog.

For those that include a cool down in their exercise or sport repertoire, congratulations, but you’re not off the hook yet. I’ll bet the majority take the last 5 minutes of their run, for example, and slow it down a bit and call it a cool down. This should be considered maybe a start to the cool down process but let us dissect the pieces of a proper cool down and then package it up in a savory morsel for you to enjoy, reflect upon, and crave.

Step One: Ramping Down Your Heart Rate for Homeostasis.

Depending on the intensity of the exercise, this could take a few to several minutes. You can use the latest technology to monitor your heart rate or the good old-fashioned two-finger pulse check on the carotid artery along the side of the neck (press gently). Reduce the intensity of movement or exercise and monitor your pulse for baseline rate. Normal baseline heart rate will fall between 60 and 100 beats per minute. Practice taking your heart rate often when at rest to determine your average resting rate and aim for this at cool down.

Step Two: Soft Tissue Restoration.

After exercise, your muscles and fascia (connective tissue, see previous blog on Graston Technique® for loads of info on fascia) have taken a toll and need some attention in order to restore flexibility and proper length tension relationships to be ready to perform for you again in exercise or general daily life tasks. All the contraction-relaxation of muscle during exercise builds tension in the muscle and its surrounding fascia (excellent! this is part of what nourishes muscle). If muscle and fascia are allowed to remain constricted, they will not be able to perform at 100% capacity for you in other tasks, which reduces your performance potential. This cyclic malpractice can also amount to injury in a short period of time. Bad news!

The soft tissue restoration routine should include self-massage and stretching. I am a huge advocate for the foam roller! It is a beautiful piece of equipment – cheap and effective – and it should be in every person’s house. My green dude is a staple in my living room and he keeps the side of my couch company when I’m away. If shoulder injury or stability is an issue and you cannot perform self-massage by supporting yourself over a foam roller, you can easily convert this method to handheld roller and apply the same principles. Rolling your body over the foam roller (most of the body is accessible for this technique) in multiple angles will, in a sense, “iron” out the “wrinkles” in the fascia and muscle. Points of significant restriction will be very tender and you want to be sure not to hold your breath or tense up over these spots. If too painful, work adjacent to these areas first and use limbs not currently being massaged to support yourself to take a little more weight of your body off of the foam roller.

Stretching is last and this is a great time to perform static stretching; whereas dynamic stretching (stretching through movement) is awesome for a warm up to prep the tissue to accept increased loads. Static stretching is holding a stretch posture for an increased length of time. The traditional hamstring stretch and runner’s calf stretch are examples.

Simply put, the recipe for a cool down is 1 part heart rate resolve, 1 part foam rolling, 1 part static stretching. We at Therapydia Portland want to be your go-to resource for specific routines that complement your fitness style. We know there are many ways to stretch and foam roll, which can be daunting to sift through all the information on the web. Schedule an appointment with us at your convenience and let us guide you to keep you healthy and injury free.

Postpartum Incontinence Case Study

Woman Suffering From Stomach Ache

Patients come to physical therapy for a variety of treatments from post-surgery rehabilitation to balance improvements. We at Therapydia Portland are happy to share a patient’s experience with postpartum incontinence on her behalf to educate our community on what this means and to eliminate any taboos around this issue.

First, what is incontinence? Here is a link that defines the basics about incontinence.

Understanding Postpartum Incontinence Treatment Methods

LK drove by our clinic one day and came in to inquire if we provided postpartum incontinence physical therapy. This category of physical therapy incorporates a lot of different solutions for healing and depending on the patients needs. Some patients just need proper hands-on interventions and exercises to improve their functional limitations while others need internal biofeedback and other internal techniques performed by pelvic floor specialists. For LK, she wanted to see if she could be treated without a non-invasive approach first and if required, we would refer her to the appropriate specialist to continue her care.

Living Accident-Free

Within two physical therapy sessions, LK’s associated low back pain and complaints of incontinence had decreased significantly.  Being able to lift her two sons without experiencing accidents was a big improvement in just the first two sessions.  LK was seeing improvements and was closer to reaching her ultimate goal of becoming physically active again and to play with her kids and being able to jog without incontinence accidents. We continued to see LK 1x/week for the next few weeks each time seeing marked improvements with pelvic floor control, decreased accidents and improved flexibility and strength. Within 1 month LK was able to squat, lunge, perform some agility drills and was able to jog on a treadmill up to 5 minutes without any accidents!

active mother jogging

LK reports 80% return to her prior level of function and even states that she feels stronger than before having her two children. LK plans to come in for 1-2 more sessions to progress her functional mobility and strength and we will emphasize a proper home exercise program for her to keep moving towards 100%.

Thanks LK for letting us share your story! If you or someone you know is experiencing postpartum incontinence problems give us a call and let us help you get these issues back to normal.

For more information on what physical therapy can do for incontinence here is a great link defining the role of physical therapists in regards to incontinence.

 

Supporting local Community

Attention local community members! Keep an eye out for our new ad in the local Laurelhurst newsletters… we are excited to provide quality care to the community and we have been receiving great feedback about our services.  Check out our testimonials on our site or see what people are saying on our Google plus page!Portland Physical Therapy: Laurelhurst, Kerns

Stay Tuned…

Happy New YearsStay Tuned…Over the last few weeks of 2014 we will be giving gifts of knowledge in regards to health, wellness and pain free functional mobility, we hope that these gifts not only provide components of education but also inspire you to make positive changes towards a better 2015 version of you.  Happy Holidays Everyone!

Run Analysis & Physical Therapy Interventions

Depositphotos_41240423_originalWe as physical therapists are a natural fit for providing movement analysis for patients with biomechanical faults.  With our educational background and clinical experience we are able to provide a complete assessment for the running athlete while also being effective in providing interventions to address the athlete’s inefficiencies. This past Tuesday (my birthday and election day for those who are paying attention) I had an opportunity to speak with two exceptional movement scientists on the topic of run analysis and how physical therapy played a role in performing these assessments.  Now I have spoken to many physicians, running coaches, and thousands of patients regarding motion analysis and how physical therapists may use certain tools to properly create treatment plans to make people pain free and more efficient athletes but what was interesting about this talk on Tuesday is that we broadcast it “live” on the internet.  This was somewhat intimidating but also exciting to know that we could answer questions from anyone around the world throughout this 60-minute slot.

Throughout the talk I not only shared my ideas and concepts of what movement analysis would comprise for a runner but I also learned a great deal from Nicole and Chris.  Some of the gems from our Google + hangout were without a proper history and subjective exam we cannot provide an accurate or efficient assessment for interventions with our patients. What does that mean? Without a defined start point of how that athlete or patient presents to us how are we as health care providers able to determine positive change? Or any change for that matter. Chris mentioned collecting his athlete’s behaviors both past and present and making changes to “habits”.  I love this and will from now on steal this in my practice to educate patients on changing their lifestyle habits rather than performing executed medical prescriptions in stretching or strengthening. (Thanks Chris) Nicole stated that as physical therapists our educational background includes studying the “whole body across many systems” & it is our (magical) ability to juggle all of these systems in our head while we have a patient sitting in front of us or moving in front of us.  Then with a quick wave of our wand we make medical decisions on how to intervene with the patient or athletes apparent functional limitations.

Something that physical therapists utilize that you won’t get in a running store or from your local personal trainer is evidence-based medicine.  What is evidence based medicine (EBM)? EBM is the process of systematically reviewing, appraising and using clinical research findings to aid the delivery of optimum clinical care to patients.  These research studies are often performed over many years and with thousands of patients…. The choices that Physical therapists make based on EBM gives you the best care!

“Doesn’t matter what tools you have, it’s the clinician who makes the decisions with those tools & applies a differential diagnosis that is the most useful – Nicole”

One of the biggest messages from this talk was that no matter what fancy machines are used, or how amazing the high-speed video cameras are the patient or athlete will not get the most complete analysis and assessment without a good clinician. So what makes a good clinician you may be asking? Someone who has taken multiple courses on biomechanics, understands the body as a complete system, and someone who has worked with thousands of higher level patients who perform at a faster speed than your typical activity of daily living.

Proper Testing

Another topic of discussion was patient testing coupled with the run analysis.  All members of the discussion mentioned that physical therapists are able to properly test strength, range of motion, functional mobility and muscular symmetry more than many other health care providers and this allows for proper interventions to address biomechanical weaknesses.  Plain and simple: If you have pain with movement the best person to see is a qualified physical therapist!  It is our job as movement scientists to help people move pain free and more efficiently.

“Shoes can’t fix your running- Chris”

As Dr. Powers states “you have to be fit to run, you should not run to get fit”.  Take home message from this whole talk is find a good therapist, get a through examination, and prepare yourself for success by building a foundation of knowledge, flexibility, strength and motor control.  Internal limitations in joint mobility and strength cannot be fixed with fancy shoes or compression braces. “Running is not easy” as Chris enlightens us.

Now if you have the time to watch the video I have attached it to this blog and if you have further questions regarding the content or possibly are interested in having a run analysis performed you can contact me at the office via phone or via email at Jason@therapydiaportland.com.

#TherapydiaRunTalk

 

New Beginnings At Therapydia Portland

We are excited to welcome Jason Villareal, DPT, ATC to the Therapydia Portland clinic.  Jason comes to Therapydia after successfully running two outpatient orthopedic physical therapy clinics, one in Newport Beach, CA and the other in Coos Bay, OR. Jason is eager and excited to contribute his clinical reasoning skill set and exceptional customer service to the Portland community.

Clinically Jason has been involved in the sports medicine and physical therapy field for the past 14 years. He has had the opportunity to work at the high school, collegiate, and professional level with athletes, while also helping patients in the pediatric, geriatric, inpatient, outpatient, transitional care and home health settings. This vast amount of experience has given Jason a unique skill set to treat all levels of patients. Jason is excited to contribute his knowledge and experience to this community and he takes pride in making positive outcomes for each and every patient that he encounters. Jason has spoken at large physical therapy conferences regarding clinical efficiency and was most recently invited to speak at Grand Rounds for the physicians at Bay Area Hospital regarding running analysis and injury prevention. Jason has participated in many specialty continuing education courses and is actively looking for ways to advance his knowledge for movement sciences incorporating technology into the physical therapy field.

Outside of the clinic Jason stays active with his beautiful wife Abbie and little girl Edie.

Physical Therapy, Health and Wellness between Kerns & Laurelhurst