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.

Breaking Down The Graston Technique®

GrastonTechnique of the Shoulder-2Breaking Down The Graston Technique®

Summer is officially here and outdoor activities are calling. However for anyone who is suffering from an injury, the longer daylight hours means you’re missing out on even more fun. If resting and icing hasn’t helped you heal as quickly and effectively as you would like, you may want to consider the Graston Technique to help you find relief and get you back out there.

The Graston Technique® is an evidence-based form of instrument-assisted soft tissue mobilization (IASTM) that enables clinicians to effectively assess and treat restrictions of scar tissue, muscle, and fascia that contribute to dysfunctional movement of the kinetic chain.   The technique involves the use of hand held stainless steel instruments applied to the body’s soft tissue in various sophisticated strokes to release or unlock areas of pain and poor function. No treatment is complete without being coupled with an appropriately designed therapeutic exercise program to restore the normal functional movement of the treated tissue.

Set Your Fascia Free

Luke, I am your fascia…. Star Wars puns aside, fascia is a very important part of the human body that I think doesn’t get a lot of credit and definitely not a lot of attention. Shameful! This beautiful tissue, also referred to as connective tissue, exists all over the body! Think of it like an internal webbing that provides dynamic internal structure by supporting and connecting all your moving parts. It is 3-D in nature and thus is not always addressed adequately by your weekly or monthly massages when lying on the table passively. Within the fascia live important cells called fibroblasts that are precursors of collagen production, super important for injury healing or recovery from regular daily abuse that results in normal break down. When there is any restriction of this fascial tissue, from injury or daily wear and tear, the fibroblasts can be left unable to do their jobs, especially if they can’t get their nutrition and hydration as a result of what can be considered a tissue traffic jam (thoughts of Oregon 217 South at 5pm, shudder!).

Living within the superficial fascia are the majority of your sensory nerve endings that transmit messages of pain. Treating this fascia and increasing regular functionality of this tissue can help mitigate pain. Bye bye pesky pain!

What Does Graston Technique® Feel Like?

Well, have you ever had a massage that in some places it feels good and others it is uncomfortable as it is happening but afterward there is this sense of “hey! I’m able to move better! And that original pain is gone!” It is much like that. Sometimes there is reddening of the skin that lingers for a day or two; this is the result of scar tissue or adhesion break down and allows for new healthy blood vessels to regenerate and allow increased healing potential.

You might be thinking that if Graston Technique® is like massage, then what is the difference? During a typical treatment, a patient should expect to be positioned in various postures, particularly the posture that is dysfunctional. The tissue is 3-dimensional and thus is treated in this manner including through movement. If adequately applied, this technique should allow the patient to see a difference in his or her movement and capability straight away!

So one or more of these six stainless steel Graston instruments can be used to restore adequate mobility of this tissue network under the skin and result in faster recovery time, reduced overall treatment time, result in less need for anti-inflammatory medication, and resolve chronic conditions not adequately addressed by other treatments. As an adjunct to a physical therapy regimen, Graston Technique® should be considered! Schedule your appointment at Therapydia Portland and try out Graston with our certified provider.GT_Provider_Logo_RGB-2

Get a Proper Bike Fit to Cycle with Confidence

Get a Proper Bike Fit to Cycle with Confidence

Bike to work

Bike to work

 

Did you know Bike To Work Day is happening next Thursday? Whether this is your first biking or your hundredth, a proper bike fit assessment can help you prevent injury and improve performance. No more neck pain, lower back aches and hand numbness. Learn about the benefits of a bike fit and top things to look for when optimizing your bike to meet your biomechanics.

Benefits of a Proper Bike Fitting

  • Lower back pain and knee pain are the most prevalent injuries with cycling. A comprehensive bike fitting will take into account your individual biomechanics to prevent injury and aid you inreaching your peak performance.
  • Prevent Injury by establishing neutral positions that reduce stress on your body. This is especially important if you have recurring injuries.
  • Improve performance by finding comfortable positioning that will allow you to exercise more effectively and build strength.
  • Master your technique by making sure all of your body is working in sync for a more seamless ride.
  • Experience a more enjoyable ride because you will have peace of mind, you will be comfortable and will start feeling improvements, which will help motivate you.
Image take from http://www.jimlangley.net/wrench/bicycleparts

Image take from http://www.jimlangley.net/wrench/bicycleparts

Mechanics of a Bike Fitting

Even with small changes in your bike fit, you can expect exponential changes biomechanically. There are multiple parts of a bike fit and depending on your pre-existing areas of pain, you can ask your physical therapist to hone in on those areas. Below are common pointers we give to cyclists of all levels who are looking to improve their cycling posture. Before making multiple changes, please talk to a professional to get their insight on how to better optimize your bike fit.

  • Bend your elbows. Having bent elbows will help absorb shock through your upper extremities and reduce stress on your cervical spine.
  • Maintain a neutral spine. This helps keep you from hyperextending your neck by trying to maintain an upward glaze. Without proper trunk alignment or thoracic spine extension riders often experience hyperextension injuries in the head and neck region from trying to maintain an upward gaze without proper upper back mobility.
  • Find your handlebar sweetspot. Poor handlebar positioning may cause stress on your spine as you try to sustain a proper position. It may also result in hand pain or numbness due to your grip.
    To keep a neutral pelvic alignment, don’t tilt your saddle downward. A downward tilted saddle may put unnecessary stress on your wrists. It may also impact your erector spinae, multifidus, obliques and quadratus lumborum if your muscles have poor endurance.
  • Find your saddle sweetspot. Oftentimes riders change the angle of the saddle for comfort rather than actually assessing if you have the right saddle fit for your body type. Before changing the position of your saddle we recommend finding the right saddle fit first. When you ride your knees constantly maintain a semi-flexed or mid-range contraction, which can put stress on your hamstrings. When a saddle is placed too high often times this places the pelvis in a posterior tilt creating a biomechanical shortening of the hamstrings. This can lead to muscle strains or even numbness and tingling in your legs during long rides.
  • Wear padded gloves and proper shoes. During long rides you may grip more tightly or apply more pressure with your feet while pedaling. Wearing the proper gear is just as important as your position on your bike to reduce stress and let you enjoy your ride.

Get a Bike Fit Today From Your Physical Therapist
Physical therapists are biomechanical experts and look at your movement from a holistic view. They will be able to analyze your bike fit and how you fit on your bike keeping in consideration any previous or recurring injuries you may have to get the most out of each ride. Our physical therapists will work with you one-on-one to make adjustments as needed to improve and build strength.

Tips to stay healthy during the holiday season…

Be active, happy and healthy

As the weather is changing and the end of the year quickly approaches there are many of us that are experiencing the holiday work parties, the friendsgiving gatherings, and the eventual holiday hustle to travel, eat, drink and be merry.

With all these increases in tasks and relative decreases in time to complete the parties, shopping and last minute meetings stress is bound to increase.  Statistically the last quarter of the year is when hospitals see a large increase in admissions.  This has been attributed to heart attacks, strokes, and car accidents mostly stress related.  Managing stress through proper planning can prevent these health issues and potential accidents.

Thankfully we only have a few weeks left of 2014 to get through this stressful quarter however here are some gems from the Center of Disease Control and Prevention to use while we close out this year.

Wash your hands to avoid getting a cold of flu

If you haven’t done so already, consider getting a flu shot

Balance your day with work, home, play and rest

Plan properly for those holiday travels

If you are more musically inclined here is The CDC Holiday song on the 12 ways to Health.

Another component to be mindful of is Vitamin D intake.  Living in Oregon most physicians recommend taking Vitamin D supplement due to the lack of Sunshine that the population receives.  In the past 10 years technologic advances have pushed people to spend more time indoors on computers, watching television or spending time on our tablets.  During the winter as temperatures drop and holiday season demands increase people spend less time outside, therefore Vitamin D intake is sparse. This leads to increased reports of depression possibly due to seasonal affect disorder and/or people who may not have friends or family to celebrate the holidays.  This article highlights some good information regarding Vitamin D, SAD and depression.

Lessons to be learned, plan ahead this holiday season, aim to properly balance work, home, play and rest, and get outside and enjoy being active!

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

Why Physical Therapy?

This video from the American Physical Therapy Association helps illustrate just how physical therapy works and why it can benefit a range of physiological issues — from joint pain and sore muscles to sports injuries and even “preventive” measure to avoid surgery. With physical therapy, you don’t have to end up on the operating table.

One of the key differences between physical therapy and, say, visiting the chiropractor, is that physical therapy tends to be less intense. We tend to use less invasive methods to increase your range of motion and flexibility. We’re also a cheerleader for progress that’s with you every step of the way.