Category Archives: Injury Prevention

  1. To Stretch or Not to Stretch? Tips for Optimizing Flexibility

    Many have grown up with the understanding that, whenever you’re about to work out, compete or otherwise push your body, it’s important to stretch immediately before the activity in order to prevent injury and perform your best.

    Yet, despite these long-held beliefs – and perhaps surprisingly – there’s little evidence to support this theory.

    Today’s evidence suggests that there’s no connection between injury prevention and stretching – static, or reach-and-hold-type stretching – before a workout. Performance-wise, there’s also no consistent connection, with some studies even suggestions that stretching before an activity or competition can actually weaken performance.

    For example, research released by Applied Physiology, Nutrition, and Metabolism in 2011 found that the vertical jump heights of young and middle-aged men actually declined when participants stretched beforehand. In contrast, the same study found heights increased after warming up dynamically, or using dynamic stretching.

    Dynamic stretches can best be described as a lower-intensity version of the exercises and movements you plan to perform during your activities or while you’re competing.

    A light jog, some leg swings, lunges, high-knees, arm and shoulder rotations … all these movements can be part of a dynamic stretching routine, depending on the activity you’re about to do.

    Such dynamic warm-ups help you break a sweat, sure, but it does so much more. It ensures your muscles are well-supplied with oxygen, promoting optimal flexibility and efficiency.

    Dynamic stretching, however, can only optimize your current level of flexibility. Static stretching is still vital in maintaining and improving your body’s level of overall flexibility … just not right before an activity.

    So, when’s the ideal time to maintain and improve flexibility through static stretching? Consider the following guidelines:

    Stretch Daily: Just as you should try to get a certain amount of exercise in each day – both cardio and strength training – it’s also important to dedicate 10 to 15 minutes to daily static stretching. Typical static stretches are held for anywhere between 15 to 60 seconds at a time, with each movement repeated two or more times.

    Experts suggest setting time aside for stretching either first-thing in the morning or just before going to bed.

    Stretch During Cool-Downs: Cooling down after an activity helps the body transition from a higher intensity to a resting or near-resting state. While slowed-down exercises (similar to those during dynamic warm-ups) may be included as part of a cool-down, this is also a great time for static stretching.

    As consistent tightness in the muscles and joints can put one more at risk of pain and injury, those who regularly exercise or compete have an annual physical therapy exam. During a PT exam, weaknesses in flexibility, strength and movement can be identified and properly addressed before they manifest into injuries.

  2. 6 Common Back Pain Myths, Debunked

    Despite being one of the top causes of disability in the U.S., affecting around eight in 10 people in their lifetimes, back pain is an ailment often misunderstood by those affected.

    Such misconceptions can cause those suffering from back pain to seek solutions, potential treatment paths, and even lifestyle alterations that aren’t necessarily in their best interests.

    Back pain can be as frustrating as it is debilitating, especially if past preventative measures and treatments haven’t been helpful. And, this can lead a person down paths that don’t result in the best and most necessary evidence-based treatments.

    These paths can sometimes lead to treatments that are more expensive or personally invasive – and perhaps even unnecessary – such as MRIs and surgery.

    MRIs, shots, surgery, medication, etc., should mostly be considered last resort-type solutions. The fact is, most back pain issues will go away on their own in a few days. And even when they don’t, most remaining cases can be successfully resolved through safer, more affordable and more effective treatment approaches.

    To help health care consumers make better decisions when considering solutions to their back-pain issues, we’d like to shed some light on the following common back pain myths:

    1. Bed Rest Helps with Relief & Healing: Once a common treatment for back pain, research strongly suggests long-term rest can slow recovery and even make your back pain worse. Instead, treatment involving movement and exercise (i.e., stretches, walking, swimming, etc.) often works better to hasten healing and provide relief.

    2. The Problem’s in My Spine: Back pain can be caused by a wide array of issues throughout the body as well as one’s environment. It can be a response to the way you move when you exercise, how you sit at work, the shoes you wear, the mattress on which you sleep, or simply your body compensating for movement limitations and weaknesses. Back pain doesn’t necessarily mean you have a “bad back,” or are predisposed to back pain.

    3. I Just Need an ‘Adjustment’: Those accustomed to visiting a chiropractor for back pain issues often claim to find relief from having their spine adjusted, or “cracked.” While this process can release endorphins that offer some temporary relief, only about 10 percent of all back pain cases can actually benefit from spine mobilization. Exercise is often more effective, as is determining and treating the pain’s source. (See item No. 2.)

    4. Medication’s the Answer: A popular quick fix, medication should never be viewed as a long-term solution to chronic back pain issues. Over-the-counter pain relievers can help get you through in the short term, but many prescription pain meds can be dangerous, addictive, and even make the pain worse in some instances.

    5. I’ll Probably Need Surgery: Of people experiencing low-back pain, only about 4 to 8 percent of their conditions can and should be successfully treated with surgery, according to the Cleveland Clinic. Even 90-plus percent of herniated discs often get better on their own through a combination of rest and physical therapy.

    6. I Need a Referral to See a Physical Therapist: Multiple studies have concluded that physical therapy is one of the safest and most effective ways to both treat and prevent back pain. And in nearly every state, patients can access physical therapy services without first getting a physician’s prescription.

  3. Strength Training Critical for Active, Independent Aging

    To the 43 million Americans who have low bone density, putting them at high risk of osteoporosis, physical therapists have an important message: exercise is good medicine. But not just any exercise – weight-bearing, muscle-strengthening exercise.

    “Essential to staying strong and vital during older adulthood is participation in regular strengthening exercises, which help prevent osteoporosis and frailty by stimulating the growth of muscle and bone,” said David Satcher, M.D., Ph.D., U.S. Surgeon General from 1998 to 2002. “Strength training exercises are easy to learn, and have been proven safe and effective through years of thorough research.”

    And while this benefit of strength training for older adults is a powerful one, it’s simply just one in a list of proven reasons why seniors should make strength training a part of their lifestyles and fitness regimens.

    While a reduction in strength is often considered an inevitable part of getting older, people of all ages should feel empowered to take charge of their overall health (including strength training) as they age.

    Along with diet and regular check-ups with both a physician and a physical therapist, an exercise regimen that includes elements of strength and resistance training can help slow some of the effects of aging – this, while also allowing one to maintain a high quality of life through activity and independence.

    “The work of scientists, health professionals, and older adult volunteers has greatly increased our knowledge about the aging process and how we can maintain strength, dignity and independence as we age,” Satcher said.

    According to reams of medical research, the many proven benefits of weight-bearing and resistance exercise include:

    Rebuilding Muscle: People do lose muscle mass as they age, but much of this can be slowed and even reversed through strength and resistance exercise. And of course, a stronger body has a direct impact on issues related to balance, fall prevention and independence.

    Reducing Fat: We also tend to more easily put on weight as we get older. Studies show, however, that while older adults gain muscle mass through strength training, they also experience a reduction in body fat.

    Reducing Blood Pressure: Studies have also shown that strength training is a great (and natural) way to reduce one’s blood pressure, even for those who “can’t tolerate or don’t respond well to standard medications.”

    Improving Cholesterol Levels: Strength training can actual help improve the level of HDL (“good”) cholesterol in the body by up to 21 percent, while also helping to reduce to levels of LDL (“bad”) cholesterol.

    Strengthening Mental Health: This goes with all exercise, including strength training. Maintaining a high level of fitness can combat anxiety, depression, issues with stress, etc. Exercise is also great for memory!

    Whether walking, jogging, hiking, dancing, etc., experts recommend 30 minutes of weight-bearing activity every day. Guidelines also suggest it’s also necessary to set aside another two to three days of strength and resistance training each week, which can include free weights, weight machines, Pilates, yoga, and so on.

    And for the sake of both health and safety, a thorough strength, movement and balance assessment should precede any new exercise regimen, especially for older adults – assessments that physical therapists are uniquely qualified to perform.

  4. Holidays an Ideal Time for Refresher on Proper, Safer Lifting

    Digging out boxes of holiday decorations, hauling packages to and from the car, hiding gifts away on the higher shelves at the back of your closet … the Holiday Season certainly requires its fair share of bending, lifting and reaching. This, coupled with the cooler weather, makes December the ideal time for a refresher on proper lifting methods.

    Back pain, after all, can put a real damper on the Holiday Season.

    As one of the most common conditions treated by physical therapists, back pain and injury will even about 80 percent of all Americans at some point in their lives, making it one of the top causes of disability in the U.S. Fortunately, it’s a condition that’s preventable, and one of the ways of doing this is to learn proper lifting techniques.

    But, preventing back pain isn’t the only concern when we talk about proper lifting. Using the proper techniques for lifting and carrying awkward and/or heavy objects is about minimizing strain on the entire body.

    The goal, in other words, is to put yourself in a position that allows the body’s musculoskeletal system to work as one cohesive unit, without putting too much strain on one area, such as the lower-back or shoulders.

    So without further ado, strongly consider the following tips for proper lifting during this Holiday Season … and throughout your lifetime:

    Warm Up: Don’t ever assume your body’s ready to lift heavy objects without first being thoroughly warmed up. Take the time to stretch you lower back as well as your legs and hips. Also, do a few jumping jacks to get the blood flowing to the muscles in your body.

    Get Close: Avoid reaching for a heavy or moderate-sized load. Get up nice and close to the box or object to minimize the force (in the arms, shoulders and back) needed to lift, and always hold it close to your body.

    Bend & Lift with the Knees: We’ve all heard this before, and it’s true. But in doing so, keep your back straight and your body upright as you lower yourself to the object in question, then use your legs to rise back up.

    Get a Grip: This seems to go without saying, but if you can’t get a strong, comfortable grip on the object in front of you – even if you know you can carry the weight – don’t try to be a hero. Find someone to help you or an alternative way of getting the object from A to B, such as a hand cart or dolly.

    Reverse the Steps: When you get to where you’re going, set the item down just as you picked it up – but in reverse. Keep it close to the body, lower with the legs and move slowly and deliberately. You can just as easily injure yourself setting objects down as you can picking them up.

    In addition, keep from twisting or reaching while lifting and/or carrying a load. Don’t rush through the process of lifting, and if you’re tired, put the work off until later

    And finally, if you do feel pain during or after lifting, or you have an injury or condition you feel is holding you back from moving properly, visit a physical therapist for a full assessment prior to trying any sort of heavy or awkward lifting.

  5. Pools Offer Fitness and Relief for Older Adults

    While drinking plenty of water is critical to life, health and healing, simply submerging your body in water (i.e., a pool) opens up opportunities for relief and fitness for those who otherwise may have difficulty exercising.

    This is especially important for aging adults and those with chronic conditions, say physical therapists and other health care professionals.

    “When you do an exercise on land, like jogging, you get an impact on your joints,” said Torben Hersbork, an osteopath from the Central London Osteopathy and Sports Injury Clinic. “But, when you exercise in the water, you don’t have any gravity forcing your body weight down onto your joints.”

    Because of this, experts say water exercise is ideal for people dealing with issues related to strength, flexibility, balance, sore joints and pain. This includes people recovering from injury or surgery, as well as those with chronic conditions like arthritis, osteoporosis and diabetes.

    The buoyancy of waist-deep water, for example, can support around half our body weight, while neck-deep water can reduce body weight by up to 90 percent. Such reduction in weight and impact on the joints can help people who may experience difficulty standing, balancing and exercising on land to move more freely – and often with less pain.

    In addition, water offers 12 times the resistance of the air around us. Because of this added resistance, movement and exercise while submerged in a pool can help build overall strength and stability in the body.

    “If you are over 50, the American College of Sports Medicine recommends moderately intense aerobic exercise for 30 minutes a day, four times a week, plus resistance strength training, plus balance and flexibility training,” said Mary E. Sanders, a researcher at the University of Nevada (Reno). “A swimming pool provides the one place where you can do all of that at the same time without the need for a lot of machines – at your own pace and more comfortably.”

    One study published in Medicine & Science in Sports & Exercise back in 2007 showed that older women who regularly participated in a pool-based exercise program performed better in daily tasks than others who exercised similarly on land. The women in the study, for example, improved their walking speed by 16 percent, their agility by 20 percent, and their ability to walk stairs by 22 percent.

    Another study published earlier in the same publication (2002) showed that combining aqua aerobics with strength training while in the pool helped participants increase their strength by 27 percent in the quads, 40 percent in the hamstrings, and about 10 percent in the upper body.

    Even when people suffer from common chronic diseases like arthritis and osteoporosis, water exercise can help improve the use of affected joints while decreasing overall pain.

    “Exercise is an integral part of any arthritis treatment program, as it helps to strengthen and stabilize the joints, preventing further damage,” wrote Andrew Cole, M.D., an author on Arthritis-Health.com. “Water therapy is an excellent option for patients with osteoarthritis of the knees, hip osteoarthritis, and spinal osteoarthritis due to the decreased pressure placed on the joints.”

    Those who feel pool exercise or aquatic therapy may help them improve fitness levels or overall functional abilities should first contact their physical therapist for professional guidance. A physical therapist can help identify your greatest weaknesses and needs, then develop a pool fitness plan that specifically addresses these needs and your personal goals.

    SOURCES:

    Arthritis-Health.com: Water Therapy for Osteoarthritis
    https://www.arthritis-health.com/treatment/exercise/water-therapy-osteoarthritis

    AAPR: Making a Splash with Water Workouts
    https://www.aarp.org/health/fitness/info-2007/water_workouts.html

    AARP: Water Works Aquatic Activity: A Painless Way to Stay Fit
    https://www.aarp.org/health/fitness/info-12-2008/water_works_aquatic_activity_a_painless_way_to_stay_fit.html

    “Take It to the Pool: Benefits of Aquatic Exercise for Arthritis”
    https://fox11online.com/sponsored/osmsgb/take-it-to-the-pool-benefits-of-aquatic-exercise-for-arthritis

    Daily Mail: How Can Aqua-Exercises Help You Slim?
    http://www.dailymail.co.uk/health/article-105285/How-aqua-exercises-help-slim.html

    Cleveland Clinic: Benefits of Water-Based Exercise
    https://health.clevelandclinic.org/benefits-of-water-based-exercise/

    CDC: Health Benefits of Water-Based Exercise
    https://www.cdc.gov/healthywater/swimming/swimmers/health_benefits_water_exercise.html

    WebMD: Water Exercise for Seniors
    https://www.webmd.com/healthy-aging/features/water-exercise-seniors#1

  6. Mind your back(pack) during back-to-school

    From homework and tests to extra-curricular activities, students already shoulder plenty of weight during back-to-school time. Their backpacks should be the least of their worries.

    Unfortunately, due to the lack of awareness or simple disinterest (or both), backpacks can pose a health risk to kids and students of all ages.

    “Wearing a backpack incorrectly or wearing one that’s too heavy can be a contributing risk factor for discomfort, fatigue, muscle soreness and pain, especially in the lower back,” said Karen Jacobs, EdD, OTR/L, CPE, an expert on school ergonomics and the healthy growth and development of school-age children.

    Statistics back her assessment.

    The American Occupational Therapy Association estimates that about 79 million students across the U.S. carry school backpacks. Among these, nearly 22,000 strains, sprains, dislocations and fractures – ailments caused by improper backpack use – were reported by medical providers in 2013, according to the U.S. Consumer Safety Commission.

    “I put backpack problems into the ‘overuse injury’ category,” said pediatric orthopedist Robert Bruce of the Emory School of Medicine. “Many attribute their back pain to heavy book bags.”

    And while weight is certainly a key factor, the way backpacks are designed, lifted and worn can also contribute to discomfort, pain and injury in students. The good news: much of this is preventable.

    In this spirit, the therapists at the American Physical Therapy Association (APTA) and the American Occupational Therapy Association, Inc., offer the following tips for kids, parents and teachers:

    Select the Right Pack: Choose a pack that’s no larger than 75 percent of the length of your child’s back. Wide straps keep the pack from digging into the shoulders, and a padded back adds comfort and protection.

    Lighten the Load: A loaded backpack should never be heavier than 10 percent of a child’s weight.

    Distribute the Weight: Use multiple pockets and compartments to distribute the weight of the items inside the pack. Keep heavier items closer to your child’s back, while light and/or sharp items (pens, scissors, etc.) should be stored away from the back.

    Lift with the Knees: Teaching your child about proper lifting will offer a lifetime of protection for his/her back. Children should always lift their backpack using their knees, not their waists.

    Adjust and Carry: Insist your child always carry his or her pack using both shoulder straps, with the sternum strap and hip belt (if part of the pack) tightly secured. Adjust the shoulder straps so the backpack rests snugly against the back, below the shoulders yet above the hips.

    Watch for Warning Signs: Signs your child’s backpack is too heavy or not fitted properly include difficulty picking up and/or putting on the pack, pain when wearing, tingling or numbness in the arms or legs, strap marks left behind on the shoulders, or a change in posture while wearing the backpack.

    Seek Advice from a Physical Therapist: Licensed physical therapists (PTs) are specially trained to prevent injury, reduce pain and restore mobility. Seek the advice of a physical therapist to learn more about properly selecting and wearing a backpack.

    “I think the backpack is a nice tool, but investigate which type of pack seems to be the most comfortable for your child,” summarized Dr. James Weinstein, chair of orthopedics at the Dartmouth-Hitchcock Medical Center. “And don’t put everything, including the kitchen sink, in it. It can’t be their home away from home.”

    SOURCES:

    AOTA: 1, 2, 3’s of Basic Backpack Wearing
    http://www.aota.org/-/media/Corporate/Files/Backpack/meet-your-backpack-8-2014.pdf 

    AOTA: Back Facts: What’s All the Flap About
    http://www.aota.org/-/media/Corporate/Files/Backpack/Whats%20All%20the%20Flap%20About.pdf

    Everyday Health: Is Your Child’s Backpack Causing Chronic Back Pain?
    http://www.everydayhealth.com/hs/back-to-school/backpack-causing-chronic-back-pain/

    NPR: Surgery & Back Pain
    http://www.npr.org/templates/story/story.php?storyId=5252993

    APTA – More Forward: Backpack Safety
    http://www.moveforwardpt.com/Resources/Detail.aspx?cid=ec576128-8e7e-4afc-87a0-e6ace64bcf0a#.Vbq2ZflVg5s