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Texts4Mom – Happy Mother’s Day!

Texts4Mom – Happy Mother’s Day!

by Bridget Dwyer

Happy Mother’s Day! This week, we invited our friend from Fit4Mom Seattle, Bridget Dwyer, to write a guest blog post about motherhood, community and being active. Movement Systems physical therapists are here to support you in your active life. Our PTs can help you with incontinence, pelvic pain, diastasis rectus abdominis and a whole host of other issues. Enjoy her post!

One of my favorite texts every Mother’s Day is the group text from my mom friends.  Every year, we take a moment to wish each other a Happy Mother’s Day.  And every year, we get a chance to think about how lucky we are to have found our little village.  Motherhood isn’t meant to be done alone.  It’s not a solo sport, it’s a team.  Behind those key players of partners and family, your Village is your backup.  Your 6th man on the bench. The women you text when you are Just. Going. To. Lose. It. Today.  The ones who you ask what the hell to do about hemorrhoids because everything you Google looks scary and you’re too embarrassed to ask anyone else.  The ladies who have seen you at your most hormonal and pregnant and are STILL your friends.

To me, the absolute best part about Motherhood (aside from my actual children) is the people that it’s brought into my life.  I found my Village in a Stroller Strides class and in a Run Club. On those early morning stretches of concrete, with no phones to distract us, and no kids to chase after, we had the chance to just be ourselves, and to connect with each other.  Other friends found their Villages in their Co-Op preschool, as they worked together.  We know that Motherhood can feel isolating, to be stuck at the mercy of a baby’s schedule and needs.  It’s a time in our lives when it can feel extra hard to put ourselves on the priority list, behind all of those things we *should* be doing.  And it’s okay.  Friendship happens when we are accepted for who we truly are.  When we open up and let someone in.  Motherhood, which was so lonely at first, became my doorway into a Village of women that I cherish.  Find your people.  And send them a text on Mother’s Day to say “Thanks for being my Village”.

Bridget Dwyer: Boy mom, FitPro, runner.  Forever chasing down my wild and crazy dudes.  Come join me on the trail or in a FIT4MOM workout.

Hamstring tightness? Should you be stretching or strengthening?

Hamstring tightness? Should you be stretching or strengthening?

Corley McBeth, DPT

Many people struggle with hamstring ‘tightness’ despite regular, sometimes daily, stretching. The tightness never seems to go away. Let’s talk about why this is happening and what you can do about it.

The hamstrings are comprised of three muscles: the semimembranosus, semitendinosus and biceps femoris. They are the primary bulk of muscle on the back of the thigh – originating on your ischial tuberosity (or “sits bone”) and running down behind the knee, where they attach on the bones of the lower leg (the tibia and fibula). This means that the hamstrings cross two joints, the hip and the knee. They are the primary flexors of the knee joint (meaning they bend the knee), as well as secondary hip extensors (meaning they help straighten the hip). The hamstrings also assist in providing rotational control at the knee, in addition to pelvic stability due to their anchoring role at the ischial tuberosities. They also play a role in deceleration when they contract eccentrically (meaning they are contracting while lengthening). This serves to slow the rate of knee extension, such as when you are trying to slow down from running to walking.

When we are focusing on stretching a muscle, it is important to differentiate muscle ‘shortness’ from ‘tightness.’ True muscle shortness is a structural issue related to a decrease in the length of the muscle fibers. Muscles become shortened due to immobilization or disuse, most often associated with casts/braces or non-weight bearing status following an injury and/or surgery. When muscles have shortened in this manner, it is called a contracture.

Muscle ‘tightness’ on the other hand, is neurologically driven and is a sensation associated with a muscle remaining in a contracted or tense state. Often the muscle is receiving input telling it to contract because the body is trying to generate stability. The nervous system may be increasing tone in the muscle as a protective response. The sensation of tightness might lead us to believe we need to stretch that muscle; however, providing input that stabilizes rather than stretches will likely be more effective in these situations.

“Muscle ‘tightness,’ on the other hand, is neurologically driven and is a sensation associated with a muscle remaining in a contracted or tense state.”

 

In many individuals experiencing ‘tight’ hamstrings, the hamstrings may actually be relatively overlengthened for optimal performance of a specific task. To improve postural control at the pelvis and/or knee, the nervous system will send excitatory input telling hamstrings to contract.  Without sufficient tension in the hamstrings (force production), the movement strategy for a particular task will be achieved through compensatory strategies impacting the performance of other muscles such as the abdominals, back extensors, hip flexors, etc. For example, consider lifting a heavy object from the floor using a hip bending strategy (i.e. deadlifting).  Without sufficient tension from the hamstrings, back extensors will create more compression on the spine.  One can debate whether this is good or bad for the back.

“Tight” muscles, despite the fact they are remaining in a relatively contracted state, are not necessarily strong muscles.  It may mean strengthening is the best course.

If you experience chronic hamstring ‘tightness,’ or have a history of hamstring strain and/or low back pain it is recommended to seek out a physical therapist for a formal evaluation. Expert advice based upon your specific experience and goals is very effective. An individualized assessment will help to address your mobility, stability, and overall movement patterns, which will increase the effectiveness of your stretching and strengthening routine.

Corley McBeth, DPT

Dancers, It’s time to crosstrain!

Dancers, It’s time to crosstrain!

By Abby Halpin, DPT ACSM

Dancers hear that they should be ‘cross-training’ from instructors, parents, choreographers, and fellow dancers. But why is it important, and how do you do it? The goal of this post is to share the facts that should convince you to make cross-training part of your dance training.  Keep reading, and I’ll share how to do it too.

Health

It is no surprise to anyone that dancers are incredible athletes who train hard. But if dance is your primary method of exercise, it does not cover your bases for all aspects of health and wellness. Studies show that dancers get about 10 minutes per hour of dance class at a moderate to vigorous intensity, and that number gets lower as you advance into higher level classes.1 The American College of Sports Medicine (ACSM) recommends that adults participate in greater or equal to 150 minutes of moderate and 75 minutes of vigorous exercise training per week for cardiovascular health.2

Injury

Dancers also have frequent run-ins with injury. Dancers can experience 1-5 injuries per 1000 hours danced.3 Improving strength and motor control, with the help of a physical therapist, can help to reduce the risk of injury.

Performance

 This may be the most convincing argument to convince dancers to engage in cross-training exercise routines. IT IMPROVES PERFORMANCE. In one study, dancers who participated in a 12 week cross-training program demonstrated significant improvement in the performance of a 4 min piece compared to the control group.

Convinced yet?

Here is a list of 5 favorite cross-training exercises for dancers:

  1. Airplane balance with pelvis rotation: To improve your turnout strength by moving your pelvis on your thigh rather than the other way around. 12×3 each

Patients and clients lovingly refer to this as “Crashing Airplane”. Stand on one foot. Hinge forward so that you are a straight line from your opposite heal to your shoulder and your body is parallel to the floor. Hold that position as you rotate your pelvis open and closed. If you were wearing jeans, your zipper would point away from your standing leg, and then toward the standing leg.

  1. Push-ups: To improve upper body and core strength. 12 reps x3

Start in a plank position. Press your hands into the floor so that your shoulder blades move away from each other and your abs are engaged. Holding that position, bend your elbows and lower chest to the floor. Don’t let your trunk sag or lift your hips!

  1. Overhead Presses: To improve scapular strength in elevation and upward rotation. Reaching overhead strengthens the shoulder in a key functional movement pattern.  Insufficient serratus anterior strength and upward rotation mobility is common in neck and shoulder pain.  12 reps x3

Stand holding a moderate weight dumb bell in each hand (10 pounds).  From shoulder height, reach the weight vertically overhead.  DO NOT DEPRESS YOUR SHOULDERS!  The purpose is to reach the weight as high as possible with natural elevation and upward rotation of the shoulder blade (scapula).

4. Frog Jumps: To improve power for jumps. 12 reps x3

Stand with feet slightly wider than hip width apart. Squat down and touch the floor. From this position spring up into a jump with hands reaching toward the ceiling. Land and go right into the next one.

  1. 30 min of Cardio: Can be anything that keeps your heart rate up continuously for 30 minutes. Your choice! Some ideas include walking, running, swimming, hiking, biking, rowing, find your favorite cardio machine at the gym. Remember that 225 mins per week of moderate to intense exercise? Subtract the number of hours you danced times 10min, then do enough rounds of cardio hit the target for the week! Find a friend and have fun with it.

Resources:

  1. Grierson, M. (Presenter). (2016). Risk factors for dance related injury: A clinical application.     Speech presented at Movement Systems Physical Therapy, Seattle, Wa.
  2. Carol, G, et al. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory,     musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing     exercise. Medicine & Science in Sports & Exercise, 43, 1334-1359. Retrieved from     http://journals.lww.com/acsm-msse/Fulltext/2011/07000/     Quantity_and_Quality_of_Exercise_for_Developing.26.aspx
  3. Allen, N. (2012). Ballet injuries: Injury incidence and severity over 1 year. Journal of Orthopaedic & Sports Physical Therapy, 42(9), 781-A1. https://doi.org/10.2519/jospt.2012.3893

Abby Halpin DPT, ACSM

High Intensity Resistance Training for Osteoporosis: Are we playing it too safe?

High Intensity Resistance Training for Osteoporosis:

Are we playing it too safe?

By Carrie Hall PT, MHS

 

The CDC and Surgeon General, along with many researchers1 have proposed that exercise plays a role in prevention and treatment of osteoporosis, but the effect has been perceived to be moderate at best. Debunking this myth, a preliminary study in Australia has shown that high-intensity resistance and impact training (HiRIT) may improve bone and muscle strength in healthy postmenopausal women with osteoporosis.2

Maybe we have been playing it too safe?

It is known that bones respond preferentially to high magnitude weightbearing loads, but most physical therapists prescribing exercise are hesitant to apply high loads to persons with osteopenia (thinning bones) or osteoporosis (low bone density) for fear of risk of injury or fracture. This study aimed to demonstrate that high intensity resistance and impact loading is both safe and effective in improving bone mass and overall physical function.

What did this study do differently?

Researchers analyzed data from the larger Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation (LIFTMOR) Trial on 101 postmenopausal women age 58 or older. For eight months, half of the women did twice-weekly 30-minute sessions of supervised HiRIT that included deadlifts, overhead presses, squats and jumping chin ups with drop landings. The other half formed a comparison group, and for eight months they did unsupervised, twice-weekly 30-minute low-intensity exercise at home.

The graduated loading, close ongoing supervision, and focus on correct technique were key to safety and overall adherence to the program (low drop-out rate). The 2 time per week dosage was also very appealing to this demographic leading to high compliance (participating with expected dosage).

All the participants had bone mineral density testing with a special type of X-ray called a DXA scan before and after the eight-month training program to assess changes in their bone mineral density (BMD), or bone health, at the spine and the femoral neck at the very top of the thigh bone that connects the long bone to the head of the femur.

By the end of the study, the HiRIT participants increased BMD in their spines by an average of about 3 percent and increased hip BMD by 2.2 percent. In the comparison group, women lost an average 1.2 percent of spinal BMD and lost more than 2 percent at the hip, researchers report in the Journal of Bone and Mineral Research.

The benefits of bone density improvements at the femoral neck and spine translate into stronger hips and backs. Women in the resistance group also had a 40 percent improvement in back and leg extensor strength, which helped improve their posture and reduce their risk of falls.

Close ongoing supervision is key!

The researcher of this study felt this demographic has traditionally been held back from high intensity resistance training for fear of fracturing fragile bone with heavy loading, but that this overly conservative approach has led to stagnation in the field. This study demonstrates preliminary evidence for safety and effectiveness of a HiRIT program for otherwise healthy postmenopausal women with low to very low bone mass.

Key to the success of this program is that HiRIT training should be supervised by adequately trained and educated professionals such as a physical therapist, to ensure correct technique and appropriate progressions, as well as to minimize injuries.

WE DO NOT RECOMMEND INDIVIDUALS WITH LOW BONE MASS TO UNDERTAKE THIS PROTOCOL IN AN UNSUPERVISED ENVIRONMENT, even after notable training, because it is not possible to self-monitor technique or self-prescribe dosage.

Despite misconception to the contrary, high intensity resistance training can be safe and has proven to be effective in improving bone mass.

Consult your PT if you are interested in beginning a program such as this.

Happy lifting!

 

  1. Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011(7):CD000333.
  2. Warson SL, Weeks BJ, Weis LJ, et al. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: The LIFTMOR Randomized Controlled Trial. JBMR. 2017.

 

Carrie Hall PT, MHS – President

Why you should be deadlifting

Why You Should Be Deadlifting

By Corley McBeth, DPT

 

There seems to be no exercise more effective than the deadlift in instilling fear in the hearts of patients. I cannot tell you the number of excuses, hesitations, and outright refusals I have heard regarding its performance. It would seem that we still mistakenly believe that the squat is the safest and most optimal way of lifting and moving load (thanks WebMD), but I am here to tell you that just is not the case. Mechanically speaking, the deadlift, when performed correctly, is the proper way to lift – whether it be a case of wine, a heavy moving box, or a piece of furniture. It is the ultimate functional movement.

So why are we so terrified of it? Usually it’s something along the lines of “my back is weak/sore/painful” or “that’s how I hurt myself” or “but I might hurt my back”. However none of those are a good reason to avoid it – in fact, those are all reasons you should be doing it! There are many contributing causes to back pain. Back pain can stem from weak glutes and hamstrings making it difficult to effectively move the load you required of the task. It can also come from weak spinal erectors and/or weak abdominal and pelvic floor muscles. A properly performed deadlift challenges your body to maintain a specific spinal position thereby training it to remain stable when exposed to high shear forces. You will get more benefit from a properly performed deadlift than you will from hundreds of crunches or a 3-minute plank hold.

This is because deadlifts are a total body exercise. Not only does the deadlift help facilitate strong and powerful glute and hamstring muscles and effectively challenge your core, it also places greater demand on the upper body than a squat. Squats don’t have the same effect on your scapula and rotator cuff in terms of stability, nor do they require the same muscle activity from your biceps and latissimus dorsi muscles. Deadlifts are also one of the safest weight lifting exercises to perform – you aren’t going to get pinned under weight or risk getting pulled over backward. They don’t require a spotter, you simply drop the weight if you get into trouble.

That being said, deadlifts, when performed correctly, are not bad for your back. Poorly performed deadlifts, regardless of weight, can place you at risk of injury. One must first have the required mobility as well as the appropriate stability, in order to perform a deadlift with proper form. And no, it’s not just for powerlifters. Deadlifts can be and should be performed by just about everybody.  Sure, you may need instruction and supervision during the learning process. There are many variations and modifications to allow for a safe and appropriate progression to lifting and moving heavy loads with the deadlift. Your physical therapist or other trained fitness professional can help to properly assess and instruct you in the correct performance of this movement (see video below for an example, but please use feedback for practice). Keep doing your squats, but don’t neglect the deadlift – your glutes, hamstrings and core will thank you.