3 Steps to Proper Bike Fitting

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?

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!

Can Physical Therapy Help to Alleviate Low Back Pain During Pregnancy?

Written by: Lisa Martin, PT, DPT

Posted on May 14, 2012 by Lisa Martin, PT, DPT

Are you pregnant and suffering from low back pain? Well you are not alone; over 50% of pregnant women experience low back pain during their pregnancy.¹ This pain can be debilitating, preventing you from working, taking care of your home and taking care of your other children. Pregnancy-related lower back pain can be due to postural changes, ligament laxity due to the release of the hormone relaxin, and weight gain, resulting in decreased stability of the back and hips.^{1, 2}

The good news is that you don’t need to suffer with pain during pregnancy. It has been shown that physical therapy can help to decrease or even eliminate pregnancy-related low back pain and improve your function through manual therapy, spinal stabilization exercises, and education on sitting, standing, lifting, use of support pillows, and turning in bed.^{1, 2, 3}Exercises will emphasize the abdominals (stomach), pelvic floor (muscles you use to stop urination), and gluteal/hip (buttock) muscles to help stabilize the pelvis. For example, some exercises your physical therapist might show you include: lying on your back with a wedge doing a bridge, getting on your hands and knees lifting opposite arm and leg, side-lying lifting your leg, and sitting on a physioball marching and standing doing small range squats.^{1, 2}

As mentioned above, the hormone relaxin is increased during pregnancy to ten times the normal levels.³ The purpose of relaxin is to help the pelvis adapt and prepare for childbirth by softening connective tissues and ligaments around the pelvis, pubic symphysis, and sacrum. These changes will allow the baby to pass through the birth canal.³ Unfortunately, due to the increased release of relaxin, your sacroiliac joint and lumbar joints can become unstable and move out of alignment contributing to your pain. Research has shown that it is safe and effective for your physical therapist to perform gentle muscle energy techniques (manual therapy) to correct the alignment and allow you to train your muscles in proper position.³

Bottom line, you are not alone and you do not need to suffer with low back pain during pregnancy. It has been shown that exercise, education, and manual therapy during pregnancy is a safe and effective way to treat low back pain, reduce sick leave from work, reduce need for bed rest, and prepare you for labor. ^{1, 2, 3}

Reference:

3. The Effects of Manual Physical Therapy and Therapeutic Exercise on Peripartum Posterior Pelvic Pain: Two Case Reports. The Journal of Manual & Manipulative Therapy. 2005; (2): 94-102.

Is Bikram Yoga Right for You?

Written by: Lisa Martin, PT, DPT

Posted on April 18, 2012 by Lisa Martin, PT, DPT

Many of you might be asking what is Bikram Yoga and is it right for me. Bikram Yoga, developed by Bikram Choudhury, is a specific practice of yoga that involves 26 postures completed over 90 minutes in a room heated up to 105 degrees with 40% humidity.¹This practice of yoga is supposed to help to develop better strength, flexibility, and balance for the mind and body. Bikram Yoga may or may not be the right form of exercise or yoga for you. In order for you to decide, you need to better understand the benefits and risks of Bikram Yoga. Of course, it is always a great idea to check with your physician before starting any kind of new exercise.

All of the postures of Bikram Yoga were specifically developed to help promote maximal health and function of all of your organs, joints, muscles, ligaments, and veins by stretching and bringing oxygenated blood to 100% of your body.¹ Through these poses, you are improving muscle flexibility, joint mobility, joint range of motion, improving circulation, and strengthening against gravity. Also, the compression and extension poses help to stretch and flush the internal organs and nerves allowing them to better function and communicate with the rest of your body.¹ This in turn is supposed to help you to live a healthier and more peaceful life. A 2010 study by Mukherjee and colleagues showed that Bikram Yoga was beneficial to improve skeletal health in pre-menopausal women (average age of 44). Women who participated in Bikram Yoga had higher bone mineral density compared to non-practicing women of the same age. This evidence suggests that Bikram Yoga could help to prevent bone loss and osteoporetic fractures.

Many people are concerned with the extreme heat associated with Bikram Yoga. The purpose of the heat is to allow the body to become more flexible. This will allow you to get the maximum benefit from each posture. Along with improving flexibility, the extreme heat also allows you to get rid of the body’s toxins from the glands and organs through sweating which allows you to flush these impurities out of the body and live a healthier life.¹

Some of the negative affects of Bikram Yoga include nausea, dizziness, fainting, muscle soreness, and psychosis. The nausea, dizziness, and fainting is often associated with dehydration due to exercising in extreme heat. This can be avoided with making sure that you are hydrating enough before class; it is recommended that you drink an additional 64-80 ounces of water beyond the recommended normal daily intake of 64-80 ounces of water.¹ It has also been speculated that salt and potassium supplements help to replenish the electrolytes you loose during the excessive sweating and in turn decrease these side effects.¹ Muscle soreness and joint pain are common if you are not practicing with good focus on each posture. You need to make sure you are in proper alignment, not pushing through the poses too quickly, breathing correctly to promote good oxygen flow and not being too aggressive with the stretching. A less common side effect is a yoga-induced psychosis which is usually associated with someone that is psychosis-prone.³ A documented case of this occurred in July 2007 when a 33 year old male with prior hallucinogen-induced psychosis (10 year remission) began to have auditory/visual hallucinations and became aggressive during a Bikram Yoga class.³ The article included that prior to the class he was eating poorly, sleeping poorly, and was dehydrated which also contributed to the psychosis episode during his Bikram training.

Many people can not fully understand the essence of Bikram Yoga until they try it. The important thing is to better understand the benefits and risks and decide if this is something you would like to try. Many people have said it has changed their lives forever and others feel that they would never want to try this kind of exercise. What do you think?