When most people think of physical therapy, they probably think of treadmills and stationary bikes, hand weights and elastic bands — plus the medical tables on which patients can be treated. Without getting wet.
“Aquatic therapy allows a gravity-reduced environment in which to exercise,” explains Kelly Lenz, a physical therapist and co-owner of Clinton Physical Therapy Center, a Physiquality network clinic in Tennessee. “This allows a variety of patients to move more freely without undue stress on their body.”
This is possible because of one special property of water: buoyancy. Because of buoyancy, the gravitational forces on the body are reduced, giving some patients immediate pain relief. “Buoyancy can be used to assist, support or resist motion,” says physical therapist Blair J. Packard, the co-owner of East Valley Physical Therapy, a Physiquality member in Arizona. “It also opposes gravity to provide spinal and joint unloading.”
There are other benefits to doing therapy in a pool as compared to on land:
Patients who are only able to do traditional exercises for a short period of time are often able to exercise for longer periods of time, with more intensity.
Patients with poor balance do well in the water as the water helps support them — and if they do fall, the water slows down the fall.
Patients with edema often see a reduction in swelling, as the water pressure increases venous return to the heart.
Aquatic therapy can help a variety of patients, but Kelly notes that it’s especially helpful for those with lower extremity injuries or issues — arthritis in the knees or hips, leg fractures where patients are just starting to put weight on the bone again, or pain in the lower back or lumbar spine. It’s also been shown to help patients with disorders like Parkinson’s disease and multiple sclerosis. And the American Physical Therapy Association points out that a pool is the perfect environment for aging individualsthat have the normal degeneration that occurs with aging.
Don’t worry if you don’t know how to swim — therapy in a pool is used to improve function, mobility, strength and balance, not actual swimming. Most pools are fairly shallow in order to allow the patients and therapists to stand and walk in the water. For example, Blair points out, the depths in the pool at East Valley PT range from three and a half feet to five feet. And if patients are still uncomfortable with the water, special adaptive equipment will help them keep their head above the water’s edge.
Not all physical therapy clinics offer aquatic therapy, and even if your physical therapist does offer it, it may not be the best treatment for your condition. But if your PT suggests getting into the pool to become stronger and improve your health, consider getting wet in order to get better.
With Memorial Day behind us and Independence Day quickly approaching, many of us have plans to travel in the next couple of months. If you’ve been trying to stick to an exercise regimen, here are some ideas for how to continue working out when you leave your regular routine behind.
“Exercise that doesn’t require bulky equipment or a lot of space is best while traveling,” advises Brian Klaus, the Vice President of Stretchwell, Inc. (a PTPN preferred vendor that offers a variety of progressive resistance products). Why take up space in your luggage with heavy weights or bulky equipment?
Physical therapist Richard Baudry, the founder and CEO of Baudry Therapy Center (a Physiquality member in New Orleans), agrees. Richard reminds readers that walking is the easiest exercise to do while traveling. “Make a point to stand tall, take long strides and swing your arms,” he adds.
If you’re worried about taking time away from other activities, says Richard, get up an hour earlier to go for a walk or jog – the fresh air will give you almost as much boost as a cup of coffee. You can also make it a daily family activity. If you’ve traveled to a scenic site, walking is a great way to explore your vacation location; you can plan a different walk for each day you’re there. Or if you’re traveling with a little one and he or she goes to bed early, plan your workouts for after bedtime; check out our post on working out while baby is sleeping for a sample workout that will get your heart pumping quickly (and quietly).
If you prefer using resistance when you work out, think about bringing resistance tubing, a set of bands that include a door anchor, or a portable weighted pulley system. A set like this one from QTEK Products (a Physiquality partner), created by physical therapist Yousef Ghandour, is easy to pack and won’t take up a lot of room in your bags. Yousef notes that you can use any hotel or household items to add weight to the system, which allows for shoulder, back, hip and knee exercises by attaching the system to your hotel room door.
Richard suggests weight lifting using items you’re already planning to bring, like your purse or a backpack, for arm curls or overhead presses. (Just make sure to securely close your bag first.) Or book your stay at a hotel that includes a gym with workout equipment that you normally use at home; look at the list of amenities when making your reservation to see what types of equipment is available. Some may even offer fitness classes like yoga or Pilates.
Lastly, Brian reminds readers to take advantage of the technology many of us already own. Use the reminders or calendar on your phone to set times for those daily walks or your gym time. Pay attention to your watch or FitBit when it notes that you’ve been sitting too long. Or have Siri remind you that a body in motion stays in motion!
Have you heard about rucking? The word “ruck” is short for “rucksack,” a military backpack that soldiers use to carry supplies on their back. Rucking, or ruck marching, refers to walking over paved or unpaved terrain with a loaded rucksack for the purpose ofimproving your fitness.
The military often uses rucking to measure physical fitness. Many units require a soldier to complete a timed ruck march in order to qualify for the unit. For instance, the U.S. Army Special Forces requires potential recruits to be able to ruck 12 miles in 2 hours with a pack that weighs 65 pounds in order to be eligible for Special Forces Selection. Even after leaving the armed services, some veterans continue to use rucking as a way to remain strong and build social ties while exercising.
For most everyone else, rucking is a great way to add diversity to your training, regardless of whether you’re in or planning to join the military. Rucking with even a modest pack strengthens the legs, back and core muscles, while improving your cardiovascular health. And because you’re walking, it’s usually considered lower impact than running. Those who backpack or hunt in the wilderness can also benefit from rucking, as it provides a very functional way to train for such activities.
So how do you ruck? It’s pretty simple: Load a backpack up with some weight (not too much!) and go for a walk. It can be down the sidewalk or along the trails at the local park. Start with short trips — less than 30 minutes — and work up to about an hour. Then slowly increase the weight in your pack until you can do about 30% of your body weight.
The number one concern regarding these types of workouts is overexertion. Even with a lightweight pack and a short workout, this is still a very tough form of exercise.Dehydration can be a factor, as much of the time these workouts are performed in thewarmer months. Lower body injuries are also common with rucking, including such ailments as shin splints, knee pain, plantar fasciitis and ankle sprains. And don’t be surprised to you feel soreness in the shoulders and neck, as these muscles aren’t used to carrying a heavy load.
As with any form of exercise, it is important to listen to your body. Start slow and build up your “ruck” stamina over time. Add weight and time gradually, and spread out the workouts with other activities — and rest. And if those aches and pains don’t go away within 48 hours of your rucking workout, talk to your physical therapist to discuss your exercise regimen and whether you may have an injury that needs to be treated.
As we grow older, our bodies change. While it may sound counterintuitive, staying activeis the best solution when our joints start to ache and our energy starts to fade. (Isaac Newton probably had no idea he was also talking about the human body when he explained that a body at rest stays at rest, and a body in motion remains in motion.)
In addition, if you’re exercising incorrectly or compensating because of pain, you’re at risk of doing more harm than good. “Doing the wrong exercise or doing an exercise incorrectly can result in more pain or even joint damage,” notes Kristina Holland, a physical therapist assistant at Clinton Physical Therapy Center in Clinton, Tennessee. Physical therapist Jessica Loncar agrees. She points out that exercise in a safe, controlled environment under the supervision of a licensed physical therapist goes a long way toward improving quality of life. A STOTT PILATES® Certified Instructor and Instructor Trainer for MERRITHEW™ (a Physiquality partner), Jessica reminds us that physical therapy is good for improving strength, balance, mobility and overall fitness.
Pilates exercises are designed to restore the natural curves of the spine and rebalance the muscles around the joints, with a focus on core stability, pelvic and shoulder girdle stabilization, neutral alignment and breathing. Pilates and physical therapy go hand in hand in teaching efficient movement patterns, which will keep us healthy as we age, explains Rachelle. Because Pilates focuses on proper back alignment and strengthening and lengthening the spine, she says, the back becomes stronger, preventing early wear and tear and reducing pain, as well as the risk of injury. This is key to staying active as one ages, as back pain often causes people to quit exercising for fear of further pain.
Many physical therapists often incorporate Pilates into their rehabilitation programs because of how it can be used to strengthen the body and improve flexibility with low-impact exercises. Mika Yoshida, a Pilates instructor at the Take Charge Fitness Program atClinton Physical Therapy Center, notes that this is especially beneficial after an injury or joint surgery, when one often loses range of motion in the affected joint. And while some of her students blame their lack of flexibility on their age, Mika reminds them that incorporating Pilates exercises into their daily or weekly regimen can improve their flexibility, regardless of their age.
If you’re dealing with joint pain or haven’t exercised in a while,Pilates is an excellent way to ease back into a more active lifestyle. A certified instructor like Jessica will know how to adapt exercises for your specific body and work with you to grow stronger. And if you take a class at a physical therapy clinic, you may end up with a physical therapist like Rachelle teaching your class. This means that she’ll zero in on any musculoskeletal weaknesses you have, and, if you need it, recommend coming into the clinic as a patient.
Practicing Pilates, says Mika, is like maintaining your car: You get an oil change for your car so that it can run for another 5,000 miles. You practice Pilates so that your body continues to move efficiently for years!
With margins in elite competitions getting smaller and smaller — Usain Bolt won his gold medal in Rio by running the 100 meter dash 0.08 seconds faster than Justin Gatlin — many advanced athletes, particularly in track and field, are constantly looking for ways to grow stronger and improve their times.
Overspeed training is one way that runners (and other athletes) try to strengthen the muscles used in short bursts of movement, by using some type of external assistance to run faster than one normally would run, about “8% to 13% faster than the athlete’s fastest speed.” Daniel Butler, a clinical exercise specialist at the Take Charge Fitness Program, a wellness facility run by Clinton Physical Therapy Center (a Physiquality network member in Tennessee), explains that there are several ways to do this. Tail wind running is the simplest method, running with a wind at your back. Similarly, slight downhill running is running down a hill with a slight grade. (A study in 2008 used NCAA sprinters to determine the best grade of hill for improving sprinting times; the authors concluded that a hill with a grade of about 5.8 degrees was optimal for improved performance.)
For more intense athletes, towing machines pull the runner down the track at a slightly faster pace than his normal rate. Runners have also used anti-gravity equipment like that from AlterG, a Physiquality partner, as well as wind tunnels, parachutes and speed harnesses. Chelsea Cole, a physical therapist assistant at Clinton Physical Therapy Center, cautions that athletes trying these types of methods should do pre-testing to determine maximum limb speeds and target speeds before training, and advises that any of these training methods should be created and supervised by a professional to ensure safety.
Daniel also notes that using pre-activation, or potentiation, exercises before sprinting has been shown to improve running times. “The exercise performed before the sprint would be selected for its ability to activate the target muscles without overly fatiguing them, allowing the muscles to fire more effectively and the athlete to sprint faster,” he says. John Shepherd, a coach for Team Great Britain, explains in an article how this has been done by other athletes: “To provide a potentiation example, the 30m sprint performance of athletes from various sports, including football, handball and basketball, was improved by performing 10 single repetitions at 90% of their 1 rep maximum 5 minutes before the completion of the sprints.”
Before focusing on speed and results, good form must be established, reminds Mark Salandra, a certified strength and conditioning specialist and the founder ofStrengthCondition.com, another Physiquality partner program. Mark emphasizes the importance of flexibility in improving stride frequency and length, two key components of faster running times. He suggests strength training to increase leg strength, incorporating such exercises as squats and deadlifts into your off-track regimen, in order to increase your stride.
Mark also notes that overspeed training often causes eccentric muscle damage, which usually presents as soreness in the quadriceps (thigh) muscles and can be painful to the touch. To minimize such pain, Mark recommends that these techniques be introduced into any training program gradually, combined with other pre-conditioning and strengthening exercises. Daniel also emphasizes that overspeed techniques should be used only by advanced or elite athletes, as beginner to intermediate runners and athletes would see more results from perfecting their technique and form (as noted by Mark above) and building their explosiveness strength.
Did you know that May is Global Employee Health and Fitness Month? Created by the National Association for Health & Fitness (NAHF), a network of state-based councils and groups that promote healthy living, the group encourages daily physical activity and quality physical education in our schools. Through Global Employee Health and Fitness Month, the NAHF asks employers to create a workplace environment that promotes healthier living.
There are a variety of reasons to do this as a business owner or manager, or for employees to suggest it to their bosses. For a start, the CDC points out that healthier employees take fewer sick days, incur lower healthcare costs and are more productive; in fact, one study found that by promoting physical fitness and regular check-ups, employer healthcare costs could be cut in half. In addition, wellness programs can be seen by some prospective employees as a great benefit. It shows that the company is willing to invest in its employees, leading to a more positive work environment, better morale and higher retention.
“When it comes to encouraging employees to be active,” says Stefania Della Pia, “the key is to make exercise easily accessible.” Stefania is the senior program director of education and a master instructor trainer for MERRITHEW™, one of Physiquality’s partners. She encourages employers to remember the many commitments employees will have outside of work hours. She suggests incorporating activities into lunch hours, or offering after- or before-work activities on a schedule so that people have time to plan for them.
Here are some of the activities she suggests:
Bring in an instructor for on-site express workouts during the lunch hour in whatever modality best suits the office environment, whether it be Pilates, yoga, or another form of exercise.
Organize a team sport that everyone can get involved in, such as ultimate Frisbee, soccer or scavenger hunts.
Sign up an office team for a local charity walk or run.
Encourage employees to walk, bike or jog to work by providing parking spaces for bikes, and provide access to showers for those who choose the sweatier route.
Partner with a local gym or Pilates studio to offer employees a discount to work out on their own time.
Another resource for office fitness challenges is your local physical therapist. As musculoskeletal experts, physical therapists are experts in how the body moves. Many PTs do fitness and wellness assessments. Why not partner with a local therapist to challenge your office to make healthier choices? The PT can come in on the first and last days of the month to assess each team member before and after the challenge, as well as weekly on-site visits for coaching or wellness presentations. “Using a health and wellness expert like a physical therapist might encourage employees or fellow workers to see how healthier choices can affect how they feel in and out of the office,” says Mitch Kaye, PT, PTPN‘s director of quality assurance.
If your office challenge is made of up activities outside of the office, be sure to find ways to track people’s progress so it can be celebrated and rewarded. Fitness trackers from companies like Polar, another Physiquality partner, can be used to count numbers of steps or active minutes, calories burned or distance traveled. If everyone in the office has a Polar device, they can even create in-office challenges, where Polar works with the team leader to determine the challenge and teams. Or the entire office can sign up at the GEHFM website to compete against each other and raise money for charities. These healthy competitions are a great way to encourage employees to support each other in achieving fitness goals, and they create a health-centered atmosphere, notes Stefania.
Employers can offer a wide range of rewards to encourage these healthy competitions. Simple rewards can be gift cards (to a juice bar or sports equipment store) for the most steps in a month, or the most active team in the office. Stefania suggests recognizing the month’s winner by highlighting her accomplishment in a company newsletter or on social media, or host an appreciation breakfast or lunch at the end of the challenge to acknowledge everyone that participated. If you really want to underscore your company’s commitment to healthy and active living, she says, “every quarter, or every year, offer a substantially larger reward, such as a trip or a piece of fitness equipment, to keep employees interested in ongoing health and fitness initiatives.”
There are many benefits to working out with another person: Motivation. Accountability. Group support. Combining exercise with a social activity. But should you work out with your significant other?
Sharing a common activity with your partner has been shown to lead to better relationships. This doesn’t have to be a physical activity, but playing sports together, or taking a dance class together, can improve your relationship. And if you’re learning together, it can help increase your confidence in both the activity and your relationship.
Randy Gustafson, a physical therapist and the owner and clinical director of Mesa Physical Therapy (a Physiquality member in San Diego, California), points out that working out with a partner can keep you accountable and improve results for both people. (And sometimes that partner isn’t even human — research has shown that people with dogs and those that use virtual partners are often more active than those who work out solo.) But research shows this correlation is strengthened within a relationship: A 2013 study found that “when partners care about fitness — their own and their partner’s — it becomes easier to achieve fitness goals. … Average-weight husbands who care about fitness engage in more physical activity when their wives offer more supportive health-related comments.”
If you’re working out at the gym, working out with your partner can help to make your time there more effective, for a couple of reasons. Having someone to spot you on the weights and to watch your form can ensure that your technique is correct. And trainers — and our own experts — will tell you that rest is essential to building muscle, even during your workout. Taking turns on equipment or with free weights will build periods of rest into your regimen, improving your pace and making your workout more efficient.
Randy notes that when you exercise, you release endorphins, which makes you happier and can improve your relationships and mood. And Psychology Today adds that exercise induces the symptoms of physiological arousal — sweaty hands, a racing pulse, shortness of breath. These symptoms mirror, in many ways, the thrill of romantic attraction, and might lead to more private activities when you get home from the gym.
Not all couples are compatible for couples workouts. If your fitness personalities clash — one into intense, sweat-dripping workouts, while the other prefers low-impact yoga or Pilates — it will be difficult to find activities that please both people. And if an agreement to work out isn’t working out, it can lead to nagging or more negative encounters than positive feedback.
The number one danger? Competition. If one of the people is highly driven to succeed on the court or in the gym, it could easily lead to pulled muscles and sore feelings. It’s probably better for those individuals to go their separate ways, in the fitness realm, at least. Maybe it’s better to join a fitness program, like the exercise and nutrition program offered at Mesa Physical Therapy. Or perhaps it’s time to get a dog.
A power lifter may utilize a low bar position to maximize hip torque and minimize anterior knee displacement, both of which will result in a slightly heavier one-repetition maximum (1RM).
A collegiate athlete may utilize a front squat to minimize forward torso lean, which will maximize range of motion and anterior core activation.
A pre-adolescent trainee may utilize a goblet squat to encourage proper squat form, as well as those benefits associated with a front squat, but without the significant spinal loading.
Regardless of which squat you choose, there are a few technique guidelines and cues that should be followed to ensure safety and maximize results. Keep in mind that while the following guidelines are for those working with weights, the points about engaging muscles and proper form remain the same for anyone doing squats with or without weights. And, for best results, consult with your fitness professional or physical therapist about exercise techniques that are right for your fitness level.
Engage your core.
Before un-racking the bar, brace your abs as if somebody were going to punch you in the stomach. This core activation will help you avoid losing the neutral spine alignment which is so paramount to a perfect squat.
Use your latissimus muscles (in the upper/middle back, below the shoulders) to stabilize your body.
The lats are an incredibly powerful muscle group which insert all along the spine. Once the bar has been un-racked, fully engage them to add even more stabilization. Think about pulling the bar down as you would in an old-school, behind-the-neck lat pulldown.
Balance your weight over your heels.
To minimize stress to the knee and maximize posterior chain recruitment, think about sitting back on your heels. Your heels should be glued to the floor, and you should be able to slightly wiggle your toes at the bottom position of a squat. Obviously, if you take this cue too far to the extreme, you risk falling backwards, so perfecting technique with bodyweight or a light external load is highly recommended.
Downward movement should be slow and controlled.
Always lower down with control. Although the squat is an excellent choice for developing power, the eccentric portion of the lift should be done slowly to minimize injury.
Pay attention to upper leg alignment.
Ideally, the bottom position of the squat will be slightly below parallel or lower. However, some individuals may find that flexibility issues in the hamstrings and hip flexors and/or mobility issues in the hip and ankle may limit their abilities to reach that depth safely. If this is the case, dedicate several weeks to improving these limitations before adding any significant weight to the bar.
Push with a quick burst of energy for your upward movement.
Once proper depth has been achieved, explosively push away from the floor. This portion of the exercise improves your power and strength, so maximizing bar speed is the primary objective. The more explosive the lift, the greater the use of type II muscle fibers in your legs, and the greater the potential for improvements in muscle size.
Use that booty.
Squeeze your glutes as you complete the lift. This encourages full hip extension.
Squats are an excellent tool for improving lower body strength and power. Whether you’re a weekend warrior, a figure competitor or a professional athlete, learn how to perform the Perfect Squat and enjoy the results!
Jeff Rothstein, MS, CSCS, CES, is an exercise physiologist and the Director of Strength and Conditioning at the PT Center for Sports Medicine, a Physiquality network physical therapy clinic in Akron, Ohio. A certified strength and conditioning specialist, he is particularly interested in sport-specific strength and conditioning and ACL injury screening and prevention.
Many Americans take a reactive approach to their healthcare needs: They only seek care once they have an injury or fall ill. This approach, says physical therapist Kathy Blair, often involves a costly progression of doctor visits, tests, medications, and procedures, in order to diagnose and treat conditions that might have been prevented. In addition, she points out, this type of care accounts for more than 75% of healthcare spending in the U.S.
Preventive or proactive care, on the other hand, means taking responsibility for your healthcare and well being before something happens. This includes taking simple actions, like exercising more and eating better, which can help you avoid unnecessary procedures and costly ER visits. Preventive healthcare, says Kathy, “stresses personal responsibility for staying well, and keeps healthcare spending in check as a result.”
Raj Thangamuthu, a physical therapist, opened Empower Physical Therapy and Fitness (a Physiquality member in Michigan) with the express purpose of integrating physical therapy and fitness in one facility. His goal was to encourage clients to improve their overall health and actually spend less time in his clinic as healthcare patients. Raj gives several reasons why it is better to have a preventive approach to healthcare:
In preventive care, pain is often not a limiting factor in making progress.
Muscle imbalances identified in preventive care often respond to treatment more quickly than when an injury is present.
Preventive care can help identify imbalances within your body and ultimately make you function much more efficiently when addressed. Read More
Simply put, when you have pain in the shin bone or tibia (the front of your lower leg), you have shin splints. Most common in runners and dancers, shin splints can be caused by overuse or overtraining, or musculoskeletal issues like ankle instability or flat feet.
When you experience such pain, especially while exercising, it is best to back off from activity. If the pain continues, says Lisa Cox, “medical care should be sought sooner than later.” A certified athletic trainer at Clinton Physical Therapy Center (a Physiquality member in Tennessee), Lisa explains that those who wait 3 – 4 weeks to seek treatment often have longer recovery times than those who seek treatment sooner.
In addition, she says, some athletes who simply shrug off the pain as “just shin splints” end up having stress fractures, which must be treated by a physician and usually require a walking boot or cast. Such treatment also requires a complete break from activity until the fractures heal.
Injuries can never be completely avoided, but there are some stretches that can help to decrease your chances of shin splints. Lisa suggests doing calf stretches (that is, stretching the gastrocnemis muscle) before and/or after activity. This can be done by facing the wall with one foot behind you or by standing on a flight of stairs and then dropping your heels down.
Companies like Medi-Dyne, a Physiquality partner, also offer several tools to help avoid shin splints. Products like the ProStretch and ProStretch Plus help to stretch out the gastrocnemius and improve calf flexibility. And muscle massagers can help to increase circulation and reduce muscle tightness.
If shin pain does not disappear after a couple of days of rest, it may be time to see your physical therapist. “PTs specialize in recognizing muscle weaknesses that can cause pain and injury,” reminds Lisa. Not only can a physical therapist develop a plan to strengthen the gastrocnemius and ankle muscles, he or she can also evaluate your gait and stride to see if musculoskeletal variances are a part of your problem. If necessary, a PT can help you select orthotics to correct foot position and alignment during activity, which can decrease pain from head to toe.