4 Exercises for a Stronger Pelvic Floor

pelvic health physical therapy strength exercises women's health

As a part of Therapydia’s Pelvic Floor Dysfunction Treatment, our physical therapists help patients to eliminate symptoms of pain and discomfort by strengthening weakened muscles and relaxing muscles that may be too tight. Along with manual therapy techniques, stretching, and patient education, custom exercises are prescribed to patients in order to increase hip and core strength to provide the necessary tools to eliminate symptoms of pelvic floor dysfunction. Below are a few example exercises utilized in pelvic health physical therapy.

Bridge with Hip Adduction

This exercise increases core activation to help strengthen and stabilize your muscles.


• With your knees bent and your feet on a flat surface, squeeze the Pilates ring using your inner thigh muscles so that your knees, ankles and hips are all in one line.
• Hold this position as you lift your hips up, squeezing through the glute muscles.
• Maintain a tight core throughout to avoid any arching of the back and to ensure proper glute activation.
• Hold for a few seconds at the top and return to the starting position.

Side-lying Hip Abduction

Hip abductor muscles are important muscles that not only contribute to our ability to stand, walk and rotate our leg with ease, but also ensure that the pelvis is stable and functioning properly.



• Lie on your side with your bottom knee bent for stability.
• Roll the top hip forward and contract the lower abs to prevent any arching of the low spine.
• Lift the top leg straight up with the toe pointed forward and squeeze the leg up and slightly back.
• You should feel this exercise in the posterior glute and not in the front or the side of the hip.

Clamshells

Clamshells help to stabilize the pelvis by strengthening the surrounding musculature. Strong hips are important when it comes to the function of your pelvic floor and the prevention of pelvic pain and incontinence.



• Start on your side in a fetal position. Keep the top hip rolled forward and the heels together as you lift the top knee up using your glute muscles. This exercise should be felt in the back of the hip, not in the front, side of inner thigh.
• Make sure that you are not rolling the top hip back as you are lifting your knee.
• Keep the core engaged throughout the entire movement.

90/90 Heel Taps

90/90 heel taps engage the abdominal muscles to promote pelvic stability.



• Start on your back, contract the low abs and lift both legs up to 90 degrees of hip and knee flexion without letting the lower spine come off the table.
• Squeeze the belly button toward the spine and keep the pelvis stable as you tape one heel to the table and bring it back up.
• Alternate legs and make sure that you are not arching through the lower spine.
• Perform this exercise to fatigue.

If you experience any pain with these exercises, stop immediately and contact a Therapydia physical therapist.

What is Visceral Mobilization?

visceral mobilization manipulation physical therapy treatment denver

Part of the manual therapy umbrella, visceral mobilization (aka visceral manipulation) is a hands-on treatment technique used to mobilize the organs.

When everything in your body is working properly, all of your organs should move and slide over each other smoothly. Unfortunately, strain, overuse or poor posture can cause organs like the kidneys, bladder and intestines to get a little “sticky” which may lead to your internal tissues binding together. This can create adhesions which, once formed, may cause areas of tension that make the organs stick together. This can lead to discomfort and decreased function.

Visceral Mobilization is helpful for those who have had any type of abdominal surgery including hysterectomy, C-section, GI surgeries, etc. It can also be beneficial for those who have a lot of scar tissue, common in athletes who play sports with a lot of blunt-force trauma such as football or hockey. The same way that we get scar tissue in the knee joint, scar tissue can form around the organs, limiting motion. This scar tissue is actually formed by your body as a type of protection. Visceral mobilization can be very relevant for lower back and hip pain and may also help with digestion issues like constipation. Though it may seem like a massage as your physical therapist is performing visceral mobilization, they’re not actually changing the tissue. Instead, they’re attempting to elicit a neurological response or more simply, trying to direct the brain’s attention to a specific area in order to get the tissue to relax.

This video created by Albert W. Stern explains the process in a very simple, straightforward way:

Strength Exercises for Baseball Players

overhead-athlete-baseball-physical-therapy

Strength training is extremely important for baseball players when it comes to working on things like shoulder stability, injury prevention and maintaining strength throughout the season. Now that baseball season is in full swing, we at Therapydia wanted to provide some great exercises for overhead athletes.

Many of the exercises below are focused on the backside of the shoulder because when an athlete throws forward, all of the deceleration components (everything that slows the arm down) is on that backside. The posterior rotator cuff is one of the main stabilizers of the shoulder and it needs to be really strong in order to protect your arm during a throwing motion. These exercises are designed to increase strength and support during that overhead movement as well as to help increase the compressive forces of the arm bone into its socket to avoid excess strain from the torque when you throw.

Exercise 1: Internal Rotation at 90/90

 

• Close the resistance band in a door and hold your arm out to the side, as if you’re getting ready to throw.
• Rotate your arm forward until your forearm is parallel with the floor. Hold and return to the upright position. Repeat.

Exercise 2: External Rotation at 90/90

 

• Face the door and hold your arm out to the side, elbow bent to 90 degrees and your palm facing forward.
• Rotate your hand up and away from the door. Briefly hold the position and then bring your arm back down. Repeat.

Exercise 3: D2 Flexion

 

• Start from your opposite hip, arm held down across your body.
• Keep your left arm stationary and move your right arm diagonally through the midline while you rotate your shoulder up and away from your body.

Exercise 4: Band-Resisted Overhead Throw

 

• Perform the throwing motion with a resistance band.

Exercise 5: Sidelying External Rotation

 

• Lie on the side of your non-throwing arm, place a rolled-up towel under your throwing arm to maintain a neutral shoulder.
• Keep your arm at a 90 degree angle and lift your hand without rotating your trunk or bringing your shoulder blade back too far.

Exercise 6: Sidelying Shoulder Flexion

 

• Lie on the side of your non-throwing arm. Keep your free arm straight.
• Holding a small dumbbell, follow a horizontal plane and lift your arm up (there shouldn’t be any pain with this movement).

The combination of some of these exercises and making sure that you have appropriate mechanics and mobility through your shoulder can help to prevent injury and avoid wear and tear throughout your season.

Simple Movements for Neck and Upper Back Pain Relief

neck pain relief back pain relief

Therapydia physical therapist Aaron Page, DPT gives us a couple of quick tips to alleviate neck and upper back pain. These simple exercises can be performed almost anywhere and can help you break out of that slouching position that is so easy to fall into. Sure, you may get a couple of odd looks in the office but these stretches will keep your neck and back moving to decrease pain associated with poor posture.

Spine Extension & Pec Stretch

This movement uses the back of your chair and helps to extend through your thoracic spine and stretch out your pec muscles.

• Find the tight spot right at the base of your thoracic spine.
• Interlace your hands back behind your head. Keep your elbows tucked and pointing forward. Keep your head relaxed.
• Tuck your head in and come up over the top of your chair.
• Move up or down an inch or so to find the stiff spot in your upper back.

Make sure that you’re not hyperextending through your low back but emphasizing movement through your upper back to help offload your neck. If the height of your chair isn’t cutting it, use a small towel roll to pin the spot right underneath the area of your stiff upper back.

Lats & Chest Stretch

This doorway/wall exercise works on extending through your upper back, stretching out your lats and the front of your chest. It’s sort of a double dip between a stretch and a thoracic spine mobilization.

• Position yourself a comfortable distance away from the wall, hands in.
• Push your butt back, keeping your spine in a neutral position.
• Look straight down and think about sinking your chest bone down towards the floor.
• Stretch down along the other sides of your arms and move through your upper back.

Dynamic Pec Stretch with Trunk Rotation

• Place your forearm up against the doorway. Bring your opposite foot forward so that you’re in a neutral position.
• Take a small lunge and add in a rotation away from the door jam so that you’re pulling from your pec and not just the front of your shoulder.
• Rotate back one step and repeat. Make sure that you’re pulling through the front of your chest.

Learn more about Neck Pain / Back Pain

Get to Know Your PT: Aaron Page, Therapydia Denver Physical Therapist

Therapydia Denver physical therapist Aaron Page takes some time to talk smoothies, his recent move to Colorado, and what he wishes everyone knew about PT.

“The best workout plan is something that’s sustainable. In order to create lasting change, it needs to be approachable and repeatable.”

When did you know that you wanted to be a physical therapist?

Like a lot of physical therapists I know, I was an athlete growing up and had my fair share of injuries, so I was exposed to PT early and often. I got to know a great PT in my area when I was 15 or so, and he was a clear example of someone who cared about his patients and I wanted to be a practitioner like that. I guess I officially knew in undergrad when I decided to switch my major from Biology to Health and Human Sciences and move forward to grad school with being a PT as my goal.

What is the biggest challenge involved in being a PT?

The biggest challenge for a PT (besides the paperwork) is not falling into specific patterns of treatment. It’s easy to start going down similar paths of rehab with patients that may be exhibiting similar characteristics. The important thing to keep reminding yourself that each patient is unique and small nuances in care can make a big difference, so you need to be constantly reflecting on your choices and adapting to new information.

How do you like to stay active?

I recently moved to Colorado so anything I can do outdoors like hiking or biking has been great. I’m a fan of resistance training too and try to incorporate that into my treatment sessions, so I’m training in the gym as well to make sure I don’t ask my patients to do anything I can’t do.

What’s your favorite song to get you motivated?

It’s kind of obscure, but my go-to song for motivation is “Quiet Little Voices” by We Were Promised Jetpacks. I like songs that build throughout and this one does that really well. It’s super helpful on a run when the tempo picks up and the band gets louder as you go on.

What surprised you the most about the physical therapist profession?

Realistically I think what most surprised me was the difficulty of navigating the healthcare system. It seems like it should be something that works for you when you need it, but often times we’re faced with the challenge of trying to provide quality care within the confines of an insurance plan that makes it difficult for patients and practitioners to access all of the benefits they pay for each month with their premium. It seems crazy to me to have to justify care in certain situations that warrant it and still have hoops to jump through to make it happen.

Are you currently pursuing any further education/certifications?

I’m in the process of reviewing to get my CSCS (Certified Strength and Conditioning Specialist) and plan on getting my OCS (Orthopedics Certified Specialist) in the next few years. In the mean time I’m looking to take a course on Functional Range Conditioning to update on some movement systems.

What is the biggest misconception you hear from new patients?

The biggest misconception I get all the time is that PTs just do massage and stretching. Though those can be helpful in their own way and are sometimes incorporated in a treatment plan, physical therapy is much more than that. I wish everyone knew that PTs are movement experts and evaluating how your body moves and can (or cannot) control movement is a unique and challenging aspect for clinicians. I always try to emphasize that the more active a patient is in their treatment the better the outcomes.

What’s your go-to breakfast?

I’m usually trying to get something quick, so I’m a big smoothie guy. My go-to is usually spinach, almond butter, bananas, some sort of berry and almond milk. It’s either that or some Greek yogurt, raspberries and granola. I basically eat the same thing every morning haha.

What is the most important personality trait that a PT must have?

Most importantly, physical therapists have to be compassionate. Truly listening to your patient and finding a way to meet them where they are is crucial. If you don’t value your patient’s goals as your own, it can be tougher to get them there.

What do you do to de-stress/unwind?

I usually try to read. I bounce back and forth between fiction and non-fiction, but it’s easy for me to get caught up in what I’m reading and it helps to take my mind out of its normal space.

Finish this sentence: On Saturday mornings, you can usually find me…

On my way to find an egg-everything bagel and an iced coffee treat.

What is your favorite piece of wellness advice to offer?

The best workout plan is something that’s sustainable. Sometimes we ask our patients to do a lot in the name of rehab, but what we’re trying to instill more often than not is consistency. In order to create lasting change, it needs to be approachable and repeatable.

Click here to learn more about Aaron and the other physical therapists at Therapydia Denver.

Get to Know Your PT: Josh Hardy, Therapydia Denver Physical Therapist

Therapydia Denver physical therapist Josh Hardy takes some time to talk about his love of the mountains, staying active year-round, and how a high school basketball injury led to a career in PT.

“Find fun things to do that will keep you fit. You’ll never work out another day in your life.”

When did you know that you wanted to be a physical therapist?

When I was a junior in high school. I fractured my pelvis during a basketball game and ended up doing a fair amount of PT to get ready for track season. Spending time with my physical therapist got me interested in anatomy and biomechanics and I never looked back.

What is the biggest challenge involved in being a PT?

Honestly, the paperwork. It is tough to give your patients what they need and deserve in each visit while staying on top of your charts. In a busy week, you can easily end up doing 10-15 hours of paperwork on top of seeing 40 hours worth of patients.

How do you like to stay active?

In the summertime I love to hike, cycle, camp, and fly fish. In the wintertime I love to snowboard and snowshoe.

What’s your favorite song to get you motivated?

“17 Years” by Ratatat. It can get me excited to do anything from snowboarding to paperwork. That song just really gets me going.

What surprised you the most about the physical therapist profession?

How much health insurance influences care. In situations where a lot of rehab is needed (ACL reconstruction, rotator cuff repair, etc.), you really have to look at the patient’s insurance situation and strategize about how to ensure that they make a full recovery within the confines of their benefits.

Are you currently pursuing any further education/certifications?

Next on my continuing education list is definitely a shoulder course. Bigger picture, I’m always considering going back to get my PhD and someday contribute to the PT profession as an educator.

What do you wish everyone knew about physical therapy?

With most insurance plans you can come straight to physical therapy. If you have a musculoskeletal issue, you can often save yourself a copay and potential added costs of imaging by going to the practitioner that is ultimately going to get you healthy again (your PT).

What’s your go-to breakfast?

2 farm freshies sunny side up, 1 strip of bacon, wheat toast.

What is the most important personality trait that a PT must have?

You have to be outgoing and enjoy speaking with people. A big part of the job is having 15 to 20, 30-minute conversations per day.

What do you do to de-stress/unwind?

I like to get out of the city and up into the hills. It doesn’t really matter what I’m doing, I’m always happy if I’m in the mountains.

Finish this sentence: On Saturday mornings, you can usually find me…

Heading west on I-70

What is your favorite piece of wellness advice to offer?

Find fun things to do that will keep you fit. You’ll never “work out” another day in your life.

Click here to learn more about Josh and the other physical therapists at Therapydia Denver.

3 Exercises for Plantar Fasciitis Pain

3 exercises for plantar fasciitis

As one of the most common sources of heel and foot pain that we encounter in physical therapy, plantar fasciitis can often show up without warning, becoming a constant source of pain and disability. If you’re experiencing any symptoms of plantar fasciitis—pain with the first step in the morning, discomfort in the heel or arch while walking after prolonged sitting, or a sensation of a lump or rock in the shoe—early treatment is key to avoiding long-term problems and more aggressive treatments like injections or surgery. If you have heel or foot pain, try these three exercises to strengthen key muscle groups and reduce the amount of force that is placed on your plantar fascia during weight-bearing activities.

Leg Wave

The leg wave strengthens the hip abductor musculature to keep too much stress from falling on the arch of your foot and irritating the plantar fascia.

1. Lying on your side, lift your leg and turn it slightly inward.

2. Bring the entire leg forward and then backward, trying to draw a perfectly level line.

Calf Stretch with Arch Support

This exercise stretches the musculature that ultimately becomes the plantar fascia.

1. Get into standing position with one foot about two feet in front of the other, front leg slightly bent.
2. Place a towel under the arch of the affected foot in order to keep a neutral position and to isolate the stretch and the correct tissue. Feel the stretch in your calf.

3. Move the foot forward and perform the same stretch with a slight bend in the back knee.

Great Toe Extension

Decrease pain of the first steps in the morning with this stretch that can be performed before you even get out of bed.

1. Sitting up, cross your leg over the unaffected leg.
2. Grab your first toe and pull it back.

3. Using the knuckle from your other thumb, move your thumb up from the heel to the toe as you use the other hand to pull the toe back.

4. Repeat 20-30 times before placing weight on the foot.

5 Benefits of Pilates for New Moms

The amount of change that comes along with new motherhood is massive. Caring for a newborn, adjusting to a new life, new priorities—it’s not uncommon for new mothers to overlook their own personal well-being. Unfortunately, back pain, feelings of weakness, and muscle soreness are very common among mothers after giving birth.

There is a great deal of research showing the benefits of Pilates for feeling great, both physically and mentally. As an effective treatment technique used in physical therapy, Pilates encourages movement and doesn’t put too much stress directly upon the injured area while still providing the tools to increase strength and flexibility. There are a number of advantages of Pilates movements for new mothers in particular.

Pilates-Denver-Physical-Therapy-Moms

Remember not to return to exercise too soon after pregnancy and always follow the advice of your doctor or physical therapist. Pushing yourself too soon can potentially make recovery take even longer than if you waited the appropriate amount of time. Listen to your body and take breaks when necessary.

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.