Take the Pain Out of Your Holiday Travels

The time of year for family get-togethers and travels are approaching. Prolonged sitting can have a negative impact on our hips and back resulting in increased pain, poor posture, and faulty movement mechanics that results from muscles that become short and tight due to being stuck in the same position for a long time. I recommend standing at least once an hour during your travels when possible or performing some gentle stretch or strengthening exercises while remaining seated.

Czech Physician; Dr. Vladimir Janda developed the concept called “Lower Cross Pattern” in the 1940’s that states prolonged sitting as a contributing factor for increased tightness of the hip flexors and hamstrings. Many of those hip flexors either have a direct attachment to our lumbar spine or contribute to that stuck sensation in our hips. Inversely stretching those tight muscles could provide some relief. The most impact to maintaining optimal muscle length can be achieved through strengthening the glutes aka “butt muscle” to aid in keeping the hamstrings and hip flexors at their proper length.

The following can be performed onboard an airline during your holiday travels:

Standing

Quad Stretch

Ankle Pumps

Seated Marches

Trunk Rotations

Chesapeake Bay Aquatic & Physical Therapy can benefit you with:

  • Manual therapy and joint mobilizations
  • Active & passive release technique
  • Trigger point dry needling
  • Stretching without aggravating your lower back
  • Strengthening to optimize proper muscle length

Please call our front desk at (301) 498-2212 for more info on how Chesapeake Bay Aquatic & Physical Therapy can help prepare you for next holiday travels.

Warm-up & Cool down

Written By: Carmelo Cimato

Exercise is an important part of living a healthy lifestyle, but can lead to injury if completed too intensely or incorrectly. Completing a proper warm-up and cooldown allows the body to adjust to the initiation and cessation of exercise.

Purpose of a Warm-up:

  • Allows blood to be properly pumped to muscles for proper energy supply and oxygenation
  • Allows for gradual ramp up of heart rate and blood pressure
  • Increases internal core temperature for improved muscle elasticity
  • Potential decreased likelihood of injury and D.O.M.S (Delayed Onset Muscle Soreness)

Purpose of a Cooldown:

  • Prevents pooling of blood in the extremities
  • Allows for gradual decrease of heart rate and blood pressure back to baseline levels
  • A great time to incorporate a stretching regimen into your workout routine

How to properly conduct a warm-up:

  • Focus on a warm-up that emphasizes larger muscle group activation. Cardiovascular exercises such as walking on a treadmill, riding an exercise bike or elliptical are great examples of dynamic warm-ups that allow for a gradual ramp-up in vitals for exercise. Intensity of the warm-up should be around a 4-6/10 in terms of difficulty.

How to properly conduct a cooldown:

  • Much like a warm-up, a cooldown exercise should allow for the body to gradually adjust vitals. Cooldown exercises should be sub-maximal intensity and be around 40-50% of max exertion The same cardio equipment that can be utilized for a warm-up are also great for a cooldown! If you have the extra time after your cardio cooldown, a comprehensive stretching regimen is also a great way to help return your vitals back to baseline.

Contact your local physical therapist at one of our great clinics to find out more about different ways to effectively warm-up and cooldown while exercising!

Don’t Forget Self-Care During the Busy Holiday Months!

The holiday season is a time of busyness and giving for most. There is so much cooking and gift buying to do! Spending time with loved ones might look different for most this year, so it is all the more important to stay on top of mental and physical well being. Here at Chesapeake Bay Aquatic & Physical Therapy, we care about our patients and about providing customized, caring service. So, grab a cup of tea and a crab cake and take some notes on ways to practice self-care this holiday season!

Think Outside the Box

This year has brought a lot of different changes to most people’s lives. That does not mean self-care during this socially distant time needs to stop. It is essential to prioritize your health and physical well being. Take a step back and try to rethink some of your everyday routines. Self-care doesn’t necessarily have to be expensive or time-consuming. Self-care may look like journaling about your day, baking some delicious festive treats or staying consistent with your physical therapy appointments. We at CBPT focus on a holistic approach to treating patients and bring together a variety of therapy specialists to form a plan right for your physical needs and goals. Not deviating from the plan your physical therapist and you have created is key to a healthier, more mobile you!

Be Mindful

The mind is a powerful wonder to behold. It is crucial to practice self-care to maintain whole being wellness, this includes checking in on your thoughts and emotions. Sharing how you are truly doing is not always the easiest. Good self-care can look like calling up a friend to catch up or even consider meeting with a licensed therapist if that feels like the right avenue for you. Meditation can seem daunting but setting aside a few minutes to take some deep breaths and slow your thoughts down can make a world of a difference. Sitting still not your thing? If your physical therapy allows it, consider a stroll around your neighborhood or town. Observe your surroundings, you might just see something you’ve never noticed before!

Throw Some (Epsom) Salt on It

Epsom salt is often an understated tool in physical therapy and self-care in general. Many people are deficient in magnesium, a mineral crucial for healthy stress management and quality sleep. Used for hundreds of years, Epsom salt has been touted as a transdermal source of magnesium when mixed in with a warm bath. Sprains, bruises, sore muscles are a few of the ailments this inexpensive mineral can alleviate. If you are experiencing major pain or discomfort, it is best to contact your physical therapist or primary physician.

Don’t Judge a Book by Its Cover

Finding some solitude time to unwind and read is severely overlooked as a relaxation method. After a good physical therapy session, sitting down to a cup of chamomile tea and an intriguing book can do wonders for the mind, body and soul. Stress can lead to heart problems, anxiety and high blood pressure. In a study done at Emory University, it was found that reading a novel can create new neural pathways in the brain. Strengthening the brain and winding down from a long day of remote working? A win, win situation.

Here at Chesapeake Bay Aquatic & Physical Therapy, our team of experienced therapists is waiting to help you meet your wellness goals. Whether you’re having issues with balance or chronic pain, we are here to assist you with compassion and care. Self-care is as important as physical exercise and proper nutrition. Try out some of the tips in this article and then give one of our five state-of-the-art locations a call to set up the start of your holistic wellness journey!

Make Hip Exercises Part Of Your Regular Exercise Routine

Hip Hip Hooray!

There are over 20 muscles that cross the hip, including the abductors (in the outer thigh), the hip flexors (in front), and the abductors (in the inner thigh), yet strangely enough, these muscles are often ignored in strength training routines. The results of neglect can be serious; when hips are tight, they can affect everything from our ability to bend forward, to overuse of the spine. By performing exercises that stretch and strengthen our hips, we can avoid pain and injury, improve motion and circulation, and release energy. These are just a few reasons why we should make hip exercises part of our regular exercise routine.

STRETCHES:

IT Band StretchHip Exercise IT Band StretchPsoas StretchHip Exercise Psoas StretchAdductor StretchHip Exercise Adductor Stretch

EXERCISES:

Straight Leg Raise FlexionHip Exercise Straight Leg Raise Flexion part 1Straight Leg Raise FlexionHip Exercise Straight Leg Raise Flexion part 2Resisted side lying clamsHip Exercise Resisted Side Lying Clams part 1Resisted side lying clamsHip Exercise Resisted Side Lying Clams part 2Ball SqueezeHip Exercise Ball SqueezeBridgeHip Exercise Bridgeand Kick!Hip Exercise Straight Leg Raise Flexion part 2

Perfect SquatsHip Exercise Perfect SquatsResisted lateral sidestepHip Exercise Resisted Lateral Sidestep

Preventing Falls in the Geriatric Population

Balance Training and Fall Prevention for the Active Geriatric Population

As we age, many changes are happening, including balance, vision, and proprioception that all decrease, which leads to increase risk for falls. Now you may ask, how do we address this? Well that is with balance exercises! A big question amongst people is whether shoes should be worn during these activities. The foot is your mobile adapter, and wearing sneakers takes away from the natural strengthening and stabilizing ability of the foot. Barefoot exercise will help improve balance and alignment. The ability to feel the ground gives you increased proprioception to feel where your foot is being placed and strengthen the foot. Physical therapy can help address balance difficulties and fall risks. Working on strength, center of gravity and proprioception in various planes of motion will help to improve the bodies response to challenges it may endure to your balance. Adding in larger ranges of motion, use of arm and leg motions allows for self-perturbations that allows for increased challenge to balance and increased strengthening and stabilization opportunities.

Yoga and Pilates based exercises are also extremely beneficial for the improvement in balance in many studies – especially for the geriactive population. Improvement in balance and physical fitness with these programs also has been shown to help improve mood states, quality of life, independence in daily activities and fall reduction. Tai Chi addresses orientation and speed of visual tracking, multiple foot placements and moving body in multiple planes, controlling respiration with one breath per movement which all play a role in balance and reducing risk for falls.

Whether you have had a fall, have a fear of falling, or just feel unsteady on your feet, there are many ways to get started with balance training! Get involved in group classes or contact your Physical Therapist!

Importance of Strength Training

Importance of Strength Training

As we spend more time on our computers, and smart phones, and sitting for work tasks (which has significantly increased since the start of the COVID pandemic) we are advised to “get up and stretch” throughout the day to prevent injury, prevent back pain, improve posture, etc. Patients coming into my clinic often point out muscles that feel “tight” and comment about how they know they “need to stretch more.” While stretching and flexibility is important, it is not the only thing your body needs – your body also needs strength!

While flexibility during activity is important, recent studies show that stretching without strengthening is not effective at injury prevention. In a 2014 study published in the British Journal of Sports Medicine, it was found that stretching alone had little to no impact on injury prevention, but that strength training consistently had a positive impact of preventing injury. In addition to preventing injuries in athletes, strength training can also be effective in reducing chronic pain, as was found in a 2012 study. In a review of over 1500 physical rehabilitation patients, resistance training was found to decrease chronic pain and improve mobility in a variety of conditions including low back pain, knee osteoarthritis, and chronic tendinopathy. Even plantar fasciitis pain – a condition that is commonly associated with stretching to relieve pain – has better outcomes when patients participate in strength training.

Muscles work together on both sides of a joint to create what should be a balance of mobility and stability throughout our body. However, our daily activities can often create imbalances between those muscles, leading to instabilities when we need support and restricted movement when we need mobility. This can sometimes lead to pain, but the cause of that pain is sometimes a hidden culprit. For example, if you sit at a desk or computer, you will most likely at some point find yourself sitting with a slouched, rounded back posture (we all do it from time to time, especially when we are feeling tired or concentrating hard.) Doing this often overtime will lead to tight pectoral muscles in the chest, causing the muscles in the mid and upper back to be pulled into a stretched posture. The area where we feel pain after sitting in that posture for a prolonged period of time is usually in the back, but it’s not our back that needs to be stretched, it’s actually our chest. Our back muscles need to be strengthened to better support our posture.

So, the question is, when should you stretch, and when should you strengthen? Part of a physical therapist’s job is helping you figure that out. Physical therapists and physical therapist assistants are “movement specialists” – our primary goal is to improve your muscle function. A physical therapist can evaluate your posture, your muscle length, and your muscle strength in all areas of your body. They can determine whether you are lacking stability or mobility, and how one area of the body is impacting another. They can then choose the best exercises and treatments for you to get you moving the right way, prevent future injuries, and improve your quality of life.

 

References:
Lauersen JB, Bertelsen DM, Andersen LB
The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials

British Journal of Sports Medicine 2014;48:871-877.
Kristensen J, Franklyn-Miller A
Resistance training in musculoskeletal rehabilitation: a systematic review

British Journal of Sports Medicine 2012;46:719-726.
Rathleff, M.S., Mølgaard, C.M., Fredberg, U., Kaalund, S., Andersen, K.B., Jensen, T.T., Aaskov, S. and Olesen, J.L. (2015), HL strength training and plantar fasciitis. Scand J Med Sci Sports, 25: e292-e300. doi:10.1111/sms.12313

Tight Pecs & Back Pain: A Love Story

Importance of Hip and Pelvis Functional Stability

Importance of Hip and Pelvis Functional Stability

As humans, we tend to be moving around a lot throughout the day in many different positions. In order to complete these activities as they become more challenging or as we age, it is important for us to have strength and stability throughout our body. This idea is called Dynamic Kinetic Chain Integration that helps us to coordinate global movement patterns involving the upper body, trunk/core, and lower body to enhance our overall stability.

The overall goal when you come to Physical Therapy is to get you back to doing the activities you enjoy in a safe way, and that is with global dynamic functional stability. Most people have underlying weakness that we need to address, which may mean we are starting with more simple exercises (steady and stable) in simple positions (lying on your back). The reason for this is to gain strength and stability locally so when we progress to higher level global and dynamic tasks that are more activity specific, you are able to demonstrate better mechanics, which means – less pain!

One of the most important stabilizers in our body is our pelvis, and the muscles that surround it to assist in this stabilization is hip and core muscles.  Your body needs to recruit as many muscle fibers as it can within the full range that a joint has – and with good control and form– to gain speed and endurance. We also want to move in different planes of motion including back to front, up and down, side to side, and even some reciprocal and rotary movements, as you get stronger some of these movements will also be combined to replicate more day to day activities. Starting with lying on your back, to lying on your side, then your stomach, then hands and knees, and finally – standing upright. We need to focus on strength and control locally (just legs, or just arms) then progress into movement patterns (combining movements) in each of these positions.

I know this may sound slow and boring; but understanding breathing patterns and pelvic positioning for optimal stabilization when lying on your back will be key with progressing to more challenging positions. Then we can progress to added resistance and increased speed and time in each position to prepare your body for the challenges of our more complex day to day movements. Whether you’re retired, a working individual, a high level athlete, or a weekend warrior this progression for optimal stabilization is the key to success with all your daily and recreational activities!

Chesapeake Bay Aquatic & Physical Therapy is privately owned and operated by highly-trained physical therapists.

The Speed You Walk Means More Than You Think

Our body’s most basic functions are measured through vital signs….. Can you name them? Quick. Ready….go!…. (Body Temperature, Pulse Rate, Respiration Rate, and Blood Pressure)……. These are strong indicators of how your body….the machine that you own and operate each day…. is performing. In 1996 the American Pain Society instituted a campaign to make Pain the 5th vital sign and at that time this movement was widely supported by medical communities and more importantly by historically strong catalysts of change in this country…..pharmaceutical companies. The purpose of this post is to let you know about the 6th vital sign…. Gait Speed. i.e. How fast you walk.

In 2009, a study was published in the Journal of Geriatric Physical Therapy shed light on this and referred to it as “a general indicator that can predict future events and reflect various underlying physiological processes.”

When you start to go down the rabbit hole with this metric you can begin to predict things like risk of falls, hospitalization rates, and discharge statuses from skilled nursing facilities.

So how is this measured?

With a test. No different than slapping a blood pressure cuff on your arm or that dude at Starbucks gunning your forehead temp.

A 20 meter (65.6 feet) straight path is utilized for the test. The true test is only 10 meters, but the full test includes a 5 meter “ramp up” and 5 meter “deceleration” zone. You, the patient, are cued to walk at a comfortable speed and the timer starts when you first lower extremity enters and exits the 10 meter zone.

It is crucial to analyze and interpret the physiological things that keep your motor running. Your heart. Your lungs. But on another level is us…Physical Therapists are trained and further driven on caring about HOW you function. Not only getting from point A to point B but HOW you get there. Can you get out of a chair without using your hands? Can you go up and down your stairs without pulling yourself with the railing and putting both feet on each step? Can you maneuver around your home without grabbing onto walls and furniture? PTs can get you walking faster in your 70s, 80s, and 90s……

If you would like to get tested or have any questions, feel free to contact us at Chesapeake Bay Aquatic & Physical Therapy 410-315 9080.

How To Stay Sufficiently Hydrated While Wearing Masks

What am I talking about?  How are we all staying sufficiently hydrated while wearing masks all day?  The struggle is real.  Facemasks should be doffed and donned (that’s “removed” and “put on,” respectively) with clean, just-washed hands.  Frequently removing and replacing facemasks to sip your favorite venti iced beverages can increase chances of spreading illness-causing pathogens.  I am very curious to hear how you all are managing to consume your recommended daily fluids, but here are three tactics that I have been utilizing these past few weeks.

  • Hydrate when home. After my first day back at work, I drank half a gallon of water immediately when I got home. My stomach couldn’t handle this however, and it promptly “returned” the water. Taking smaller sips throughout the time I am home has been more successful. Filling a large container (or several glasses) with water and setting it somewhere obvious like a kitchen counter has helped me keep hydration at the forefront of my mind, and I have avoided the consequences of “over-chugging.”
  • Be deliberate about “hydration breaks.” I have made it a point to take advantage of times when I am not close to a lot of people. Generally this is when I take a break to use the restroom. I wash my hands, remove my mask, and drink several large gulps (8-10 oz) before donning a clean mask. If I start to feel a little dehydrated, I take an intentional “hydration break” where I step away to drink water and replace my mask with clean hands.
  • Be smart about supplements. Adding fruit or electrolyte supplements to water can help keep chemicals in the blood at appropriate levels. Obviously, please consult your primary doctor before changing anything about your diet. This has helped ME to manage the symptoms of dehydration, but it may not be the best choice for you.

So what has helped you maintain optimal hydration levels if you are wearing a face mask for part of the day? Leave a comment and let me know!

What Does Three Sets of Ten Mean?

Every day, you, my beloved patients ask me – How many of these do you want me to do? while they are performing therapeutic exercises for increasing strength. For this discussion, it doesn’t matter what the exact exercise is, but my response rarely deviates far from “three sets of ten.”

But what does this mean?

I can almost hear your inner dialogue bubbling to the surface. “What is a set? And why on earth would this greedy clinician want three of them?”

I may be greedy, but it’s only because I want to see strength improvements in the patients I’m treating and this technique, called Progressive Resisted Exercise, has been time-tested for success.

A repetition or rep is one time performing an exercise. Imagine one squat. One bicep curl. That is a rep. Doing several reps consecutively without rest breaks between them is called a “set.” A set generally consists of 5-15 reps. Imagine doing ten squats without taking a break, that is a set. You know you have reached the end of your set when you can’t do any more (though often you will hear me request one more because I know you can do it!).

A short rest sets between permits the muscles to recuperate and get ready to do more reps, but the muscles will be tired the second time around. This is important. Tired muscles have to work harder to complete the same task. The third time around, your muscles will have to work even harder, and this makes them that much stronger.

So when I ask you to do another set, it’s because I love you and I know you can do it, even if your muscles are tired. They are supposed to be tired. That’s why we do three sets of ten.