REHAB the RUNNERS!

To everyone that competed in this year’s P.F Chang’s Rock and Roll runs- great job! It was a beautiful day for a run! As a Physical Therapist who was a competitive collegiate runner and has treated high school, collegiate, and professional runners, I wanted to share my insight with anyone planning on running this year.

Training for runs of any distance is a marathon, and not a sprint. Hopefully by this time you have a couple of months of training under your belt and you feel confident that you can reach your goal, whether that goal is to finish your first 5K or set a new PR in the marathon. Good news- The finish line is in sight! Don’t stress, trust your training, and have fun!

Having spent so much time training over the past few months, some runners may feel a void after completing their run, and wonder what they should do next. Here are some suggestions:

·       Take time off! You have been dedicated for a while now, in order to prevent burnout and help reduce the risk of overuse injuries, take some personal time and enjoy yourself.

·       Spend quality time with loved ones! Hopefully your training regimen hasn’t totally alienated those around you, and now is a good time to spend those extra couple of hours each day with friends and family.

·       Sleep in! If you have been training for longer than a couple of months you probably have been getting up early to beat the heat. Sleeping in can help give your body a chance to rest and recover.

·       Cross train! You may never want to run again in your life after what you just went through. But you have made such great improvements to your health and fitness, it would be a shame to let that go to waste. Hop on a road bike, go find a heated pool, or get in the gym to help keep your fitness up and continue to lead a healthy lifestyle.

·       Visit your friendly neighborhood Physical Therapist! Especially if you have a nagging injury that has been bugging you for the last few weeks of training, or if any new injuries arose during your run.  Going to a Physical Therapist who is skilled at functionally evaluating runners, which may include a running analysis, can illuminate any inherent strength or flexibility deficits you may have.  Addressing these limitations can help prevent injuries in the future and make your next run that much more enjoyable.

·       Look for your next race! Especially if you caught the running bug, having another race planned can keep you on schedule and give you the extra motivation to lace up those shoes. Be careful scheduling another race too soon though. You want to give your body adequate time to recover between races to help prevent injuries.

Whether you plan to run the 5k or the full marathon, run hard and enjoy yourself! Remember, the race is the reward for all the hours of sleep lost, miles logged on your shoes and blisters you (hopefully) have overcome! If you do have any aches, pains, or injuries you have been fighting, or are interested in what you can do to prevent future injuries, schedule an appointment with me at Spooner and Shaft Physical Therapy by calling 480-837-2595.

Battling Illness: To run or not to run?

Most runners I know are driven, determined, dedicated and persistent, which is what keeps them performing at very high levels! We love runners at Spooner Physical Therapy as many of us are runners ourselves. Skipping a run or workout seems out of the question; even though we are blessed with nice weather here in Arizona, it is still the time of year where illnesses are very common. Therefore, the million dollar question becomes: “Am I healthy enough to run?”

At Spooner Physical Therapy, we understand that all systems of the body must be functioning at optimal levels in order to perform as such. (Durst, Jeana) When in doubt as to whether you are healthy enough to run or not, consider using the “neck rule”. Symptoms below the neck (i.e. - chest cold, bronchial infections, body aches) require time off, while symptoms above the neck (i.e. - runny nose, stuffiness, sneezing) don’t pose a risk to runners continuing their workouts.

Be extra cautious when training with anything worse than a minor cold because it can escalate into more serious conditions involving the lower respiratory tract and lungs. Depending on the conditions and accessibility, consider running in a pool. Water adds moisture to nasal passages, especially in winter weather.

If you are still on the fence about whether you are healthy enough to run, take your temperature. If your temperature is above 99 degrees, skip your run. Most runners are under the assumption you can “sweat it out”, when in reality, running does not help your immune system fight a fever. (Laskowski, Dr. Edward, Mayo Clinic).

While symptoms may not be severe enough to stay home from work or keep us in bed, running can still cause more harm than good. Exercise can provide a mental and physical boost, but it’s important not to compromise the body’s integrity and health. Know your limits, and consider the phrase, “when in doubt, wait it out!”     

Marc Carpio, NASM-CPT 

Marc Carpio is a personal trainer, Golf Enhancement Specialist, and FIT Coordinator at Spooner Physical Therapy Scottsdale. He has been training runners to improve their speed and fitness for 8+ years. He has worked in various health and fitness arenas, including the highly reputable Canyon Ranch Health Resort. For questions or to schedule an assessment, please call 1-480-860-4298 or e-mail: m.carpio@spoonerphysicaltherapy.com

Is there a “magic pill” to make my pain go away?

As a Health Care Provider in physical therapy and as an endurance athlete, I am seeing a growing trend of the “miracle treatment” society. With our fast paced lives, we don’t have time to wait for anything, especially healing.  It’s the “Microwave Society” as some may call it. We have information, technology, everything we can dream of at our fingertips. Why not our health? Why can’t we heal quickly with a magical pill, treatment, or app and solve all of our problems? As an endurance athlete myself, I personally have been reminded that just because I have temporary pain relief, that does not mean it is okay to continue with training.

There are so many gimmicks, treatments, and quick fixes out there that all sound so great. I recently read about a procedure for chronic plantar fascia pain that breaks up scar tissue in the foot. This treatment claims to “cure” the patient and allow them to return to running in 2 weeks, also saying physical therapy may not be necessary. Unfortunately, that is not the case. If someone has been plagued by chronic pain, there have most likely been adaptive changes in strength and mobility resulting in abnormal mechanics. Most likely, you need a little training or re-education to your now pain-free body before you get excited and start training for that race.  Similar claims are often used with treatments just as injections, steroid packs, and Platelet Rich Plasma (PRP) treatments. 

I am not here to argue the effectiveness of these treatments. In fact, sometimes they can make people feel better. The people providing these treatments really do want you to have less pain. We have to ask ourselves, why do these people have chronic pain? Something is not allowing the tissue to heal, whether that is a training issue, diet, or biomechanical breakdown. There is usually an underlying issue that causes the problem. A good healthcare professional will try their best to find this breakdown, not just chase symptoms. 

I urge you as active individuals, to not just seek a miracle treatment; I ask you to find someone who is willing to treat your body and your whole person and not just pain. Helping people get better is not about “curing them,” it is about empowering them and finding a solution to their pain, rather than just chasing it. So before you spend hundreds or thousands of dollars on finding your miracle fix, look for potential causes, rather than just slapping a bandage on your pain and heading out for another run.

Tracy Hill, PT, DPT, CSCS, FAFS 

Tracy Hill is a Yoga Instructor, APTA member, NSCA member, Youth leader of high school ministries at East Valley Bible Church. She has been a physical therapist at Spooner Physical Therapy since March 2007. She completed a Fellowship of Applied Functional Science with the Gray Institute in 2010 and is also a certified Gray Institute’s Nike Golf Performance Specialist. As a runner herself, Tracy has a passion to treat runners and tri-athletes through their training and addressing their injuries.

Shoulder Golf Swing Mechanics

Every year many of us step onto a golf course attempting to hit the ball farther, faster, and more accurately. Many people will spend thousands of dollars on equipment and course fees, even hundreds more on golf lessons, with hopes of improving their game. Unfortunately the latest technology of titanium alloy graphite composite driver cannot compensate for deficiencies in movement or poor body mechanics. Realizing that many people will continue to play over the course of their lifetime, can you imagine this pattern being repeated year after year. Unknowingly, many golfers will plateau, as they are not aware of their poor mechanics, nor do they know how to correct them.

The body’s mechanics are sequenced going through the golf swing. This sequential loading occurs from the ground up, starting at the ankle, then knee, into the hips and low back, the upper back, scapula and shoulders, and into the neck. As with many functional movements, faults in a golf swing will occur in pairs, with a compensation resulting from each fault. Let us examine the synergistic relationship between the shoulder and the scapula. The relationship of  humerus movement relative to the scapula called the Scapulo-humeral rhythm, which usually occurs in a  2:1 ratio. Limited mobility of the scapula can limit the 3 dimensional movement of the shoulder complex, not allowing the scapula to clear the rotator cuff when raising the arm. Over time, repetitive impinging of the rotator cuff can result in pain, weakness, and lead to an eventual tear.

 Another key component related to the movement of the shoulder/scapula complex is the amount of mobility of the upper back (thoracic spine). Although the thoracic spine is not linked to the shoulder directly, there is a connection in the kinetic chain. Consider the amount of rotation that occurs in your trunk (thoracic spine) as you wind up into the back swing. It is evident if you try and swing a club without rotating your trunk, and primarily moving the shoulders. You will generate very little, if any power, as you swing through the ball. Your shoulders and the club merely act as a whip on the follow through, as the power is generated through the hips and trunk.

Referring back to the golfer suffering from chronic Rotator Cuff symptoms, as previously mentioned; we would likely find limitations in thoracic mobility, and limited scapular movement, resulting in the constant impingement of the shoulder. For a right handed golfer suffering R shoulder pain, these symptoms will limit the amount of shoulder abduction and external rotation required to fully load the kinetic chain during the back swing. Aside from pain, this golfer will have limited power, accuracy, and be less likely to have the endurance to complete a round of golf with their buddies.

Once we have identified these limitations a proper training program must be developed to address such deficits. If you notice any professional athlete, a lot of time is spent on training activities, aside from practicing their respective sport. Functional training needs to be multi-faceted , addressing flexibility, strengthening, and endurance: more than just swinging a club. A training program needs to occur in all 3 planes of motion to allow the body to experience proper loading. You can stretch the front and back of the shoulder by holding onto a doorway and rocking your pelvis in all 3 planes of motion. To stabilize the shoulder an effective exercise is shoulder raises in all 3 planes, moving from the hip to shoulder height. To address thoracic mobility a simple but effective exercise is a lunge while raising the club overhead in all 3 planes.

 Our bodies are designed to function synergistically in all 3 planes of motion. If there is a kink in one of the links, the entire kinetic chain may be affected. For those enduring golfers who refuse to allow age, or pain dictate their ability to continue playing a sport they love, focus on the movement of your body 3 dimensionally and you will achieve optimal performance.  

Certain health professionals are movement specialists, who have been extensively trained in the assessment of functional human body biomechanics, and are known as Fellows of Applied Functional Science. Additional specialized training focuses specifically on the biomechanics of the golf swing. Such people are recognized as Nike Golf Performance Specialists. My name is Adam Fry, and I am among a very small group that has received the aforementioned training. My services are offered through Spooner Physical Therapy. A thorough assessment will include the breakdown of the body mechanics during the 2 main transformational zones (TZ’s) of the golf swing, which are the backswing and the follow through. Beginning posture, or address position is of great importance, as it can impact the movement of your head, shoulders and scapula as your arms bring the club back into the loaded position. We will address poor postural mechanics can limit your body’s potential to maximally load during the back swing, ultimately limiting your power on follow through.

Adam Fry, PT, DPT, FAFS

Low Back Pain and the Golfer: A Body Swing Connection

The most common cause of pain in golfers is in the lower back region, with national averages being around 70%.  The cause for lower back pain in golfers is multifactorial with causation potential from swing flaws and/or physical limitations.  A thorough evaluation by your golf teaching professional, including a physical screen, can assist in determining if a referral to a medical specialist is necessary.  An understanding of the body swing connection is paramount in fully assisting the golfer. Has your golf teaching professional performed a physical screen in addition to a detailed analysis of your golf swing?

                The most common swing flaw that leads to lower back pain is a reverse spine angle.  Reverse spine angle occurs at the top of the backswing when your head actually points towards the target line instead of away from the target line.  This is a compensatory movement pattern and is to maintain counter balance during the swing.  As the feet stay planted, the hips move away from the target which lends the spine to move the opposite direction of the hips and towards the target line in order to maintain balance.  This creates a relative compressive force through the facet joints of the lumbar spine on the left side for a right handed golfer.  Left sided low back pain is not, however, the common side of pain for golfers.  As the golfer initiates downswing, a rapid force occurs and the lower spine is then moved through the frontal plane creating an aggressive compressive force with speed through the right sided facet joints of the lumbar spine.  Your golf professional will be able create swing drills to assist with reducing a player’s tendency for moving into a reverse spine angle.

There can be physical causes for a player to move into a reverse spine angle.  Some possible causes are such as decreased hip rotation, decreased thoracic spine rotation, and decreased gluteal strength.  If a player has the inability to rotate through the trail leg, (the right leg in a right handed golfer),this can lead to a compensatory movement through the upper back.  In a survey conducted by the Arizona Golf Association (AGA), only 54% of respondents reported stretching their hips prior to a round of golf.  Another potential physical cause is the inability to rotate your thoracic spine on a stable pelvis.  This will create a similar compensatory movement where the player will move into another plane of movement to allow for adequate backswing rotation.  In the same AGA survey, again, only 54% of players stretch their thoracic spine prior to a round of golf.  In the golf swing, the hips and thoracic spine are to be relatively mobile, allowed to move freely, while the lumbar spine, or low back, should remain relatively stable.  If a breakdown in this pattern occurs, it can lead to pain during the golf swing and decreased performance. 

If a golfer’s low back pain could be decreased, would that person enjoy playing the game of golf more?  Would that same golfer play more rounds of golf and purchase more equipment?  A golfer who wants to play the game of golf longer and have more fun, is great for the industry as an entirety.  Working together with your golf teaching professional and a medical expert who specializes in the game of golf can help you achieve playing the game of golf pain free, for a longer period of time!

Daniel Miriovsky, PT, DPT, OCS, ATC, TPI

Titleist Performance Certified

d.miriovsky@spoonerphysicaltherapy.com

Spooner Physical Therapy Scottsdale

9097 E. Desert Cove Ave., Suite 110
Scottsdale, AZ 85260                             

 480.860.4298

 

 

Golf Hips

 

Have you been playing golf for many years and are starting to notice that your body does not bounce back from aches and pains the way it used to?   One of the most attractive things about golf is that it is played long into the aging years of life.   However, there may come a time when you start to notice slight changes in your golf swing and do not feel as smooth as you once did. 

As a physical therapist, Fellow of Applied Functional Science and Certified Nike Golf Specialist, I am trained to evaluate the entire body as it relates to the golf swing.  Addressing the entire body and treating various ailments has given me the opportunity to provide comprehensive treatment, as well as allows patients timely recovery and improved performance.  For example, in my practice I often treat golfers who have been diagnosed with arthritis and pain is frequently manifested in the back, knees and shoulders.  My approach always includes evaluating movement mechanics in search of the source of pain instead of simply blaming arthritis for pain and suggesting that these athletes to give up golf.  It is imperative to address movement patterns that may be increasing stress to certain areas of the body and allow the athlete to play to the best of their ability for many years. 

One major contributor to the breakdown of golf swing mechanics is the hips.  In the evaluation of the entire golf swing, one can appreciate the power and motion that is required to come from the hips in order for the rest of the swing to be successful.  Over time, we lose motion in our hips due to poor postures or prolonged sitting.  This limits the ability of the hips to move around the rest of the body and decreases the power of the hip muscles to explode through the swing. 

Now, let’s examine the golf swing.  Moving from the address position to the backswing, the body transitions to a more upright posture as the club comes up and around the body.  Ideally, there is also significant rotation occurring at the hips that is transferred through the spine and shoulders to allow the club to get over the shoulders.  If the hips do not allow for optimal rotation, the body will compensate and try to gain increased rotation from other areas in order to get a full backswing.  Try to execute your swing without allowing your hips to rotate, keeping them fixed.  Is it difficult to take your club into a full backswing position?  You might even experience discomfort in your back, shoulders or knees.  This is because other body parts  have to over-compensate to provide enough rotation to execute the backswing.  Now take your club through the downswing into your follow through position.  Do you feel like you were able to generate as much power as normal?  Perhaps it took a lot more effort to generate the same amount of power.  Did you feel more stress on your shoulders, back or somewhere else?  You might be able to get away with this once, or even several times in a row.  However, imagine playing that way an entire round, several times a month. This results in the back, shoulders and knees being over-worked repetitively which will eventually cause breakdown and potential joint pain, muscle strain, or other injuries; not to mention inefficiency.  Upon completion of the above exercise, does it make sense to blame our “bad” back, knees or shoulders for hurting?  It seems that there is another culprit to be blamed for these pains.  The lack of hip motion is the true contributor to the pain.  It is imperative that the true source of the breakdown of swing mechanics is addressed in order to make lasting changes in swing efficiency and the treatment of golf-related injuries. 

It is appropriate to appreciate the movement of the hips as large contributors to creating power in the golf swing.  Optimal loading during the golf swing occurs when the hips move and function effectively in all three planes of motion.  I encourage you, if you are being treated for any golf ailment or injury, to inquire to your provider if your hips are functioning as they should be to maximize your swing, and if they are being addressed in relationship to your pain. 

Your hips are a key factor to a successful golf swing.  Make sure they are being unlocked in order to unleash the power and capability of your golf swing for years to come.

 

Tracy Hill, PT, DPT, CSCS, FAFS

Nike Golf Performance Specialist

t.hill@spoonerphysicaltherapy.com

Spooner Physical Therapy Ahwatukee

16611 S. 40th St., Suite 130

Phoenix, AZ 85048

(480)706-1199

 

 

How much NEAT are you getting a day?

You eat right, workout religiously, and still can’t rid yourself of the extra pounds.  It could be that you are not getting enough NEAT in your life.

According to the American Heart Association, most of us aren’t.  What is NEAT?  Non Exercise Activity Thermogenesis.  What does this mean?  NEAT is the energy expended through activities other than sports type activities; in other words, movement such as standing, fidgeting, doing housework, etc. 

 A recent study suggests that overweight and obese people tend to sit an average of 2.5 hours a day more than their leaner sedentary counterparts.  When we consider that obesity was rare 100 years ago and the fact that the human genotype has not changed over that time, we realize that a lifestyle conducive of more sitting is a strong factor towards the obesity epidemic. Physical activity levels have dropped markedly with modern conveniences, such as drive through restaurants and banks, televisions, escalators, computers and portable phones, as well as labor saving devices. 

So how much does extra movement included throughout the day add to calorie expenditure?  According to the American Council of Exercise, it is possible to burn an extra 300 calories per day.  This means a net loss of 1 pound of body weight in 12 days or 31 pounds in a year!

Fitting more NEAT into our daily activities isn’t as complicated as it may seem.  For example, at the office, we can walk down the hall to a co-worker’s office instead of calling or emailing them.  Get up from your desk to stand or walk for 5-10 minutes every hour.  Use part of your lunch hour to walk outside or around the office instead of staying seated the entire time.  Use the stairs instead of an elevator or escalator.  Find the farthest parking spot from the entrance.

At home, don’t record your favorite show.  Instead, use the commercial breaks as opportunities to walk around the house.  Put away the remote control and get up to change the channel on your TV.  Position the portable phone in another room so you have to get up and walk to go answer it.  While talking on the phone, stand instead of sitting, hand wash and dry the dishes, hang the clothes out to dry, wash windows, do some gardening, clean and organize the garage…the possibilities are endless!

Keep in mind that NEAT is not a replacement for a clean diet or regular bouts of moderate to intense exercise.  Those two components are very important to our overall health and well being.  Nevertheless, regular exercise sessions and a healthy diet may not be enough to assist us with fat loss.  Since we live in a modern society of physical convenience that leaves us more sedentary than ever, adding more NEAT to our daily lives may be necessary to help us reach and maintain our goals.

 

Sources:

American Heart Association; Non-Exercise Activity Thermogenesis:  The Crouching Tiger Hidden Dragon of Societal Weight Gain January 26, 2006.

Everyday Health; Burning Calories with Everyday Activities;   

 

 

Rhonda Trollmann, AFAA PFT/GFI (FIT Coordinator)

Spooner Physical Therapy Estrella