Women’s Health: Pelvic Therapy

Pelvic What? Therapy?

We know, nobody wants to talk about “down there” and the many issues you can have or already experience. So instead, we will talk about it for you and let you know how therapy CAN help you! Warning – we are holding back nothing so you get the answers you need!

Can help with what? You may ask

Let us enlighten you!

Incontinence: This in when you are unable to hold urine or fecal matter. There are different types of incontinence including stress, urgency, overflow and total. The most common are urge and stress incontinence.

Prolapse: This is when your bladder, vagina, or anus start protruding and “falling” outside of you. You may feel a bump on the outside as you wipe and this is due to your internal organs beginning to drop.

Pelvic Pain: This can encompass a lot of people and symptoms and is primarily any pain you have in the lower abdomen. It may feel like cramping, stabbing, or tingling. It is typically from reproductive, digestive, or musculoskeletal systems being inflamed. It can also be called pelvic Inflammatory disease (PID).

Low back pain during pregnancy and post-partum: This is very common in pregnancy and is pain in the low back, Sacroiliac (SI) joint, and may also have pain down the leg causing sciatica.

Diastasis Recti: This is separation of the abdomen. It typically occurs after a quick weight gain, often associated with pregnancy.

Dyspareunia: Otherwise known as painful intercourse. It can also be associated with vulvodynia in which is pain around the vagina and vaginismus in which the vaginal muscles contract too much, typically felt more with pressure during intercourse and using the restroom.

No way therapy is able help with ALL that! I have been dealing with it for so long! How can it help? You may ask

The one thing all of these things have in common are “the pelvic floor”. The pelvic floor is consists of these muscles

  • Levator ani: pubococcygeus (pubovaginalis, puborectalis), iliococcygeus
  • Coccygeus/ischiococcygeus
  • Piriformis
  • Obturator internus

We know, big words, but these muscles are the basis of how we treat any pelvic floor dysfunction. As you can see in the picture above the pelvic floor is the “bottom of the bowl” with your hip and pelvis bones. As we discuss a few things, it is good to return to the picture as needed for reference. Typically with any of the issues mentioned above, the pelvic floor has some weakness and in the case of incontinence and prolapse, the weakness will be the worst.

So how do you strengthen the pelvic floor?

I am sure you have heard of Kegels before and may or may not try to do them on occasion. And when asked, how do you do a Kegel? You may answer “I pretend like I need to stop my urine flow”. This is good, however it does not completely entail the full pelvic floor. How I describe a Kegel to my patient’s is very direct, but it paints a good picture. Women have three holes “down there” that sit within the bottom of the pelvic floor bowl. If you just stop your urine flow to do a kegel you are only getting the front of the pelvic floor. What you want to do is try to pull all three holes up at the same time. A few good illustrations are 1. Think like you have the flu and have to run to the bathroom to make it on time. When doing this, we typically engage every bit of our pelvic floor to avoid an accident and 2. Pretend like you are sitting on some hot coals and the only way to avoid burning yourself is to pull the pelvic floor off the chair.

How many should I do?

When doing Kegels, don’t just do 30 all at once like you would for a normal workout routine. The pelvic floor needs to be engaged multiple times throughout the day so I recommend finding an activity you do often, i.e. checking facebook, checking emails, answering the phone, stopping at a stop light or sign, or changing and feeding you newborn, it can be virtually anything that is repeated throughout the day, and do one Kegel holding for 5 seconds, YES just ONE at a time. But if you are doing this activity 10-20 times a day, you are then doing 10-20 Kegels a day!

If all I have to do is Kegels, then why would I need therapy?

In addition to proper education and engagement of Kegels, we also look at pelvic alignment. Due to women’s hormones, the shapes of our pelvis, bearing children, and even the pressure during intercourse, our pelvis can become misaligned.

How do you fix it?

Using muscle energy techniques we can help correct the alignment of the pelvis. Muscle energy is a gentle technique that uses your muscle against the therapists’ gentle resistance to move the bones back to where they should be. There is no forceful thrust or manipulation involved and it should not be painful.

Can’t I just go to a chiropractor to fix the alignment?

Yes, you could, however in physical therapy we are correcting your hips using your muscles. When doing this, you are retraining the muscles to contract or to release depending on your goals, in order to keep the alignment. It takes fewer visits to achieve this when you use the muscles rather than a forceful manipulation.

And then what?

And then we stabilize and strengthen your core, pelvic floor, and hip muscles to keep the alignment. Using the muscles to realign the hips and then using the muscles around the hips to stabilize helps significantly to improve your outcome.

What types of diagnoses is this used for?

ALL of the conditions mentioned at the beginning of the article benefit from this!

  • Incontinence and prolapse is primarily weakness in the pelvic floor. You can do kegels all day long, however if your hips are out of alignment, it can cause one side of the pelvic floor to be stretched, the other to be contracted and tight. When this happens, the kegels are not as effective. So to make it worth your time to do the kegels, we correct the hips first. This is also beneficial after a surgery for prolapse bladder.
  • Pelvic pain and low back pain (associated with and without pregnancy) typically has some type of mal-alignment in the hips. Correcting the hips first allows us to strengthen the core, pelvic floor and surrounding hip muscles with better outcome.
  • Dyspareunia can be associated with tightness and difficulty relaxing the pelvic floor, weakness in the pelvic floor, and hip alignment. If the pelvic floor muscles are in constant spasm, it can pull on the hips affecting the whole structure. So with strengthening the pelvic floor and alignment, we teach relaxation of the pelvic floor as well.

And a few other treatments:

Myofascial release: In some instances the pelvic floor muscles become too contracted and tight and you may have difficulty relaxing completely. This can cause the issues of vaginismus effecting intercourse or even the pressure with wiping. In order to help with this we can do an external release of the pelvic floor in which we focus on allowing the muscle to go from a contracted state to relaxed state by gentle pressure and massage.

Biofeedback: Are you having trouble getting the concept of doing a kegel correctly or feel like you are not doing it at all? A biofeedback machine helps you see how well you are engaging those muscles. It uses a probe in the vagina and can also have a lead on the abdomen wall to give you feedback on how well you are contracting and how well you are relaxing those muscles as well.

Painful Intercourse: Physical therapy for this issue is a lot about education as well as focusing on the aforementioned strengthening and manual techniques. Remember ladies, men are like microwaves, you hit the start button and they are warmed up and ready but women are ovens, we need to be preheated. When we “preheat” our bodies are much more relaxed and ready, which in itself can decrease the pain.

Astym for scar tissue: Astym is a technique using some tools that can help to break up scar tissue. For women’s health we think of c-sections or multiple laproscopies in which scar tissue can build up around the abdomen. The tools can help the bottom to resorb the scar tissue and then with strengthening get you feeling strong and painfree again.

Whew! This is a lot….but we are almost done!

Lastly, I think physical therapy post-partum needs to be discussed. Women’s health physical therapy is not JUST incontinence or even pelvic pain. It CAN BE simply, you had a child via either vaginal deliver or c-section and you need help strengthening those pelvic floor and hip muscles again.

Think of what your body goes through from conception to child birth!

As the baby grows inside of you your ligaments soften and start to stretch in order for your hips to open up and make room for the baby. Not to mention, your abs begin to expand and there is a lot more pressure on the pelvic floor. Yes, some back pain, round ligament pain, pelvic pain is common in pregnancy, however pain where you have difficulty walking, standing, rolling in bed, can be helped while you are pregnant and it is 100% safe for you and the baby! We focus on the hip alignment, stabilization, and strengthening as mentioned above.

Next when baby is born vaginally, you are stretching every muscle in your pelvic floor and the hips are separating. Think of all the weakness that can occur just from the stretching! Some women may even encounter a pubic symphysis separation which can be very painful (p.s. therapy CAN help!).

If the baby is born via c-section, think of all the layers of muscles being cut! Surely there will be a lot of weakness just from cutting through the muscle and fascia. And imagine if it is your 2nd, 3rd, 4th, and so on c-section!

So what do I really need to take from all of this?

PHYSICAL THERAPY CAN HELP!

Most women don’t recognize physical therapy is an option for them! They think having incontinence can be “normal”, pelvic pain is “normal”, back pain from pregnancy is “normal” and they don’t recognize it doesn’t have to be normal anymore. Most women also believe physical therapy is just for incontinence, however we see many women that are fully continent but the issue is more with pain in the pelvis, pain during intercourse, or no pain at all and has a diastasis recti preventing them from getting back in shape and into their full workout routines.

Does any of this “down there” talk seem to be hitting close to home for you? If so seek out a physical therapist! You will be glad you did!

October is Physical Therapy Awareness Month!

October is Physical Therapy Awareness Month!

How Can Physical Therapy Help You?

What is a Physical Therapist?
A physical therapist (PT) is a licensed healthcare professional. The education involved in becoming a PT is intense and takes approximately 7 years to complete from start to finish. Once a PT becomes licensed, he or she will be required to fulfill a continuing education requirement of 24 professional development hours every two years, as required by the state. This requirement is to ensure that the PT’s are staying up to date on research and medical advancements. The PT profession prides itself on practicing using current evidence-based practices.

How do you know if you would benefit from physical therapy?
The answer is simple. If pain is limiting you from doing your activities of daily living or the sport you love then PT can help you. Pain will occur in the body if there is an imbalance between muscles. The imbalance can cause stress on joints, increased tension of nerves, decreased circulation and eventually lead to a postural deformity. Manual therapy (joint mobilizations, massage, Astym etc. by your PT), modalities (ultrasound, electrical stimulation, cold pack, hot pack etc.), posture education, exercises and stretching can correct these imbalances and prevent injury or impairments.

What should you expect at a physical therapy visit?
Your physical therapist will sit down with you on your first visit (PT initial evaluation) and take a thorough history of your condition. Then your PT will complete a comprehensive evaluation to determine if you have limitations in range of motion, flexibility, strength, balance, coordination and gait. Based on the findings the PT will educate you on your diagnosis. Together you will develop a treatment plan and goals that will address your areas of limitations and your desires to get back to what matters the most to you.
From there, during your future visits, you will come in warm up, perform exercises that will address your deficits, manual therapy may be performed by your PT and modalities may be used to help decrease pain. Throughout your treatment, your PT will reassess your progress and modify or advance treatment as needed.
Initially, you should expect to come in three times per week. As you progress, your frequency may drop down to two times per week. Depending on your diagnosis and severity of injury you can expect to be coming to PT for 1 to 3 months. The goal is to have you better as soon as possible.
At the end of your treatment plan, when goals have been met, your PT will sit down again with you and look at the original deficits and measure to see if the deficits have resolved or are improving. Your PT will give you the feedback and send the information to your physician so they can see where you were and how you progressed. If the majority of the goals were met then your PT will discharge you with a home exercise program.

How can you be involved in your treatment plan for PT?
It is imperative for you to be an active participant in your treatment plan. Your involvement will determine your success. Coming in for all of your appointments and communicating with your PT is essential to your healing process. Research has shown that coming in two to three times per week enhances your healing process.

If you think you may be a good candidate for physical therapy then please call us at (248) 460-1572 and we will help you get back to what matters most.

Grocery Shopping and Proper Body Mechanics

Ever feel hurried when grocery shopping? Often, to save time, we cut corners leaving ourselves more prone to injuries. We wanted to take a moment to define good posture, body mechanics and suggest a few ways you can incorporate these principles when grocery shopping.

Good posture is defined as maintaining the normal spinal curves. The spine has five groups of bones: 7 cervical (neck), 12 thoracic (mid back), 5 lumbar (low back), 5 sacral/4 coccygeal (sacrum). When positioned properly, the neck and low back have inward curves, and the mid back and sacrum have outward curves. Proper body mechanics can be defined as posture in motion. Back pain is seldom caused by a single injury or incident. Poor body mechanics and faulty postures (i.e. postures outside of the normal spinal curves) over time contribute significantly to back pain.

Proper body mechanics allows the spine to maintain its natural curves and minimizes the stress on the joints and muscles. The use of the “ready position” will allow you to maintain good posture while moving. The “ready position” is when you knees are bent, your feet are shoulder width apart, and your weight is on your heels. You spine remains straight while you bend at your hips. It will feel like you are lowering yourself to sit down in a chair. All the normal curves of your spine will be maintained and the large muscles in your legs will do most of the work. The “ready position” should be used with all activities of daily living, including grocery shopping/bending/carry and lifting.

Moving into the “ready position”

Poor Posture Normal Curves

When carrying your groceries keep the load even on each side of your body and only take in a few bags at a time. It is important to keep your spine upright and not lean to one side to avoid injury to your back.

Make sure you pick a good shopping cart. If you get a cart and notice it is pulling more to one side or isn’t rolling easily then stop and grab a different cart. Once you start loading the cart the small pull will intensify and cause increased stress your low back.When pushing the cart try to keep your body forward and straight and avoid rotating your body while shopping. It is important to not push a load with your spine in a twisted position because this can cause injury to your back.

When getting items from the shelves it is important to use proper lifting mechanics.

BODY MECHANICS – WAIST HEIGHT LIFTING
Start by standing close to the object with feet spread apart. Bend at the knees and hips and NOT at your spine.
Hold the object close to your body as you use your legs muscles to stand back up lifting the object.
Walk over to the surface you want to set the object on to and set it down. Be sure to NOT twist your spine but to pivot your feet so that your feet are pointed forward to where you want to set the object.
Slide the object on the shelf to off load your body.

BODY MECHANICS – KNEE HEIGHT LIFTING
Start by standing close to the object with feet spread apart. Bend at the knees and hips and NOT at your spine.
Hold the object close to your body as you use your legs muscles to stand back up lifting the object.
Walk over to the surface you want to set the object on to and set it down bending at the knees slightly. Do Not bend at the spine. Also, be sure NOT to twist your spine but to pivot your feet so that your feet are pointed forward to where you want to set the object.
Slide the object on the shelf to off load your body.

BODY MECHANICS – OVER HEAD LIFTING
Start by standing close to the object with feet spread apart. Bend at the knees and hips and NOT at your spine.
Hold the object close to your body as you use your legs muscles to stand back up lifting the object.
Walk over to the surface you want to set the object on and raise it up over head with a “one-hand-under and one-hand-over” technique as shown. Set it down and DO NOT extend at the spine. Also, be sure NOT to twist your spine but to pivot your feet so that your feet are pointed forward to where you want to set the object.
Slide the object on the shelf to off load your body.

Loading and unloading your car is a critical time to think about your body position. It is easy to forget about body mechanics as you reach in the back seat or into the trunk of your car. You want to bend at your knees and hips keeping the natural curves of your back and lift with your legs. Face the area your lifting from and move your feet instead of twisting your back to get to the area where you are putting your groceries. As you set the groceries in your car make sure you are facing the area as well.


So, the next time you are grocery shopping stop and check yourself before bending and lifting. Go through the steps for the “ready position” and incorporate them in your shopping routine. The couple of seconds you take to do this could save you from a back injury that could last for months/years.

Meal Planning 101

We are getting geared up for the kick off of our Meal Planning workshop series here at Summit! We are excited to bring the basics of meal planning to you and also provide the opportunity to build upon that knowledge each month to help you become a meal planning expert.

The Basics:

  1. Start by printing out a blank calendar for the month.
  2. Add in all upcoming events for that month. By doing this, you will be able to plan more realistically for your family’s schedule.
  3. Add in easy and favorite meals. See if you can use the leftovers form these meals for something else also.
  4. Go through your freezer, fridge, pantry, etc. and make a list of what you have that needs to be used. Add those recipes using those particular items into the plan.
  5. Next, find out what coupons you have and what sales are going on. Incorporate those sales into your meal plan.
  6. Make sure you are using fresher ingredients towards the beginning of the week so they don’t go bad before you can use them.
  7. We recommend starting off planning week-by-week. Some seasoned meal planners might plan for an entire month at a time. We just find that schedules can change and can throw a wrench into your meal plans.

Expanding your meal planning skills:

  1. Create a master list of meal ideas. You can do separate lists for breakfast, lunch and dinner if you desire.
    • Check out this link for some beginner ideas
    • You can also scroll through Pinterest which has an overwhelming amount of recipe ideas you can use
  2. You want to develop an arsenal of tried and true recipes that you can use for quick meal planning.
  3. Keep your budget in mind. You don’t want to go overboard. Try finding recipes that use fewer or similar ingredients as much as possible
  4. Designate a day for meal prepping to make your week run smoother
    • Check out this link for prepping chicken
    • Try batch cooking so you can freeze sauces and things for later us
  5. Make rotating themes to help you get out of the meal planning rut. Some dinner theme ideas you could use are:
    • Pasta night
    • Taco night
    • Ethnic night
    • Salad night
    • Soup & Sandwich night
      • There’s nothing like a bowl of tomato soup paired with a crispy, gooey grilled cheese!
    • Crockpot night
    • Casserole night
      • Check out this link for some awesome Casserole ideas!
    • Freezer Meal night
      • Check out this link for some great Freezer meal ideas!
    • Seafood night
      • Shrimp scampi, fish tacos, Baked tilapia… Check out Pinterest for some great seafood recipes!
    • Grill night
      • Burgers, brats, hot dogs… perfect for a summer night!
    • Leftovers night
      • Reusing things from past meals is the easiest way to stretch your grocery budget.
    • Breakfast for dinner
      • How could you go wrong with pancakes or bacon?
    • Kids cook dinner
      • Have your child/children pick out a recipe they’d like for dinner. If they’re older, have them cook on their own. If they’re younger, spend some quality time together and cook with them!
      • Follow this link to get some ideas for some kid friendly recipes
    • Take Out night
      • For those crazy nights, sometimes it truly is easier to just grab something.
    • Restaurant night
      • We can all use a night out. 🙂
    • Sheet Pan dinner night
      • Check out this link for some sheet pan dinner ideas!
    • Meatless/Vegetarian night
      • Don’t let the thought of meatless scare you! A meatless dinner could be a fresh mozzarella, basil and tomato panini with a balsamic glaze!
    • Pizza night
      • Get creative! There are so many different types of pizza you can make at home.

If you enjoyed what you read here, come join us for our meal planning workshop series! Call our office or visit our Facebook page for more information!

Taking Care of Yourself in the Kitchen

Are you reluctant to cook anymore because of back pain, foot pain, or neck pain? It is difficult to get in the kitchen to make healthy meals or wash dishes when you are in pain after a short amount of time. We have put together a few ways to help manage or even decrease your pain to get you back in the kitchen!

Low Back Pain
Back pain in the kitchen is very common due to our position and the hard floors we stand on. When standing at the counter to cut up food or standing at the stove, our backs are not always straight. If you are tall, you are in a slight forward bend to reach down and if you are short, you may have to reach up more. Because of this, our backs can take a lot of stress.
In order to help manage pain, the first thing you want to do while standing is to “engage your core”. To do this, you are attempting to pull your navel in toward you spine and tighten your deep abdominal muscles. It should feel as if you are on the verge of laughing or coughing, or bracing yourself as if you were going to get socked in the stomach. Engaging the core helps to stabilize and protect the low back and also helps you to stand up taller so you are not leaning over as much.
Another option is trying to prep ahead of time. If you are able, cut vegetables in the morning, or prepare the meat early so you are not on your feet for extended periods. You may also find ways to prep vegetables or meat while sitting.
Prior to cooking and standing you may want to stretch your hamstrings and quads. These muscles can tight with standing in one spot to help support the lumbar spine. With the core engaged while cooking and the hamstrings and quads stretched, you are helping to manage the low back pain.

Neck Pain
Neck pain can be common in the kitchen as well due to looking down at the counter to cut, stirring a pot, or lifting heavy pots can even put stress on the cervical spine. To help manage some of the symptoms, here are a few things to try.
Check you posture often while cooking. It may be difficult to stand up tall the whole time because you have to look down, however if you keep your shoulder blades back instead of rounding them forward, it will help keep your neck in a more neutral position while looking down. It is always good to take a break in between activities and when going from cutting to sautéing then make sure your posture is good during the transition.
As mentioned with low back pain, attempt to prep what you can ahead of time so you don’t have to look down as long while cutting then cooking immediately after.
If you feel the neck gets tight and stiff, stretching your upper traps (first picture), levator (second picture) and scalenes (third picture) will help to decrease some of the tightness and relieve pain.

Foot Pain
Another common issue with standing in the kitchen is foot pain, usually plantar fasciitis, though can also be tendonitis, post-surgical, or arthritis.
To help with manage foot pain, make sure you wear supportive shoes while standing for long periods. Wearing just any shoes, sandals, or slippers will not work, rather you need to make sure they are supportive tennis shoes.
Getting an anti-fatigue mat will also help to protect your feet in standing, and dually will help with low back pain as well! Place a few of these around the kitchen where you may be standing the most to help soften the floor and protect the feet.
Lastly, you can stretch the calf and the bottom of the foot to increase the flexibility. Also using a frozen water bottle to roll on the bottom of the foot can help. Doing this before helps to keep the pain down during and doing it again after will help with any pain from standing long periods.

Along with all of these tidbits, don’t be afraid to take an anti-inflammatory or use ice or heat (whichever is most comfortable and helpful for you) in order to manage the symptoms.
Now that we have given you ways to manage the most common pain areas in the kitchen, don’t be afraid to get in there and make those healthy meals!

Taking Care of Yourself in a Car

It’s that time of year again. The time of year where school starts, which means sports, clubs, programs, and extracurricular activities are starting as well. This also means more time in and out of the car, helping the young ones get in and out, and lifting the babies in car seat carriers in and out. All of it adding up to stress on your body, specifically your low back.
There are many ways you can start feeling back pain in the car. So when can you get the pain and how can you prevent it?

Sitting for long periods
Sitting in the car where your lumbar spine is in a “flexed” position is a large proponent of low back pain. You may get this by driving long periods or by simply sitting in the car waiting to pick someone up/drop them off.
When the lumbar spine is put in more of a “flexed” position, meaning the spine is more curved, the low back can get very painful. To help ease or prevent the pain, use a lumbar support in your car. The easiest way is to roll up a towel, tape it together, and set it in the small of your back against the seat of the car. This helps create more “extension” or arching of the back, restoring the spines natural curvature.
Many of you may say, “My car seat has a built in lumbar support,” or “I can increase the lumbar support in my seat.” Yes, you may be able to do this and have no issues. However, there are cases when the seat does not provide enough and the towel works better. There are also instances in which you “cannot feel” the lumbar support. In this instance you need to look at your posture, which brings us to our second point.

Poor posture
Poor posture can also contribute to low back pain. The next time you are driving and you come to a light, become aware of your posture. Are you slumped forward? Are your shoulder blades are touching the back of the seat? Is your low back is rounded? And are you slumped to one side resting on the door or the center council? If your answer is yes to one or more of these, your posture needs to be fixed.
Starting with a good lumbar support, such as a towel roll or increasing the air in the seat to its max, you can sit in the seat making sure you feel your low back beginning to arch. If it is exaggerated, then it is too much. Next, check to make sure your shoulder blades are touching the seat as well. At this point you can grab the steering wheel with arms high or low whichever is more comfortable. Your head should also be upright and not leaning forward. Below is a good picture of what to avoid and what you should look like.

Getting kids in and out of the car
Those of you struggling to get your toddlers in car seats and lifting the infant carriers into the base may have other low back issues.
When lifting young toddlers into the car, make sure you are bending at your knees, keeping your back straight, and engaging your core. When you use your legs to lift, you are taking pressure off the lumbar support and using your core to lift helps to protect the low back.

This picture shows exactly what you want to do, the knees are bent, the back is straight, and the core is engaged. After squatting down, you can pick up your child and use your legs and core to stand back up. Once you pick up your child, make sure to keep the child close to you. You can then transfer the child to the seat and buckle them in. If you have to bend over to buckle the child in, make sure you are bending at the knees slightly and engaging the core. We call this a “hip hinge”.

Notice just the slight bend in the knees, back is straight, core is tight and engaged, and she can reach her arms out to perform an activity, specifically buckling in your toddler.
“What do you mean by ‘engaging your core?’” you might ask. The muscles of the core consist of more than just the “6-pack”, the rectus abdominis. While this muscle may be appealing, it doesn’t do much for stability since its primary role is to curl the trunk. Contracting the spinal stabilizers, particularly the transversus abdominis (the deepest abdominal muscle) is the key to spine stability and truly engaging your core.
To practice, lie on the floor and place your fingertips one inch above your hip bones and one inch in towards your navel. Continue to breathe normally as you draw your navel in towards your spine and up towards your ribcage and then slightly bear down, imagine lowering the navel towards the floor. You should feel your abdomen tighten; you may feel like you’re on the verge of laughing or coughing. Another way to think of engaging your core is to imagine you’re bracing yourself for a punch in the stomach. After getting the idea of it laying down, you are now ready to do it in any position!
You are now ready to “engage your core” while lifting and buckling in your child!

Fussing with Car Seats
What about low back pain when lifting those heavy car seat carriers and clicking your infant into the car?
Just as before, you will want to bend your knees and “squat” down to pick up the car seat, engaging your core and keeping your back straight. When doing this, grab the car seat at the bar with the crease in your elbow rather than with your hand, then turning your hand over you can grab the side of the car seat. This will help you get more leverage to lift and keep the load closer to your body, not to mention it puts less strain on your shoulders and upper back/neck as well! Once you get to the car, make sure you get as close to the base in the seat as you can. You are then able to use your free hand to hold the bottom edge of the car seat and lift using both arms to click in the seat. Don’t forget to check your core again before attempting to lift and place the car seat in the base. This will ensure your back is protected as you reach more in front of you.

When doing these tasks over and over in one day, it can get taxing on the low back, however, now you should be able to protect yourself better with correct posture, correct form, and engaging the core.

Back to School Without Injury from Backpacks

With back to school being just around the corner it is important to make sure your child has a healthy start. When buying your child’s backpack there are several tips you need to know to help prevent injury to your child’s shoulder, neck, or back. One of the most important tips is the weight of the backpack.


Did you know?
It is recommended that a child only carry 10 to 15% of their body weight in their backpack?
Examples: 40 pound child = 6 pound backpack max
60 pound child = 9 pound backpack max
80 pound child = 12 pound backpack max
100 pound child = 15 pound backpack max

If your child is carrying more than the recommended weight then your child is more prone to injury. The excessive load can create a force to your child’s spine that will make him/her compensate and compress the spine unnaturally, leading to potential shoulder, neck and back pain.

There are several causes of shoulder, neck and back pain with carrying backpacks. Some possible cause are:
• Wearing backpacks over just one shoulder
o This can cause the child to lean to one side to offset the extra weight
• Too heavy of a load
o Leads to poor posture and excessive load to spine
• Backpacks with tight, narrow straps
o Straps can dig into the shoulders and interfere with circulation and nerves -may result in tingling, numbness, and weakness in the arms and hands
• Backpack doesn’t fit child properly
• Lifting backpack improperly
When you go out to buy your child’s backpack this summer consider the following tips before your purchase:
1. Start with a lightweight backpack made of lightweight material.
2. Make sure the shoulder straps are wide and padded. Wide, padded straps provide support and prevent the straps from becoming too tight or digging into your child’s shoulders. The straps should be snug, but not so tight that they cause discomfort.
3. The back should also be padded. Padding that sits against your child’s back will provide additional support and prevent discomfort.
4. Look for a backpack with a waist strap. A waist strap holds the contents closer to your child’s back, which will decrease the load and help him or her maintain balance.
5. Multiple compartments are a plus. If your child’s backpack has multiple compartments, it will be easier to evenly distribute the weight of the items inside. The heaviest items should be packed low and toward the center of the bag.
6. Both straps should be worn at all times. Make sure your child is always wearing both straps. Wearing both straps can also help distribute the weight more evenly and prevent your child from leaning to one side.
7. Do not overload! Remember the backpack should be no more than 15% of your child’s body weight. Anything more than that can force children to slouch or hunch to compensate for the extra weight. Remove any items that are unnecessary, and encourage your child to carry heavier items in their arms, if possible.
8. Make sure the backpack is the correct size for your child. The backpack should not be wider or longer than your child’s torso and should not hang more than 4 inches below his or her waist.

It is important as parents that we educate and instruct our children in backpack safety. Involve your child by weighing your child and then weighing the backpack. Figure out together what 15% of their body is. Then show them what that weight feels like in a backpack so they can understand what too heavy of a load is and how it can vary with the fit of the backpack. Encourage your child to use their locker throughout the day instead of carrying the entire days worth of books in the backpack. Help prioritize with your child items that are needed to be carried in the backpack vs. items that can stay home or be left at school. Instruct your child in how to pick up their backpack. As with any heavy weight, they should bend at the knees and grab the pack with both hands bringing their backpack close to their body when lifting a backpack to the shoulders.
We hope you found these tips helpful and help you get off to a healthy start to the school year!

Resources:
https://www.moveforwardpt.com/resources/detail/backpack-safety
https://kidshealth.org/en/parents/backpack.html
https://www.nsc.org/home-safety/safety-topics/child-safety/backpacks

7 Backpack Safety Tips

The Importance of Sleep

Sleep is crucial to a person’s mental and physical health. When you sleep, you allow your body ample time to heal and repair for what’s to come the next day. Your body needs that time to rest and recharge. When we don’t get enough sleep, you will begin to experience a variety of unpleasant side effects. If your body becomes deprived of sleep for long periods of time, it becomes extremely dangerous to your health.

The Importance of Sleep

It’s important to know that your body goes through 5 stages of sleep. Each stage of sleep is vital to ensure you wake up feeling rested. When even one of those stages is interrupted, you will notice negative side effects the next day.

According to Tuck.com, A complete sleep cycle takes an average of 90 to 110 minutes, with each stage lasting just 5 to 15 minutes. Stages 1-4 are non-REM (rapid eye movement) sleep and stage 5 is REM sleep. “REM sleep stimulates the brain regions used in learning. This may be important for normal brain development during infancy, which would explain why infants spend much more time in REM sleep than adults. Like deep sleep, REM sleep is associated with increased production of proteins” (psychcentral).

Without adequate sleep, you may experience some of the following troublesome symptoms:

  • Trouble remembering things
  • Negative moods, quick to anger or become irritable and more emotional
  • Weight gain due to increased appetite
  • Weakened immune system

In order to get a good night’s rest, we must eliminate as much stress as possible. Setting a nightly routine can be very beneficial in doing so. Below are some tips you could try implementing into your nightly ritual to help ensure better sleep.

  • Set a bedtime. Start by figuring out what time you need to get up in the morning and how many hours of sleep you need to properly function. Below are the recommendations from the National Sleep Foundation.

  • Set a time you want to start winding down. This should be at least 2 hours before you plan on getting into bed.
  • Make sure your meals are packed and prepared for the next day. Prepare coffee for the following morning, breakfast, water bottles, lunches, and have a plan for dinner.
  • Make sure all of your normal chores are done. The dishes are done and the sink is empty, no laundry is left in the washing machine, any clean clothes you have washed are folded and put away. Do a quick reset around your home. Taking care of the clutter makes for a more peaceful environment when trying to wind down. You will be able to relax and wind down without being stressed about the chores or clutter you have piling up around you.
  • Lay out your clothes for the next day to avoid rushing around and stressing because you can’t find what you need.
  • Try not to drink alcohol or eat a heavy meal or snack too close to bedtime as that will have a negative effect on your sleep pattern.
  • Do something that relaxes you. Things like sudoku, reading, word searches, crosswords, solitaire, etc. are great things to do before bed. Try to avoid watching TV when trying to go to bed. The light from the TV will affect your sleep pattern and if you’re watching something you really enjoy and want to pay attention to, chances are you’ll stay up later. It’s suggested to turn off all electronics an hour before bedtime and avoid any bright lighting.
  • Try putting on lotion with soothing scents.
  • Make sure your bedroom is a comfortable temperature.
  • Have a warm cup of tea. Try Celestial’s Sleepytime tea.
  • Try yoga or stretching before bed to relax your body and your mind. If you’ve never tried yoga before, try the simple yoga sequence below or give one of our Thursday night Yoga classes a try! Click the image below to access a free printable!

Which tips will you try to implement into your nightly routine? Do you have any useful tips? Feel free to share them with us!

DID YOU KNOW?
You can actually lose brain tissue after just one night of sleep deprivation?
– The Huffington Post
When you fall asleep while overthinking, the mind remains active as if you were awake which is why you tend to wake up tired.
– ThePsychMind.com
If you feel tired even after a good night’s sleep, you may be dehydrated. Drinking water can help you wake up.
– ThePsychMind.com

Sources:
www.sleephealth.org
https://www.better-sleep-better-life.com/
https://www.tuck.com/stages/
https://psychcentral.com/lib/the-importance-of-rem-sleep-dreaming/

3 Most Common Golf Injuries

I. Elbow Pain – commonly known as “Golfer’s Elbow”

What is it?
Golfer’s elbow (medial epicondylitis) causes pain and inflammation in the tendons that connect the forearm to the elbow. The pain centers on the bony bump on the inside of your elbow and may radiate into the forearm.
What causes Golfer’s Elbow?
Golfer’s elbow can be caused by an acute injury or an overuse injury. Most often, golfer’s elbow is the result of an overuse condition where a specific activity performed many times causes a chronic irritation to the tendon. Golf is one common cause of these symptoms, but many other sport and work-related activities can cause the same condition.
How can you treat Golfer’s Elbow?
Golfer’s elbow is a problem that may heal with simple treatment. Treatment is rarely surgical, as this condition is well managed with a little rest and proper rehabilitation.
Lifestyle Modification – Lifestyle modification is important if golfer’s elbow does not resolve or if it recurs. With golfers, often a change in technique a change in equipment, such as a different size grip, can help to resolve the problem.
Changing Swing Mechanics – Golf clubs should be sized properly, including grip size. Swing mechanics should be evaluated to ensure patients are swinging properly. See a golf pro/instructor for a swing and club evaluation. Usually, the development of golfer’s elbow is a sign there is something wrong with the swing that can be addressed.
Anti-inflammatory Medications – Anti-inflammatory medications are often used to help control pain and inflammation. The oral forms of these medications are easy to take, and often help control the inflammation as well as manage the pain associated with golfer’s elbow.
Cortisone Injections – If these conservative measures fail, a steroid (cortisone) injection is a reasonable option. If a person has tried more than two cortisone injections without relief, it is unlikely that additional injections will benefit the patient.
Stretching & Exercises – Some simple stretches and exercises can also be helpful in controlling the symptoms of golfer’s elbow. These exercises should not cause pain, and if they do the exercises should not be done until the pain resolves. By strengthening the muscles and tendons involved with golfers’ elbow, you can help prevent the problem from returning.
Here are the most common stretches to perform to help alleviate the pain and stretch the muscles involved:

Passive Wrist Flexion/Extensor Stretch

With the elbow straight with palm down, use opposite hand to pull wrist back.

Passive Wrist Extension/Flexor Stretch

With elbow straight and palm up, pull wrist back using the opposite hand

If conservative measures do not help relieve the pain, consider Physical Therapy. We do a technique called Astym ® which specifically helps to heal the soft tissue in the muscle with overuse injuries. You can click here for more information and how it may help you: www.Astym.com

II. Shoulder Pain

What kind of shoulder issues can you have with golf?
The most common shoulder injuries with golf are:

Labral tears – Tearing and/or fraying of the cartilage ring around the socket of the shoulder joint
Rotator cuff tears – Tear of one of the 4 muscles (most commonly the supraspinatus) that make up the rotator cuff
Tendonitis – Inflammation of the supraspinatus muscle tendon
Impingement – pinching of something between two bones.

What can cause these injuries?

Shoulder injuries can be a combination of overuse and poor form which can cause inflammation of the rotator cuff tendons. Weakness in the rotator cuff muscles as well as poor posture may also attribute to the injuries.

How can you treat shoulder injuries?
The best way to treat shoulder injuries is strengthening, stretching, and posture changes. Below are some of our favorite rotator cuff exercises as well as posture exercises and pec stretches.

ELASTIC BAND SHOULDER EXTERNAL ROTATION (ER)


While holding an elastic band at your side with your elbow bent, start with your hand near your stomach and then pull the band away. Keep your elbow at your side the entire time.

ELASTIC BAND SHOULDER INTERNAL ROTATION (IR)

While holding an elastic band at your side with your elbow bent, start with your hand away from your stomach, then pull the band towards your stomach. Keep your elbow near your side the entire time.

STANDING ROW WITH THERABAND

Anchor the bands in front of you at waist height as shown. Begin with your arms straight in front of you, and pull your elbows next to your body, squeezing your shoulder blades. Slowly return to the starting position and repeat.

ELASTIC BAND SCAPULAR RETRACTIONS WITH MINI SHOULDER EXTENSIONS


While holding an elastic band with both arms in front of you with your elbows straight, squeeze your shoulder blades together as you pull the band back. Be sure your shoulders do not raise up.

PEC CORNER STRETCH


Upper arms should be parallel to ground. Don’t hyperextend low back. Shoulder blades should be down back and together. Lean forward to feel a stretch in the pecs. Can move arms up or down to get a different stretch of the pecs

THORACIC ROTATION


Laying on your side, keep your hips stacked and rotate your upper body so your arm is flat against the bed/floor.

III. Low back pain

Low back is the most common golf injury, not surprisingly.

What can cause the low back pain?

The repetitive action of the golf swing is the number one cause of low back pain in golfers. A ‘Reverse Angle’ swing fault is a common cause of back pain that occurs when the spine deviates from the vertical during the swing.
Numerous structures of the lower back can be affected – the discs, ligaments, muscles or Facet joints – but in golfers, particularly older ones, the discs are most commonly affected. A herniated disc or ‘slipped disc’ refers to a protrusion of gel material from inside the disc. This can cause back pain and / or Sciatica, particularly when bending forwards.
Weakness in the core and hips as well as decrease flexibility of the hamstrings, hip flexors and tight rotation can also cause more strain on the lumbar spine with the repetitive motion of swinging.

How can you treat the low back pain?
Correct any faulty swing you may have. Are you compensating because you are tight or because of weakness? If so, this compensation needs to be address and corrected.
The most beneficial treatment is doing core strength and stability exercises. This can help decrease your pain as well as prevent future injuries. Here are a few core exercises to get you started.

PELVIC TILT – SUPINE


Lie on your back with your knees bent. Next, arch your low back and then flatten it repeatedly. Your pelvis should tilt forward and back during the movement. Move through a comfortable range of motion.

BRIDGING


While lying on your back, tighten your lower abdominals, squeeze your buttocks and then raise your buttocks off the floor/bed as creating a “Bridge” with your body. Hold and then lower yourself and repeat.

Hip Hinge Level 1


Stand holding a rod (or your golf club) in contact with your spine. Try to maintain the same points of contact as you squat down. Your butt should go backwards as you squat down and your knees should flex but SHOULD NOT move forward. Keep your stomach engage to keep your back as flat as you can.

Stretching before and after is also very beneficial. Below are some stretches you can do right at your golf cart warming up.

Hip Stretch:


Standing with one foot on cart. Place club behind back and bend forward on front knee. Lean into front leg and rotate trunk toward same leg. Repeat for other leg.

Trunk/Shoulder Stretch:


Standing in backswing position. Hold club at each end. Rotate further into backswing to feel stretch in chest, hip, trunk, and back of shoulder. Repeat for other side.

Hamstring/Chest Stretch:

Standing with one foot on cart, hold club behind your back. Raise arms up behind you as you lean chest toward extended leg. Should feel stretch in hamstring and chest/arms.

References: www.hep2go.com; www.verywellhealth.com; www.physioroom.com

Safety Tips to Help Avoid Injury doing Yard Work

It’s the time of year where we all love to be outside and of course yard work comes with it. We have compiled some ways to help you get through the hard yard work in the spring, maintenance in the summer months, and cleaning up in the fall without injury.

First, make sure you warm up. We know it may sound silly, however you are more prone to injury if your muscles are “cold” and not ready for activity. Warming up could be just taking a nice 5-10 minute walk around the neighborhood. After you are done walking, make sure to do some stretches: Stretch your hamstrings, quads, and calves to help you get more limber. These stretches below are the perfect ones!

Second, make sure to change positions often. If you have a lot of raking and weed pulling to do, then make sure you alternate them to give your body a rest from repetitive work. Switching activities can help to avoid any overuse injuries including tendinitis and bursitis, so be sure to give your body a break every 15 minutes by alternating your work.

Third, when doing ANY lifting, be sure to lift with your legs and NOT bend at the waist using your back. We highlight ANY as back injuries are often caused from even the lightest of lifting such as bending over just to pick up a stick causing people to “throw out their back”. To help avoid this, we suggest always bending the knees and lifting with the legs. Below depicts a great picture of how lifting should be done!

Fourth, when using equipment, such as a chainsaw or lawn mower, make sure it is sharpened, there are no leaks, and it works properly. When equipment does not work correctly, it causes you to exert more energy and effort in operating the equipment, which in turn can cause injury. In addition, when going to use the equipment, make sure your path is clear and it is clear around the area you are working on. You do not want to have to squeeze by chairs or step over debris on the ground with a heavy piece of equipment. This may cause you to lose balance and result in injury.

Lastly, use common sense when working outdoors! Common things you should think of and abide by are:
• Wear gloves and long sleeves to protect yourself from chemicals you may be spreading or to prevent any irritation and blisters from use of the equipment.
• Use knee pads when you are going to be gardening to prevent bursitis or tendinitis of the knees
• Wear sunscreen to protect yourself from the hot sun
• Wear goggles or head phones when weed-whipping or using loud equipment
• Stay hydrated! Drink a lot of water and make sure to take breaks to eat
• Do not climb or stand on an unsteady ladder or equipment
• Do not work on wet or slippery surfaces

When you have completed your yard work for the day, make sure you do some of the quick stretches above again as a nice cool down. If any body part is aching you, ice and rest to help relieve some soreness.
Yard work can be very taxing on anyone’s body so be sure to follow the tips above to avoid serious injury!

Picture Credit: hep2go.com
Other sources: https://fitbottomedgirls.com/2013/06/yard-work-without-the-backache/#_a5y_p=2880911
https://www.thestatenislandfamily.com/safety-tips-to-help-avoid-injury-while-doing-yard-