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December is here, and so is the winter weather! There are two major types of injuries that seem to go along with one of winter’s biggest issues: shoveling snow.  The first and by far the most serious injury is heart attacks. Every year across the country, people suffer heart attacks and/or heart-related symptoms when shoveling snow. Snow can be heavy, and in combination with all the extra clothes we wear, very taxing.  This leads us into the second and probably the most common injury: back pain. Shoveling is one of the most taxing activities on your back. It is very repetitive and at times heavy, putting a lot of stress on your spine. There are several things to keep in mind to keep you safe and healthy during this winter weather:
If you keep these few simple things in mind, it can lead to a healthier and happier winter.  By: Brian Colvin, PT
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Many sports involve repetitive overhead upper body movements, whether it be throwing, hitting, or swinging. This can put a lot of strain on the shoulder muscles over time. Overhead athletes face a unique challenge of needing the shoulder joint to be both mobile AND strong/stable to throw, hit or swing a racquet.
One way to proactively protect the shoulder is to perform strengthening exercises of the scapular area and the shoulder joint, including exercises in the range in which you use your shoulder in your specific sport. Let’s break down a couple examples of what you or your kids or athletes could add to an exercise routine to help strengthen and protect the shoulder. Keep in mind it’s not just which exercises you do, but HOW you do them that will make them effective and help translate into good movement patterns in sport! Try to incorporate some of each type of movement into your routine: 1. Horizontal Pulling/Scapular Retraction Select an exercise or two that engage the muscles around the scapula. Think about the motion of pulling your shoulder blades down and together in your back, and think about how that feels – now try to transfer this to your pulling exercises. For example, use a looped mini-band and perform external shoulder rotation while engaging the scapula. Or, using a cable machine or bands, perform horizontal rows, focusing on the same thing (squeeze those blades together!)  External Rotation of Shoulder with Mini-band Incorporating some external rotation exercises will help develop the muscles responsible for the deceleration phase of your throw/hit/swing, which can put a lot of stress on the joint. 2. Horizontal “Pushing” Movements Add in pushing movements, such as push-ups, bench presses, chest flies, or cable presses, with a focus on engaging the scapula at the end of the motion. Think about a pushup, for example. Don’t stop at the “top” of the push-up if your shoulders are chicken-winged – push your arms into the ground at the end, thinking about raising your back an inch or two higher (protraction).  Pushup without Protraction vs. with Practration Practicing pushing movements is important to being able to engage the anterior chain and internal rotators. A study of handball athletes even shows the relationship between bench press strength/power being related to athletes’ throwing velocity.
Most athletes do incorporate pushing into their exercise routine, where posterior chain (pulling, back exercises) tends to be the more neglected side. This can also result in rounded shoulders and poor posture. It’s important to engagement both anterior and posterior chains to set yourself up for success in movement patterns. Remember to engage scapular protraction at the end range of your pushing/pressing movements! 3, Vertical “Pulling” Vertical pulling exercises include lat pull downs, pull-ups, and banded pull-downs, and should primarily engage the lats, traps, and posterior delts. Obviously, your arms will be involved in these pulling motions, but one mistake that many athletes make is using an “all arms” approach and NOT engaging their scapula. Consciously engage the lats and traps and muscles around your scapula (think: pull shoulder blades down and together) during these exercises, even if it means lightening the weight while you figure out proper form. In the long run, you’ll be able to pull more, and engage your back muscles in your throwing or hitting!  4. Vertical Pushing/Overhead Pressing Vertical pushing exercises include shoulder press and variations, such as a military press or Arnold press. With an overhead press of any sort, it’s important to make sure you can do the movement properly before adding a load to it – adding weight to a poor movement pattern does not help (and can potentially hurt!) Overhead pressing requires mobility at the glenohumeral joint (think ball-and-socket shoulder joint) as well as the scapular and thoracic mobility. A lack of mobility can put pressure on the rotator cuff, making your prone to injury when weight is added to the motion. If your mobility is lacking, before adding weight to your overhead press, exercise mobility by doing wall slides, facing away from a wall with your elbows and forearms against (or near) the wall, sliding your arms slowly up and down.  Wall Slides Some alternative “pressing” type exercises that will work these muscles and train proper positioning under load include Turkish get-ups and kettlebell carries. Push the weight in that final range to really engage the scapula.  Turkish Get-Up A good exercise program for overhead athletes should include a variety of these movement patterns, to strength, mobilize and protect the shoulder. If you're struggling with a shoulder injury or looking to strengthen your shoulder for your sport, give us a call: 616-662-0990.  By: Lisa Pfotenhauer, Cert. Exercise Physiologist Many people have heard of physical therapy or had relatives who had it. Often times these people will describe they received some kind of treatment or had to perform exercises to get better. The key take away from physical therapy is that the therapist will try to identify what deficits you have that may be contributing to your problem. This may be stiffness, weakness, poor posture, or some other variable that may be causing your pain or lack of function. Once those problems are identified, we can tailor a program to address those issues. Often times, when the person starts to improve in those areas, they begin to feel better and have less discomfort.  The physical therapist will look at the area where you’re hurting and perform various tests see what is the problem. Information from your physician is helpful to verify what the therapist discovers in their evaluation. The therapist will work with you through a program likely consisting of exercises, stretches, avoidance of harmful activities, etc. to help you progress along. We ask our patients to clearly define their deficits so we can benchmark them to see if there is progress along the way. We want you to see results soon and be encouraged to try to progress yourself to return to the activities you want to do!  By: Steve Bartz, PT If you have been dealing with pain and your doctor has ordered physical therapy, you may be asking yourself will it be worth it? We often tell people the advantage of physical therapy over many other courses of treatment is that it is a fairly conservative way to see if you can improve your pain or function in a relatively short period of time. While we don’t expect people to be immediately healed when they first start physical therapy, we do expect to see some gradual improvements over the first 2 to 3 weeks. If we don’t see improvements in that time, therapy is not likely to help the individual.  But, if there are improvements in function or pain, we can ultimately progress the person to an independent home exercise program which they can continue on their own. Our goal is to have people independent of their doctors or therapists and be able to manage their condition themselves. Again, we tell people to think of it as a 2 to 3 week investment in their health to see if they can conservatively manage their own care. If we see success, then they simply try to progress through their exercises until they are at a point where they feel they can continue on their own. If you have questions about your specific condition, please contact our office: 616-662-0990.  By: Steve Bartz, PT I was golfing recently with a friend who mentioned that his dad had read an article about how using good posture during the golf swing could improve performance. My friend decided to try to focus on improving his “golfing posture” and was surprised at how much of a difference it made. He reported improved distance on his shots, as well as better control. He noted that his new golfing posture felt strange, yet better. He was very surprised that something that seems so simple could have such a positive effect!  Physical therapists typically spend a great deal of time educating our patients about the importance of good posture, as well as giving frequent reminders to correct posture or form during exercise. We understand the importance of good posture, especially in terms of how it relates to physical performance. The body has optimal positions (postures) in which it is intended to perform, and when people do not maintain good posture, it eventually results in pain, soreness, or decreased muscle performance. Good posture involves more than just “standing up straight”. Obtaining optimal postures often involves stretching tight muscles and strengthening weak or imbalanced muscles, as well as correction of old habits. If you would like to learn more about this subject, we have a group of exceptional PT’s that would love to help you out!  By: Mason Riegel, PT As the weather cools off to comfortable fall temps, it's a great time to get outside for some exercise! Before you exercise, you can reduce the risk of injury (and make for a better exercise session) by doing a short warm up.  The old-school methods of a "warm-up" included a lot of static stretching, like reaching down and touching your toes. Think back to your gym classes or school athletics, is this what your warm-up looked like? Research has shown that static stretching does not reduce the incidences of exercise-related injuries. Keep in mind that static stretching does have it's benefits (such as increasing range of motion), but it should not replace your warm-up.  So, what should a warm-up look like? Think about your goal - you want to utilize the muscle groups that you will be working during your exercise session or activity, as well as gradually increase your heart rate. This will look different depending on what you're doing! For example, if you are warming up for a run, your warm-up may look like a couple minutes of standing leg swings, some brisk walking/light jogging, or even some light exercises that target the muscle groups you'll be working (body weight squats, lunges, glute bridges, calf raises). If you are going to play softball, a warm-up could include arm circles and several short bouts of jogging with acceleration. Basically, think about the movements you will be performing, and aim to use those muscles at a low intensity, and incorporate some exercises that will elevate your heart rate as well. Make your warm-up dynamic.  Lastly, planning your warm-up ahead of time will increase the chance that you actually take a few minutes to execute! Think through your activity and take a couple minutes to build a warm-up plan for yourself, to set yourself up for success in your exercise!  By: Lisa Pfotenhauer, Cert. Exercise Physiologist Sources:
McCrary JM, Ackermann BJ, Halaki M. A systematic review of the effects of upper body warm-up on performance and injury. Br J Sports Med. 2015 Jul;49(14):935-42. doi: 10.1136/bjsports-2014-094228. Epub 2015 Feb 18. PMID: 25694615. Small K, Mc Naughton L, Matthews M. A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Res Sports Med. 2008;16(3):213-31. doi: 10.1080/15438620802310784. PMID: 18785063. Woods K, Bishop P, Jones E. Warm-up and stretching in the prevention of muscular injury. Sports Med. 2007;37(12):1089-99. doi: 10.2165/00007256-200737120-00006. PMID: 18027995. We have all heard this phrase before - "I've fallen and I can't get up!" Many of us have probably even joked around with it! There is some seriousness to this phrase howevever - as we age there are many things in life that become more challenging. One of those that directly affects most people is BALANCE. Changes in balance, barring any significant injury or disease, come on naturally, and falls (including the subsequent recovery) can be very debilitating.  As we get older we are not as quick on our feet and cannot always catch ourselves if we "lose our balance." This often results in increased falls as we age. There are several reasons for this; the first and most obvious is that we lose strength and flexibility as we age.  The second reason is less obvious. These changes are harder to see and directly affect the three main components of our balance system. These are: 1. Inner ear or vestibular function 2. Eye sight 3. Join proprioception These three systems decrease in efficiency as we age.  The good news is, that it is a slow process that happens very gradually in most people. So now we must ask - what can we do to combat these natural changes, in order to prevent the chance of a fall? No one wants to lose their ability to function at a high level. We all would love the agility and balance of a 10 year old, but that's not possible. The good news is there IS something that can be done: first, stay active! They say "use it or lose it," and that is very true when it comes to muscle and balance. The longer we stay active, the better shape we will be in.  Secondly, practice your balance. Like many things in life, the more you practice, the better you will get, and your balance is no exception! We all see our ability to balance decrease as we age, however remember that there are simple steps that can be taken to slow or minimize this decline. For more information or exercise tips, come see your local physical therapist and get a customized program to improve balance and decrease risk of falls.  By: Brian Colvin, PT We hear this saying almost every week in our clinic. We all want to be healthy, lose weight or be able to perform the activities we love. But what does “getting in shape” mean? To some, it’s weight loss, to others it means running a marathon, or not be winded after what was once an easy activity. Being in-shape is unique to your needs and desires.  We are often hesitant to start because we have not defined what we want to achieve. Think about what would be a fulfilling goal and then write it down. Put your goal in front of you each day, and then take steps to accomplish it.  First, write down the ways you think you could achieve this goal. Today, let’s talk about weight loss. Weight loss requires considering both calories you take in and energy you expend to burn off those calories. You probably know what foods contribute to your gaining weight and if you are adverse to any types of exercise. List those areas, then list other options that may achieve the same goal. If you are not a jogger, then walking or bicycling is an option. If you have a sweet tooth for ice cream every night (like I do!), then try halving the amount or substituting a sweeter fruit instead. Think about an appealing option that may work for you now, BEFORE you are faced with the dilemma of choosing. That will make it easier when you are faced with the decision. Determine to have at least one “victory”, that is choosing a better option when you want to go back to your usual habits. Typically, that success feels good. Remember that you were able to make a positive change. Plan for the next time you know you will be tempted to eat more or skip exercising. It will make it easier if you anticipate your decision ahead of time!  By: Steve Bartz, PT Over the past year, Covid has turned all our lives upside-down! Every aspect of our lives has been affected – including our work environment. Our jobs and the way we perform them has been significantly changed. A large amount of the workforces has transitioned over the last year to working from home, and in the world of physical therapy we have seen some of the consequences. We have experienced an increased amount of work-related injuries – not the normal sprains and strains, but rather in the form of neck injuries as well as upper- and lower-back injuries.  Many of these spine-related injuries involve a person’s home work station that it not optimized for hours of sitting. Lots of people are using a laptop or mobile device, sitting on the couch or at the kitchen table. Although the return to work movement is happening already for some people, others may never go back to the office 100% of the time. So, how do we solve these types of issues when it may be negatively affecting your health? Here are a few simple steps to try to improve the situation and avoid aches and pains while working remotely:  1. First, improve your work station. Try to work from a chair that fits you better. Sit up straight, and use a separate monitor if available so that you aren’t looking down at the monitor (creating neck tension over time). 2. Take frequent breaks. Your body is made for movement, and the worst thing for you to do (even is your posture is great) is to stay in one position for too long. I recommend getting up and moving around every 30 minutes or so – that does not mean going for a mile walk every time, just take a minute or so to move around and get the blood flowing.  3. Lastly, throw in a few exercises to break up the work day. Here are three quick and easy to help improve posture and prevent back and neck pain: 1. Shoulder blade pinches: Simply squeeze the should blades together 10-15x.  2. Backward shoulder rolls: Roll the shoulders backwards while sitting, repeat 10-15x.  3. Standing back bends: Stand up, place hands on hips and bend backwards 5-8x.  If these simple steps are followed, we can all work more effectively from home and stay injury-free! If you have a work from home injury, don’t hesitate to call your local physical therapist! Let us know if we can help you: 616-662-0990.  By: Brian Colvin, PT  It’s amazing how golfers have transformed the modern game by focusing on their bodies. Today’s golfers are much more physically fit and athletic than they were even 20-30 years ago. Back then it was often hard to discern a professional golfer from an “average Joe” just by their physique. Current golfers, however, are typically fit and athletic, and are very devoted to working out and eating right. The emphasis on fitness has resulted in massive gains in yardage. Golfers such as Brooks Koepka and Bryson DeChambeau look more like linebackers, and they hit the ball a country mile.  So, you might ask, how does that apply to all of the non-professional golfers out there? Well, most golfers would love to hit the ball further, and the good news is that we can, simply by devoting more time to our bodies. However, it doesn’t mean that we have to become massively muscular. Probably the most important factor in producing optimal speed to hit the ball a long way is flexibility. This includes being flexible in the spine, shoulders, & hips. A golfer such a Will Zalatoris, who recently nearly won the Masters, is a good example. Despite being very thin, he is incredibly flexible and has great mechanics, which enable him to be a big hitter. One of the main reasons that people lose distance as they age is that they become much less flexible. As a result, their swing becomes much “shorter”, and they cannot produce nearly enough speed to hit the ball far. Even if they were strong, the lack of flexibility prevents the production of a full swing with lots of rotation. The optimal situation is to be both exceptionally flexible and very strong. Physical Therapy can be very helpful with both of these areas. We are trained to assess your flexibility and prescribe exercises to improve it. Becoming more flexible in the spine, shoulders, and hips will allow you to create more rotation with better mechanics. Most golfers develop compensations in their golf swing because they lack the flexibility to produce the proper mechanics that they strive for. For example, you to take a lesson with the best golf instructor out there, and he could tell you exactly what you need to do, yet you may not be capable of doing it because you lack the flexibility to do so. So improving your flexibility is the most important first step that you can take. Once you have made those improvements, then an investment in lessons can be much more effective.  The other key component to address is strength. Interestingly, many people would think that improving their upper body strength would produce the best results. However, improving core strength and lower body strength is the key. Once you have completed your backswing, the downswing should be initiated by your core and hips, not your arms. A strong core will result in a fast, powerful swing. Unfortunately, most people do not have a strong core, which limits their distance potential. This article is obviously just a glimpse of the overall picture. But if it is interesting to you, we would love to help you out. The best starting point is a Physical Therapy Evaluation to assess your flexibility, strength, and movement patterns. From there we will be able to focus on the areas that you need to work on to make the gains that you desire. Give us a call if you would like to explore this further!  By: Mason Riegel, PT |
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