Making Excuses

 

Too often we make small excuses that can lead us down the road to frustration from unmet goals. We think that making a small excuse today for not moving our bodies, not strengthening our bodies or not eating well is okay and we justify by telling ourselves that our bodies need rest. While rest days are a major component in good health, they can sometimes lead to the lack of motivation to move at all. It is easy to put off our workouts, stretching or to ignore pain signals, but are you really helping yourself by making excuses? 

 

Our bodies need mobility, strength, sleep, nutrition and mindfulness to work the way we need them too. 

 

But our lives have become more fast paced. We place many demands on ourselves to be the people our minds say we should be. We cram our schedules with tasks and use business as an excuse to put off taking care of ourselves. These excuses prevent us from being truly authentic to ourselves and how our bodies need us to live. 

 

Take a look at your daily life…

Do you allow time for movement, flexibility, stress relief, good sleep and mindfulness daily? 

 

If not, take baby steps today to implement one of these into your daily life. Do a few stretches in the morning to help you wake up and loosen up any tightness before you start your day. Add in a simple 10 minute workout ( you have 10 minutes to spare)! Or, if you work at a desk, make a point to stand up, stretch, and walk around every 30 minutes to an hour during your work day.

 

Having a hard time keeping yourself accountable in these areas? 

Here are some courses that may help you:

 

Back Pain Relief Course https://www.stretchptondemand.com/back-pain-relief-course

Knee Pain Relief Course

https://www.stretchptondemand.com/knee-pain-relief-course

On demand Stretch and Mobility Class this Friday 2/12/21 at 11:00 LIVE  only $5.00

https://stretchptondemand.punchpass.com/classes/7693360

Upcoming Webinars and Events

https://stretchptondemand.punchpass.com/classes

Give yourself some grace today!

 

Shin Splints- What they are, how they develop and how to get rid of them

Have your shins been painful during and after running lately? You may be dealing with medial tibial stress syndrome, more commonly known as shin splints. Let’s discuss what shin splints are, how they develop, and how you can get over them so you can get back to your favorite activities pain-free!

 

What are shin splints?

Medial tibial stress syndrome or shin splints can be defined as pain or discomfort along the edge of your tibia (the bone that runs down the front of your lower leg) that primarily occurs during exercise. Shin splints are especially common with activities that require repetitive loading such as running, jumping, or dancing. Shin splints are one of the most common painful syndromes among athletes and are the most frequent injury among runners1.

 

How do shin splints develop? 

When you run or jump during athletic activity, your bones, joints, and muscles in your legs have to absorb the ground reactive force, which is the impact of your feet returning to the ground with each stride or jump. When the amount of impact that you’re absorbing during exercise OR the total amount of exercise is more than your legs can currently handle, you may begin to experience discomfort during the activity. One of the most common areas where this discomfort develops is in the shin bones and their surrounding muscles, because they help absorb a significant amount of the ground reactive force. Shin splints develop over time due to these excessive forces on your lower legs and can be classified as an overuse injury. This condition is one of the most common lower leg injuries among runners.

 

Overuse injury

Overuse injuries commonly occur when someone begins a new activity or are returning to an activity after a long break. Oftentimes, overuse injuries can be described as “too much, too soon, at too high of an intensity.” “Too much, too soon” refers to the volume (how much exercise you’re performing) and frequency (how often you’re exercising) of exercise. For example, if you are a beginning runner, doing too much too soon would be going from running 1 mile on 3 days one week (3 miles total) to 3 miles on 5 days the next week (15 miles total). This would be a 500% increase in running volume and a 67% increase in running frequency. Your body is likely going to have a hard time adjusting to the sharp increase in the amount of stress that you are placing on your legs.

 

“Too high of an intensity” refers to how fast you’re running, how high or far you’re jumping, or how difficult your dance moves are. Let’s go back to the running example. You recently ran a mile at max effort in 9 minutes. An abrupt increase in intensity would look like transitioning from running 1 mile each session at 11 minutes per mile to running 3 miles per session at 10 minutes per mile. The faster you run, the more force that your muscles and bones have to absorb. It’s important to make small changes to your exercise routine over time to progressively overload your body so that your performance improves.

How can I determine whether I have shin splints or some other issue?

When dealing with lower leg pain, one of the most important aspects is determining the difference between shin splints and a bone stress injury. A bone stress injury or stress fracture is a serious running injury that can have long term effects on your ability to exercise if it is not dealt with properly. I’m going to outline a couple of self-tests that you can perform to help determine whether your pain is coming from shin splints or something more serious.

  • Test 1: Find the bony border of your shin. Press on this bony border and on the area where your muscles and the bony border meets. Press along the whole length of your shins, starting at your knee and down to your ankle.
  • Test 2: Take a look at your shins – are there any areas where the color of your skin has changed, any redness or swelling?
  • Results of tests: For Test 1, if you had a painful area along your shin that was about 2 inches in length or more and this is the same area that hurts when you run, this indicates that you may have shin splints. However, if you pressed along your shin and had one very specific painful spot in the bone, this may indicate a bone stress injury.  If you have this specific painful spot and noticed a skin color change and/or swelling, this may further indicate a bone stress injury.

 

What should I do for my injury?

If after reading this article, you suspect that you have either shin splints or a bone stress injury, you should get evaluated by our physical therapists as soon as possible. If you suspect that you have a bone stress injury, you should immediately stop running, jumping, and dancing activities until you can confirm whether there is a true bone injury. Here at Stretch, we are happy to help you with any running-related information. Give us a call at 513-874-8800 to set up an appointment Today!

 

References

  1. Winters, M. The diagnosis and management of medial tibial stress syndrome. Unfallchirurg 123, 15–19 (2020). https://doi.org/10.1007/s00113-019-0667-z
  2. Burrus, M. Tyrrell & Werner, Brian & Starman, Jim & Gwathmey, F. & Carson, Eric & Wilder, Robert & Diduch, David. (2014). Chronic Leg Pain in Athletes. The American Journal of Sports Medicine. 10.1177/0363546514545859.

 

Rotator cuff impingement: Treat the cause not the symptoms

The use of posture management and scapula stabilization exercises to improve rotator cuff impingement outcomes.

Woman with shoulder pain is holding her aching arm – body pain concept

What is Rotator Cuff Impingement?

Impingement occurs when the rotator cuff tendons get pinched in the space between the arm bone (humerus) and the arch of the shoulder blade (acromion) in a region within the joint which is called the sub acromial space. Pain is felt at the front of the shoulder due to irritation and inflammation of the tendon at the point where it becomes trapped. This pain is usually aggravated by overhead or twisting movements of the shoulder. 

Causes of rotator cuff impingement

There are a number of reasons to which this problem can be attributed, these might include:

  • Wear and tear of the joint between the collar bone (clavicle) and the shoulder blade, 
  • Structural abnormalities of the acromion  
  • Weakness of the rotator cuff muscles 
  • Trauma or direct injury

 

However one very common reason relates to poor posture which affects the position of the shoulder and the body’s ability to maintain control through movement. The shoulder joint is a ball and socket joint and is the most mobile of any joint in the body. To achieve such large ranges of motion, the socket is quite shallow which means the joint itself is inherently unstable. Complex ligament, muscle and tendon structures (soft tissues) work together to provide the stability that would otherwise be lacking. The rotator cuff is extremely important in providing this balance between mobility and stability.

 

Postural abnormalities including forward head position, rounded shoulders, internal rotation of the shoulders and an increased curve in the middle back (kyphosis) are commonly seen in patients with rotator cuff impingement (1). The soft tissues at the front of the joint tighten and the soft tissues at the back of the joint lengthen. This adaptation may simply be as a result of prolonged poor posture or could have been caused by poor training methods which have created what is known as a muscle imbalance. 

 

Treatment of rotator cuff impingement

Pain is one of the major symptoms of rotator cuff impingement. It can be treated with a variety of modalities and by a range of clinicians and thus the irritation associated with impingement can be fixed with relative ease. However failure to address the cause of the problem i.e. the imbalance which has caused the impingement in the first place will only lead to a recurrence of the injury and persisting pain.

To achieve long term relief of rotator cuff impingement syndrome, posture management and scapular stabilization exercises must be implemented. 

 

Posture Management and Scapular Stability Exercises

 

The shoulder has a ‘neutral zone’ much like that commonly described in the lumbar spine. This is the point at which the shoulder joint complex is aligned in such a position that all the supporting structures (muscles, ligaments and tendons) are able to work together to maintain control of the joint throughout the required ranges of motion. The ability to maintain this ‘neutral zone’ is lacking in impingement cases. It can only be restored through correcting postural defects (stretching tight structures, strengthening weak muscles) and stabilizing the scapula to provide a strong base of support around which movement can occur. An exercise program can be implemented very early on the recovery phase. There is no need to wait for pain to settle, in actual fact working within a pain-free range at a load that does not provoke symptoms, will only serve to relieve pain (2).

 

Unfortunately, there is no universal blueprint of exercises that can be given to correct this problem. The imbalances that lead to the development of impingement are often complex and interlinked. The skill in prescribing the correct exercise program lies in the exercise professional’s ability to fully understand the issues which have led to the onset of the problem. Only through delivery of such an exercise program will long term relief from rotator cuff impingement be achieved.

 

References

  1. resting positin variables at the shoulder: evidence to support a posture-impairment association. Bostard, J D. 2006, Physical Therapy, Vol. 86, pp. 549-557.
  2. Dynamic evaluation and early management of altered motor control around the shoulder complex. Magarey, ME and Jones, MA. 4, 2003, Manual Therapy, Vol. 8, pp. 195-206.

 

Exercises for Chronic Low Back Pain

Benefits of core exercise progression, balance activities, and dynamic movement exercise to overcome chronic low back pain.

Progression of exercises, balance activities and dynamic movements. 

There are many causes of low back pain; it can be the result of a range of conditions that affect the muscles, joints, ligaments, discs or nerves. Regardless of cause, back pain has a negative effect on the muscles which support and stabilize the lumbar spine (these muscles are collectively known as ‘the core’). This phenomenon is known as pain inhibition. Counteracting the negative effects of pain inhibition by strengthening the core is essential to overcome chronic low back pain and return to normal function. Core exercise progression, balance activities and dynamic movement exercises all contribute to this cause. 

The ‘core’ is a group of muscles which include the Transverse Abdominis, Multifidus, Internal Oblique, Paraspinal, and pelvic floor. Initially it is a big enough challenge to learn how to activate the ‘core’ muscles when lying down still! But for maximum effect therapeutic exercises must go beyond this and the muscles have to be taught how to control the position of the lower back during dynamic, everyday, movements. It is not just the ability of these muscles to contract that is important, but also the way in which they contract; the order in which they ‘fire’. Transverse Abdominis and Multifidus in particular are what are known as pre anticipatory muscles; this means that their job is to switch on just prior to dynamic movement in order to stabilize the spine in preparation for movement. 

Core Exercise Progression

Like any training programme, core training needs to be within the capabilities of the individual becoming more challenging in line with improvements. Initially volitional activation of the core muscles should be practised; this is normally done in lying encouraging the Transversus and Multifidus to return to its role of stabilization prior to movement . Once the muscles are ‘awakened’ this should be transferred to more functional positions. Functional progression is vital, there is no blue print of exercises; a ‘one size fits all’ prescription is useless. Exercises need to be individualized to meet the needs of the individual. All programmes should incorporate exercises in sitting, standing and walking (1).

Balance Activities

Training using an unstable surface has been shown to increase core muscle activation (2). Examples of such unstable surfaces that are commonly used in recreation and rehabilitation are: physio balls, BOSU’s, foam rollers and wobble boards. 

Dynamic Movement Exercise

Everyday activities involve movements which are side to side, front to back and up and down. To complete a rehabilitation programme, the core needs to be challenged in all these planes and at different speeds. Faster movements change the centre of gravity relative to base of support. This means that the muscles are required to make quicker adjustments in order to maintain stability and control of the spine. 

 

By mastering the ability to control the lumbar spine through the application of a progressive and individually tailored exercise programme, full resolution of back pain can be achieved. The negative effects of pain inhibition can be countered and future episodes of back pain can be minimised or even eliminated.

 

References

  1. Core Strengthening. Akuthota, V and Nadler, SF. 2004, Archives of physical medicine and rehabilitation, Vol. 85, pp. S86-92.
  2. What I always wanted to know about instability training. Fowles, JR. 2010, Applied physiology nutrition and metabolism, Vol. 35, pp. 89-90.

 

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