Yesterday we posted about some of the most common injuries you can experience from running and walking. Today, we wanted to post some stretches and exercises to help prevent those injuries.
All of these Stretches can be performed before and after your workout, and wherever you are running/walking. Hold for 30 seconds and repeat 2x each.
Bottle Roll (for relief of Plantar Fasciitis):
Use a frozen water bottle (plastic, no glass). In sitting or standing roll the bottom of your foot with moderate pressure. Use as much pressure as you can tolerate without discomfort.
Standing Calf/Achilles Stretch:
Start by standing in front of a wall or other sturdy object. Step forward with one foot and maintain your toes on both feet to be pointed straight forward. Keep the leg behind you with a straight knee during the stretch.
Lean forward towards the wall and support yourself with your arms as you allow your front knee to bend until a gentle stretch is felt along the back of your leg that is most behind you.
Move closer or further away from the wall to control the stretch of the back leg. Also you can adjust the bend of the front knee to control the stretch as well.
Repeat with back knee bent to get an Achilles stretch (Soleus Stretch).
Sitting Hamstring Stretch:
While sitting with your leg stretched out, reach forward with your hands towards touching your toes.
Standing IT band stretch:
In a standing position, cross the affected leg behind your unaffected leg.
Next, with your arm over head, lean to the side towards the unaffected leg.
Standing Quad stretch:
While in a standing position, bend your knee back behind and hold your ankle/foot.
Next, gently pull your knee into a more bent position until a stretch is felt on the front of the thigh.
These exercises consist of hip and leg strengthening exercises to help prevent injury with running or walking. Do each exercise 3 x 10 reps for each side
Lie on your side, knees bent. With feet planted together, open and close your knees.
Lateral Leg Raises:
Lie on your side, propped up on one elbow. With your bottom leg bent, slowly raise your straight top leg, being careful not to let your toes point up as you raise the leg. Lower slowly back to your start position.
In all fours position, raise your bent leg up to the side, and back again. This exercise got it’s name because it mimics a dog peeing on a fire hydrant. 🙂
In all fours position raise your leg up behind you as shown. Keep your knee bent at 90 degrees the entire time.
Wall Sit Squats:
Slowly lower to the wall sit/squat position of knees at 90 degrees to the floor, not letting your knees go over your toes, then back to standing.
While standing, raise up on your toes as you lift your heels off the ground. This can also be done on a step where your toes are on the edge of the step and you raise up as high as you can then slowly lower back down letting the heel hang just below the step.
Photo Credit: www.hep2go.com
With the weather finally getting warmer, the will to get outside to start exercising is getting stronger. With that being said, it is important to remember how to prevent possible injuries that are associated with running or walking.
Some of the most common injuries are Plantar Fasciitis, Achilles tendonitis, Shin splints, Runner’s knee, IT Band syndrome, and Hamstring strains.
• Inflammation of tendons and ligaments that run from your heel to toes, causing pain along the arch or heel
• Very high or very low arches
• The way your foot lands when you run, too far in or too far out
• Standing for a long time period
• Worn out shoes
• Stretch & massage your arches. A golf ball works well as a massage ball, or foot rollers can help as well. A frozen bottle of water works perfectly as a foot roller and decreases the inflammation at the same time.
• Wear properly fitted running shoes
• Irritation or tightness in the Achilles tendon that connects your calf and heel
• A sudden increase in hill training or speed work
• Weak calf muscles
• Worn out shoes
• Strengthen your calf muscles
• Stretch your calves gently
• Increase flexibility in your ankle
• Avoid wearing high heels or flat shoes like flip flops for a long time
• Inflammation of the muscles and tendons around the front part of the lower leg
• Running on tired legs so the tendons are forced to take the strain
• Increasing mileage, too much too soon
• Running too long or too much on hard surfaces when your body isn’t accustomed to it
• Brand new shoes or worn out shoes
• Gradually increase your mileage
• Wear shoes that are fit for your feet and that aren’t worn out
• Improve the strength of your calves and muscles of your outer hip (hip abductor exercises)
• Stretch the front muscles of your lower leg and your calf muscles
Runner’s knee/ Knee pain
An aching pain behind or just above the kneecap. It also might feel tender to the touch, almost like a bruise. The cause of the pain is the patella (kneecap) rubbing against the head of the femur.
• Inflammation and irritation of the cartilage under the kneecap
• Weak quadriceps muscles
• Tight hamstrings and IT band
• Running or walking on hills or stairs that you haven’t worked up to
• Long runs or walks that your body isn’t prepared for
• Wearing shoes that are worn out
• Strengthen your leg muscles, in particular with quad strengthening exercises and hip strengthening exercises
• When you’re running, land with your knees slightly bent to take the pressure off of the joints
• Stretch your hamstrings, IT Band, and quads
IT Band Syndrome
• Irritation and inflammation of the iliotibial band that runs along the outer portion of your upper leg from the hip to the knee. The pain is typically felt on the outside of the knee
• Too much downhill running or walking that your body isn’t prepared for
• Increased mileage too much too soon
• Wearing shoes that are worn out
• Stretches that focus on hip flexors and butt muscles
• Rolling on your IT band with a foam roller
• If you’re including speed work in your training plan, gradually incorporate it in small amounts
• Strengthen outer leg muscles
• Weak hamstring muscles
• Your quadricep muscles and hamstring muscles aren’t balanced with each other – quads are significantly and disproportionately stronger than your hamstrings
• Hamstrings that are too tight
• Strengthen your hamstrings and glutes
• Improve the flexibility of your hamstrings
When seeking health care services, it is important to know and understand your insurance benefits so there are no surprises when it comes to your financial responsibility.
When making an initial appointment, office staff will most likely ask to collect your insurance information from your insurance card so they can verify your policy is active. Some offices will even check your insurance benefits for the services you may receive at their facility. Please note this is a professional courtesy to you and not a requirement or a guarantee of payment. It is beneficial for you to call and also verify your financial obligation prior to being treated.
First, an office will verify that you are in-network with their providers. If a provider is in-network, that means they are participating with your insurance plan. If they are out-of-network, depending on your insurance plan, you may still be able to see the provider, however, your financial obligation may be higher.
Second, an office will check to see if you require prior authorization from your insurance to receive services. Not all insurance require this prior authorization, however if your insurance requires it, the office will request the authorization to make sure you are approved prior to being seen. Once the request is made your insurance will either approve or deny your visits. If approved, they will award you a certain amount of visits before a new request must be made to continue your care. Typically, your therapist and the office will track your visits and make sure you are covered prior to continuing your services.
Third, if the office is looking to obtain your insurance benefits, the following information is what they will be asking:
- What is your annual deductible and how much of it has been met so far this year?
- A deductible is the amount you owe for health care services before your health insurance plan begins to pay.
- For example, you may have a $1,000 deductible per year. This means, you must pay the first $1,000 of medical bills before your insurance will pay anything.
- In some instances, physical therapy does not go toward the deductible and may be covered. However, you may only be responsible for a coinsurance or copay. If neither is the case, your physical therapy services will be your responsibility until your deductible is met.
- Do you have a coinsurance?
- A coinsurance is a certain percentage you are required to pay after your deductible has been met.
- What this means is your insurance plan will cover a certain percentage of the cost and you are responsible for the remainder.
- For example, if you have a 20% coinsurance, your insurance plan will cover 80% of the allowed amount and you will be responsible for paying the other 20%. We call this an 80/20 plan.
- Do you have a copay?
- A copay is a fixed dollar amount you must pay to be seen at an office visit.
- Copay’s do not go towards your deductible.
- For example, if you have a $20 copay, you will be expected to pay $20 at each therapy visit and the insurance will cover the rest of the visit.
- Do you have an annual cap for the services being received?
- A cap is the maximum dollar amount that an insurance will allow on a service.
- Primarily with Medicare insurance programs, there will be an annual cap instead of a certain amount of visits that we must stay under.
- For example, Medicare has a $2010.00 annual therapy cap. The office keeps track of how much is used up so you do not exceed your benefit amount.
- Do you have a maximum number of visits? If so, have any been used yet this year?
- Similar to a cap, sometimes the number of visits will be limited annually.
- For example, as part of your insurance plan, you may only be able to receive 30 visits of therapy per year before your benefit maximum is reached. Again, the office will keep track of this to avoid exceeding your limit.
How does this all work after we verify your benefits?
When a provider sends a claim, or an outline of services rendered along with a charge amount and a corresponding code to your insurance provider, the insurance company will adjust the amount the provider charges to an allowed amount based on a prearranged contracted fee schedule the provider has with the insurance company. The insurance company will then write off part of the charged amount and the remainder is what you are responsible for, what they pay, or a combination of what you and the insurance pay based on your benefits.
Let’s break down what this means into numbers.
Claim charge/billed amount: $200
Allowed amount by insurance: $100
If you have a deductible you will pay $100 toward the deductible until met. Once the deductible is met you will be responsible for a coinsurance if you have one or the insurance will cover the service for you.
If you have an 80/20% coinsurance you will be billed $20 per visit for your coinsurance and the insurance pays $80.
If you have a $10 copay you pay the $10 per visit for the copay and insurance covers $90.
Note: this is just an example. Each insurance company has its own “allowed amount” or “fee schedule” indicating how much you pay. We can predict some, however not all insurances are predictable and depend on the billed amount (claim charge) by your provider.
We hope this has helped you understand your insurance and how it pertains to your physical therapy. As always, we encourage you to verify your benefits with your insurance company to ask questions so your financial responsibility doesn’t come as a surprise.