It is February, and already we have above average snow fall.  March typically has more snow than February.  So are you tired of shoveling snow?  Are you experiencing low back pain after all that  shoveling?  Here are some stretches that might help.

Pelvic Tilt

1.  Lie on back with both knees bent and feet flat on the floor.

2.  Tighten abdomen and buttocks, pressing lower back onto the floor.  Hold for a count of 10. Release.  Repeat 5 times.

Knee To Chest

1.  Lie on back with both knees bent and feet flat on the floor.  Tighten stomach muscles.

2.  Bring one knee to chest and hold for 30 seconds.  Then lower to floor and repeat with opposite leg.  Repeat 5 times.

Hamstring Stretch

1.  Lie on back and loop a towel around one foot.  Tighten stomach muscles.

2.  Keeping lower back straight, raise leg to upright position and hold.  Relax leg and repeat 5 times.  Switch to other leg.  Slowly increase holding time to 30 seconds.

Press Up

1.  Lie on your stomach and place your hands on the floor near the sides of your head.

2.  Slowly push your upper body off the floor by straightening your arms, but keep your hips on the floor.  Hold for 10 seconds, then relax your arms, moving back to the floor.  Repeat 10 times, lifting slightly higher each time.

Did you know that shoveling snow can be an aerobic workout? 

Get ready for the next snow storm and protect your back with these tips.

1.  Know your limits.  You can ask for help from family, friends or neighbors.

2.  Warm up those muscles and get the blood flowing.  Walking in place, squats, lunges, and jumping jacks are just some of the things you can do to warm up the muscles.

3.   Dress appropriately.  Wear clothing that is easy to move in.  Dress in layers.  Wear boots with good traction.

4.  If the ground is icy or slick, spread sand or salt over the area to help create foot traction.

5.  Choose a shovel that works for you.  A shovel with a curved handle helps you keep your back straighter reducing spinal stress.  A shovel with a plastic blade is lighter weight than a metal blade.  Consider a smaller blade to lighten the load.

6.  When lifting the snow filled shovel use the large muscles in your legs by bending your knees and hips.  Set your legs apart for a more stable base.

7.  Turn the whole body and then toss the snow.  If you twist and toss you are making the small back muscles do the work.

8.  If you can push the snow out of the way instead of lifting do so.

9.  Be sure to take breaks to give your muscles some time to recover.

10.  When you finished drink plenty of water and do the stretches above.

Your back will thank You!

Shovel your way out of back pain is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

One should consume 1/2 oz. of pure water per pound of your body weight daily (200 lbs= 100 oz. each day) and at a slow but steady sipping pace of about 3-5 oz per half hour for optimal liver and kidney clearance. Proper hydration is essential to your healing and your health each and every day.

People taking medications or even vitamins may have a unique need to add water to their diet. Exercise and forced-air heat like furnaces and car heaters dry you out as well. Many bottled drinks are in fact, less effective than plain old water. If your urine is yellow, or your feet are dry, add 2 glasses of water to your normal routine. Drink extra water on days you exercise, have massage, or require the heater in your house or car. Stop the pain. Don’t get dehydrated!

Eight a day

The body loses, on average, about two to three quarts of fluid daily through perspiration, exhaled moisture, and excretion. You must replace this fluid, hence the rule of thumb about consuming the equivalent of at least eight 8-ounce glasses of water daily. Some of the water you need comes from solid foods, especially fruits and vegetables. You get the balance from liquids you consume (juices, milk, soups), which are just as good as water.

Any change in diet, particularly an increase in protein or salt consumption. or an increase in exercise or outdoor temperature may raise your fluid needs. Certain drugs, notably diuretics, will increase water loss, as will alcohol or caffeine. Dehydration is a particular problem among the elderly, in part because the thirst mechanism becomes less efficient as we age.

Normally thirst is the best sign that you need more fluids. But if you’re exercising or working strenuously in the heat, you can lose a quart of water an hour. Don’t wait until you’re thirsty: drink before, during and after your workout.  If you fail to do this and need to replenish the water you’ve lost, weigh yourself after your workout, and drink a pint of fluid for each pound you’ve lost.

One glass of water shuts down midnight hunger pangs for almost 100% of the dieters studied in a University study.

Lack of water is the #1 trigger of daytime fatigue.

Preliminary research indicates that 8-10 glasses of water a day could significantly ease back and joint pain for up to 80% of sufferers.

A mere 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen or

Drinking 5 glasses of water daily decreases the risk of colon cancer by 45%, plus it can slash the risk of breast cancer by 79%, and one is 50% less likely to develop bladder cancer.

Are you drinking the amount of water you should every day?

Are you drinking enough water? is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

The answer is dynamic stretches. Dynamic stretches Dynamic stretching is useful before competition and has been shown to reduce muscle tightness. Muscle tightness is one factor associated with an increase occurrence of musculotendinous tears. More recent scientific studies seem to suggest that dynamic stretches before competition are preferably to static stretches. This may be particularly true for strength and power athletes. 

All exercises should have 5 second holds and be done 5-10 times.
Standing Cat n Camel/ Pelvic Rotation
Begin in your address position, arms across chest. Tuck the pelvis under then arch the back, creating a rocking of the pelvis into anterior and posterior position and return to a neutral spine. 

Trunk Rotation/ Vertical and Horizontal Axis
Standing in your address position, bring the palms together. Inhale as you rotate from the core and bring the both arms back. Mimic backswing then follow through with a stop at the address position.

Try the same exercise at chest to shoulder height twisting trunk and keeping arms in the parallel to the ground.

Standing Hip Stretch
Use a golf club for assistance with balance. Place one ankle on the outside of the opposite knee. Inhale as you bend your stance knee, sitting back as if you are sitting on a chair. Bring the chest toward the shin, rolling the shoulder blades together.  Reverse legs.

Shoulder Rotation Stretch
Place the club or towel in your right hand, palm facing the ceiling. Bring the right arm over your head and the right palm behind your back. Bring your left arm behind your back and clasp the club or towel.  Move the club up and down your back stopping when you feel a stretch and squeezing the club together.

Upper Trapezius Stretch
Bring the right ear toward the right shoulder. Inhale as you press your left arm toward the floor, exhale and relax the left arm.

Standing Shoulder Blade Stretch
Bring the club to shoulder height, bend your knees and tuck your pelvis under. Inhale as you press your arms away from you, tucking your chin into your chest. Exhale, lift the head and squeeze the shoulder blades together.

1) National Strength & Conditioning Association. Essentials of strength training & conditioning. Champaign, IL: Human Kinetics. 2000
2) Yamaguchi, T., Ishii, K. Effects of static stretching for 30 seconds and dynamic stretching on leg extension power. J. Strength Cond. Res. Aug;19(3):677-83. 2005
3) Shrier, I. Stretching before exercise does not reduce the risk of local muscle injury: A critical review of the clinical and basic science literature. Clinical J. Sports Med. 9: 221-7. 1999

Golf: Dynamic Stretches is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Forever looking for that magical move that takes strokes off your score probably leads you straight to the driving range to hit a few hundred golf balls. Sure! Practice makes perfect, right?  Even simple pre-season training drills will improve your swing, game and help prevent mid-season injuries for years. Let’s go golfers, other sports have pre-seasons. Let’s catch on!

What’s the bottom line?

The goals of any golfer are:

Increase range of motion in the golf swing.  Improved flexibility allows a complete backswing and extended follow through.  Having this full ROM will decreased chance of injury.

Add control and power to the golf swing.  Well trained muscles increase control and ability to generate more club head speed.

Improve energy and endurance.   muscular control will improve function and muscles will tire less through each round.

Reduce chance of injuries on the golf course through stretching and identifying uncomfortable movements.

Analysis of “Your Swing”

Leg and hip is responsible for power production initiation of the golf swing.

Trunk muscles transfer power from the legs to the torso to accelerate the club head.

Chest and shoulder muscles produce the actual swing action and play critical role in club head speed.

Arms are responsible for club control and largely determine club head impact.

Off-Season:
Three strength training sessions per week for general base and core strengthening, as well as for muscle control is sufficient. During the off season months is the best time to focus on overall muscle strength and enhance golf driving power.

Examples of exercises include all on machines: leg press, squats, hip abduction and adduction, trunk rotations, push ups, planks, standing hip extension, abdominal crunches.

Pre-Season:
Once you have a strong base and balance of muscle, you can maintain by reducing your total body strength training sessions to twice per week. Now is the time to develop sport specific skills utilizing tiny, but key muscles such as low back and rotator cuff musculature.

This program might include progressing to free weight and cable or theraband as resistance.  Exercises would include leg press, squats, hip abduction and adduction stepping with theraband resistance, standing cable trunk rotations, push ups, planks, U stance training with theraband leg swings, hip extension, trunk rotation and abdominal crunches.

In-Season:
Practice and Play! To prevent injury after long activity days with multiple rounds, you must take care of the sport specific muscles. Stretching muscles used will aid in not only assist in a better golf swing with a larger range of motion, but injury prevention as well.

The basic flexibility exercises that are relevant to golfers are standing or seated hamstring, lower back, and upper back and shoulder stretches.

These stretches will allow for the ability to play and practice more golf with fewer aches and pains at the 19^th hole as well as on off days.

Golf Exercise is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Resistance training, whether through lifting weights, performing body weight exercises, or using resistance tubes or bands continues to play an important role as you progress through life.  First off, resistance training does build muscle mass.  The reason this is important is that the more muscle mass you have, the higher your metabolism is.  This makes it easier to lose weight or maintain a healthy weight.  Also, by maintaining muscle mass, you will maintain more strength and will fend off decreases in strength and power that occur naturally after a certain age, thus keeping you independent longer. 

Perhaps the most important reason for resistance training as you progress through life is to maintain bone mass.  It is possible to add bone mass through the teen years and up to about the mid-twenties.  After this, it is important to do all you can to prevent and slow age related decline in bone mass.  One good way to do this is through resistance training.  When you move a weight, the muscles required to perform that movement pull on the bones.  When this pull on the bone occurs repetitively, the bone adapts to this by adding more bone in that area to reinforce it.  So lifting weights regularly will continue stimulating the body to form bone.  Though after a certain age you can’t actually add bone mass, this process will keep bone density higher for longer, thus decreasing the chances of developing bone fractures secondary to osteoporosis or osteopenia. 

As mentioned above, resistance training doesn’t have to include heavy weights or lots of equipment.  Simple exercises such as squats and pushups use your body weight as resistance.  Resistance tubes or bands are often available in stores, are inexpensive, take up very little room when not in use, and provide a variety of exercises which can often be done in the comfort of your own home. 

Now that you know why resistance training is so important, try to mix it into your regular exercise routine for about 30 minutes 2-3 days per week.

Benefits of Resistance Training with Aging is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

     Shoulder injuries are the most common injury among swimmers.  Many swimmers have very lax shoulder joints, which is a benefit to them in their sport but also places them at an increased risk of injury.  Swimmers often train with high mileage which often leads to fatigue and decreased swimming technique.  Poor form combined with shoulder laxity can lead to bony structures in the shoulder bumping into tendons in the shoulder which can cause wear, inflammation, and pain.   In order to avoid this it is important for swimmers to strengthen the muscles which stabilize the shoulder blade.  In addition to strength, it is important to improve the coordination of these muscles so that as they fatigue they are still able to stabilize the shoulder blade and keep the athlete free from injury.

     Another a common complaint among swimmers is knee pain.  This is most frequently due to the whip or frog kick employed in breaststroke.  This kick places a sudden valgus force on the knee, forcing the knees together faster than the feet.  This position places a stretch on the ligaments on the medial (inside) surface of the knee and a compression of the structures on the lateral (outside) surface.  Unfortunately, the mechanics of this kick call for the swimmer to repeatedly put forces on the knee which have a great potential for injury.  This kick also has the potential to cause irritation in the hip which can lead to hip pain.  In order to avoid these injuries, it is important for swimmers to build strong hips and a strong core to avoid having these same stresses put on the knee and hip during other activities they might be involved in such as PE classes at school.  It is also important for swimmers to train in a variety of strokes in order to minimize the repetition and decrease wear on the tissues in the knee and hip.

      It is also common for swimmers to experience pain in the lower back.  This is partly due to the optimal body position in the water which calls for the head and shoulders to be high in the water.  To achieve this position, swimmers often utilize increased low back extension (backwards bending) which puts increased pressure on the disks, nerves, and muscles in the lower back.  This position also decreases activation of the abdominal muscles which help stabilize the lower back.  Because swimmers are in this position for long periods of time, it is common for this posture to transfer to standing posture which can compound the problem.  To avoid this it is important to build strength in the transverse abdominis muscle which supports the back and keeps the spine in proper alignment.  This muscle is one of the core muscles which, when strengthened and trained properly, can help prevent a wide array of chronic and traumatic injuries, as well as contribute to athletic performance.

Dr. Heather Shaughnessy is a triathalete, and clearly understands the possibility of injury during herow swimming training.

     Though swimming is a low impact sport compared to many others, it does come with its own unique set of injuries and complications.  The factors described above give a brief overview of some common problems for competitive and recreational swimmers alike.  There are many other factors that can contribute to an injury.  For a full evaluation and an individualized plan of care, call Accelerate Physical Therapy today to set up an appointment with one of our licensed physical therapists.

Preventing Swimming Injuries is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Heather Shaughnessy, DPT

Often times, adolescents have not developed proper control of the muscles which stabilize the body’s core.  Though some athletes have been playing for many years and are often very good at their sport, they usually still lack the core coordination and strength required to keep them healthy.  In the sport of volleyball the core is important for generating strength and arm speed for a harder overhead swing during spiking and serving.  Without enough core stability, the athlete ends up using the shoulder muscles to generate speed.  Asking these smaller muscles to do the work of the larger core muscles puts them at a disadvantage and will inevitably lead to breakdown resulting in injury. 

Also necessary for a harder spike is thoracic extension, the backward bending of the upper and middle back.  This is important for allowing the arm a greater range of motion through which to swing, thus giving it more potential for speed generation.  Thoracic extension often goes hand in hand with having good posture.  In our culture of TVs and computers, adolescents and adults alike often end up with a forward head posture, shoulders which are rounded forward, and a slumped upper back.  This posture is a result of tightness in the chest muscles and weakness in the upper back muscles.  By addressing these issues an athlete can increase their thoracic extension, thereby allowing the core to do more of the work generating power.

Also hand in hand with core strength is hip strength.  Some even consider the hips to be part of the body’s core.  When an athlete has hip weakness it is often in the hip abductors and external rotators- the muscles which raise the leg to the side and turn the thigh out.  When these muscles are weak, it allows the knee to fall into a position of genu valgum, also known as being knock-kneed.  Even when an athlete does not appear knock-kneed they could have weakness leading to malalignment at the knees which could lead to injury.  Weakness at the hips also decreases the overall stability of the hip and knee so when an athlete experiences a collision or lands awkwardly from a jump, they are less able to correct their position before an injury occurs. 

There are many factors that can lead to injury in a young and the ones discussed here are only the most common.  Proper evaluation and treatment from a licensed physical therapist can determine areas of weakness and/or tightness leading to an injury.  A therapist will then be able to create a personalized treatment plan to address these areas, restoring the athlete to health and allowing them to enjoy their sport for years to come.

Preventing Volleyball Injuries is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Got a short leg? is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Mechanically adding height to the navicular bone at the medial arch changes the functional position of the foot, knee and hip, and dramatically prevents many common problems. Gradually, as the body adjusts to corrective changes, stresses change and any resultant pain subsides.  The problem will continue or return if left uncorrected.

Wear arch supports if you are standing, exercising, shopping, working and always at home.  A number of products are available in stores near you.  Go to our website for links to information about invaluable and inexpensive arch supports, which are available at a variety of stores near you.

Everyone should wear supplemental arch supports in their shoes, slippers, athletic footwear, training shoes and cleats.  Orthotics, or at least foam arch supports have been repeatedly effective in curing pain and dysfunction of foot, ankle, knee, hip and back.

Arch supports reduce the degree of:

• Flat feet or falling arches (pes planus)
• Foot pronation
• Ankle eversion
• Q angles at the knee (valgus)
• Uneven hips (pelvic obliquity)
• Lumbar scoliosis.

Mechanically adding height to the navicular bone at the medial arch changes the functional position of the foot, knee and hip, and dramatically reduces, and prevents most problems. Residual pain can take a few weeks to go away, but the problem will not get better if left uncorrected. Leg and back pain sufferers benefit from supplemental arch supports and orthotics. Even if you only stand all day, arch supports will control pain and manage many progressive problems that we commonly treat.

Wear Arch Supports! is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Training Tip # 1: FLEXIBILITY:
The first component of pre-season training is flexibility.  Typically we are beginning training pre season because we are not in the best shape possible.  Flexibility has been shown to decrease injury as long as it is done often.  It is not important when it is done relative to exercise but it is important that it be done often.  Flexibility training regimes should focus on hip flexors, hamstrings, trunk flexibility, and calves.

Stretching should be done with at least 20 second holds and no bouncing.  Each stretch to a point of pull and discomfort not pain.  6 repetitions of 20 second holds should be sufficient but with problem areas, holding a moderate stretch for several minutes may be appropriate.

Training Tip #2: BALANCE AND COORDINATION:

Trying to balance standing on one leg can be a challenge, however if you want to improve balance and coordination try standing on semi-circle foam tubes (available at most physical therapy practices) and doing one-legged dips. For timing and a good plyometric workout try jumping rope. Bongo boards and BOSU balls are fun and are used by many national ski teams for coordination drills, Excellent cross-training can be done through inline skating, trail running, and trampoline training.

Balance and coordination are the corner stone to good alpine skiing. Without it you fall down a lot. A prescription for training in this second focus area can progress from 2 legged to one-legged activity.  Bicycling, Total Gym squats, jumping rope, are all quality plyometric activities. Stair and bleacher hops are good too as a progression of weight. When you get good at it try it on one leg.
Training Tip #3: STRENGTH:

Here, a heavy dose of legs and trunk work with moderate focus on the upper body is good. As in all these components a good warm-up period is mandatory. Once the blood is moving a series of squats, leg press, calve raises, leg curls, and ab/adduction exercises is suggested. The trunk focus could be using a gym ball for high crunches, low crunches, twisting crunches, and face down lower back exercises over a gym ball and plank exercises in each position.  Plyometric ball throws overhead, and side to side will also train the trunk in a faster, resisted mode. 

Even though we don’t ski on our arms it’s good to work the lats, triceps, and upper back muscles to support a pole plant and assist you ability to withstand falling, if and when you may. With a strong core you can stabilize and correct while allowing the feet something solid to turn against.

Training Tip #4: SPEED:
Quick lateral movements can be ingrained by placing a pillow on the floor and hoping sideways from foot to foot while maintaining a balanced upper body. An excellent resistant drill is to attach a rubber sport cord around your waist, then have a partner hold one end while you run. Your partner should provide enough resistance to keep you at bay. Try this while running sideways. This is the true test of your lateral movement agility.

Quick sprints, lateral hops, resistant running drills with a sport cord (surgical tubing), and obstacle course hops are suitable drills. Timing is everything and in skiing if you don’t have quick feet the skis will soon be taking you for a ride instead of the other way around.

Training Tip #5: ENDURANCE:

Raise your heart rate. It doesn’t matter what sport your chose to do this via, as long as it is one you enjoy and can commit to doing. The sky is the limit for this: mountain biking, swimming, roller blading, running, hiking, basketball, soccer, tennis, and any other aerobic activity to improve your endurance level. The key is to pick something you enjoy and then do it regularly.

If your goal is to ski strong all day long then a solid base of aerobic fitness is essential. How long you tend to ski continuously without rest will dictate the duration of you aerobic fitness training. If you ski runs from top to bottom then you may need longer intervals of training, however if you ski short distances or duration of the day you may only need to match or slightly increased that interval.

The components of flexibility, balance and coordination, strength, speed, and endurance should be a part of every skier’s preseason training. Of course the intensity will change from World Cup racer to recreational free skier but the fundamentals will remain the same. Most skiers over age thirty don’t aspire to be the next Bode Miller, however we all want to be quicker, stronger, and more confident and safe on our skis. The benefits to be gained from preseason conditioning, include increased athleticism and injury prevention.

“PT Ski Tips” by Ross Hutchinson, PT is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy