Lacrosse Ball Trigger Point Exercises

At Therapydia Denver, every patient receives one-on-one hands-on treatments. Our PTs are certified in manual therapy and these techniques allow us to mobilize the joints and muscles as well as release trigger points. Trigger points are areas of adhesions within soft tissue resulting from trauma or overuse and can lead to ineffective movement and pain. In addition to hands-on manual therapy techniques, all our PTs are also certified in dry needling – a great way to release trigger points.

The goal of each physical therapy visit is to restore proper length tension relationships of soft tissue and enhance normal joint mechanics for proper function. Our patients can replicate some of these myofascial release techniques at home with the use of a lacrosse ball applied to trigger points in tissue. We like lacrosse balls because they can get into those hard to reach places foam rollers may miss. Below are a couple of lacrosse ball exercises we recommend for our patients:

pec-trigger-point-massage

PECTOLARIS MINOR

  • Great for posture correction and for patients that sit at a desk or computer all day
  • Picture on left demonstrates a less aggressive pec minor release
  • Picture on right is slightly more aggressive for those stubborn trigger points in the pec muscle
  • Trigger point is typically found an inch or two below the collarbone and just to the inside of the shoulder
  • Be careful not to place ball directly on the front of the shoulder.  This is where the biceps tendon is located and can get irritated from the pressure.  This will typically feel like a sharp pain if you are on the tendon vs an achy sensation on the trigger point.
  • 10-90 second hold, repeat 1-3 times, 1-2 times per day

hip exercise

TENSOR FASCIA LATAE

  • Find boney point in front of hip (ASIS) and move ball 2-3 inches down and to the side
  • Lay on side and apply sustained pressure with ball to the muscle
  • Duration of pressure depends on how long it takes for muscle or trigger point to “release”
  • Release of the trigger point can usually be felt when there is a significant decrease in the intensity of the pain from the pressure of the ball
  • We typically tell patients that the intensity of discomfort should drop several points on the 0-10 pain scale
  • For example, if discomfort is 8/10 on the pain scale, then hold the pressure on the trigger point until the pain drops to at least a 3-4/10
  • This can take anywhere from 10 – 90 seconds

calf tightness exercise

CALF

  • Place one calf on ball and cross opposite leg over the top
  • Locate tender trigger point and hold sustained pressure
  • Gently pump bottom ankle up and down for more aggressive trigger point release
  • Again hold pressure until there is significant change in intensity of symptoms
  • 10-90 second hold, repeat 1-3 times, 1-2 times per day

 

rotator cuff releas

ROTATOR CUFF

  • Locate tender trigger point(s) in back of shoulder, specifically on back of shoulder blade
  • Start with arm externally rotated (picture on left)
  • Maintain pressure on trigger point as you rotate shoulder into internal rotation (picture on right)
  • There are several trigger points in the back of the shoulder/shoulder blade so more than one point may need to be treated to address symptoms
  • These trigger points tend to cause radiating pain into front of shoulder and/or down the arm so don’t be surprised if ache is felt in areas other than where the ball is placed.
  • 10-90 second hold, repeat 1-3 times, 1-2 times per day

lacrosse-ball-plantar-fasciitis-therapy

PLANTAR FASCIITIS

  • Place the lacrosse ball under the arch of your bare foot and begin rolling.
  • Roll the ball in multiple directions
  • You should feel instant relief from tight arches. (Image source: Shape)

INTER-SCAPULAR

  • Place lacrosse ball in between scapula and spin
  • Add movement of the arm into flexion overhead and back down to the hip for several reps, encouraging more upper thoracic extension at end range shoulder flexion.
  • Move lacrosse ball to multiple locations left and right side of spine with short duration holds of pressure

How Kinesio Taping Works For Injuries

Kinesio Taping Injury Physical Therapy

Most of you have probably seen athletes with tape attached to various parts of their bodies, like their necks, backs, arms, or legs. It’s an elastic form of tape called Kinesio tape and it’s used to stabilize muscles in a specific area. Although it’s commonly used by athletes, anyone with an injury can use Kinesio Tape to provide some extra support. Being taped still allows you to move, just in a controlled way that gives your muscles and ligaments a chance to heal. Taping around an injury can be a great tool for someone recovering from an injury or trying to train through one.

Keeping Your Injury Stabilized

Kinesio tape can either allow you to move better or restrict movement so you’re comfortable as you’re healing. Applying Kinesio tape to an injured, sprained, or strained area works to stabilize and take pressure off of the injury. That means that if you want to keep moving you can—but you also won’t move enough to put strain on your injury. It can be applied to injuries all over the body, with the most common athletic injuries being around the ankles, knees, shoulders, and even the neck. It’s used as a low level stabilization technique to help get the injured muscle or joint in a more supported position in the body. For example, if you’re getting over an ankle injury and no longer need a brace or boot, Kinesio tape could be applied to the outside of your ankle for additional support. Besides just giving your injury extra support, taping also works by giving your injury a chance to heal. If you’ve hurt your knee, taping around it could take pressure off of the knee joint by helping with support. That way, inflammation in that area is reduced and it gives a chance for the injured area to restore and heal.

Alignment & Support For Your Limbs

Kinesio taping can also be used to align certain joints and muscles to prevent further injury. For example, if you’ve hurt your ankle, you’re putting your knees at risk for getting injured as well since your body is off balance. If you’re working through an injured ankle and feel weakness or wobbliness around the joint, taping the outside of the ankle a specific way will allow it to align better with the rest of your leg. Having correct alignment can also work to decrease pain and help the joints and tightened muscles recover from activities. It also has added neuromuscular benefits simply by making you more aware of your movements and posture. Since you’re injured muscle is Kinesio taped into proper alignment, you’re re-educating your movement patterns.

Find A Taping Expert For Your Needs

With Kinesio taping, it’s key that you go to someone who has a background in kinesiology, anatomy, and physiology to apply taping techniques to injuries. It may look simple, but there are several different taping techniques, combinations, and tension strengths that have to be applied above specific muscles or joints. Taping yourself is also difficult, especially if your injury is in a hard to reach area. If you’ve been injured and are using Kinesio tape in the meantime as you continue with training, keep in mind that you need to get checked out by a medical professional to treat your condition. It’s important to know that Kinesio taping is just another tool in your treatment toolbox when it comes to recovering from an injury. It’s an effective short-term solution that’s used to relieve strain and pain from an area of injury. To completely resolve the source of your pain, Kinesio taping should be in conjunction with a full-fledged treatment program.

Snow2Sand Event: How’ll They’ll Bike From Denver to Los Angeles

Snow2Sand Charity Bike Race Denver

Therapydia Denver is excited to be partnering with NextStep Fitness for their upcoming Snow2Sand event kicking off in Denver on September 3rd. The goal of the charity bike race is to raise funding for healthcare and new facilities for people with paralysis. The team of 10 bikers and friends are doing the Snow2Sand 1,300 mile course in 8 days. Cycling for a that long of a distance in a short period of time requires extreme endurance training and physical preparation. At this point before the race, the team is working on gradually upping their training levels to prepare for what they’ll be facing on the journey. Besides having good mechanics on the ride, they also need to know how to move so they can prevent any sudden injuries.

The Training Regimen

With a few weeks before the race starts, the 10 person team is consistently training about 4 to 6 hours per day! It’s key for the team to balance all the repetitive movements they’re doing in a way so they don’t get injured. The team is being led by retired USMC Sergeant Brendan O’Toole and paralyzed athlete, Mike Murphy. Mike is completing the long race on a recumbent bicycle or handcycle, which means that for him it’s all about arm and shoulder strength. He’s getting in the same hours and preparing his body for the positioning he’ll need to power his bicycle. Overall, the whole team prepares this way: getting in the long hours, perfecting mechanics, and doing interval workouts.

In general, all of that overuse to their muscles puts a lot of strain on their ankles, knees, hamstrings, lower backs, and even the neck. Having strength in the right areas on the ride comes into play when considering how these overuse injuries can occur. For example, bike fit and an aggressive riding position can be at the source of lower back pain from cycling. To combat that, spending time working on core strength helps cyclists sustain the power they need during a ride. The lower back won’t be forced to compensate for the power that should be coming from the muscles around the core. Keeping to good mechanics on the bike also matters. Neck pain on a ride is because the muscles at the base of the skull get fatigued. Without proper positioning and bike fit, this will only aggravate your neck if you have to constantly crane forward. To prevent any issues with the knee, they have to make sure that they’re not diving inward while they cycle. Having to cover 1,300 miles in 8 days means preventing as much strain to your muscles as possible.

Role of Medical Support Team

Along with the team, a group of medical support staff will also be going along on the trek. One of our Therapydia Denver physical therapists, Casey, is part of the medical staff. Their main role is to get them through the journey and help them through any discomfort. Long hours on the bike might result in the medical team seeing a lot of lower back discomfort, quad soreness, and neck pain. They’ll most likely be feeling sore, fatigued, and have painful flare-ups in overused joints and muscles. They’ll use manual therapy and massage techniques to get rid of any muscle restrictions that may have built-up on the ride. Casey may also use dry needling techniques to release tension in overly tight muscles. They’ll also be available for any sudden injuries or accidents that may happen on the road, but hopefully will not. The goal of the medical team is to manage symptoms for everyone on the team. Relieving painful muscle tension and soreness is essential for the team to get through 8 days of constant cycling.

They’re Kicking Off In Denver

The mission of the Snow2Sand Charity Bike Race is to raise awareness for the paralyzed community and give them access to healthcare resources and facilities. The race to Los Angeles kicks off in Denver on September 3rd at 12pm at the Call to Arms Brewing Company. Come by to show your support for the team before the start their brutal journey. We’ll also be at the event with a booth to support the event. We’ll also be doing some complimentary kinesio taping for all attendees! Make sure you take the time to stop by.

Relieving Pain With Trigger Point Dry Needling

Dry Needling Pain Injury Therapydia

The problem with feeling pain because of an injury is that it has the potential to creep back into your life again. Unless pain is resolved at the source, the same injury may be getting triggered because of your daily habits. Most general areas of tenderness and irritability in your muscles are called latent myofascial trigger points. Almost everyone has these latent trigger points or knots in their muscles, but they don’t normally cause you any issues until they become active. Once a trigger point becomes active, it’ll cause you pain and start limiting the way you move. Whether or not you will develop an active trigger point depends on your posture, daily body mechanics, repetitive movements, or nerve irritation.

Latent Versus Active Triggers

The longer you leave a latent point of tenderness untreated it could cause long-term damage and stress to your muscle. Unless you press on a latent point and feel tenderness, you probably wouldn’t even notice that they were there. Any type of sudden trauma or repeated injuries to any muscles could cause a trigger point to start forming. Even spending a lot of time sitting at the office in the same position could cause these points of tenderness to start forming around your neck and along your back. Later on, this continued stress could cause you to start feeling pain and discomfort in those strained parts of your muscles.

Getting To The Point

The goal of getting rid of latent trigger points is to keep active and painful trigger points from developing in the future. Having irritable and hypersensitive sections of muscle can put you at risk for further sudden injuries, chronic pain, and poor muscle strength. Dry needling comes into play when you consider treatment for these points in your muscles. You can begin the prevention process by going to a certified physical therapist who specializes in dry needling. Dry needling is a form of physical therapy that involves inserting a thin needle through the skin and into the muscle. Physical therapists can assess which parts of your body have developed any latent trigger points by palpating the muscles and locating the knots. They can determine how these trigger points are affecting the mechanics of that area of your body. That way, they’ll know exactly which areas they need to needle in that surrounding area.

When a muscle is directly needled, the stimulation from the needle causes the muscle to have a twitch response. The trigger point in the muscle responds biochemically to the contact with the needle and releases tension quickly. Afterwards, your muscle begins to contract and relax the way a healthy muscle should instead of being constantly tense and irritated. Whether or not your latent or active trigger points are being needled determines how much discomfort you’ll feel during your session. You’ll feel some soreness in the area that was needled 24 to 48 hours post-needling.

Fighting Trigger Point Activation

The only way to avoid the pain, stiffness, and restriction of movement that active trigger points cause is to treat latent areas of muscle irritation. Trigger points can be found in any muscles and be caused by any type of sudden injuries or repetitive movements. Once your muscle begins to enter into a state of constant contraction, it’s hard to break out of that cycle. Physical therapists can use dry needling to quickly release muscle tension in many areas. Depending on your injury, you may need to use dry needling to complement manual therapy and guided exercise programs. Call Therapydia Denver if you have any questions about preventive dry needling or whether this treatment would be beneficial for you and your lifestyle.

Dry Needling Relieves Headache Pain & Tension

Therapydia Pain Relief Dry Needling Treatment

Many of us know that sitting and having good posture have become a part of our daily lives. Sitting in the same static position on a daily basis can cause a lot of problems with your posture that can eventually cause pain in unexpected locations. Headaches can be caused by issues that aren’t actually in your head. A cervicogenic headache is caused by shortening of muscles in and around your neck and at the base of the skull. Tight muscles can develop painful knots called trigger points and these trigger points can refer pain up from your neck to different parts of your head. Dry needling comes into play as a method of treatment for headaches by releasing tension in those tightened neck muscles and trigger points. Once you loosen those chronically tense neck muscles, you’ll be able to work on getting out of your poor posture and movement habits.

The Tension Around Your Head

Dry Needling Treatment Headache

This type of tightness in your neck muscles usually happens because of incorrect posture patterns. Many of us tend to hold a lot of tension up around the shoulder and neck muscles. This could be due to a lot of different aspects of our daily lives. Tension could result from:

• General stress and muscle fatigue
• Overall poor posture
• Constantly sitting at poorly designed work stations
• Carrying heavy items
• Using a shoulder strap for heavy bag
• Prolonged sitting in car seats while driving

Once you have that shortening of the muscles, your neck shifts into a forward head posture. The pulling at the base of the skull and in the neck is what causes the pain to extend up and around your head. The pain can also refer to different places around your head, like behind your eyes and around your temples. Taking painkillers like NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) will help with pain levels, but they won’t ultimately solve the source of the issue. The goal with trigger point dry needling treatment is to release tension in those muscles, restore muscle length, and ultimately decrease pain.

Treating Your Triggers

Dry needling acts as an effective treatment option because it allows tension to be released from the muscles in your neck. Since certain types of tension headaches are caused by muscular issues, they can be solved by directly treating those restrictions. A certified physical therapist can palpate the base of your skull, neck, and upper spine to look for knots in the muscle called active trigger points. Trigger points are tight areas of your muscle that are usually caused by trauma or repeated strain. Once the needle makes contact with those trigger points, they’ll cause a twitch response, or a small contraction. Contact with the needle causes an actual chemical change inside the muscle that releases tension, increases blood flow, and heals the issue. You’ll be getting rid of the trigger points that are causing tightness in your neck while also solving the source of your headaches.

Moving Back Into Alignment

Once those muscles are released, you’re also giving your body the chance to start moving back into correct spinal alignment. Extended periods of sitting or poor postural habits in general might have thrown all the muscles in your neck and upper back out of sync. Some may be too tight and others too stretched out and lengthened. After needling, you’ll able to bring the muscles along your upper spine into their proper ranges of motion. You’ll be able to move your head and shoulders back into the positions they’re supposed to be in. Without treating the restrictions around our neck and upper spine, you won’t be able to improve your posture.

Healing The Source Of Your Headaches

Using dry needling as a treatment method for muscular-based headaches will release the tension at the source of the pain. The goal with dry needling is to decrease the intensity as well as the frequency of your headaches. For example, if you’re used to experiencing a headache for the entire day you might start having a headache for only a few hours a day. After a few more sessions, you may not feel any pain around your head at all. Once you have the necessary range of motion you need around your neck and upper spine, you’ll be preventing any future headaches from happening. Consider dry needling for your headaches by getting rid of them in the present as well as healing the muscles to prevent the issue from happening in the future. If you have any questions about whether or not the headaches you’re experiencing can be treated with dry needling, call us at Therapydia Denver.

Therapydia Denver & NextStep: Racing From Snow2Sand

Snow2Sand Charity Bike Race Denver.

We’re excited to announce that we’re partnering with NextStep Fitness in support of their Snow2Sand Charity Bike Race. The goal of being a sponsor for this event with NextStep is to raise enough funding to provide healthcare resources for people with paralysis. For anyone with paralysis, maintaining a healthy lifestyle isn’t just about keeping fit. It’s also essential for them to ward off any secondary complications. Beyond having the necessary medical care, it’s also key for people with paralysis to have the rehabilitation facilities and equipment that they need.

The Problem With Healthcare For Paralysis

Without the right tools, people with paralysis don’t have or can’t afford the resources they need to lead healthy and injury-free lives. About 6 million people have paralysis in the United States. For people with spinal cord injuries, they can incur up to $800,000 in medical expenses their first year of recovery. The Snow2Sand Charity Bike Race is aimed to spread awareness and raise funding to address the lack of resources and access many people with paralysis face. The team of bikers and medical support crew, led by paralyzed athlete Mike Murphy and retired USMC Sergeant Brendan O’Toole, are biking 1,300 miles in 8 days from Colorado to California.

Building Better Better Quality Of Life

NextStep was founded based on the fact that there weren’t many progressive rehabilitation centers for people with paralysis to go to. At the time, there were no centers in California and no centers with locomotor training at all in the United States. Most people with paralysis will have direct rehabilitation for 3 to 6 months with a physical therapist after being injured. Afterwards, they’ll have to continue to manage any secondary complications for the rest of their lives. These include pulmonary and cardiovascular issues such as sudden instances of high blood pressure (autonomic dysreflexia) or blood clots (deep vein thrombosis). Having the resources to keep active to combat the loss of muscle function and atrophy in your body keeps these conditions from developing. NextStep Fitness has made this possible by providing a variety of resources such as specialized adaptive equipment, Locomotor Training, and functional electrical stimulation (FES) cycling.

Support The Biking Team & Crew

A main mission of Therapydia is to have people of all injuries moving better and integrating wellness and activity into their lifestyles. Sponsoring Snow2Sand helps us expand those values into the paralyzed community as well. We’ll also have a member of our team along for the ride to Los Angeles as well. One of our Therapydia Denver physical therapists, Casey, will be a part of the medical support team during the 8 day ride. Come by the kickoff event on September 3rd at 12pm at the Call To Arms Brewing Co. in Denver. Let’s help the biking team have the best send-off possible before their 1,300 mile journey!

How To Keep Balanced With Pilates After ACL Surgery

Therapydia Pilates ACL Tear Treament

If you’ve had surgery or suffered a major injury to your ACL, you’ve likely felt immobile as you worked through the recovery process. Your ACL works as a rotational stabilizer for the knee. When you make quick turns or sharp movements, it keeps your knee as stable as possible. Objectives during ACL rehabilitation are to make sure you can fully move your knee through every range of motion. Pilates comes into play as a solution that furthers your ACL recovery. One major component of ACL treatment is to rebuild strength in the muscles that surround your hips and thighs such as your quadriceps, hamstrings, and glutes. Pilates doesn’t put too much stress directly on your injured knee but gives you all the tools to increase strength and flexibility.

Reforming The Knee

Therapydia ACL Injury Treatment

Pilates has different exercise options available depending on how much weight you can put on you knee. Working on a reformer, as opposed to a mat or chair, can help you begin doing Pilates moves much earlier. A reformer is a piece of equipment used in Pilates which looks like a bed with springs, a sliding carriage, and resistance bands. If you’ve had ACL surgery, it allows you to stay horizontal and have lighter resistance on your injured knee as equipment guides you to strengthen the muscles around your knee joint. Common movements on the reformer involve footwork and side-lying movements for your injured knee. You’ll begin correcting any muscles that aren’t aligned in your lower body, which will help your knee recover by keeping it stable as you start walking.

Stabilize Your Knee Joint

Once you start being able to bear more weight on your knee, you have the option of doing some Pilates mat work. Since you’re able to move around a bit easier, you’ll work on continuing to increase the range of motion of your knee that may have started on the reformer. Better alignment throughout your spine and pelvis is key. Instead of just focusing on strengthening your injured knee, you’ll be increasing flexibility around your back, core, and hips as well. Without alignment in those areas, you’ll be putting too much force on your injured knee. All pilates exercises are designed to have built-in postural awareness to improve spinal alignment. You might be able to do an exercise like The Saw to not only stretch the hamstrings but also your abdominals and the muscles of your back. These all work together to promote a more stable knee joint.

Therapydia ACL Injury Treatment

• Sit up straight on your bottom
• Extend your legs in front of you, keeping your feet shoulder-width apart
• Stretch your arms out to the side, palms facing forward
• Inhale and twist to the right, keeping your abdominals and hips steady
• Reach the pinky finger of your front hand across the outside of the opposite foot
• Touch your little toe if you can, but move in that general direction if you can’t
• Once you’ve gone as far as you can, inhale and untwist back to sitting position
• Repeat the same movement on your other side

Retraining your injured knee to have the balance you need after an ACL injury is tricky. That’s why another point of focus is on your hips. A move like Swimming builds a lot of much needed strength in your core, glutes, and hamstrings. That way, you’ll be more balanced and put less pressure on your healing ACL.

• Lay on your stomach with your legs together in parallel
• Keep your arms stretched straight overhead and the tip of the nose to the mat
• Pull in your abdominals so you lift your belly away from the floor
• At the same time, keep your tailbone moving down towards the mat
• Reach out and extend your arms and legs in opposite directions
• Focus on getting length in your spine so your head moves up off the mat
• Continue to reach your arms and legs out as you alternate sides
• Pump them up and down in small pulses

Staying Balanced

After ACL surgery, what you need from your body is better strength and balance. Using Pilates to develop strength in your back, core, and hips will give your body the alignment it needs. That way, you’ll develop your body’s sense of balance which was thrown off after your ACL injury. You’ll be able to use Pilates to focus on specific weaknesses and retrain imbalanced muscles that may have contributed to your injury. Having musculoskeletal issues in your body will delay recovery and continue to strain your knee. Pilates allows you to maintain control, balance, and coordination in your healing knee. Talk to your physical therapist to see if Pilates is an activity you can do to complement your ACL rehabilitation.

Run Assessment: Find The Right Form

Therapydia Run Assessment Analysis

Running isn’t just about speed and distance. It’s also about considering your body’s movements so you can run as efficiently as possible without pain. Most runners have to deal with mild aches and injuries every now and then. What may begin as a slight misalignment in form can develop into a serious injury. It’s important to remember that as you’re running and your feet are striking the ground, the ground is also punching back on you. For most people, it’s hard to visualize exactly what body mechanics put you at risk for injury. Recognizing what’s misaligned with your running form will allow your body to move as efficiently as possible. One of the best ways to analyze how to improve your running form is to participate in a comprehensive running assessment.

Better Form Equals Less Injury

Runners are mostly at risk for repetitive use injuries. Some statistics estimate that 90% of runners miss training time every year due to injury. A combination of running too far, too quickly, or too often can aggravate areas in your lower body. Common injuries affect your kneecap (Runner’s Knee), the tendons around your shin (Shin Splints), the tendons around your heel (Achilles Tendinitis), and the tissue around your foot (Plantar Fasciitis). Small aches here and there have the potential of developing into these conditions over time. You want to put the least possible amount of force on your joints and muscles when you go for a run. Keeping good form is one way of being a more efficient runner and can help prevent overuse injuries.

• Focus on striking the ground with the middle of your foot, not the heel
• Keep your head and chest upright
• Keep your gaze ahead as you run and try to keep yourself from bouncing up and down
• Have a slight forward lean to propel your body forward
• Move forward, don’t cross your arms over the middle of your body
• Keep your shoulders relaxed
• Keep your hands loose
• Relax your jaw and neck

Analyze How You Run

Running form is always something you should be looking out for, but it can get more specific than that. The way you move and what injuries you’re at risk for really come down to how your muscles work together when you run. A comprehensive run assessment specifically analyzes your body’s mechanics as you run. An assessment can be done for runners of all levels—from someone just starting out who’s unsure of the right way to move to elite athletes who are trying to avoid re-injury. Using a video analysis will give your physical therapist real-time insight into your range of motion, gait, and posture. They’ll focus on observing how hard your feet strike, how much you bend your knees, and your footwork as you push off. They’ll also be able to see if you’re stronger on one side of your body compared to the other. Any asymmetries in the muscles of your legs might be affecting your stride. If you overstride or lean too far forward when you run, your physical therapist will be able to adjust your form.

Locate Those Weak Points

After a video analysis is complete, your physical therapist can focus on problem areas that were observed in your run form. They’ll do a thorough musculoskeletal exam to see where you need to increase range of motion and develop more strength and flexibility. If you’ve had a previous injury, the analysis also takes this into account by determining how at risk you are for reinjury. For example, if you’ve sprained your ankle in the past, any ankle instability you still have might be affecting how well you’re able to control your balance while landing on the unstable ankle. Your body can often compensate further up the chain in your knees, hips, back, or upper body.

To counteract the impact of running, it’s not only about having strong muscles surrounding your knees. You also need strength and mobility in your hips, spine, and core. Based on how you move, your physical therapist will be able to tell if you have weakness in your glutes or if you’re too tight in your hips. Without adequate strength and flexibility, you could be compensating by putting too much pressure on your knees as your run. It’ll also help keep you light on your feet by balancing the amount of force your body absorbs.

Prevent While You Train

With a sport like running, it’s all about keeping your body’s movements synchronized and efficient. Otherwise, your feet, knees, and hips will be dealing with the majority of the impact. Even small twinges of pain in your knees or shins are warning signs that point to your form being off. Based on the findings of your run analysis, your physical therapist will do a more in-depth musculoskeletal assessment and likely begin treatment during that session. This might include manual therapy on any injured joints or muscles, instruction for at-home exercises to help correct problems seen on the video running analysis, or provide a running plan to help you achieve your distance or race goals. A run assessment is the first component of treatment. Baseline measurements about your range of motion, strength, and flexibility are collected during your analysis. That data is used to drive your custom treatment plan specific to how you move. Make sure you focus on injury prevention as much as you focus on hard training. Don’t try and run off those aches.

How Pilates Can Relieve Lower Back Pain

If you have lower back pain, you know that many different types of treatment approaches exist. These include stretching, functional training, postural exercises, hot and cold therapy, and general exercise. How does Pilates fit into the spectrum of lower back treatment options? By combining some of the most important aspects of what it takes to relieve lower back pain. General lower back pain is difficult to diagnose—many different musculoskeletal imbalances could be contributing to your pain. In general, Pilates routines are an effective way to obtain strength, balance, and flexibility throughout your body. They work to specifically relieve lower back pain by targeting the core muscle groups that support the spine.

Better Alignment For A Healthy Back

The structure of the back is designed to act as a support for nearly every move the body makes. Keeping the back pain free involves focusing on the stabilizing muscles that surround your spine in the lower back. Not only that, it’s also key to strengthen the abdominals and obliques around your core. All of these muscles support the alignment of the spine’s natural curvature. Studies have shown that Pilates is more effective than minimal physical exercise interventions in reducing chronic lower back pain. Lower back pain is usually caused by abnormal pulling and tightness of muscles in the area. This happens when muscles in the back compensate for stabilizing muscles that are weak, which could be the ones in your core. By strengthening and mobilizing the muscles that keep your back aligned, you’ll correct the imbalances that may be causing your lower back pain. A simple move to engage your lower abdominals might include The Single-Leg Stretch:

Therapydia Pilates Lower Back Pain Treatment

• Begin on your back with your knees bent into your chest and shins parallel to the floor
• While exhaling, pull your abs in as you curl your head and shoulders up
• Continue until you reach the tips of your shoulder blades
• Extend 1 leg straight to a 45 degree angle
• As you do so, place both hands on the opposite shin
• Place the outside hand near the ankle, inside hand near the knee
• Focus on engaging your core as you switch your legs
• Extend your opposite leg straight and pull the opposite knee into your hands

Extend To Your Neck & Hips

Therapydia Pilates Lower Back Pain Treatment

Certain Pilates movements also focus on getting your hips and neck muscles aligned with the rest of your spine. Your pelvic and neck areas are extensions of your core. Without alignment and stabilization extending up and down into those parts of your body, you’re going to keep having issues in your back. Beneficial movements for your neck and shoulders might include what are called Scapular Isolations:

• Lie on your back with your knees bent
• Reach your hands with your palms facing in straight up towards the ceiling
• Keeping your head down, inhale and reach your shoulders off the mat
• As you do this, focus on stretching upwards

Exercises for the muscles in the neck and shoulders work to increase their range of motion while also strengthening the muscles in your upper and middle back. With lower back issues, increasing strength and flexibility in your hips and glutes also plays a big role in treating pain. Pilates movements such as The Bridge Roll-Up help to strengthen the glutes and core stabilizers while also improving hip extension:

Therapydia Pilates Lower Back Pain Treatment

• Start by lying on the floor with your knees bent and arms at your sides
• Widen across the chest and slowly raise your pelvis and lower back off of the floor
• As you do this, inhale and focus on pulling in towards your belly
• Pause for a bit as you maintain that bridge with your hips and lower back
• Slowly lower your bottom back towards the ground

By keeping your glutes and pelvic muscles activated, you’ll be taking that extra pressure off of your lower back.

Relieve Stress On Your Spine

Therapydia Lower Back Pain Treatment

Pain in your lower back isn’t usually caused by just issues in your back. Pilates strengthens those weaker muscles that stabilize your spine to relieve lower back pain. If you go into Pilates with lower back pain, you may be able to see a decrease in pain and symptoms within 4 to 5 sessions. If you have any conditions that affect the spine such as scoliosis, sciatica, or any nerve impingement consult with your doctor or physical therapist to see which specific Pilates movements would be the most beneficial for your rehabilitation. Almost everyone who goes into a Pilates program with lower back pain would be able to benefit. Athletes have begun to use Pilates as a way to maintain or improve core stability and control for better performance. Even if you sit at a desk all day and feel some tightness in your lower back, working on spinal alignment could offer you the relief you need.

ACL Recovery Timeline: Treatment Breakdown

A common athletic injury that you’ve probably heard about might have to do with tearing the ACL. The ACL, or anterior cruciate ligament, joins the upper leg bone (femur) with the lower leg bone (tibia) and functions as the primary rotational stabilizer for the knee. When you’re moving forward, such as when you’re running, the ACL isn’t really involved. It only comes into play when you’re cutting around or changing directions to stabilize the knee joint area. An ACL injury commonly happens when you rotate too quickly or with too much force in that joint area, which causes your ACL to overstretch and tear. Depending on how badly torn the ligament is, you may be a candidate for surgery to repair the damage. Post-surgery, you will likely feel immobile. You may wonder how you’ll ever get back on your feet again. Although the timeline for ACL recovery varies depending on your specific injury, you should expect 4-6 months of one-on-one treatment with your physical therapist.

Therapydia ACL Injury Treatment

0 Weeks, Treatment Before You Even Have Surgery

Pre-rehabilitation physical therapy, or “prehab”, is a form of physical therapy that begins before you have scheduled surgery. Prehab focuses on increasing strength and flexibility of the muscles in your surgery area. Although the surgery will fix the tear, it will also cause the muscles in the knee area to become weak and stiff. You’ll want to strengthen all the muscles that will aid in keeping you balanced post-surgery. Undergoing prehab before surgery has been proven to improve knee function faster after surgery. One study in 2013 found that patients participating in prehab returned to sports almost 2 months faster. Prehab treatment might involve building up quadricep and core strength pre-surgery so you’ll see greater knee stability and faster recovery post-surgery. It could also involve teaching you how to use assistive devices (i.e. crutches) and tackling tricky movement barriers, such as stairs, so you know how to move around after surgery.

Therapydia ACL Injury Treatment

0-4 Weeks, Baby Steps

Many of the same goals you would want to achieve in prehab also apply here in the initial phases of physical therapy treatment. Some of these processes may vary depending on your doctor’s protocols. Main priorities will be to reduce inflammation, regain range of motion of the knee (i.e. bending and straightening the knee), and begin to slowly withstand bearing weight on your injured knee so you can start to walk. Making sure you have the proper flexibility includes immediate manual therapy, or hands-on techniques, that your physical therapist will perform on the surface of the knee joint and the muscles surrounding it. A common complication post-surgery is stiffness and loss of range of motion because of excess scar tissue formation. Your physical therapist will manually breakdown any scar tissue restrictions that may be developing in your knee. Manual therapy can also help decrease swelling around your knee. You’ll slowly wean off of your dependence on crutches as your knee tolerates. Important exercises in this phase of rehab (i.e. straight leg raises, half squats, partial lunges, etc.) will be targeted toward quadricep strength. By strengthening the muscles at the front of your thigh, walking will become that much easier and the knee will feel more stable.

Therapydia ACL Injury Treatment

4-10 Weeks, Getting Back To Walking

At this point, the goal is to start getting your natural walking pattern back. You want to be able to control your walking movements again, which means you may have to begin some balance training. Both the fact that your knee is injured and that you haven’t been using your injured knee very much will have thrown your body’s sense of balance off. Guiding you back into proper walking form involves a combination of continued manual therapy and personal exercise-based treatment. It’s key to start building up balance on your weaker leg by doing some one-legged activities. There will also be a focus on building up strength and full flexibility in the muscles around your hips as well as the muscles around your knee. With improved strength in your hips and quads, you’ll be putting less pressure on your healing ACL. You’ll be working your way from exercises such as single-leg squats to step-up and step-down techniques (using a step) as well as resistance training with a band.

Therapydia ACL Injury Treatment

12-16 Weeks, Starting Some Light Running

By about 3 months, any swelling you had will likely be gone. You also should have full range of motion in your knee, which means being able to extend and bend without restriction (135-145 degrees for bend, 0 degrees for extend). If you still have muscle stiffness, your physical therapist will apply more manual therapy to any specific muscles that are restricting your ability to extend or bend your knee. Depending on your unique recovery progress, your knee joint may still need to be manually mobilized in a certain way. Any basic aspects of leg movement should be back under control, such as naturally walking or being able to move around casually. Your personal ACL treatment program will continue building strength in your core and lower body muscles. You might be doing some endurance training on a stationary bike, elliptical, or treadmill. At this point, you will want to do some more advanced balance training on balance boards or bosu balls to ensure that your healing leg is stabilizing well. Your physical therapist will want to customize your treatment to make sure that you’re treating any balance issues that were caused by your ACL injury. At some point in this phase, you might begin lightly running, jumping, or getting back into any physical activities you used to do.

Therapydia ACL Injury Treatment

4 Months+, Getting Back In The Game

There’s a range of what patients with a healing ACL injury might begin to do around 4 months. Everyone has different preferred physical activities and you’ll begin to get back into your favorite activities at this point. If you played basketball, you might begin some shooting drills. If you’re a runner, you might begin getting back into some longer jogging. It all depends on what your activity takes to get back into. You don’t want to halt any progress you made by overly exerting your knee, but certain sports-based drills will be okay to practice. Your treatment program post-injury should focus on not only reducing pain, but building up your body’s strength and flexibility in a way that prevents a future ACL tear. Beyond that, you’ll be given the tools you need to have better endurance, balance, and coordination with your healing knee. You may feel totally thrown off balance and mobility-wise after your ACL injury, but one-on-one treatment is meant to steadily get you back to 100%.