Bone Health

Whether or not you know this, bone health has a lot to do with mobility! Take a look at this article from MoveForwardPT to learn more about the different aspects of bone health and how to prevent injury.

Physical therapists are experts in improving and restoring mobility and play an important role in ensuring optimal bone health. Healthy bones can help you stay strong and active throughout your life. If good bone health is achieved during childhood and maintained, it can help to avoid bone loss and fracture later in life. For healthy bones, it is important to maintain a physically active lifestyle and eat a balanced diet with plenty of calcium, vitamin D, and perhaps other supplements as needed. Physical therapists can design a unique program for you to help keep your bones healthy.

Osteoporosis is a common bone disease that affects both men and women (mostly women), usually as they age. It is associated with low bone mass and thinning of the bone structure, making bones fragile and more likely to break.

Some people are more at risk for osteoporosis than others. Not all risk factors can be changed, but healthy habits and a proper exercise routine designed by your physical therapist can keep bones healthy and reduce risk. Risk factors* include:

Age: More common in older individuals
Sex: More common in women
Family History: Heredity
Race and Ethnicity: Affects all races. In the US, increased risk for Caucasian, Asian, or Latino
Weight: Low body weight (small and thin)
Diet, especially one low in calcium and vitamin D
History of broken bones
Menopause
Inactive lifestyle
Smoking
Alcohol abuse
Certain medications, diseases, and other medical conditions

Physical therapists can help prevent osteoporosis and treat its effects by designing individualized exercise programs to benefit bone health, improve posture, and enhance core stability and balance. Most of these exercises are simple and can be done at home with no special equipment.
Fight Fracture with Fitness

Inactivity is a major risk factor for osteoporosis. The right exercises and good habits can keep bones strong and prevent or reverse the effects of osteoporosis. Weight-bearing exercise, such as walking, is an important way to build and maintain healthy bones. Muscle strengthening exercises have been found to stimulate bone growth and can help prevent and treat osteoporosis. These types of exercises are best if started early in life and done regularly. However, it is important to remember that you can begin exercising at any age and still reap great benefits.

If you have osteoporosis, are at high risk for a fall or fracture, or have a medical condition, affecting your ability to exercise, do not begin an exercise program without first consulting your physician and a physical therapist.

Avoid exercises and daily activities, which round the spine, such as sit-ups, crunches, bending down to tie your shoes, exercise machines that involve forward bending of the trunk, and movements and sports that round and twist the spine.
Benefits of Good Balance

Preserving balance and stability with exercises can help reduce falls and resulting fractures. Exercises that improve posture, core stability, balance, and coordination, can also protect the spine against compression fractures. An individualized program may include a walking regimen, Tai Chi, and other exercises geared toward conditioning, balance, and coordination.
Bone Health Begins With Good Posture

Physical therapists recommend good posture and safe movements to protect bones from fracture during daily activities. Using proper posture and safe body mechanics during all activities protects the spine against injury. Here are some tips:

Keep your back, stomach, and leg muscles strong and flexible.
Keep your body in alignment, so it can be more efficient when you move.
Do not slouch. When sitting, keep your spine and head straight. Put a small pillow behind your waist to keep your spine in a good position.
Use good body positioning at work, home, or during leisure activities.
When lifting or bending forward, bend your knees, keep your back straight, bend forward at the hip crease, and lift with your legs. Keep the load close to your body.
Ask for help or use an assistive device to lift heavy objects.
Maintain a regular physical fitness regimen. Staying active can help to prevent injuries.

*National Osteoporosis Foundation

Acknowledgements: APTA Section on Geriatrics

Pilates for Exercise

Pilates may be a good way for you to get fit if you’re looking for exercises with less impact to protect your joints and your body. Here’s an article shared by San Diego Sports Physical Therapy all about Pilates.

The Pilates Method
By Kristen Schott, PT, MPT

Making the decision to become more physically fit is an easy choice to make. The tough part comes when deciding how to go about it, especially in a time where there are so many fitness programs available to us. One school of fitness that requires consideration is the Pilates Method. This fitness program, although gaining relatively new publicity, was created in the early 1900s by Joseph H Pilates. It is a renowned method of improving one’s muscle tone, flexibility, strength, posture, balance, and body-mind connection. Today, some of the basic principles and exercises of the Pilates method are used by many fitness experts and healthcare professionals, including physical therapists.

Historically, the Pilates method has helped athletes as well as injured individuals attain their fitness and rehabilitation goals. It can also be used as a preventive measure to gain postural awareness and core stability which can help reduce the risk of everyday repetitive strain injuries. Pilates is safe and appropriate for a variety of people of all fitness levels as it focuses on engaging the body’s central musculature around the spine, torso, hips, and shoulders. By focusing on these core muscle groups, individuals build a stable base or core from which progressively skilled upper and lower extremity movements are derived.

The Nine basic principles incorporated in every Pilates exercise:

Concentration: focus on the contraction of core muscles and be conscious of the body’s position in space or in relation to its environment.

Control: Maintain postures and positions- outside forces, such as gravity, should not influence or disrupt deliberate and slowly controlled movements.

Center: All Pilates exercises are initiated from proper central or core positioning about the spine and torso and then flow outward to coordinated movements of the extremities. A strong stable base is needed to effectively move the limbs repetitively without injury.

Fluidity: movements are slow and graceful as opposed to quick and jerky.

Precision: focus on obtaining accurate positions and movements.

Breath: utilize full inhalations and exhalations during exercise, never hold your breath while exercising; the body needs oxygen to nourish the tissues of the working neuromuscular system.

Imagination: use visualization or metaphors to enhance movements or to improve body’s response to the mind’s messages

Intuition: listen to your body- if a movement hurts, stop.

Integration: utilize the entire body, (central core and peripheral extremities), as well as the mind’s concentration and visualization to successfully complete an exercise.

Exercises:
These are a few basic mat exercises which target the core muscles of the spine, torso, hips and shoulders. These exercises do not represent the entire Pilates method, but are great for beginners.

Breathing:

Lie flat on back with knees bent, feet resting flat on floor, and arms at side or resting on lower abdomen. Pull torso muscles in and upward while exhaling. Place hands on lower abdomen just below navel and feel a mild abdominal contraction. Muscles of pelvic floor (used for bladder control) should also tighten. Release contraction on inhalation. Repeat breathing cycle 5-10 times.

Pelvic Bowl:

Lie flat on back with knees bent, feet resting flat on floor, and arms at side. Exhale and roll hips under drawing navel to floor and pelvis toward ceiling (keep back flat on floor). Inhale and reverse motion- pulling pelvis to floor and lifting navel toward ceiling. Repeat 5-10 times. Now try side to side- rotate one hip bone up toward ceiling, dropping other hip down toward mat. Imagine that the pelvis is a bowl filled with water sloshing back and forth. Repeat 5-10 times. Now try “swishing the water” in a circular motion, combining all movements. Repeat 5-10 times clockwise and counterclockwise. Return to rest position.

Cervical Nod/Chin Tuck:

Lie flat on back with knees bent, feet resting flat on mat, and arms at side. Using a small motion, “tuck” chin using the motion you would to look at your chest. Imagine a string is pulling from the top of your head to lengthen the vertebral bones of your neck.

Shoulder Flexion and “Angel Arms”:

Lie flat on back with knees bent, feet resting flat on mat, and arms at side. Pull shoulder blades down toward mat (scapula setting). Lift one arm up overhead, keeping opposite shoulder blade against the mat. Alternate arms. Repeat 5-10 times each side. Now try bringing arm out to side and up overhead while setting opposite scapula against the mat. Alternate arms. Repeat 5-10 times each side.

All About Running Injuries

If you like running, Fitness Together Point Loma has the perfect article to share with you! Fitness Together Point Loma can help get you back into running shape and avoid major injuries by this high impact exercise.

By Jeff Erickson, PT, MPT

Spring is upon us and that means that more people will be heading outdoors to go running. There’s nothing better for the mind and body than exercise, especially when it’s outdoors. However, avid runners are prone to overuse injuries that can hinder performance and possibly stop it altogether. Here are a few helpful hints that will help to keep you running throughout the warm weather months.
Injuries in runners generally occur in the legs and low back. The following are the most common along with some tips on how to prevent them from happening to you.

Low Back Pain- Eight out of ten Americans suffer from this. Running uphill for too great a distance can contribute to this because the torso will be swayed back into an uncompromising position. Running on uneven or hard surfaces can also cause back pain. Uneven surfaces cause asymmetrical forces on the lower back region while hard surfaces increase stress on the area due to increased force of impact on the ground.

* TIPS*
1. Run with proper trunk posture
2. Run on soft, even, dirt track with short, intermittent hills
3. Increase abdominal, back and leg strength to support low back
4. Stretch all trunk and leg muscles to prevent strains and tears

Hip or Buttock Pain:
1. Trochanteric (hip) Bursitis- This can result from increased stress to the outside of the hip as runners tend to overuse the muscles due to the one-legged stance

2. Piriformis Syndrome- The piriformis is one of the deep rotators of the hip. If this is tight, it can cause pain and increased pressure on the sciatic nerve as well as shooting pain down the leg.

* TIP*
STRETCH! Specific stretches are the ITB and piriformis illustrated at end of article

Anterior Knee Pain- This is common in most athletes, especially teenage girls. It is often due to poor body mechanics, faulty muscular strength, or poor muscle flexibility. This creates an abnormal tracking of the knee cap in the groove of the knee. This is usually easy to cure, but may require physical therapy or even surgery.

* TIP*
You should see a doctor to determine the best treatment options

Iliotibial Band (ITB) Friction Syndrome- This is lateral knee pain along the outside of the knee down past the knee. The one-legged stance in runners causes increased tightening of the ITB and will cause friction between it and the bony protuberances of the knee.

* TIP*
Again STRETCH that ITB!

Shin Splints- This is pain in the front of the shins. It is debatable what causes this but one factor is usually tight calf muscles, especially the soleus. Many hills can be the culprit of tight calves.

* TIPS*
1. Stretch the gastroc and soleus muscles
2. Monitor and modify hill training

Ankle Sprains- Usually caused by turning the ankle on a curved or uneven surface.

* TIPS*
1. Strengthen ankles
2. An ankle brace/support may help if you are prone to sprains

Asymmetrical Pain- Pain in one sector of the back or one leg vs the other probably means you are running on uneven surfaces. Many runners run on the crown of the road, so if you are always on the right side of the road, the left foot lands with the inside down and the right with the outside down.

* TIPS*
1. Find a flat surface to run on

In general, because of the repetitive pounding, battling elements, and the nature of runners to push themselves beyond limits, injuries will occur. Many of these injures start slowly and gradually become worse. Often there is not a specific cause of injury, which causes them to be overlooked until the pain limits activity.

The best prevention is to address pain when it first starts. To cure it, you may only need to do a few simple stretches, strengthening exercises, or maybe just changing running surfaces. However, at the onset of pain, if it is significant and lasts for at least a week, consult a physician.
Other Common Causes of Pain

Improper Footwear
Increasing intensity or distances too quickly
Running while sick or fatigued

* Final Tips *

1. Watch the Weather
-hypo vs hypotension
2. Wear Proper Clothing
-light, breathable material for proper sweat evaporation
3. Maintain Proper Fluid Intake
-drink water even before you feel thirsty
-sports drinks are fine
-don’t take salt tablets
4. Don’t be Overzealous
-don’t do too much too soon
-keep pace and distance to an achievable level
5. Stretch
-take the time to stretch every time you run
6. Wear Proper Sneakers
-you may need to be evaluated by a PT for this
-good sneakers vs orthotics
7. Enjoy and Don’t Push too Hard