Dr. Sara Murphy's Blog

Improving Your Golf Swing Through Pilates and Yoga

2010-05-12T06:38:00.000-07:00

I am sure if you golf and you are reading this post you are wondering, "How can Pilates and/or Yoga possibly improve my golf game?" Well, you will be pleasantly surprised to know that Pilates and Yoga can greatly improve your golf swing.

The difference between an amateur and a professional golfer is consistency. Understandably so because professional golfers have increased play time.
Many aspects of mind/body/fitness are evident in golf:
1. Concentration/focus
2. Breathing
3. Flexibility
4. Strength(entire body)
5. Balance

Pilates and Yoga encompass all of these practices. Yoga and pilates focuses on stretching and strengthening through full body movements. On the golf course it takes ample focus, concentration, and proper breathing techniques to relax your mind and body during your swing/short game. If you are nervous your muscles will tighten causing a faulty swing pattern. Flexibility of the entire body, especially in the rotational (transverse) plane, is essential to achieve an excellent golf swing. Yoga and pilates work to strengthen and lengthen muscles in various static and dynamic rotational positions. Like other sports such as baseball/softball, golfing is predominantly one-sided. This causes your body to become asymmetric leading to increased tightness on the stronger side. Balance is essential to maintain throughout the swing as well as the finishing position of the golf swing. Yoga and pilates focus on both static and dynamic balance in all planes of movement.

Happy Golfing!

Stretch your low back pain away!

2010-05-07T10:36:00.000-07:00

When you bend over to pick up something you dropped on the floor do you feel tightness and/or pain in your lower back? Do you feel tightness in your back with simple daily activities, such as sitting, walking, or standing up from a chair?

You can prevent back injury and unwanted pain and tightness in your lower back by simply stretching your hamstrings daily. It literally takes 90 sec of your time 1-2 times per day to accomplish this. Here's how:

1. Pick a comfortable place to stretch such as the floor or bed.
2. Find a belt/rope/tough cord.
3. Lie on your back with both legs straight.
4. Hook the belt/rope/cord around the bottom of your foot (i.e. you can make a loop with your belt and place the loop over your forefoot).
5. While keeping your knee completely straight, lift your one leg until you feel a stretch at the back or your thigh. Your non-stretch leg should lie relaxed with your knee straight on the ground/table (or whatever surface you are stretching on).
6. Hold this stretch for 30 seconds (you can stretch as long as a minute or more if you desire). Once the 30 sec are up, relax the leg down and then repeat the same stretch 3 times.
7. Repeat on the other leg.

Congratulations!! You have just stretched your hamstrings and you are on the road to back injury prevention.

Note: If you felt a burning sensation in your back, buttock, or back of your thigh during this stretch you should consult with a physical therapist as you may have an underlying condition.

Are You Warming Up Enough???

2010-02-23T11:12:00.000-08:00

I am sure you have heard a thousand times that you MUST warm-up before you weight train, but do you know WHY???

There is a reason why it is essential that you warm up your muscles and joints prior to weight training. Repetitive movement of your joints signals your body to produce synovial fluid which lubricates the joints and prevents injuries, such as tendonitis, arthritis, bursitis, etc. Increasing your heart rate will increase the flow of blood to the muscles in your body. Increase of blood flow warms up your muscles which increases pliability of the tissue and therefore prevents injury such as muscle strains (or tearing of the muscle), tendonitis, etc.

Now that you know WHY let's talk about HOW you to warm up...

A warm-up is supposed to be fast-paced, heart rate raising, and sweat-producing. It is NOT supposed to be a stroll in the park. First, figure out what your maximum heart rate using this formula --> 220 - YOUR AGE (i.e. I am 30 so 220-my age is 190 beats per minute(BPM). Then, take 65% and 85% of that number (i.e. my max heart rate (190)(.65)= 123.5 and (190)(.85)= 161.5, therefore, my heart rate range is 124 BPM to 162 BPM). This is your heart rate range that you should be working within in order to consider yourself "working out". When taking a stroll in the park your heart rate will not even reach 65% of your maximum heart rate. Now, back to the warm up... Your warm up should be anywhere from 6-15 minutes. You want to BREAK A SWEAT! If you have not broken a sweat and your heart rate is less than 65-85% of your max heart rate then stay on that machine until you achieve this.

Need a few examples to get you started?

1. Treadmill - Set speed at 3.8 mph. Begin with incline at 6%. Every 30 seconds increase the incline by 1% (i.e. start at 6% and at 30 sec. increase to 7% then at 1:30 increase to 8%). Do this for 5 minutes (incline 15% will be your last 30 sec interval).

2. Next hop on the Step Mill for 5 minutes. Keep the steps per minute at 75-80.

3. If you still want more or if you prefer not to use the Step Mill then hop on the upright bicycle. Increase your level to 6-8 and keep the revolutions per minute (RPM) at 80 for 5 minutes.

If you are not sweating after that then I don't know what to tell you!! :)

I promise you that if you WARM-UP aka BREAK A SWEAT prior to every weight training workout you will prevent numerous unnecessary injuries and have a more efficient work out every time you step on the gym floor!

Shoveling and Injury Prevention TIPS

2010-02-09T19:10:00.000-08:00

As I sit here and look out my window, I watch the snow begin to fall down. I am thinking about how excited I used to get when I was a kid knowing that school would be closed the next day. Today I sit here thinking of how many of my patients are going to come in on Thursday and Friday with aches and pains in their backs, shoulders, etc from shoveling. So, I have decided to write this blog in hopes that some will read it prior to their shoveling adventures tomorrow.

Here are some suggestions for preventing injury while shoveling:

1. If you have a large broom/brush available try to brush away as much snow as possible, as often as possible. The only catch to this is you have to stay on top of it and go out every so often to do this. If you periodically do this then the amount of snow to shovel will be significantly less and it will be lighter as well. It is much better for your body to push then it is to dig and lift. And, obviously, If you have a snow blower (or a neighbor does) try to use that instead.

2. When you are shoveling make sure you are mostly using your legs to maneuver the shovel. Lunge or squat as you bend to pick up snow with your shovel. Avoid keeping your knees straight and hinging at your hips. Also, don't rush it and try to pick up as much snow as possible. This most likely WILL cause you to hurt your back!! Please, please protect your back as much as possible.

3. Do not lift and swing the shovel around your body rotating your spine while your hips are stable. Lift the shovel and pivot your body where you want to place the snow.

4. Take breaks. Don't try to shovel everything at once. Brush what you can away, shovel, brush, shovel, have hot chocolate somewhere in between, build a snowman, do whatever! Just don't shovel for 2 hours straight. You will regret it for the next two days! I promise you that.

5. Keep your core tight! When you pick up that shovel, tighten your core by pulling your belly button in towards your spine and then begin shoveling. This will help stabilize your spine and prevent injury.

6. Last, but not least, if you can pay someone else to do it for you (or if they are nice enough to offer to shovel) then that would be your best bet. However, let them read this blog first! ;)

HAPPY SHOVELING!
I hope I don't have to treat any snow-related back injuries this week!!

Spondylolisthesis

2010-01-29T07:37:00.000-08:00

You are probably looking at my blog title and saying...spondyloli-what???
Well, I have been seeing this condition more often in the clinic lately and so I thought I would write a blog about it since I "had" the condition.

Spondylolisthesis sounds like a big word, however breaking it down makes it more simple. Spondylo- refers to the "spine" and -listhesis refers to "slippage of". Put it together and it means a slippage of the spine. Spondylolisthesis is the condition where one vertebrae (bone of your spine) slips forward on an adjacent one. This usually occurs in the lumbar spine (lower back). The slippage can be present at birth, occur in early childhood, or appear at any time later on in life. It can be the result of a structural deformity, trauma, or degeneration of the vertebrae. It is common in dancers, gymnasts, javelin throwers, divers, football linemen, weight lifters with improper technique. It can be easily diagnosed with an x-ray. Sounds scary, doesn't it? Well, it can be, but I had one and I live to tell so it can't be that bad, right?

Here is my story...
I have been dancing since I was 5 years old (jazz, tap, theater dancing) and playing sports since I was 9 years old (basketball and softball mostly). In high school, I picked up a new hobby...throwing a javelin. Random, I know. The track and field team at my high school needed more athletes and my friends were on the team. So, I joined so I could hang out with them after school and pass time before dance practice at night. I quickly learned to throw discus, shot put, and javelin. Those of you who know me probably cannot picture me throwing a shot put (haha). Hey, I never said I was actually good at throwing shot put, however, I was decent at discus and very good at javelin. When I graduated, I went to college and threw javelin there as well. I had a blast doing it, until one day I woke up with severe back pain. Long story short, I had to stop throwing javelin once my physician discovered that I had a spondylolithesis. Just like most of you when you read the title of this blog, I said spondyloli....whhhaaaat?!? So, needless to say I had to give up throwing javelin. I decided to workout as often as I could and focus on my core in order to keep my back feeling strong and decrease the amount of "ache" on an everyday basis. Unfortunately, my spondy (as I like to call it) become more unstable and slipped from a 25% in 1999 to an 85% in 2004. I required surgery known as spinal fusion in order to stabilize my spine. Many people live with spondylolisthesis from 25-50% and are very functional with minimal pain. I was living with an 85% with minimal pain, but an 85% slippage is too unstable to "play it safe". I received spinal fusion surgery in 2004. They fused three of my vertebral levels in my lumbar spine (lower back). Following surgery, I received physical therapy 3x/week for 3 months (what my insurance would allow) and I also did my exercises on my own. Physical therapy is essentially what brought me back to "normal function" again. I was able to be the energetic and active person I have always been. The true test was working Rutgers football camp the summer (a year and 2 months) after my surgery. I made it through with flying colors! I cannot tell you how happy and relieved I was. I never said it was easy or that I had no aches and pains throughout the way, but I took good care of my back and made it through with a huge smile on my face. I am currently a full-time physical therapist and it definitely helps my back having such an active job. Prolonged sitting and standing are still not something I can tolerate for longer than an hour or two. I feel so stiff as well as muscle tightness and ache if I sit or stand for too long. I must work out my core, stretch, and keep my body strong in order to counteract back pain. If I stop being active/training my body feels like I have aged 10 years! It's amazing what a difference exercise and stretching can do for back pain. I barely notice my back when I am on a consistent workout schedule. So, I make time in my busy schedule to keep active (working on my patients all day helps with this too!).

So now that you know a little more about me and my condition let's talk about you.
Back pain is not an end to life the way you know or knew it. The pain is grueling, extremely depressing, and it may feel as if you have an annoying little devil riding on your back 24/7, but I promise you there is hope. You NEED to seek professional medical help. Don't Google your symptoms and expect an answer. Don't print out stretches and exercises online until consulting with a medical professional first because they may not be the right exercises for you. When it comes to back pain there are certain motions that should be avoided depending on the condition. Many of these exercises contain all different motions and you may harm yourself more and not know it.

Here are common symptoms of a spondylolisthesis (that I have had or patients with this condition have explained to me):
- general ache in lower back region
- in some cases, sciatica pain, numbness, tingling, or weakness in the leg(s)
- aching pain in lower back when lying flat on stomach
- aching pain when lying flat on back with knees straight (usually unable to tolerate)
- intermittent muscle spasms on one side/both sides of the spine (usually in the lower back)
- pain when bending backward/with back extension (in standing/sitting/lying down)

Tips on how to prevent further slippage and decrease back pain if you have spondylolisthesis:
- avoid hyperextension of your spine (excessive backward bending) - try to keep your spine in neutral during sitting, standing, and exercise.
- avoid lying or sleeping on your stomach - if you are lying on your belly place 1-2 pillows underneath your hips and a bolster/rolled towel under your ankles.
- avoid lying or sleeping flat on your back with both legs straight - try keeping your knees bent or placing 2 pillows underneath your knees to relieve the pressure off of your lower back.
- DO stretch your lower back muscles (sit with pillow on your lap and lean forward 3 x 30 sec./perform Child's pose stretch), hamstrings (back of your thigh), hip flexors (front of your thigh), glutes (buttocks)/piriformis.
- DO perform core strengthening exercises everyday. Your core should be activated during everything that you do!!
-DO seek advice from a medical professional if you believe you have this condition. Don't be afraid. A year from now you will be happy you did what you did today.

Any questions please email me (sara@mavenpt.com) or comment on my blog.

Just Breathe...

2010-01-24T15:06:00.000-08:00

Sometimes when life gets stressful and busy we forget the most important thing to do and that is to BREATHE. Over the past week my life had gotten pretty hectic. My daughter was sick for the first time and being a first time parent I was so worried about her. It turned out to a common virus that many children under two catch called Roseola. Roseola causes high fever in children under the age of two for five days and on the fifth day they break out in a rash. So after doctors and ER visits we finally figured out what it was.

During this stressful week I had to constantly telling myself, "Sara, don't forget to breathe". Sounds silly, doesn't it? Well, it's not. Breathing provides the oxygen that our mind and body need to function optimally. Without, oxygen we allow more carbon dioxide and other toxins to invade our bloodstream which promote fatigue and decreased concentration/alertness. This can cause us to make poor decisions. At this time when I am making decisions for my little girl, the last thing I needed was lack of focus.

Here is a simple breathing exercises that I use and that I often teach my patients:

Lie on your back and place one hand just above your belly button and the other hand on your chest.
Take a deep breath in through your nose and focus on your bottom hand that is just above your belly button rising as you fully breathe in. Your top hand should only move slightly at the top of the breathe; it should not be the first and only hand to move while taking in your breathe.
Breathe in 1...2...3.
Then exhale through your mouth as if you are trying to fog a mirror feeling your bottom slowly lower (moving towards your spine/back).

Initially, you can perform this exercise for 5 minutes and then try to increase your time. Eventually, you will breathe like this without having to think about it.

Good luck and DON'T FORGET TO BREATHE. =0)

Weight Loss Tips: What worked for me

2010-01-10T20:57:00.001-08:00

In lieu of this weekend's seminar I wanted to give you a weight loss tip that has worked for me in the past. Two years ago I worked with a personal trainer three times per week. My goal was to tone up and lose weight. That I did, but not without hardwork, sacrifice, and commitment.

My personal trainer wanted me to keep a food journal. I laughed at him. He said he was so serious and he handed me a notebook and a calorie counting book that was small enough that I could carry it everywhere I went. It was perfect for me because it had every restaurant/cafe you could ever imagine (i.e I loved that it had two of my favorite places; Starbucks and Houlihan's) so I never had to wonder how many calories I was consuming.

During our initial assessment, he figured out how many calories I should consume in order to lose weight and wrote that number on the inside of the notebook. He also instructed me that I shouldn't eat after 6pm. You can imagine how wide my eyes got when he said that!! Every week I had to hand in my book to my personal trainer like homework. This also helped me stick with the journal because he would really get on my case if I didn't stick to the plan. The trick to the food journal is to write down the calories down BEFORE you eat them. Oh boy, was this a reality check! I remember when I was about to eat a cookie and I wrote down the calories in my food journal. I immediately crossed it out and decided against eating that cookie! I then chose a snack with a more reasonable calorie count.

I worked out with him three days per week for 45 minutes of resistance training and 15 minutes of stretching at the end of the session. I did 30-45 minutes of cardiovascular training (I most did elliptical, upright bicycle, recumbent bicycle with rowing) 3-4 times per week. I logged all of my workouts because it helped me organize my week and see what I had accomplished. It felt really good to write down my exercise in my workout journal.

In the end, I ended up losing 13.5 lbs and became toned and flexible again! It was such a great feeling and I was extremely proud of myself.

My weight loss tips:
1. Buy a notebook and start a food journal.
2. Purchase a calorie counting book or log on to a website that works best for YOU.
3. Write down the calories before you ingest them. Then decide if you want to still ingest them.
4. Start eating early aka eat breakfast and then don't eat late (after 6pm or 7pm).
5. Buy a notebook or use the food journal notebook and start a workout journal.
6. Find a person who you see weekly that you must hand your food journal over to in order to keep you on track.
7. Don't cheat because you're only cheating yourself!
8. Perform resistance training 3x/wk for 45-60 min.
9. Schedule 10-15 minutes at the end of your workout to stretch the muscles you just worked.
10. Perform cardiovascular training 3-4x/wk for 30-45 minutes.
11. Believe in yourself and don't give up!

Video Gaming and Back Pain

2010-01-08T07:35:00.000-08:00

'Tis the season or 'tis always the season for video games!

After the holidays, I have had a handful of patients with increased back pain. They complain of tightness in their lower back, hamstrings (the back of the thighs), and hip flexors (the front of the thighs). I ask them, "What have you been doing differently?" Their answer is usually, "Well nothing really strenuous. I have just been sitting around playing video games for hours at a time." And there you have it! That's where their back pain is coming from. Due to the fact, that the cord to the controller is very short, you must sit on the floor in front of the tv. This puts the body in a position of poor posture and if sustained for periods of >10 minutes will cause tightness of the muscles and joints of the shoulders, back, knees, and hips.

Video games, just like being on the computer, can be time consuming and somewhat addicting. According to the Bureau of Labor Statistics, information received from the American Time Use Survey revealed, in 2008 "individuals ages 15 to 19 read for an average of 0.2 hour (10 minutes)per weekend day while spending 1.0 hour playing games or using a computer for leisure".
Amazing how times have changed. What did we do before video games and computers? I remember playing manhunt outside with my friends all day only to come inside to eat dinner. Unfortunately, life for most kids isn't like that anymore.

Playing video or computer games is setting our young population up for poor posture, which will eventually lead to injury in their future. Here are some suggestions on how to prevent back pain and other injuries in your future.

1. First, limit your playing time. Make a point NOT to sit in front of the tv playing video games for hours. It is not good for your posture, your eyes, your nutrition, or your well-being.

2. Second, get a "video rocker" also known as a "gaming chair". These are somewhat ergonomically correct (well anything is better than sitting on the floor in indian style, right?) chair that is made specifically for gaming on the floor. However, you must still be aware of your posture while sitting in this chair also. Trying not to slouch forward. Tuck your chin back and pinch your shoulder blades together.

3. Third, stretch your muscles after you have been sitting for a while. My suggestions are to stretch your hamstrings (at the back of your thighs), lower back muscles, and pectoralis (chest) muscles for at least 30 seconds for 3 sets each.

4. Last, but not least, consult with a professional on your posture and how to improve it. A physical therapist or physician will be able to look at your posture and advise you whether your posture requires improvement and specific techniques on how to improve it.

If you can't seem to pull yourself away from the tv then try to break your gaming up by using a Wii or Wii Fit. These video games will keep your muscles active and you burn calories while you play. Remember, the Wii is a very dynamic game and it is very similar to a gym work out or playing a recreational sport. Warming up for 5-10 minutes beforehand and stretching will help prevent injury. You don't want to end up in Wii-hab. =)

Happy Gaming!!

Ice vs. Heat

2010-01-03T18:32:00.000-08:00

This is probably the most commonly asked question that I hear in the clinic. Should I use ice or heat on my injury and for how long?

When an injury or trauma occurs such as a muscle strain (tear), a direct blow, fracture, etc. inflammation occurs due to rupture of tiny blood vessels surrounding the injury site. The increased volume of blood around the site causes pain, swelling, and bruising of the injured body part. Here are some FAQs regarding when and when not to use ice/heat for an injury.

ACUTE (NEW) INJURY:

Question: Should I use ice or heat?
Answer: Ice. Ice causes your blood vessels to constrict (narrow) in order to draw blood and inflammation away from the site of injury, which decreases pain and swelling. When using an ice pack be sure to place one layer of protection in between your skin and the ice pack (i.e. pillowcase). There are other forms of ice available for use instead of the traditional ice pack. These include ice cup or ice bath. The ice cup can be made by filling up a medium sized Dixie cup with water and freezing it. When ready to use you can rip the top half of the cup off so that the ice is exposed. Then, apply ice to injury site and massage the area by making small circles with moderate pressure for 6 minutes. The ice cup penetrates deeper than the traditional ice pack and is great for quick on-the-go application. The ice bath is very effective, however most are unable to tolerate placing their extremity in a bucket of ice water. First, you fill the bath or a bucket of water with ice and then place your affected extremity into the water for 4-6 minutes.

Question: How many minutes should I keep the ice on my injury?
Answer: You should use ice for 10-20 minutes max. If ice is used for more than 20 minutes it actually does the opposite of what we want it to do. It causes the blood vessels to dilate (widen) allowing increased blood to enter the area of injury. You can use this schedule when icing: 20 minutes on, 1 hour off and repeat 4-8 times per day. Also, make sure to periodically check your skin for ice burns.

Question: How many days should I use ice on my injury?
Answer: The inflammatory phase of healing last 2-4 days, therefore ice should be used up to 4 days following injury.

RECOVERY FROM INJURY:

Question: When I am recovering from an injury, when can I begin to use heat?
Answer: Heat may be applied to injury after day 4. Heat is excellent to use before exercise and/or stretching in order to increase blood flow and relax the muscle.

Question: How many minutes should I put heat on my injury for?
Answer: 10 minutes of heat will suffice prior to exercise. If you want to use it to relax your muscles you may also submerge your body or injury site in a nice, warm, relaxing bath for 20 minutes, twice a day. The water temperature should be between 92 to 96 degrees Fahrenheit.

Attention Holiday Shoppers!

2009-12-22T08:21:00.000-08:00

With all the hustle and bustle of holiday shopping we tend to forget about the "little" things such posture, proper lifting techniques, etc.

Here are some tips to keep in mind in order to prevent injury:

1. Proper footwear: If you know you will be out all day shopping make sure you have shoes that are comfortable. Try to avoid heels if possible, however if you MUST wear heels then make sure they are 1-2 inches or less and are made of a material that has some give to it, such as rubber. If you are wearing boots or shoes with no support in them you can buy an arch support at your local pharmacy and place it inside the shoe for added support (if possible, take the insole out of your shoe and then put the arch supports in).

2. Carrying bags: When carrying bags, pocket book, baby, etc. make sure that you even the weight out on each shoulder. Do not carry all of the weight on one side of your body. This will directly affect your posture and may cause serious injury to your back.

3. Lifting: When lifting always remember to "activate your core" first by drawing in your belly button towards your spine before you perform the lift. Remember to bend at the knees and hold the object as close to your body as possible. If you are taking presents/bags out of your shopping cart and/or trunk first activate your core, move the object as close as you can to the edge of the cart/trunk, then lift object as close to your body as possible. Do not pull the bags/presents out of the car by tugging and rotating your spine. This may cause a serious injury to the back and prevent you from completing the rest of your shopping!

4. Wrapping: When wrapping presents have your gifts and wrapping supplies placed directly in front of you. Sit at your dining room table, stand at a high counter, or tall kneel at the side of your bed (that's if the bed isn't positioned too high). Remember to always "activate your core" and keep it activated. Sitting on the floor will place your body in a compromised position which you might regret later.

These helpful tips will help save you some unwanted post-holiday discomfort. I hope you find these helpful and I hope you remember them this holiday season and in the future.

HAPPY HOLIDAYS!

Tendinitis vs. Tendinosis

2009-12-22T08:19:00.001-08:00

There is a common misconception regarding the term we commonly hear called "tendinitis" and a term we don't hear as often called"tendinosis". However, the latter is far more common than most of us think.

Tendinitis is an inflammation of the tendon. Tendinosis is degeneration within the tendon caused by repetitive microtrauma, decreased blood supply to the tendon, or the natural aging process.

When a tendon is repetitively stressed or "overused" microtears form on the tendon in turn igniting an inflammatory process, which is called tendinitis. The inflammation can usually last anywhere from 7-10 days. It can be decreased if treated promptly with rest and anti-inflammatory agents such as ice and anti-inflammatory medications (NSAIDS, OTC Ibuprophen such as Advil, Motrin, etc.).

However, if the tendon is continuously placed under stress for an extended period of time the condition can no longer be called tendinitis and is now termed tendinosis. The reason for the name change of the condition is due to the physiological changes of the tendon. Due to increased stress, the tendon becomes ischemic meaning there is decreased blood supply to the tendon. If the tendon is ischemic for an extended period of time the collagen (that all tendons are made up of) begins to die. Once the collagen dies there is no longer a presence of inflammatory cells. If there are no inflammatory cells that means there can be no inflammation (aka tendinITIS) and therefore, NO PAIN. I am sure no pain sounds great to all of you, but this is very bad. If there is a lack of pain there is no way for your body to tell you if and when the tendon has been overly stressed again. Hence, there is a very high chance that the tendon will rupture or tear completely as in when an individual tears their Achilles' tendon.

Collagen can regenerate if the proper treatment is rendered. If the tendinitis has become tendinosis it is much harder and it takes longer, but it can still be done. So if you think you have tendinitis, please do not wait for the pain to go away because with the proper treatment it will not turn into tendinosis. It doesn't hurt to get it checked out, right?

What is the best cardiovascular exercise to do if you have knee pain?

2009-12-09T10:49:00.000-08:00

Choosing the right cardiovascular machine that prevents further damage to your joints is so important and will save you pain in the long run. The best cardiovascular exercises for your knees are the ones that put the least amount of stress on your joints. Two of these exercises include the stationary bicycle (recumbent or upright) and swimming. The exercise bike is a great way to burn calories and to build strength in your leg muscles without putting excessive stress on your lower extremity joints. When you set up your bike you want to make sure that when seated your knees are slightly bent. Also, when you extend your leg at the fullest rotation your knee should still have a slight bend in it. You also want to make sure your knees are not bent too much (greater than 90 degrees). Hint: When your knee is bent at the proper angle you should still be able to see your toes. Excessive bending in the knee will increase the stress on the patella (knee cap) located in the front of your knee. Swimming is also another great way to burn calories and increase muscle strength throughout your whole body without putting excessive stress on the your joints. If you suffer from bad knees and a bad back, swimming is a great exercise. You can burn up to 450-900 calories per hour. Sounds good to me! I have found a website where you can figure out caloric expenditure during various exercises based on your body weight. Go to http://www.nutristrategy.com/activitylist3.htm.

Some helpful advice:

1. If you have back pain as well as knee pain the recumbent stationary bicycle may be a better fit for you.

2. If you have shoulder pain and you want to swim try using the breaststroke. The breaststroke does not require rotation of your shoulders which can cause excess shoulder pain. If the breaststroke still causes pain then stick to the stationary bicycle for the cardiovascular portion of your workout and do you weight training in the pool.

Pain in the foot...

2009-12-04T11:14:00.000-08:00

I am just getting over a bad bout of plantar fasciitis. For those of you who are unfamiliar with this painful and ruthless foot condition, it is an inflammation of the fibrous band of tissue that runs along the bottom of the foot from your heel to the ball of your foot. When inflamed it can become extremely (did I say extremely?) painful causing one to limp or have to use an assistive device, like a cane or crutches, to walk. So, I have been limping around on the ball of my foot (sometimes with straight cane in hand) due to plantar fasciitis. I am positive that many of you are wondering “How did a physical therapist let herself get to this point?” Well, I am as guilty as many of you and I ignored my pain. I thought ‘Oh, it’s not so bad…it will go away tomorrow. I can deal with the pain.’ Well, it did go away…and then it came back with a vengeance! So, for the past 8-10 days I have had to treat myself like a patient and even become a temporary patient of Dr. Yoo’s. After 8 days of consistent treatment I am finally step on my heel with minimal pain and today (day 12) I have hardly any pain! I cannot explain how amazing it feels to be able to finally step on my foot without wincing in pain.

Prevention is the solution! The human body is a kinetic chain; everything is connected! Over time, poor mechanics of one part of the body will affect another part of the body somewhere up or down the chain. Shoes, shoes, and more shoes! I cannot stress enough how important footwear is when it comes to preventing injury. I own great shoes that are wonderful for my feet and I own shoes that even though they may look good they are terrible for my feet. When I wear my great shoes, my foot doesn’t bother me at all, however when I don’t I suffer tremendously. I understand that footwear can be pricey, but it is even pricier down the road for treatment of injuries caused by poor footwear. If you have proper footwear it may prevent you from having to purchase orthotics. Some individuals may even do well with over-the-counter arch supports (i.e. Dr. Scholl’s, Spenco). These can be purchased at your local pharmacy, Road Runners (on Route 4 West in Paramus), and/or On Track (Englewood, NJ). However, some individuals depending on the severity of the condition or foot positioning may need to be fitted for orthotics by an orthotist in order to permanently correct the problem.

I hope this blog has helped save you from some unwarranted pain. I will continue to treat my condition until my foot feels 100% better and I will take preventative measures so this does NOT happen again.

Dr. Murphy on lower back pain...

2009-10-21T08:06:00.000-07:00

Being the mother of an 11 month old little girl, I understand the mental and physical demands of a full-time job and having less “me time” to take care of myself. I am also realizing that mid and lower back pain is often a common occurrence when you are caring for a little one. The repetitive bending from picking up baby Ava and toys off the floor, holding her on one hip while you try to get things done around the house, lifting and carrying the car seat, leaning over the crib patting her on the back or stomach trying to get her to sleep and rocking her to sleep at all times of the day (including the middle of the night). It all started when I was nursing and pumping. I had such bad ache and pains in my neck and mid to upper back from looking down at her while she was feeding. I would have to do stretching at home on my floor after each feed to help the pain subside. Then the lower back pain kicked in once she started crawling. I was constantly bending and squatting on the floor picking up her and her toys up or just stopping her from breaking the family vase that has been in the family for 75 years (don’t worry I have since then childproofed my house).

Repetitive bending, whether it be looking down for extended periods of time during the day or bending down to picking objects up off the floor, puts a tremendous strain on the structures of your lower back. A daily proper stretching and core stabilization routine can be the answer to all of your problems. Stretching can be done anywhere; sitting, standing, or lying down. There is no excuse not to stretch. I know we are all guilty of saying things like “I don’t have time” or “I’ll do it later.” I catch myself saying these things sometimes. But, once I take a few minutes to do some stretching I am so happy and relieved that I did! Essential muscles to stretch and strengthen to prevent lower back pain are the hamstrings located in the back of the thigh, hip flexors located in the front of the thigh and deep in your trunk, and the glute or buttock muscles.

Six tips from Dr. Murphy for preventing low back pain:

1. Whatever you are doing you should always start with drawing in your belly button towards your spine. If you are about to lift an object, tighten your core by drawing in your belly button towards your spine and then lift the object.
2. Don’t sit for too long! Take small breaks every 15-20 min. Get up and walk around. Reach your arms up over your head and stretch. Anything…just don’t stay seated! Research has shown that the brain can only retain information what it learns in 20 minute increments. So, even more of a reason to take that break!
3. When lifting an object keep it as CLOSE to your body as possible. This is includes anything from boxes to babies. The further away the object the more strain it puts on your lower back. Babies put even more strain on you because they are mobile unlike a box!
4. When you walk squeeze your glutes! Many people tend to shift their hips from side to side (the infamous model walk) or rotate their lower back and pelvis too much when they walk. Think about squeezing your glute (or buttock) muscle on your push off leg with EVERY step. Your heel should strike the floor first and then you should push off with your toe. Draw your belly button in towards your spine, stand up straight with your shoulders back and walk with purpose; no more strolling.
5. When you stretch make sure you hold the stretch, no bouncing! Hold all stretches for 30 seconds or longer and repeat three times. You should stretch twice a day, EVERY day.
6. For the females: Decrease your time on heels! I’m not saying don’t wear heels (because we all know that’s not going to happen) just decrease your time wearing them. If you’re still shaking your head NO WAY! then another option is to decrease the height of your heels and/or wear a heel that has more give to it in order to absorb the shock from the floor (which will travel right up to your back!). Heels place your body in a more forward position and it order to maintain an erect posture your joints and muscles need to work overtime against gravity.

So after a good 10 minute stretch I am good to go again (until tomorrow when I need to repeat my stretching again from my daily duties a mother.). Best of luck with your stretching and hopefully some of my tips will come in handy.
Sara

Dr.Sara Murphy
Physical Therapist [Maven Sports Medicine]