Kinesio® Tape~ Fad or For Real?

Posted on August 1, 2012 by Susan Kim, MPT

So what’s the deal with all the colored tape you see elite athletes wearing now? From Keri Walsh to Lance Armstrong to David Beckham to Kevin Garnett, professional athletes in all sports have been seen with a colorful new look.

The tape is called Kinesio® Tape and was developed by Dr. Kenzo Kase, a chiropractic doctor and acupuncturist in Japan. Developed in 1979, it was first introduced to rehab hospitals in Japan and was exposed to the international market during the 1988 Seoul Olympics. Kinesio® Tape found its way to the US in 1995 and has become more and more popular since then.

So what’s the difference between Kinesio® Tape and other taping methods? First of all, it is completely latex free! Since it is made of 100% cotton and elastic fibers, it is more “breathable” and easier on the skin, allowing people to wear it for up to 3-5 days at a time. In addition, it is water resistant, which helps it stay on even after you shower. It also allows for more normal range of motion than athletic tape and McConnell® tape. Finally, the different ways of applying the tape allow for the different functions and taping effects.

The major uses for Kinesio® Tape are the following:

Relieving pressure on the skin
Improving remodeling of soft tissue (known as fascia) after injury
Promoting circulation to decrease swelling
Help activate or inhibit specific muscles (e.g. to decrease muscle spasms)
Improving joint alignment and motion

I recently used Kinesio® Tape on a patient that is a waitress who was overusing her biceps tendon. I put the tape on in a way to inhibit the use of the biceps so that her tendon would perform less work and therefore get some rest. It was not an option for her to stop working in order to rest her arm, so this was a great alternative for her and made a significant difference in her ability to get through her work day.

Some people will respond well to the techniques, so it is worth looking into and seeing if it can work for you!

3 Steps to Proper Bike Fitting

Written by: Lisa Martin, PT, DPT

Posted on July 30, 2012 by Lisa Martin, PT, DPT

The summer months are upon us and I’m sure that many of you are out riding your bikes to enjoy the beautiful weather. I’m going to give you a few easy steps on proper fit for your bike to make sure your bike riding is enjoyable and comfortable.

First of all, proper seat height is very important. When you’re sitting on the seat with your feet on the pedals, you should only have a slight bend in your knee when the pedal is at the bottom position.¹ I usually tell my patients when standing next to the bike, their greater trochanter or hip bone should be about even with the seat. If you can sit on your seat and plant your feet on the ground your seat is too low. If you have to rock your hips side to side while pedaling, your seat is too high.² When having to stop, you should have to get off the seat or be on your tip toes when seated.¹

Second, your seat should be level. Try to avoid tilting it too far forward or backward. You should feel like you are sitting on the same spots on your bottom that you do while sitting upright in a chair, often referred to as your “sit bones”.^1,2 On most bikes you can also move the seat forward or backward allowing you to make sure that you are centering your weight over the bike.¹ Also, in this process make sure that you can still reach the handlebars. Your elbows should not be locked and you should not feel like you have to shift forward on the seat to reach the handlebars.²

The third step is adjusting the handlebar position to avoid having any strain on your back, neck, shoulders, or wrists.¹You should never feel like your arms are falling asleep or your upper body is too heavy to hold up. If you are feeling that way, try adjusting your handlebar position. This will vary depending on the type of bike you are riding, your body type, and just personal preference. Here are the three main types of bikes and you can experiment with what you like the best.

Road Bike (skinny tires): Handlebars about 1-2 inches lower than the seat allowing you to lean forward and be more aerodynamic.¹
Mountain Bike (rugged tires): Handlebars often 3-4 inches lower than the seat allowing for a lower center of gravity to better negotiate obstacles you might find on trails or in the woods.¹
Cruisers: Handlebars about 1-2 inches higher than the seat allowing the rider to sit more upright and take a more leisurely ride.¹

A good rule of thumb is that if you’re having increased back, neck, shoulder, or wrist pain, your handlebars are likely too low.²If you’re feeling every bump on the road and your bottom is hurting, your handlebars are likely too high.²

Hopefully these few easy steps will make your bike riding experiences this summer more fun and long-lasting. If you’re having pain while riding your bike and you don’t have any previous aliments, you’re likely just not positioned correctly on the bike. Hope you have a safe and fun summer! Please share any exciting bike riding experiences with us.

P90X: Great Way to Lose Weight or Just Hurt Yourself?

Written by: Lisa Martin, PT, DPT

Posted on July 19, 2012 by Lisa Martin, PT, DPT

P90X is a series of 12 exercise DVDs that bases its success on “muscle confusion.”¹ It is thought that by changing up the exercise routine daily, your body does not get a chance to adapt. Therefore, the body burns more fat and builds more muscle.¹ Each DVD starts with a warm up, followed by a circuit training routine, and then finishes with a cool down. One of the key things to remember is that these DVDs are intended for a healthy population that has already been working out. If you have not worked out in years and have spent the last several months having more of a sedentary lifestyle, this is NOT the workout series you want to jump into. Doing so would likely result in injury.

Unfortunately, as physical therapists, we see many people at our clinics that come to us after doing P90X. Some reasons include doing too much too soon, poor body mechanics, or aggravation of an old injury. First, as mentioned above, this is meant for a population that has been exercising, so you need to do the intro fitness test before starting the DVDs that is included with this series. If you can’t pass the fitness test, you likely need to do other exercise to prepare your body for P90X. Second, you need to be aware of your body mechanics and posture during all of the movements. If you don’t have a good understanding of a proper squat, lunge, push-up, etc., you could end up hurting yourself.

Improper Squat Proper Squat

Since this is a circuit series, the repetitive nature of this type of exercise can cause aggravation to old injuries or even cause new injuries if not completed correctly. This would be a great opportunity to contact your physical therapist to review these mechanics to assure that you are in the correct position. Lastly, you need to listen to your body. Do NOT push through pain or push past the point where you cannot maintain good form; this can lead to joint pain, tendonitis, or muscle strains which, in turn, will result in you not being able to tolerate any kind of exercise for an extended period of time.

Although P90X is not for everyone, it does have great potential to burn calories and help the already active and exercising individual get into better shape. A 2011 study took 16 healthy subjects 19-26 years old that exercised regularly through four of the P90X DVDs over several weeks. The results showed that P90X, in combination with a healthy diet, meets or in some instances exceeds fitness standards for losing weight and improving cardiorespiratory fitness.

Obviously, there are a million different ways to exercise: P90X, yoga, zumba, machines, weights, jogging, Tai Chi, and the list can go on and on. You need to find the best way to exercise with the least detrimental effects on your body. Some people are in good enough shape and have a good understanding of proper form with exercise positions, so P90X is a great challenge and addition to your workout regimen. However, for those of you on the other end of the spectrum, you might want to try a less intense workout DVD and progress to P90X over time to prevent injury. If you want to learn about proper mechanics with exercise you should come visit us and we will be able to show you the correct way to exercise to avoid injury.

Have you ever tried P90X before? If so, what was your experience?

The Sacroiliac Joint Rarely Gets the Credit for the Back Pain It Causes

Written by: Sarah Todd, PT, DPT

Posted on July 11, 2012 by Sarah Todd, PT, DPT

Back pain is one of the most common complaints of patient’s coming in for physical therapy. The sacroiliac joint (SIJ) can be a contributor to back pain. Interestingly enough, I was fairly oblivious of this sneaky cause of back pain until a senior clinician and women’s health practitioner opened my eyes and started my fascination with this joint.

The sacroiliac joint consists of 3 bones — the 2 ilium and the sacrum. The sacrum wedges snugly between the 2, serving as a keystone. Even though this is a “snug” joint, there is still a fair amount of movement that occurs here.

Common mechanisms of injury are:

a sudden jar to the body
falling on your buttocks
a possible lift and twist maneuver

Common symptoms of SIJ pain are pain at the belt level and pain that radiates into the buttocks, hip, and/or thigh. Your physical therapist can diagnose SIJ dysfunction through observation, palpation, and special tests.

Treatment of SIJ dysfunction may entail:

soft tissue mobilization of muscles, which may be in spasm or are short/tight
muscle energy techniques to correct the malposition of the joint
joint mobilization to decrease pain and/or improve the mobility of the joint
strengthening of the muscles surrounding the joint, including the pelvic floor muscles
stretching to decrease abnormal stress on the bones of the pelvis
taping or the use of a brace to help stabilize the SIJ

The SIJ is a “snug” joint that experiences small amounts of movements, but has the ability to cause a large amount of back pain. If you suspect you are experiencing SIJ dysfunction, consult with your physician or physical therapist for a full evaluation.

Gardening Tips to Prevent Injury

Written by: Lisa Martin, PT, DPT

Posted on July 5, 2012 by Lisa Martin, PT, DPT

Now that we find ourselves in the middle of gardening season, we want to make sure that you are thinking about proper body mechanics to take your garden from seeds/seedlings to blooms and veggies without injury. Below are a few easy tips to follow to help prevent injury during gardening:

1. Never bend straight over – this puts tremendous stress on your low back.

Squat Down: Keep your back straight, feet a little more than shoulder width apart, push your hips back and squat down. Do NOT push your knees forward over your toes.
Half-Kneel: If your knees will tolerate this position, place one leg in front and one leg behind you to kneel on the ground. Push your hips backward, letting your knees bend and keep your back straight as you lean down toward your garden.
Tall-Kneel: Again, if your knees can tolerate this position, kneel on both knees, keep your back straight and push your hips back toward your heels as you move closer to the soil.
Sit on a Stool: Sitting will decrease the stress to your legs and back. Keep your back straight, knees a little more than shoulder width apart and hinge at your hips to get movement toward the soil.
Hands and Knees: Get on your hands and knees with the plants off to one side. Keep your hands under your shoulders and your knees under your hips. This is a great position to move around mulch or pull weeds.
All of these positions are a safe way to plant, weed, and move soil or mulch.
You always want to make sure that you are not being a “lazy” gardener. Take a few extra minutes to figure out what position is most comfortable for you. Then make sure you are keeping your stomach and gluteal muscles contracted. Don’t forget about keeping a gentle squeeze of your shoulder blade muscles as well, you can do this by squeezing your shoulder blades together and down toward your back pockets. Activating these muscles will help you keep your spine in a good position.

2. When raking, never stand still.

Take steps and walk to what you are trying to rake. Keep your strokes small and never lean to the items you are raking.
Keep the rake or yard tool close to you – you should never be farther than an arms length away from what you are raking.
Do not twist – this can be avoided by always moving toward the object you are raking and keeping your body squared off to the object.

3. Lifting plants.

Keep the plants close to you when lifting. Remember to keep your stomach and gluteal muscles contracted.
Make sure to always move your feet when turning, never twist.
You can use a squat or half-kneel technique when lifting to avoid injury. Squat: Keep the plants close to your body. Have your feet a little more than shoulder width apart, hinge through your hips to push your butt back and keep your back straight. Place the plants on the ground. Half-Kneel: Keep the plants close to your body. Start with your feet shoulder width apart. Take a step forward with one leg, begin to bend both knees, and let the knee behind you touch the ground. Then you can push your hips back, keeping your back straight and place the plants on the ground.

Make sure that you get to enjoy the ENTIRE gardening season this year by following some of the guidelines listed above. If you are unsure about your gardening mechanics and proper positions, you should come visit us. We would be happy to review these with you and help you achieve an injury-free gardening season. Please let us know how these gardening positions worked for you!

Adhesive Capsulitis – aka Frozen Shoulder

Written by: Teresa Hall, PT, DPT, OCS

Posted on June 27, 2012 by Teresa Hall, PT, DPT, OCS

Adhesive capsulitis is the medical term for the more commonly used phrase “frozen shoulder.” The capsule of the shoulder thickens and tightens, contributing to pain and loss of motion in the shoulder. There is no known cause for adhesive capsulitis; however, risk factors include diabetes, previous shoulder surgery, and hyperthyroidism. Some statistics show that up to 20% of diabetics may develop adhesive capsulitis compared to only 5% of the general population. The condition is also more prevalent in women around menopause.

The first sign of adhesive capsulitis is often pain. Next is loss of motion and function of the arm. The shoulder may continue to be dysfunctional for several months. It is typically diagnosed by clinical exam, as X-ray and MRI findings are usually insignificant but can help to rule out any other causes of your symptoms.

Adhesive capsulitis of the shoulder can resolve on its own in about a year without treatment however, both conservative and surgical interventions can help to speed your recovery. This condition is most commonly treated with NSAID medication, steroid injections and physical therapy to restore motion. The rehabilitation process is painful and involves aggressive range of motion activities for the shoulder, as well as the therapist moving your shoulder for you. A home program is typically included as well. It is essential for the patient to perform their exercises in PT and at home to restore the movement in their arm.

People with adhesive capsulitis often make a full recovery with no residual effects. Get help from a qualified PT if you suspect you may have the beginnings of adhesive capsulitis to get moving again. Motion is lotion for the joints!

What is the Rotator Cuff?

Written by: Melissa Graham, PT, DPT, OCS

Posted on June 13, 2012 by Melissa Graham, PT, DPT, OCS

The rotator cuff consists of four muscles that provide shoulder joint stability and is important for shoulder movement. The four muscles are the supraspinatus, infraspinatus, subscapularis and teres minor. All four of the muscles start on the shoulder blade (scapula) and connect to the head of the upper arm bone (humerus). The shoulder joint is a ball and socket joint which resembles a picture of a golf ball (head of upper arm bone) sitting on a golf tee (shoulder joint). The rotator cuff muscles surround the joint forming a cuff. It is important during shoulder motion to maintain the proper position of the ball in the socket. The rotator cuff muscles assist in lifting the arm out to the side and rotating the shoulder for activities such as opening doors or tucking in the back of your shirt.

There are differing degrees of injury to the rotator cuff. An injury to this area can vary from a strain of one muscle, to a partial tear(s), to a complete tear of one or more muscles. Injury to the rotator cuff can be caused by age-related degenerative changes, muscle imbalances in the shoulder, repetitive overhead motions or trauma. Symptoms of rotator cuff involvement include shoulder joint pain, upper arm pain and functional limitations, such as difficulty lifting arm up overhead or reaching behind your back.

Physical therapy can be extremely beneficial to rehab rotator cuff injuries. During the evaluation, the physical therapist will assess shoulder range of motion and strength and perform special tests to determine the cause of pain. From there, an individualized treatment program will be designed. If rehab is unsuccessful or the muscle is completely torn, surgery may be necessary.

Pain in the Neck?

Written by: Lisa Martin, PT, DPT

Posted on June 11, 2012 by Lisa Martin, PT, DPT

Chronic neck pain is something that can affect your work and personal life. If you have been suffering with neck pain for greater than 3 months then you would be categorized as having “chronic” neck pain. You don’t need to suffer anymore!

Neck pain can be caused by several different things including muscle spasms, joint restrictions in your neck or upper back, weakness in your neck or shoulder blade muscles, a disc herniation, or arthritis in your neck. Neck pain can also be associated with your posture or work station.

If you are experiencing any of the above issues then you should contact a physical therapist (PT). They will be able to evaluate you by taking you through a series of tests and measures along with functional tests to determine why you are suffering. An evaluation will assess your neck range of motion, your neck, arm, and upper back strength, as well as the mobility of your joints of the neck, upper back, and shoulders. Other functional tests that might be screened are your posture when you are sitting or working at your computer, how your body moves when you reach overhead and when you lift something off the floor. These tests will help the PT determine why you are having your neck pain.

Your PT will then develop an individualized exercise plan to address your areas of weakness and joint restriction. These exercises will help you achieve proper posture (e.g. getting your ear in line with your shoulder and your shoulder in line with your hip) in order to avoid forward head position and rounding of your upper back. The PT will also help to educate you on proper work station set up. Ideally, your wrists are below the elbow, the computer screen is in front of you, feet are flat on the floor and knees are below the hips. ⁽¹⁾

In addition to an exercise routine and education on proper body mechanics, your PT will perform manual therapy on you as well. Manual therapy is when the PT stretches your muscles and assists your joints to move. Research has shown that if your upper back is moving well, this will decrease the strain to the neck muscles and joints, decreasing your neck pain and improving your quality of life. The combination of both exercise and manual therapy can help to reduce your neck pain symptoms, reduce your sick leave from work, reduce the need for pain medication and improve your ability to function at home and at work! ⁽²^,³⁾

How long have you been suffering with neck pain? What position seems to really cause you the most discomfort?

Iliotibial Band Syndrome – What’s That?

Written by: Melissa Graham, PT, DPT, OCS

Posted on June 6, 2012 by Melissa Graham, PT, DPT, OCS

The iliotibial band, also known as the IT band, is a superficial thickening of tissue on the outside of the thigh. It extends from the outside of the pelvis, over the hip and knee, and inserts just below the knee. The IT band is very important in stabilizing the knee. Irritation is often found around the insertion of the band as it rubs on the outside of the knee area and is referred to as iliotibial band syndrome (ITBS). ITBS is a common injury in runners and cyclists due to the repetitive knee range of motion, which can cause excessive rubbing along the knee.

There are many different causes of irritation that can vary from training habits to anatomical abnormalities or muscle imbalances. Running on banked surfaces and/or cycling with a toe in increases the stress to the insertion and make these individuals even more prone to injury. ITBS may also be found in individuals with foot abnormalities, such as high or low arches, that affect the knee position during walking or running. Muscle imbalances, especially weakness in the hip muscles and excessive tightness of the IT band, may also cause friction along the knee area. In addition to knee pain, injury to the IT band can cause hip pain.

As you can see, ITBS can have various mechanisms of injury which can be addressed with physical therapy. On your first visit to physical therapy, the physical therapist evaluates the injury, determines the cause or source of pain and tailors a treatment program specific to the individual. The goal is not only to restore the individual to full function, but to address the primary cause to decrease the risk of future occurrences as well.

Heat or Ice? What’s Best for Your Injury?

Written by: Melissa Graham, PT, DPT, OCS

Posted on May 30, 2012 by Melissa Graham, PT, DPT, OCS

One of the most commonly asked physical therapy questions is, “should I use heat or ice on my injury?” or “I didn’t know which one to use, what is the difference?”

Heat increases blood flow to the applied area and can help to relax and loosen tissues. Heat is often used with areas that have been bothersome for some time or before participating in activities. Ice causes the opposite effect; it decreases blood flow and is often used to minimize swelling, inflammation and irritation to an area. Ice tends to be used on new injuries and areas of swelling. Both heat and ice can have pain-relieving effects if used appropriately and sometimes it may be appropriate to use both. For instance, some individuals might heat up a chronic painful area before activity and ice it down after to decrease soreness.

Here are some common examples and suggestions as to what is best for certain types of injuries. A newly sprained ankle should be iced to decrease the swelling and inflammation. Ice is also commonly used after surgeries to minimize inflammation and can be used indefinitely for pain and inflammation. It is often recommended to ice injured areas for ten minutes twice a day. On the other hand, a tight back or stiff leg would most likely respond favorably to heat before physical activity. Heat will help to increase blood flow and loosen the muscles whereas, back pain, that is caused by nerve irritation or inflammation, would probably respond better to ice as ice will minimize swelling and inflammation.

Heat and ice should never be applied directly to the skin and should not be left on longer than 15-20 minutes at a time. Both can be applied throughout the day, but you should allow 45 – 60 minutes between applications. The skin should be monitored for excessive redness and pain, which could be signs of a burn or frost- bite.

Hopefully this information has helped so that next time you have an injury you know exactly how to assist in treating it. Do you have any specific examples that you would like guidance on?