Your Smart Phone Could Be Rapidly Aging Your Spine

Chances are that you probably haven’t given much thought to how your neck and back are faring in the era of the smart phone, but studies show that you most certainly should. It’s practically a reflex these days to pull out our smart phones when we’re standing in line, sitting at the airport or riding the subway. And while it’s great that we rarely need to venture beyond our pockets for entertainment, our bodies are beginning to retaliate—and mourn the pre-texting days. So, what exactly are these contemporary conveniences doing to our bodies? A surgeon-led study that published in Surgical Technology International assessed what impact surgeons’ head and neck posture during surgery—a posture similar to that of smart-phone texters—has on their cervical spines. With each degree that our heads flex forward (as we stare at a screen below eye level), the strain on our spines dramatically increases. When an adult head (that weighs 10 to 12 pounds in the neutral position) tilts forward at 30 degrees, the weight seen by the spine climbs to a staggering 40 pounds, according to the study.

How pervasive of a problem is this? According to the study, the average person spends 14 to 28 hours each week with their heads tilted over a laptop, smart phone or similar device. Over the course of a year, that adds up to 700 to 1400 hours of strain and stress on our spines. As a result, the number of people dealing with headaches, achy necks and shoulders and other associated pain has skyrocketed. Trained to address postural changes and functional declines, physical therapists are well-versed in treating this modern-day phenomenon, widely known as “text neck.”

Over time, this type of poor posture can have a cumulative effect, leading to spine degeneration, pinched nerves and muscle strains. Scheduling an appointment with a physical therapist can help people learn how to interact with their devices without harming their spines. The PT will prescribe an at-home program that includes strategies and exercises that focus on preserving the spine and preventing long-term damage.

Exercise is an important part of taking care of our spines as we age, but what we do when we’re not in motion matters, too. So next time you pick up your smart phone or curl up with your e-reader, do a quick check of your head and neck posture. Your body will thank you for years to come.

What to expect when you are expecting…..a total hip replacement!

In this blog I am going to review the surgical process and recovery of a total hip replacement!  This is not a new procedure by any means, but like anything in medicine, there has been some new developments in joint replacement material, and surgical techniques.

The current hip replacement consists of two main components.  The femoral component which is placed into your upper leg bone(femur), and the acetabular component, which is placed into you pelvis.  The material being used in a total hip replacement is metal, plastic, and usually bone glue(bone cement).

The main difference lies in whether your MD decides you are a better candidate for a cemented or un-cemented hip replacement.  If you get a cemented hip replacement you can start rehabilitation right away and there is thought to be less post op pain.  In this procedure they use bone cement to help keep the prosthesis in place.  In a non-cemented hip placement there is no bone cement being used and it takes some increased time for recovery to allow the bone to fuse to the prosthesis(12 weeks).   The main difference between the two is that a cemented hip replacement may not last as long as an un-cemented hip.  Typically 10-15 years for a cemented hip replacement and 15-20 years for an un-cemented hip replacement.

In general, older adults may choose to go with the cemented prosthesis to allow a quicker recovery as they generally wont need the hip replacement to last as long.  Younger, more active individuals may choose to get an un-cemented hip replacement as they will more easily recover from the time off after the surgery and they need the hip replacement to last longer.

I am going to blog about the cemented hip replacement this week since as that is mostly what we see clinically.

Day 1: The Surgery!

On surgery day they like you to get to the clinic about 1-2 hours before hand to get paperwork done.  Then they will take you back and do a spinal block with moderate sedation or a full anethesia(being put to sleep) to get you surgically prepped.  The actual surgery takes about 1-2 hours depending on the surgeon and his/her surgical approach preference.  The surgeon will decide whether an anterior approach or a posterior approach will be better for you.  With the anterior approach you will not be allowed to bend you leg backwards for 6 weeks.  With the posterior approach you will not be allowed cross your legs, bend your hip more than 90 degrees, or pivot around you foot with it planted on the ground.

Day 1-2: The Hospital Stay

The minimal amount of time you will spend in the hospital is usually 1-2 nights.  During this time they will be monitoring your vitals and pain level to make sure everything is acceptable.  Pain wise at this point it usually isn’t too bad because some of the anesthesia from the spinal block can still be in your system.  Your physical therapist will becoming in the day of or day after the surgery to get you up and walking!  Yes walking!  This helps get your blood pressure stabilized, helps with your digestive track to get your bowels moving, and help you get comfortable moving your hip again.  The physical therapist will also review your specific surgical precautions depending on the type of hip surgical approach you had done.

Day 2-Week 3: Initial Rehab

From the hospital you will either be sent home or to a rehab center depending on the amount of help you have at home.  As long as there is somebody at home to help with bathing/toileting and meal prep you should be able to go home.  If you have a driver that can take you to an outpatient physical therapy clinic then you will start physical therapy by usually the 4-5th day post op.  If you do not have a driver at home, then you will start with a home health therapist that comes to your house 2-3x a week.  During this time your therapist will be working on regaining your ROM, your walking tolerance, and some light strengthening activities.  Pain during these three weeks can vary from patient to patient but typically is in the 4-6/10 range.  So it’s uncomfortable and swollen feeling, but typically isn’t really all that painful.  You should also be doing some light walking of 5-10 minutes everyday, usually 2x a day.

Week 3- 12 weeks: Late Rehab

During this period the hip will really start to improve.  Sleeping will become much more comfortable and functionally you will be able to do a lot more.  Therapy will consist of strengthening exercises and improving your overall endurance with functional activities.  After 6 weeks you will be able to start moving your hip in all the directions without the fear of breaking your surgical hip precautions.  Most people will say they turned a corner at 6 weeks and felt like they could do a lot more with less discomfort.  By the end of 12 weeks you should be pretty much back to doing all your normal activities of daily life with the exception of some of your more physical endeavors.

Week 12-1 year: Full Recovery

By this point you will be done with physical therapy an on to hopefully an independent gym or walking program.  The hip itself will take anywhere from 9 months to a year to really feel normal again.  You will continue to get stiff in the hip after sitting for long periods or when you first get up in the morning for about 9 months.  But over the span of the year that will eventually fade and you will be so happy with all the things you can now do again with your new hip!

That’s it in a nut shell.  Overall I’ve been told by several patients it is a much easier surgery then a total knee replacement or rotator cuff repair.  So if you are in need of a total hip replacement don’t despair, get the repair!

How Physical Therapy Helps Retirees Keep Dreams Alive During the Golden Years

Are you among the millions of Americans who have high aspirations for how you’ll spend the extra time during your post-retirement years? Whether you plan to travel the world, pick up fly fishing, spend more time woodworking or sign up for a golf league, your physical fitness level will be a factor.


A 2010 study suggests that the fitness declines we typically attribute to advancing age are largely caused by living sedentary lifestyles—which are on the rise due to the prominence of desk jobs in the workplace and activity-limiting personal technologies including smart phones and voice-activated remote controls in the home. Still, this runs contrary to the widely held belief that any declines in our physical abilities are caused solely by biological aging. Do we really have control over how active we’ll be in our “golden years”?


In a word, absolutely. The study—which examined 900,000 running times of marathon and half-marathon participants aged 20 to 79—found no significant age-related performance declines in those younger than 55 years old, and only moderate declines among the older cohorts. In fact, more than one-quarter of runners aged 65 to 69 were faster than half of the runners aged 20 to 54.


And for those thinking that these runners must have been lifelong enthusiasts of the sport, the study revealed that 25% of runners aged 50 to 69 were relative newcomers—and had started marathon training within the previous 5 years. The researchers concluded that even at an advanced age, people in the “non-athlete” category who engage in regular training can reach high performance levels.


If this revelation is intriguing, then perhaps it’s time for you to get moving! If you aren’t currently active, then you likely have questions and concerns about where to start. And if you regularly engage in physical activities, then you’ve probably set goals that you’d like to achieve. Either way, there’s no shortage of tools and resources to help you live a more active lifestyle but one reliable place to start is with a physical therapist.


The benefits of beginning with a physical therapist consultation are many: PTs are trained to assess your abilities and limitations, consider your health concerns, demonstrate safe exercises and build a plan to increase strength, function and mobility. Whatever your passion is, physical therapy will help you be fit and injury-free so you may enjoy life’s many pursuits.

5 Most Common Running Injuries

Listed below are the 5 Most Common Running Injuries and the typical recovery timeline.  I’m also going to add a few treatment ideas when dealing with these injuries.  These can help to speed up the healing process and hopefully get you back to running sooner.

1. Shin Splints- 2-6 weeks recovery timeline

Shin splints are typically caused by an increase in miles without proper build up or improper foot wear.  There are two types of shin splints that affect either the front of your shin or the inside.  The best treatment options for shin splints are icing, ice massages w/ ice cups, calf massage, calf stretching, and new shoes!

2. Piriformis Syndrome – 6 weeks to 2 years

Piriformis syndrome is actually a coverall term for pain in your glute or hip region exacerbated by running.  Piriformis syndrom is commonly caused by weak core and hip muscluature, old footwear, poor postural body mechanics while running, and increasing mileage too quickly.  The main issue with piriformis syndrom is the tightening of the piriformis muscle which lies over sciatic nerve.  It is best treated with hip and core strengthening, massage, dry needling, foam rolling, and piriformis stretching.

3.  Achilles Tendinitis/osis- 4 weeks to 18 months

Achilles pain is also typically caused by increasing mileage too quickly, tight calf muscles, improper footwear, and adding too much hills/speedwork too quickly.  Achilles tendinitis means it is an acute flare up of inflammation in your achilles, either at the insertion or mid belly.  For this problem calf stretching, icing, increasing cushion in your footwear, and calf massaging can really help the problem.  If the achilles pain becomes chronic, it can take much longer to heal and may require the use of eccentrics (strengthening the muscle while lengthening it) to get the tendon fully healed.

4. Plantar Fasciitis- 6 weeks to 18 months

Plantar fasciitis is another injury that when treated early usually isn’t too debilitating, but if allowed to get chronic can last for a long time.  Plantar fascitis is again caused by tight calf muscles, tight intrinsic foot muscles, poor arch support, and improper footwear.  Some treatment ideas for plantar fasciitis is rolling your arch with a golf ball or frozen waterbottle, calf stretching, night splints, over the counter or custom orthotics, and calf/arch massage.

5. IT Band Syndrome- 2 weeks to 6 months

IT Band Syndrome is typically caused by hip tightness/weakness or misalignment, increasing mileage too quickly, improper footwear, and lack or core stability.  The best treatments for IT band syndrome is foam rolling, icing w/ ice cup massage, glute/hip strengthening, piriformis stretching, and IT band stretching.  This is definitely one injury you want to catch early as the pain can get quite intense if you continue to run on it.

In conclusion, there are a few things that every runner should do to avoid sustaining these injuries to begin with.  First and foremost is make sure you have good shoes!  You should typically get new shoes every 500 miles or 6 months, whichever comes first.  It’s amazing how many injuries could be prevented with just making sure to change out your shoes.  Next, don’t increase your mileage or training intensity too quickly.  A lot of injuries occur during either building up mileage too quickly or increasing the intensity of your workouts too dramatically.  Like going from running base training on the trails to track workouts.  And finally, don’t let you pains near joints and tendons go untreated for too long.  Learning what type of pains are more muscle soreness and what are more sharp in nature can really make a difference in catching your injuries early enough to avoid them becoming chronic!

Physical therapists specializing in orthopedics or sports injuries are best at treating and diagnosing what may be causing any of these injuries.

See Your Physical Therapist to Nip Potential Injuries

You probably already know to make an appointment with a physical therapist when you sprain your
ankle or develop tennis elbow. But what if you’ve felt a slight twinge in your knee during your daily
walk or noticed that your posture has changed since you accepted a job that requires sitting for eight
hours a day? Or maybe you’ve been thinking about joining a gym to get in shape. Are these reasons
to see a physical therapist? Yes!

Each of these scenarios has the potential for injury. Physical therapists are experts in injury
prevention and are trained to spot small problems before they become big problems—and often
before you know that there’s a problem at all. Physical therapists evaluate, screen and assess patients
using a variety of tools to detect mobility limitations and muscle imbalances that, if left untreated,
may leave you prone to serious injuries down the road.

When caught early, injuries—or the very beginning signs of an injury—are easier to treat and the
recovery period is shorter, less expensive and less of a burden on everyday life. Knowing what to
look out for—and when to see a healthcare professional—is often not as obvious as it sounds. Some
signs and symptoms aren’t recognized as indicators of an injury while others may be brushed off as
nothing serious. Here are a few things to look out for:

• Joint pain
• Tenderness
• Swelling
• Reduced range of motion
• Weakness
• Numbness or tingling
• Balance issues

If you’re experiencing any of these signs or symptoms, schedule an appointment with a physical
therapist to rule out a potential problem or to nip one in the bud before it becomes more serious.
Based on background, training and experience, PTs understand how a patient’s risk for specific
types of injuries can increase based on participation in certain sports and recreational activities as
well as identify physical strains due to on-the-job and household demands.

An individualized exercise program designed to strengthen your muscles, improve flexibility and
optimize your physical ability can help correct and prevent issues that could turn into injuries in the
future. For example, a teenage field hockey player can learn exercises to perform regularly to lower
her risk of tearing her ACL. Your PT can design an injury prevention exercise program to suit your
specific needs and ensure your healthy participation in sports, recreational activities and everyday

Ready, Set, Run! Combat Depression with Regular Exercise.

Imagine going to the doctor with symptoms of depression and she hands you a new prescription: Do two sets of squats, 15 bicep curls, 10 laps around the track and call me in the morning. Though this is not (yet) an accurate picture, experts are starting to recognize that regular exercise is not only good for your mood but may help combat depression, too. Until physicians and other healthcare providers universally prescribe exercise as an alternative treatment for depression, it’s best to turn to a group of professionals who are already in the know: physical therapists. PTs are trained to recognize the signs and symptoms of mental health illnesses like depression and understand how the disorder can interfere with a person’s ability to enjoy life.

An individualized care plan starts with a thorough assessment and detailed patient history so the
PT can capture the limitations of the illness and understand the goals the patient would like to
achieve. Each custom treatment plan includes some combination of flexibility, strength,
coordination and balance exercises designed to achieve optimal physical function and to help
shed the layers of depression.

For patients suffering from depression, it can be stressful and overwhelming to think about
incorporating exercise into their lives either for the first time or after a long hiatus. Because the
illness’ symptoms often include fatigue and loss of interest in activities, it can be difficult for
patients to take that first step, both literally and figuratively. But physical therapists excel in
motivating patients to perform exercises both safely and effectively. In fact, another bonus of
seeing a physical therapist to get started on a new exercise program, is that he’s trained to
identify other injuries or illnesses that require a special approach.

You don’t have to have depression to reap the benefits of exercise. In fact, the mood-boosting
pastime can help anyone who might be temporarily sad or otherwise not themselves. Major life
stressors—divorce, loss of a job, and death—are difficult for anyone and regular exercise is a
great way to help people through a tough time.

With regular exercise, you’re guaranteed to see improvements in the following areas:
• Strength and flexibility
• Sleep
• Memory
• Self-confidence
• Energy
• Mood

Even minimal changes in any of these areas could change your outlook on the day and your
ability to participate in activities you once enjoyed. So, what are you waiting for?

Explaining Pain

Have you ever wondered, where does my pain come from?  Or why are some days more painful than others?  Well these are both loaded questions, but it can be summed up in one simple answer.  Pain is always 100% in your brain!

Believe it or not, your experience of pain is entirely a function of your brains response to a certain stimuli.  Which mean, yes we have pain sensors in your muscles, tissues, skin, etc., but none of the input into these sensors gets assigned a “pain” or “fear” response until it has been translated from our brain.  Here is a link to a video that further explains where pain comes from and how in translates into chronic pain.

One of the main basic concepts of this video is that there are lots of different factors that affect pain.  Especially chronic pain, but really all pain in general.  Stress, past experiences of pain, anxiety, fear of pain all contribute to our pain experience.  And because the brain is where all of our pain comes from, it is really an intertwined network of emotions that give us our pain response.  Like the video mentions, a lot of times the tissue that has been damaged has already been corrected, but in our minds we still have the fear or “threat” of pain.  And in turn we still “feel” the pain, even when the tissue is healed.

Definitely some food for thought.  So remember to stay positive in your thoughts and keep in mind all the different factors that may be affecting your pain.


Top 3 Exercises for Core Strengthening

To piggy back off of last months blog about top 4 stretches for sciatica, this week I am going to review the top 3 exercises for core strengthening.  There has been a good amount of research done to show how core strengthening can help prevent and decrease back pain.  Most of these articles have found that it’s the activation of the deep abdominal muscles that help the most with back stabilization and decreasing back pain.

The deep abdominal muscles are connect to your back through a deep fascial layer….

These deep abdominal muscles can then act as your own personal corset to keep you back more stabilized and protected.  Individuals who have had back surgeries in the past have had some of this fascial layer cut through, so rebuilding the muscle becomes even more important.  Here is a picture of the deep abdominal muscles from the front.

The muscles that are most responsible for creating that corset affect around you back are called the external obliques, internal obliques and transverse abdominis.  The rectus abdominis or “6 pack” muscles are actually strictly trunk flexors and do not have the corset affect around the back as the deep abdominal muscles do.

So now the important part….how do you exercise these muscles?  Well here are my top 3 core strengthening exercises for the deep abdominal muscles.

  1. Bicycle Kick Outs- Start with 30 seconds x 2 sets.  Progress to 1 minute x 2 sets.

2. Front and Side Planks- Start with 2 sets of 30 seconds.  Work up to 2 sets x 1 minute.


3.  Bridging with kick outs-  Start with 2 sets of 30 seconds.  Work up to 2 sets of 1 minute.


There you have it.  These are the top 3 exercises to work on strengthening the deep core abdominals to help prevent and recover from back injuries.  Another important part of core stabilization is pelvic floor strengthening, which will be addressed in another blog.  Thanks for reading!

Top 4 stretches for Sciatica Pain

Sciatica is a very common problem that more then 50% of the population will experience at some point in their lifetime.  It is often associated with lower back pain, but not always.  There are two main causes of Sciatica pain that runs down the back of the leg.


The most common cause of sciatica pain, which accounts for 80-85%,  is from impingement of the lower lumbar nerves.  This impingement can come from many different causes including poor posture, a rotated lumbar segment, a compressed lumbar disc, or degenerative disc disease.

The second common cause of sciatica pain is from piriformis syndrome.  True piriformis syndrome is quite rare because only about 15% of the population has the sciatic nerve actually course through the piriformis muscle.  However, most of the time the piriformis muscle is closely associated with sciatica due to the sciatic nerve irritation causing spasms or guarding of the piriformis muscle.  When the piriformis muscle is in spasm, it then can cause increase sciatica irritation, and in turn, increased sciatica pain.

So what can you do about Sciatica?  Well here is a list of the top 4 exercises for sciatica.

  1.  Double Knee to Chest- Do 10 repetition ever 3-4 hours

2.  Lumbar Rolls- Do 10 repetitions every 3-4 hours

3. Piriformis Stretching – Do 2 reps of 30 seconds.  Every 3-4 hours.

4. Sciatic Nerve Gliding-  Do 10 reps every 3-4 hours.

These exercises have been proven to help relieve sciatica pain over time.  See your physical therapist if you have questions on any of these exercises.  Looking forward to helping you in the future!

Kim Saunders, DPT has been published in the Physical Therapy Journal!

We are very proud to announce that our very own Kim Saunders PT, DPT has officially been published in PT Journal!!!  PT Journal is a premier physical therapy journal that is the international journal for research in physical therapy and related fields. It publishes content for both clinicians and scientists and uses interactive approaches to communicate that content, with the expressed purpose of improving patient care.

Please check out this link to an abstract about her journal article..

Here is a little bit more info about Kim.

Kim earned her Bachelor of Arts degree in Physiology with minors in Chemistry and Psychology from Southern Illinois University in 1997. While at Southern Illinois University, Kim competed as an NCAA Division I scholarship athlete in Cross Country and Track, earning All Conference honors twice. She also worked as physiology researcher, studying the interaction of brain and adrenal hormones in diabetics. In 1999, she achieved a Master of Science degree in Physical Therapy from Washington University in St Louis, which has been consistently recognized among the Top 3 physical therapy education programs in the country by US News & World Report for decades. Kim received her certification as a Pilates Instructor in 2003. Most recently, Kim completed her Post Professional Doctorate of Physical Therapy through Washington University in St Louis in 2014. During her doctoral work, Kim’s projects focused on physical therapy related to generalized joint hypermobility and women’s health issues such as: female athletic injuries, peri-partum back pain, exercise during pregnancy, and pelvic organ prolapse. She continues to work toward a Certificate of Achievement in Pregnancy-Postpartum Physical Therapy from the Women’s Health Section of the American Physical Therapy Association.