Paspa Physical Therapy

Specializing in Orthopedic and Sports Physical Therapy

An Essential Tip for Runners to Improve their Performance!

Building a strong foundation of core strength and flexibility is essential for runners. “Joint stability” can also be described as “the ideal movement of a joint”. This occurs when a working set of muscles operates a joint versus the flexibility of opposing musculature, gravity, and other forces without disorder. Maintaining joint stability helps minimize the chance of injury, improves resistance to fatigue, and improves muscular endurance. Stability also helps improve your posture which can improve your breathing, balance, and running efficiency, as well as improving your energy transfer from the upper body to the lower body. Understanding how your joints are operating, and how they are supposed to operate, can greatly benefit you in making appropriate adjustments toward improving your running performance.
Happy Running!
Jason

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Simple Solutions: The Lumbar Roll

Simple Solutions:  The Lumbar Roll

The lumbar roll is a simple and effective way to help support the lumbar spine when sitting.  How does the lumbar roll work?? Well, before I answer that question, I need to talk first about one aspect of the lumbar spine’s structural anatomy. 

The lumbar spine is shaped like an S curve.

 The S curve functions to absorb mechanical stresses placed on the lumbar spine from daily life, it increases balance, and allows for full range of motion and flexibility.  Humans could not maintain erect posture and move normally without the S curve.  It allow us to not only walk, stand and sit, but to dance, do yoga, rock climb, bicycle and bend to pick up a baby. Without the S curve humans would be stiff and immobile.

When the spine is not in a normal S curve shape it leads to PAIN! Eventually that pain will lead to tissue breakdown and injury – most commonly a herniated disc.  Most Americans spend upwards of 80-90% of their day sitting. Prolonged sitting puts increased stress (- pressure) on the lower lumbar spine. That stress is compounded when we sit in a flexed or slouched posture.

 Lumbar supports are simple cushions that are place in the lower lumbar spine to help maintain the S curve of the spine.  Most chair backs are not shaped like an S and have no lumbar support build into them, the same holds true for train, plane and classroom seating.  What happens is that you wind up sitting in a C shape all day and the end result after a full day at work or school is pain and stiffness. 

Lumbar supports are a simple solution.  Relief of pain can be almost immediate.  They are placed right at the low back just below your waist.  They are the simplest ways to prevent low back pain when sitting for long periods of time.

I recommend to my spine patients that they research getting a lumbar support that works for them and there are multitudes to choose from.  From inflatable travel versions to deluxe supports made with Tempurpedic cushion (filling).  It is always best to speak to your physical therapist on what would work best for you.

Happy sitting!

Pam Paspa, PT

Paspa Physical Therapy

Kinesio-taping for quicker recovery and back to sports

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Kinesio taping has been in the field of physical therapy and sports medicine for many years now.  We’ve all seen athletes on TV with the colorful tape on different parts of their bodies.  The tape isn’t being applied to look “cool” or to be a fashion statement.  Kinesio taping is being applied to help support joints, facilitate muscle action, and optimize performance to promote the body’s natural healing process.

I must admit that as a physical therapist that is used to treating most orthopedic conditions using manual techniques, stretching and exercise, I was nothing short of a skeptic.  How is this thin, flexible tape going to help decrease pain and increase support of a joint?  Well I have been proven wrong time and again.  I am now a true believer.

I have been using Kinesio tape with my patients for over a year to enhance the PT treatment being given. Yes, I am a little late in the game, but better late than never.  Numerous conditions such as tennis elbow, knee pain (patellofemoral pain syndrome), tendonitis, neck and low back pain, and shoulder impingement are just a few of the conditions that I have used the tape on with great success.  I must say I often feel like a miracle worker.  After the tape is applied, patients will often feel better almost immediately.  I rarely use the rigid sports tape anymore.  Kinesio tape is so light and thin, making it much more comfortable for patients to wear.  It is designed to mimic the elasticity and feel of skin.  Patients forget that they have it on.

If you have a nagging injury or painful joint I recommend that you give Kinesio tape a try.  It’s not just a pretty pink, blue, fuchsia colored tape that you put on your skin to look good, it is a great rehab tool that more and more physical therapists are using to enhance their treatments and allow for quicker recovery and return to sports.

Pamela Paspa P.T.

Paspa Physical Therapy

Importance of postural education

Posture refers to the body’s alignment and positioning with respect to the always present force of gravity. Whether sitting, standing, or laying down; gravity is exerting force on our joints, ligaments, and muscles.  Postural assessments help indicate undue stresses and strain on your bones, joints, ligaments, and muscles.

Because your joints are operated by your muscles, faulty postural alignments more importantly tell us what muscles may be dysfunctionally operating your joints. Repeated movements and prolongedpostures cause joint deviations, making them (your joints) less efficient, and in some cases painful. The changes that occur with repeated movements due to sustained postures also develop neuromuscular changes. These are the changes that take place as your brain sends signals to your muscles, which have been conditioned to move in a path of least resistance.

The process of “bad posture” develops over time, while looking at a computer monitor to the left of you at your desk every day, or carrying a heavy bag on one side of your body for years. Changes in alignment also commonly present in athletes. This is most often due to strength and flexibility imbalances with overtraining or overstretching. A perfect example seen in NYC is the weekend warrior training with a faulty muscular system. It is important to remember that faulty alignment is always muscular imbalance, which is what leads to muscle pain or poor joint dysfunction.

In short: when your muscles become elongated or shortened due to postural deficits, they won’t operate your joints properly. The result of this is decreased movement efficiency, pain, and “wear and tear” on your joints. But there is good news! Your muscles are connected to your brain, and with the right education, behavioral modifications, and other possible necessary measures, reversing these undue stresses on your body can be done surprisingly quickly. Learning how your body works, and how your body should work, is the most valuable way for you to sustain musculoskeletal health and improve your body’s performance.

Jason Maggard

Do you feel pain or stiffness on the bottom of your foot when you step out of bed in the morning? While running? After sitting for long periods of time?

If yes, chances are that you may have plantar fasciitis.

Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot.  It connects the heel bone to the toes and creates the arch of the foot.

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CAUSES

  • Arch problems (both flat feet or high arches)
  • Obesity or sudden weight gain
  • Long-distance running (especially downhill or uneven surfaces)
  • Tight Achilles Tendon
  • Shoes with poor arch support

SYMPTOMS

  • Dull or sharp pain, stiffness, ache or burn in the bottom of heel
  • Usually worse when you take your first steps in the morning
  • After standing or sitting for a while
  • After intense activity
  • May develop slowly over time or sudden onset after intense activity

TREATMENT

  • Physical therapy to help stretch, strengthen and eliminate pain.
  • Anti-inflammatory medications (NSAIDs) to reduce pain and inflammation
  • Heel stretching
  • Rest from exercise/activity
  • Wearing shoes with good support
  • Night splints to slowly stretch plantar fascia and allow tissue to heal

** If above treatments do not work your doctor may recommend:

  • Wearing a boot cast 3-6 weeks
  • Custom made orthotics
  • Steroid shots into the heel

PROGNOSIS

Non surgical treatments usually work, however plantar fascia may last for many months to years.

Helpful Tips in Avoiding Shoulder Impingement Injuries with Weight Training:

As a physical therapist and active recreational weight lifter, I feel that understanding the shoulder is vital to a healthy workout. Weight training is an exceptional form of exercise when practiced sensibly. In following certain stretches and strengthening exercises, shoulder injuries such as rotator cuff tears, impingement syndromes and bursitis could be avoided.

Below is an example of an external impingement syndrome. Over time, this injury can lead to rotator cuff tears, tendonitis and bursitis.

Shoulder Impingement (External):              

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Serratus Anterior:

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Rotator Cuff Anatomy – The Shoulder Stabilizers:

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These are examples of special tests that would indicate an impingement syndrome. These positions would cause pain.

Positive Shoulder Tests

1. Hawkin’s Sign     

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2. Neer’s Test

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Many times, someone with an impingement syndrome will have a tight inferior capsule (arm pit area) or posterior shoulder capsule (back of shoulder) which drives the humerus upward, causing the rotator cuff tendon to be pinched between the humerus and acromion (as shown in the picture above). These are good stretches to restore flexibility and to avoid this problem. Remember, stretches should not be performed to the point of pain.

Shoulder Stretches:

1. Inferior Capsule Stretch

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2. Posterior Capsule Stretch

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3. Sleeper Stretch

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Common Reasons For Injuries:

1. Overtraining: Many injuries occur from repeatedly training to failure or from too much resistance. Not enough recovery time is also a factor. Muscles need about 24 hrs of recovery time. Do not train the same muscle group daily.

2. Not warming up sufficiently. By increasing your body temperature through the use of an Upper Body Ergometer or other cardio equipment, you are increasing the circulation into the muscles and increasing their elasticity.

3. Not stretching sufficiently. It is safest to stretch before and after a workout. Make sure to stretch the areas mentioned above, not just the chest muscles. Hold your stretch for 20-30 seconds minimum.

4. Hyperextension of the shoulder when weight training. For example, allowing your elbow to drop too far below the chest with a bench press or too far back when doing an upright row. This motion may be overstretching the anterior shoulder and encouraging a shoulder impingement over time.

5. Performing shoulder press or lat pull downs behind the head.

6. Poor rotator cuff strength. Poor serratus anterior strength. The serratus anterior is a muscle that moves the shoulder blade upward and outward on your rib cage and is very commonly left out when weight training. Do not forget these small but very important muscles. They will allow your larger muscles to work more effectively and you will be less likely to have an injury.

7. Winging of Scapula. This means, the inside border of your shoulder blade wings outward. This is an indication that your lower trapezius and mid trapezius muscles are weak. Your shoulder blade must be stable on your rib cage in order to lift heavy weights.

See below for examples of shoulder exercises:

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Written By:
Gabriel Manzon, MPT

Paspa Physical Therapy

Plantar Fasciitis: Do you feel pain or stiffness on the bottom of your foot when you step out of bed in the morning? While running? After sitting for long periods of time?

Do you feel pain or stiffness on the bottom of your foot when you step out of bed in the morning?  While running?  After sitting for long periods of time?

If yes, chances are that you may have plantar fasciitis.

Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot.  It connects the heel bone to the toes and creates the arch of the foot.

Image

CAUSES

  • Arch problems (both flat feet or high arches)
  • Obesity or sudden weight gain
  • Long-distance running (especially downhill or uneven surfaces)
  • Tight Achilles Tendon
  • Shoes with poor arch support

SYMPTOMS

  • Dull or sharp pain, stiffness, ache or burn in the bottom of heel
  • Usually worse when you take your first steps in the morning
  • After standing or sitting for a while
  • After intense activity
  • May develop slowly over time or sudden onset after intense activity

TREATMENT

  • Physical therapy to help stretch, strengthen and eliminate pain.
  • Anti-inflammatory medications (NSAIDs) to reduce pain and inflammation
  • Heel stretching
  • Rest from exercise/activity
  • Wearing shoes with good support
  • Night splints to slowly stretch plantar fascia and allow tissue to heal

** If above treatments do not work your doctor may recommend:

  • Wearing a boot cast 3-6 weeks
  • Custom made orthotics
  • Steroid shots into the heel

PROGNOSIS

Non surgical treatments usually work, however plantar fascia may last for many months to years.