Consequences of Decreased Activity
- SIT TO STAND TRANSFERS
- HEEL RAISE
- TOE RAISE
- SINGLE LEG STANCE
Flexibility is defined as the range of motion available in a joint. Many structures influence flexibility including muscles, tendons, ligaments, and bones. Research shows that increasing your flexibility by stretching can decrease injuries, minimize and alleviate muscle soreness, and improve athletic performance.
Ballistic stretching (bouncing, jerking) uses the momentum of a moving body or limb to force it beyond its normal range of motion. This type of stretching tends to be done in an uncontrolled manner and often results in injury. At the very least ballistic stretching prompts the muscle(s) to tighten up instead of relax. This type of stretching is usually not recommended.
If you have any questions or concerns about your stretching routine, please contact us! Our therapists would be happy to help you refine your stretching technique for maximum benefit.
I think we all can agree that October is a special month with the beauty of changing leaves and the mystery of unpredictable weather. It also holds National Chocolate Week (October 10-16, yum!) and has been declared National Pizza Month (really! Yum again!). And let’s not forget the fun of seeing kids tromp around in their costumes-often covered by coats thanks to that unpredictable Colorado weather—on Halloween. This month is also famous around the world for Breast Cancer Awareness, and here in the USA, as National Physical Therapy Month.
Breast Cancer impacts all of us, as most of us love someone who has dealt with this disease or we have dealt with it ourselves. This month, I’d like to take a moment to look at how physical therapy can impact a person’s journey with cancer, including breast cancer.
Cancer treatments include chemotherapy, radiation, and/or surgeries. These treatments can yield many different side effects including:
Although most of us don’t necessarily think of PT as a treatment for cancer, when you look at the side effects of cancer treatments, you might be able to recognize a connection. If you’ve worked with a PT before, you know that we are experts at decreasing swelling, stiffness, and pain and at returning people to fitness! Exercising with skilled guidance from a PT during cancer treatment is safe and can help maintain a sense of control and an outlet for the anxiety and depression that comes with fighting for your life.
We know that exercise can reduce the risk of falling that is common when people feel weak or dizzy from treatment. Exercise can also:
Physical therapists routinely deal with wounds and provide manual therapy that ensures healthy scar formation. Overall, PT has been shown to significantly improve quality of life for individuals during and after a cancer fight.
This month we encourage you to enjoy the changing leaves, unpredictable weather, costumes, chocolate and pizza. And as you honor all those who fight with breast cancer, remember to take care of your own breast health and don’t forget that your PT is here for you no matter what fight comes your way.
Since reopening after the COVID-19 shut down, our clinics have seen a spike in back, neck, and hand pain from increased computer use at home. People have suddenly been relocated to laptops on kitchen counters, couches, or beds. These poor ergonomic situations combined with uninterrupted computer time have led to postural strain.
In the office setting, computer time and sitting activity are broken up by trips to other cubicles, long walks to bathrooms/ break rooms or walks to other offices. Home offices can be a much tighter set-up. Lack of movement is a big contributor to orthopedic problems. Here are a few tips to help you work from home without pain.
Sitting on the front edge of chair doesn’t usually work well. Your chair should allow you to scoot all the way back and have support in your lower back. A good adjustable chair works, but a towel roll or firm pillow can be used as well. From a side view, your ear should be in line with the tip of your shoulder, and your shoulder should be in line with your hip to allow you to relax into an upright position. The seat of the chair should support your thighs but not press into the back of your knees. The chair should allow your feet to sit flat on the floor. If the chair is too tall, then put something under your feet for support.
Your computer monitor should be at the correct height to limit neck strain. Ideally, your eyes should be at the same height as the top of the monitor. This is easy to do with desk top computers, but is more challenging with laptops. To modify your laptop consider using a laptop stand, separate keyboard, and an external computer mouse. Prolonged sitting with the head/neck in poor position is a set-up for headaches and neck pain.
Your keyboard should also be set-up correctly to limit wrist and hand pain. Ideally the wrist should be straight with forearms parallel to the floor and elbows in at the sides with a 90 degree bend.
Get up and move around every 20-60 minutes. If you have pain, then move every 10-15 minutes. Shrug your shoulders, turn your head side to side, reach overhead, stand up and bend backward, do wrist circles, get up and walk around. Pinch your shoulder blades together, tuck your chin toward your throat, and shift around. Our bodies are designed for movement, and when we don’t move our bodies think we’re asleep and start shutting down some blood circulation that leaves our tissues susceptible to strain. This is part of why we strain ourselves with sitting. Fun tip: use your computer or phone alarm as a reminder to move around every 20 minutes or so.
Some good information and illustrations by the University of Michigan can be found at: Computer Ergonomics: How to Protect Yourself from Strain and Pain | University Health Service.
Laptop specific tips and information can be found at: htps://www.scoe.org/files/ergo-tips-laptop.pdf.
We at Foothills Orthopedic & Sport Therapy hope that this information helps keep you out of trouble with musculoskeletal pain. However, if you do find yourself with an overuse injury we are here to help. Stay safe at home and stay pain free on those computers.
Two of the most common non-steroidal anti-inflammatory medications (NSAIDs) are Ibuprofen (Advil, Motrin) and Naproxen (Aleve). What do these drugs do, and how do they help with pain? Read on to learn more.
NSAIDs prevent your body from making chemicals called prostaglandins. Prostaglandins are made in response to injury. These chemicals can contribute to inflammation, pain, warmth (fever), and swelling. NSAIDs work to reduce or prevent this inflammatory response and help alleviate pain that might be acute (injury, recent surgery) or chronic (arthritis, bursitis, degenerative changes).
Although Ibuprofen and Naproxen are very similar, they are not exactly the same. Ibuprofen tends to be more short acting while Naproxen tends to be more long acting. These differences make Ibuprofen more useful for short term conditions and Naproxen a better option for chronic conditions. Other differences between these two medications include:
Ibuprofen – any age including children
Naproxen – 12 years and older
Ibuprofen – 200 to 400mg every 4 to 6 hours as needed
Naproxen – 220 mg every 8 to 12 hours as needed
All medications come with the risk of unwanted side effects. Both Ibuprofen and Naproxen can cause the following:
Like any medication, do not take more than the recommended dosage unless directed by your physician. These medications, in conjunction with physical therapy, may help you to overcome a recent injury or manage an ongoing condition. Be sure to consult your physician or pharmacist before taking any new medication.
Life is returning to a new “normal.” The world is opening back up, and along with it are sports. Athletes are starting to get back to work. Now is not the time you want to have an injury. It is however, the perfect time to change bad habits and focus on proper strengthening and stretching to help prevent injury.
Knee Injuries by the NumbersKnee pain and injury plague many athletes every year. As many as 8.5% of non elite athletes will suffer from patella tendinopathy or “jumpers knee.” Patella tendinopathy can cause pain, interfere with performance and can be career ending in up to 53% of athletes. Another injury that impacts athletes are ACL tears. There are up to 200,000 ACL ruptures/tears every year. Research shows that female athletes are as much as 10 times more likely to tear their ACL than males.
Injury Prevention Tips
Here are a few simple things you can do to help prevent injury.
1) Start back slowly and listen to your body.
2) Allow time for a proper warm up.
3) Make sure you wear proper shoes. Wear shoes that have a good arch support and control the position of your foot preventing your arch from collapsing.
4) Stretch your calf muscles. Having good flexibility in your calf muscles allows for adequate motion in your ankles to help absorb the impact of landing.
5) Strengthen your core and your gluteal muscles, especially the gluteus medius muscle. Poor strength of the gluteus medius leads to decreased hip and knee control.
6) Maintain flexibility in your hip flexors and quadriceps.
7) Don’t forget about the hamstrings. Your hamstrings, along with the ACL, help prevent your tibia (lower leg) from sliding forward. Focus on making sure you have a good strength in your hamstrings not just your quadriceps muscles.
8) Avoid knee extension machines. Once a staple in every gym this exercise puts a tremendous amount of stress on the knee.
9) Use a hip/glute strategy when landing. Land with your hips back, keeping your knees behind your toes. This helps to protect your knees but also allows you to prepare for the next jump and for more power production.
10) Focus on landing softly and quietly. Allow your hips, knees, and ankles to bend. Make sure your knees don’t collapse in toward each other as you land. Allow your muscles to absorb the impact not your joints.
If, despite these tips, you do experience knee pain or injury we at Foothills Orthopedic and Sport Therapy are available to help.
How AWARE are you? Take this quiz to find out:
1. How many types of Ehlers-Danlos Syndrome are there?
2. The Ehlers-Danlos Syndromes affect which body system?
E) all of the above
3. What do people with Ehlers-Danlos Syndrome look like?
a) pale, tall, and skinny
b) short with a curvy spine
c) covered in scars and bruises
d) sagging skin
e) any, all or none of the above
4. When in the lifespan does Ehlers-Danlos Syndrome onset?
c) after trauma or illness
5. Is Ehlers-Danlos Syndrome life threatening?
c) no, but it can significantly impact quality of life
d) it depends
6. How do people with Ehlers-Danlos Syndrome get around?
d) sensible shoes
e) like a high-class athlete or performer
7. How is Ehlers-Danlos Syndrome treated?
a) vitamins and minerals, nutrition, hydration
b) carefully selected exercise, lifestyle modification, counseling
c) adaptive equipment and supports
d) prescription medications
e) none, it is incurable
8. Why are people with Ehlers-Danlos Syndrome called Zebras?
a) zebra stripes represent the abnormal appearance of the skin in EDS
b) doctors are taught to look for the most common diagnoses instead of being distracted by the possibility of rare disorders like EDS by being told ‘When you hear hoofbeats, look for horses, not zebras!’
c) living with EDS is like being a jungle animal
d) the debate of ‘white with black stripes’ vs ‘black with white stripes’ represents the aspects of the disorder that remain poorly understood
9. What is the easiest way to spot a zebra?
a) look for stripy skin
b) look for a history of doing the splits or entertaining contortions
c) look for joints that seem to bend the wrong way
d) test their Beighton score
10. What do people with EDS need in 2020?
a) to be seen, heard and believed when they relate challenges
b) more public awareness and acceptance of the disorder
c) more healthcare providers who are educated, aware, or simply willing to read about EDS
d) more research into diagnosis, management of EDS
ANSWER KEY (yes, there were a lot of ‘trick questions’)
1. C: there are 14 types of EDS, each named for which body system is most impacted. All the types involve some degree of joint hypermobility. Only the most common types (hEDS and HSD do not yet have identifiable genetic markers that can be tested to confirm diagnosis)
2. E: all types of EDS impact connective tissue, which is part of the composition of every system of the body! Some types impact connective tissue of one system more than others, while the most common types (hEDS, HSD) impact the joints of the body the most and are also associated with GI, neurological, cardiovascular and immune disorders
3. E: Ehlers-Danlos Syndrome is called an ‘invisible illness’ for a reason. Most people with EDS look ‘fine’ or just like anyone else. Some rare types do cause spinal deformities or obviously different appearing skin. In some people, difficulty with chewing/swallowing/digestion/muscle building can cause a gaunt appearance; other people have activity limitations, metabolic changes, or changes in tissue deposition that lead to increased adiposity.
4. A, and B-E too: EDS is genetic, so it is present at birth. In some of the very rare types, it may be diagnosed shortly after birth related to joint dislocations, unexpected bleeding, or failure to develop movement as expected. But most types remain undiagnosed until symptoms begin to significantly interfere with life AND the symptoms are presented to a health care provider knowledgeable about EDS. Puberty, trauma, pregnancy/parenthood can all be a trigger that leads to greater awareness of symptoms. However, many people with EDS wait 5-50 years from the awareness of symptoms to diagnosis due to a lack of knowledgeable providers.
5. D: vEDS, or vascular EDS, and some other rare types of EDS can be life-threatening disorders, especially when undiagnosed; with timely diagnosis precautions and management can allow longer life. Most types of EDS, however, impact quality of life much more than longevity.
6. A-E: mobility varies dramatically among people with EDS. In fact, many individuals can use all these modes of getting around in the same lifetime, and sometimes even the same month. While many disorders are progressive, the progression of EDS is very unpredictable. Many people with the most common types, hEDS/HSD, have phases of very high function, very low function and everything in between despite conscientious management of their disorder. Fun fact: most people diagnosed with hEDS/HSD relate a history of exceptional talent in athletics, music, or the arts. Often, difficulty utilizing these talents are what drives individuals to seek a diagnosis.
7. A-E (again): There is no cure for any types of EDS. All of the listed options can be beneficial in optimizing function and quality of life in EDS. Most treatments are focused on minimizing associated conditions in the various body systems. At various phases of the disorder, medications and adaptive equipment are especially helpful. The need for lifestyle management, right-size exercise and movement, nutrition, hydration, and care for mental health are never ending for those with EDS. Even at the very best phases, the individual is always working to manage life with unique connective tissue.
8. B: This is good advice for young doctors most of the time, but it does a disservice to those who are zebras. Many ‘zebras’ are accused of lying, faking, seeking some sort of gain, or simply dismissed when they don’t respond to treatment as expected or when diagnostic testing is inconclusive. While it’s smart to look for the most common cause of a complaint first, it would be better for all of us if the next step was to look for more rare causes of a complaint like EDS before moving to accusations or dismissiveness.
9. Not A! Probably B & C. Definitely D: The Beighton Scoring System is the most widely accepted way to assess joint hypermobility and is quite easy to check on your own and then show your healthcare provider. This link explains it all: https://www.ehlers-danlos.com/assessing-joint-hypermobility/ CAUTION: moving your body parts to extreme/awkward positions routinely can damage supportive structures, so avoid the temptation to ‘show off’ or do ‘party tricks’ just because you can; taking photos and showing them from your phone is a great way to achieve validation without abusing your body!
10. A, B, C, D: Yes, yes, yes and more yes!
As communities around the world feel the impact of the coronavirus (COVID-19), we would like to answer some questions about coronavirus and inform you of the steps we are taking at Foothills Orthopedic & Sport Therapy to help protect the health and safety of our patients, guests and employees.
What is Coronavirus Disease (COVID-19)?
Coronaviruses are very common and most do not cause serious illness. The common cold is a type of coronavirus. The COVID-19 coronavirus is believed to have jumped from an animal population to people in Wuhan, China. It began to spread from person to person in December 2019 and has since impacted many countries around the globe.
Due to this spread The World Health Organization has declared the outbreak a “public health emergency” and as a result has implemented travel restrictions to China and South Korea.
Of the 97,975 cases reported thus far, 54,124 (55.2%) have recovered and 3,355 (3.4%) have resulted in death. Eighty-four percent (84%) of the current known cases are considered mild. The United States has 245 reported cases of COVID-19 with 15 reported deaths.
The CDC and other global public health entities are aggressively implementing measures to slow the spread of the COVIS-10 virus.
How does COVID-19 Spread?
Coronaviruses spread primarily from close person-to-person contact through respiratory droplets such as those produced by coughing or sneezing. These droplets can land in the mouths or noses of nearby people or be inhaled into their lungs. Transmission of the disease typically occurs when:
The CDC maintains that the immediate risk of contracting COVID-19 in the United States is low.
There is currently no vaccine for COVID-19 but infectious disease experts are working to develop one with the hope of testing to begin over the next few months.
Typical Symptoms and Presentation of COVID-19
What are the best ways to prevent the spread of COVID-19?
What we are doing to minimize the threat of exposure to infectious diseases within our offices.
What we need everyone to do to minimize the spread of infectious diseases.
Please let us know:
We will continue to employ procedures to minimize the spread of COVID-19 according to the CDC and other credible authorities and will keep you informed of any changes in protocols.
At Foothills Orthopedic and Sport Therapy, we often treat snow-related injuries. Common injuries include back strain, shoulder injuries, and injuries from slipping and falling on the ice. A 2009 study in the American Journal of Emergency Medicine noted that on average 11,500 people are injured per year in snow shovel-related injuries. Injuries to the lower back accounted for 34.3% of the cases and 95.6% of the cases occurred around the home. So when the next storm hits, here are a few tips to help prevent injury.
If, despite theses tips, you do experience injury, we at Foothills Orthopedic and Sport Therapy are available to help you get better.
Stem cell treatments are all the rage right now. If you watch TV or listen to the radio, then chances are good that you have heard a commercial touting the benefits of this new treatment. It sounds like a wonder cure, but what does the science actually say?
Stem cells are the precursors to all other cell types. After they divide stem cells have the potential to grow into any other cell type in the body. A stem cell could become a muscle cell, nerve cell, bone cell, or cartilage cell. This is important because stem cells could be used to treat diseased or damaged body parts.
The most recent study conducted on stem cells and joint pain was performed in 2013 and the results were published in the periodical “Stem Cells and Development.” This study looked at patients with rheumatoid arthritis. When compared to a control group who received medications only, the group who also received stem cells experienced remission of their disease. The effects lasted for 3-6 months and there were no side effects reported. Although the results of this study are encouraging, it is important to remember that most people with arthritis suffer from osteoarthritis which is very different from rheumatoid arthritis.
The Food and Drug Administration (FDA) is responsible for regulating stem cell therapies to make sure the treatments are safe and effective. The FDA released a statement in 2019 warning consumers about the risks of unapproved stem cell therapies. If you are interested in this new therapy, be sure to talk to your doctor to understand the risks involved.