SAN DIEGO PHYSICAL THERAPY Archives - Innovative Physical Therapy

My Hips and Feet are Connected?!

The foot is our base to our body and our direct connection to the world. But many people find themselves having foot problems or just do simply not know how to care for and control their feet. Well if you have feet, you need to learn how your hips directly affect your feet. The musculature around the hips (the glutes) helps rotate the lower extremity outward (we call it external rotation). Learning how to activate these muscles in the hips while the feet are on the ground will actually help the feet become stronger.

As PT’s, we see weakness in the external rotators of the hips quite often, and this weakness in the hips is often in combination with poor arch control or flat feet. It is important to note that foot shape alone does not dictate whether they are weak or inactive. However, the glutes can assist the intrinsic musculature of the foot to activate. Here’s how:

Stand with your feet underneath your hips barefoot on the floor.
Slightly sit your hips back and create a slight bend in the knees – this is a small hinge position.
Start by gripping the ground lightly with your feet – think suction cupping your foot to the ground. (you should already feel some activation on the bottom of your foot with this technique). If you don’t feel it here, no worries…. Here’s where the hips come in.
Without letting your feet move, think about rotating or “corkscrewing” your feet into the ground by driving your knees outward toward the side edges of your feet.
You should see your arches rise. Be careful not to rotate the knees out too far where the base of your big toe comes off the ground. Then relax the knees.

By rotating your knees out, you activate the glute and the intrinsic muscles of the foot in conjunction with one another.

Check out our social media posts and videos of some other activities to help activate your feet and glutes together!

Learn a Proper TRX Row in 17 Seconds

Did you know that swimming is a low-impact exercise that manages to work every muscle in the body?! That’s part of why we love it so much, but that doesn’t mean it’s 100% safe.

Strength training to the rotator cuff, scapular stabilizers, and core muscles will enable a more powerful and safe stroke, and TRX rows are a great way to do that!

Watch this video from Dr. Maya Bizik where she shows how to strengthen these muscles with TRX rows.

TRX Bent Knee Row
- Complete 3 sets of 10 repetitions
- Starting position: hang shoulder under handles with arms straight, back and hips straight with knees bent and feet flat on the floor.
- Movement: Pull body up so sides of chest make contact with handles while keeping the body straight. Return until arms are extended straight and shoulders are stretched forward. Repeat as directed.

References:

1. Tovin BJ. Prevention and treatment of swimmer’s shoulder. N Am J Sports Phys Ther. 2006;1:166–175.

2. Improving your front crawl technique. Swimming.org website. Published on November 24, 2014. Accessed October 22, 2020.

If you need more help maintaining injury prevention, inquire about our virtual classes or virtual 1 on 1 physical therapy and wellness services (exercise training also available!) Call (619) 260-0750 today!

5 Tips for Preventing Injury During Swimming

Swimming is a low-impact exercise that works all the muscles in the body. Even though swimming is the preferred type of exercise to maintain fitness and rehabilitate certain injuries, there is still a risk of swimming injuries, commonly shoulder injuries, if you are not using the proper swim stroke technique.

Here are some key components to consider when swimming:

Bilateral Breathing This is the ability to breathe comfortably on both sides resulting in equalizing muscle development and symmetry
Posture Tightness in chest musculature or rounded shoulders can put you at risk for shoulder impingement
Kick Your kick should originate from the hips with a slight bend in the knee at all times.
Catch and Pull “Catch” is when hand enters the water and your thumb should NOT enter the water first to prevent internal rotation at the shoulder. “Pull” is the sweeping phase when arm pulls through the water to move the body forward. During the “pull”, the arm should NOT cross midline or reach out too wide.
Body Rotation I.e. as the right arm enters the water, the body should rotate slightly toward the left and vice versa.

In addition to the above tips mentioned, strength training to the rotator cuff, scapular stabilizers and core muscles will enable a more powerful and efficient stroke.

TRX Bent Knee Row
- Complete 3 sets of 10 repetitions
- Starting position: hang shoulder under handles with arms straight, back and hips straight with knees bent and feet flat on the floor.
- Movement: Pull body up so sides of chest make contact with handles while keeping the body straight. Return until arms are extended straight and shoulders are stretched forward. Repeat as directed.

Shoulder Extension with Theraband (Speed Skiers)
- Complete 3 sets of 10 repetitions
- Starting position: Anchor an elastic band to a secure object at top of the door. Grab ahold of both ends of the exercise band and place your arms straight out in front of you.
- Movement: Extend your arms backward while keeping your elbows straight and squeezing your shoulder blades down and back. Return to the starting position. Repeat as directed.

Medicine Ball Slams
- Complete 3 sets of 10 repetitions
- Starting position: standing with a medicine ball in both hands.
- Movement: Take medicine ball overhead, slam straight down, catch the ball, and repeat.
- Tip: Stance may be a little wider than normal.

Shoulder Internal Rotation with Resistance Band
- Complete 3 sets of 12-15 repetitions
- Starting Position: Begin by placing an exercise band at chest height securely in a door jam. Standing perpendicular to the doorway with the arm you wish to exercise closest to the doorway. Place a towel roll between your elbow and your side and bend the elbow to be exercised to 90 degrees.
- Movement: Slowly bring your hand towards your stomach, keeping your elbow bent and arm at your side. Repeat as directed.

Shoulder External Rotation with resistance band

Shoulder External Rotation with Resistance Band
- Complete 3 sets of 12-15 repetitions
- Starting Position: Begin by placing an exercise band at chest height securely in a door jam. Standing perpendicular to the doorway with the arm you wish to exercise furthest from the doorway. Place a towel roll between your elbow and your side and bend the elbow to be exercised to 90 degrees.
- Movement: Slowly pull the band away from you, keeping your elbow bent and upper arm at your side. Repeat as directed.

Pectoralis stretch
- Hold the stretch for 30 seconds and complete 3 sets
- Starting position: Begin standing with a doorway about 1-2 feet in front of you. Bend the elbows of both arms to 90 degrees, raise both arms so the upper arms are parallel to the floor, and place your forearms on either side of the doorway.
- Movement: Step forward with one foot so that it’s on the other side of the doorway. Slowly shift weight onto the front foot until you feel a stretch in your chest. Hold as indicated.

References:

1. Tovin BJ. Prevention and treatment of swimmer’s shoulder. N Am J Sports Phys Ther. 2006;1:166–175.

2. Improving your front crawl technique. Swimming.org website. Published on November 24, 2014. Accessed October 22, 2020.

How to ACTUALLY Activate Your Core

“Activate your core!”

“Squeeze your core!”

“Tighten up your core!”

If you have been to physical therapy or seen a personal trainer, you’ve likely heard the term “activate your core”. But do you know what this really means? Do you know what your core is, actually? Well hopefully this post clarifies what the core is, how it works, and why it is important in movement and even not in movement!

Let’s start with anatomy:

The core is made of many muscles and a few different structures. Think of the core as a large soup can – it has a top, a bottom, and then an encasing cylinder to connect above and below. The top of our core is the diaphragm – this is our main muscle of respiration (breath).

Many people in our society tend to have difficulty breathing with the diaphragm and begin to breathe with accessory muscles in the neck, chest, and shoulders. The bottom of our core is the pelvic floor – this is a complex structure that males and females both have to help keep our organs in our trunk. This is often a neglected part of the core contraction. Now to the familiar muscles – the abdomen. We have the abdomis recti, the internal and external obliques, and the transverse abdominis. This is our front and side core. It includes very deep muscles that act like a corset around us to help stabilize our trunk. Lastly, we have our multifidi and smaller stabilizing muscles in our backs. These help to segmentally stabilize each vertebrae in our spines. Some anatomists and therapists also consider the glutes as part of the core.

So, what does the core do? The core muscles work in conjunction with each other to keep our organs in place, increase intrabdominal pressure (which actually makes us stronger in the moment), stabilize our spine, stabilize our trunk for our limbs to function better, and to help us breathe properly. These muscles do so much for us on a daily basis and are definitely one of the most important parts of our body for daily function.

So how do I activate my core? Listen up because this is the most important and useful part of this post. Here are a few ways and tips to think about while “activating your core”!

Diaphragm: place one hand on your stomach and one on your chest – take a breath in and try to fill your belly first prior to your chest rising. Then let it all out. It doesn’t matter if you use nasal or mouth breath for this activity, but nasal breathing does have some additional perks. Taking a belly breath is the best way to ensure you’re using your diaphragm.
Pelvic floor: This can be tricky for a lot of people. Think of a kegel exercise… a kegel is when you consciously contract your pelvic floor like you are trying to clinch your bottom and for lack of a better word, “pull up your genitals”. Another cue that helps many people is acting like you are trying to stop the flow of urination. For men, think about walking into a cold body of water – we’ve all been there! Make sure after you squeeze you relax that contraction fully.
The abdominal muscles: there are many cues for this – pull your belly button toward your spine, pull your belt buckle towards your belly button, tuck your ribs, and smashing your back into the table are all very common. My personal favorite to ensure proper abdominal contraction is through using breath. Take a belly breath in, then on the exhale, draw your ribs down toward your feet. With exhalation, our abs naturally want to help, so we use this to our advantage with this technique. Once you are able to feel your belly tighten – you are ready to apply this technique to other functional activities such as lifting, bending, squatting, and carrying.

I hope this post helps clarify what the core is, why it is important, and how to activate it properly. If you have more questions about the core and how to activate it best for you individually give us a call at Innovative PT and schedule an in-person or virtual appointment!

Innovative Physical Therapy, “Solutions in Motion”

619-260-0750

info@innovativept.net

Start 2021 Off Right With a Custom Health Check

January 1st is a chance to start anew, and after a year like 2020, boy do we need it! If you’re anything like us, your New Year’s resolution list requires a few scrolls, but we have one more to add to the list.

It can be easy to stick to your routines and forget about your general health, so we’re here to remind you that it’s probably time for a check-up. At Innovative Physical Therapy, we offer custom Health Checks that act as a status update on your overall health. There really is no better time to make sure you’re in tip-top shape than the new year.

The benefits of a Health Check include:

Decrease your risk of injury
Improve your overall health
Live an active life
Decrease daily aches and pains
Improve overall energy and quality of life

Our Custom Health Check usually costs $180 but to help celebrate a much-anticipated 2021, we’re offering it for $140 for a limited time.

Let us help answers some of your questions…

Why Should You Get a Health Check if You’re Not Injured?

Much like getting a physical and checking your overall health from your primary doctor, a physical therapist can address the specific needs of your musculoskeletal system, which is comprised of your muscles, bones, cartilage, tendons, ligaments, joints, and other connective tissues. A musculoskeletal evaluation can ensure that these essential internal structures are working together to support, stabilize and move your body.

Most people assume physical therapy is for those with current injuries or post-surgery. Physical therapy can help prevent future injury and help decrease pain that you may not consider chronic but could be avoided.

What Happens During the Evaluation?

During your Custom Health Check, your physical therapist will review your medical history and perform a series of tests to check your strength and ability to coordinate and move your body from head to toe, including a custom movement screen. Based on the information gathered from the screen, we can best help you reach fitness goals and prevent future injuries. We always recommend scheduling regular checkups before a problem even arises.

Start 2021 off right and give your body the physical check-in it needs!

With the help of your physical therapist, you can move better, feel better, save money, and prevent injuries!

Please call to schedule your custom checkup today to receive a discounted price of $140 for a limited time.

Innovative Physical Therapy, “Solutions in Motion”

619-260-0750

info@innovativept.net

How Much Weight Should I Be Lifting?

COVID-19 has made working out from home a new reality, and with that, it’s also made hand weights a hot commodity as they have been sold out for months. If you’re lucky enough to have a set, you might be wondering what weight is best for your body.

To ensure safe weightlifting, follow these easy tips that apply the RPE Scale (rate of perceived extension).

We are open for in-office and virtual services! Call (619) 260-0750 today to book your next visit!

A Beginner’s Guide to Resistance Training

The health benefits of strength training are numerous: strength training can reduce the risk of many conditions (i.e. cardiovascular disease, diabetes, osteoporosis, depression), promote fat loss, and, of course, improve strength and fitness levels. While there are clear benefits to beginning a strength training program, getting started can be a daunting task.

To build strength, according to the American College of Sports Medicine, we should lift 60-80% of our 1 rep maximum (the most amount of weight that can be lifted once) for 8-12 repetitions per set. But what is our 1 rep max? Many individuals don’t know. An alternate way to appropriately lift the correct weight is to rely on rating of perceived exertion (RPE), which has been shown to correlate well to 1 rep max. An easy way to rate RPE is through a 0-10 scale, with an RPE of 0 equivalent to rest (no effort) and an RPE of 10 equivalent to maximal effort.

With an understanding of RPE, beginners should strive for a set of 8-12 repetitions with good technique and aim for an RPE of 5-7 out of 10. Repeat for 1-3 sets. Remember, it is better to underestimate how much weight can be lifted than to overestimate, which can lead to injuries. If you find that the set was not as difficult as you thought it would be, you can always adjust next time with additional resistance.

How often should I be resistance training?

According to the National Strength and Conditioning Association (NSCA), a general guideline is to allow for 1-3 days of rest in between exercise of the same muscle groups. The NSCA recommends 2-3 weightlifting sessions per week for those at the novice or beginner level and 3 lifting sessions per week for those at the intermediate level. An intermediate level lifter can strength train up to 4 times per week if muscle groups are split into separate days (i.e. lower body on M/Th, upper body Tu/F).

I’m getting stronger. How do I progress my exercise?

Here are a few simple ways to make your routine a little harder: increase reps/sets, increase resistance, and/or decrease rest time. You can also start mixing some new exercises into your routine.

If you have any questions, please don’t hesitate to ask! Give us a call 619.260.0750.

References:

Westcott W. ACSM strength training guidelines: role in body composition and health enhancement. ACSM’s Health & Fitness Journal. 2009; 13 (4): 14-22.
Westcott W, Winett R. Applying the ACSM guidelines. 2005. https://www.athleticbusiness.com/health-fitness/applying-the-acsm-guidelines.html.
Morishita S, Tsubaki A, Takabayashi T, Fu J. Relationship between the rating of perceived exertion scale and the load intensity of resistance training. Strength Cond J. 2018; 40 (2): 94-109.

Mask Myths & Facts

MASKS & TMJ

The Centers for Disease Control and Prevention issued a recommendation that everyone wear a cloth face-covering mask in public to slow the spread of coronavirus. COVID-19 can be spread by tiny droplets that get into the air when we cough, sneeze or even laugh or talk. Wearing a mask also can help contain the droplets you produce.

Many of us hold our faces with more tension or with our chin forward to hold our masks in place which can increase or even create symptoms of TMJ. Temporomandibular joint dysfunction is pain and compromised movement of the jaw joint and the surrounding muscles.

Here are some tips to avoid mask pains and aches:

Trust the elastic on your mask and let it do the work of holding your mask in place, not your jaw! Relax your face, let your tongue rest of the roof of your mouth, teeth slightly apart. If your mask slips while you are in this position, take it as a sign that you need to find one with a better fit.

An ill-fitting mask can also cause headaches by tugging on your ears. This can be caused by the auriculotemporal nerve which runs just in front and above the ear into the scalp. Try finding a mask with longer elastics or try extenders for glasses or goggles. Those will eliminate ear loops all together.

Having your nose covered may prompt you to breathe through your mouth rather than your nose. Breathing through your mouth causes you to hold it slightly open which leads to tension and pain. Breathing through your nose is not only preformed in a more relaxed position, but also helps your body get more oxygen with each breath which expands your blood vessels and soothes muscle tissue.

MASK MYTHS

Myth: The mask only protects others, not the wearer.

Truth: Masks actually protect both the wearer and others around them. The No. 1 goal of masks is to contain people’s germs and prevent them from reaching others.

Myth: Masks with exhalation valves are more comfortable and offer the same amount of protection.

Truth: Masks with exhalation valves are not nearly as safe and do not limit the spread of COVID-19. Exhalation valves allow germs/droplets to be expelled into the air around you, putting others at risk.

Myth: Wearing a mask causes a dangerous build-up of carbon dioxide if worn for long periods of time.

Truth: There is no science supporting this. Wearing a mask is a safe practice.

Health care workers have been wearing masks for prolonged periods of time – many, many hours for longer surgeries and things like that without incident. That’s because CO2 particles are extremely small, unlike viral loads, and can pass through masks. That’s even the case for a higher protection mask like an N95.

Myth: I’m wearing a mask, so I don’t need to social distance.

Truth: Social distancing AND mask wearing is the most effective combination in limiting the spread of COVID-19.

Wearing a mask limits droplet spread to about one foot. But that doesn’t eliminate it altogether. Additionally, all of the scientific data and recommendations assume masks are being worn properly by everyone, which is certainly not the case.

MASK FAQ’s:

WHO YOU PROTECT BY WEARING A MASK

By wearing a mask, you are protecting yourself and further protecting those who are at a higher risk of developing severe illness, including people who are or have:

Asthma
Lung disease
Diabetes
Serious Heart conditions
Kidney disease
Liver disease
Obesity
Elderly adults over 65
Immunocompromised
Pregnant or breastfeeding

WHAT KIND OF MASK SHOULD YOU WEAR

The gold standard N-95 mask is 95% effective at keeping the wearer free of inhaling viral particles. These masks are still best reserved for front-line workers in high risk settings where aerosols of viral particles occur. Surgical masks are less effective and cloth face coverings even less so in protecting the wearer. However even a 50% reduction in viral transmission is statistically important.

For the general public, the reason for wearing a facial covering is to help protect others from you when you cough, sneeze or even talk and spray viral droplets into the air. Many people who become infected can unknowingly spread the COVID-19 virus because they have few or no symptoms. So wearing a mask is showing respect for others and is your way of helping lessen the spread of the disease. It is important that the mask not be so thick as to make breathing through them completely uncomfortable. Filter inserts are probably not necessary and may make the masks more uncomfortable.

HOW TO WEAR A MASK PROPERLY

Cloth face coverings should-

fit snugly but comfortably against the side of the face
be secured with ties or ear loops
include multiple layers of fabric
allow for breathing without restriction
be able to be laundered and machine dried without damage or change to shape

Do NOT touch your eyes, nose or mouth when removing the mask and wash your hands immediately after mask removal.

WHO SHOULDN’T WEAR A MASK

Cloth face coverings should NOT be placed on:

Young children under age 2
Anyone who has trouble breathing
Anyone who unconscious, incapacitated or otherwise unable to remove the mask without assistance·