Happy National Physical Therapy Month!

by Sally Fansler, PT

Every October we celebrate National Physical Therapy Month, an annual opportunity to raise awareness about the benefits of PT. We are proud of our profession and feel grateful to be able to help people move better, achieve their goals, and live pain-free every day!

Rocking the Wall

by Constance Karwandyar, PT

If you’ve ever been inside Lakeshore Sport and Fitness at the Illinois Center in downtown Chicago, the first thing you’ll likely notice is the monumental rock climbing wall. Spanning 10 stories, this wall currently sits as the tallest indoor rock wall in North America! While humans have always been drawn to scaling heights, rock climbing as a common indoor sport only dates back to the 1980s. As the sport grows in popularity, so too, unfortunately, do the number of rock climbing related injuries that often go undiagnosed and untreated.

According to a recently-published article in PT in Motion magazine, some of the most common rock climbing related injuries involve the hands, elbow, and shoulder due to the pulling nature of the sport and strong need for finger and hand holds. Landing and falling related injuries are also common in the foot and ankle. Jared Vagy, DPT - dubbed “The Climbing Doctor” due to his extensive experience in both physical therapy and rock climbing - claims that 40% of rock climbing injuries are in the fingers. Strains to the pulleys of the finger are common due to the overuse of the flexors of the fingers and wrist. The pulleys on the palm side of the fingers work to hold the finger flexor tendons close as they slide back and forth when we curl and extend our fingers (think of the rings on a fishing pole that the fishing line runs through). A strain or rupture to one could cause bowstringing of the flexor tendons, difficulty with curling and extending the fingers, swelling, and pain.

An illustration of the flexor tendons in the fingers.
By Steve Graepel, www.rockandice.com.

As with any sport, injury prevention and education is a top concern for physical therapists.
Imparting specific and proper warm-up techniques to climbers is key to making sure they prime their entire bodies before they ascend any indoor wall or mountain face. Using larger hand holds on the first ascend allows proper blood flow to enter the upper extremities, especially in the hand and fingers. Climbers can also use a “downclimb” to work these muscles eccentrically, lowering themselves in a slow and controlled manner instead of repelling down the wall on the first climb. Properly warming up “pulling muscles” such as lats, biceps, and rhomboids will also ensure proper blood flow and tissue temperature before climbers begin. 

Even with proper warm-up technique, injuries do still occur. Rehabbing a climbing injury takes some critical thinking to identify the root of the injury and not just simply treat the symptoms. For example, if a climber experiences a finger injury, it is important to assess shoulder, core, and lower body strength, as a deficit in any of these categories can cause an over-reliance on the fingers during holds and grips. Additionally, working on upper body strengthening and stability training in a closed kinematic chain (hand on the ground, wall, or rock wall) as opposed to open kinematic chain (hand free in the air such as swinging a baseball or performing a bicep curl) can mimic the way the rotator cuff and scapular muscle have to work together on the rock wall.

Another key component to prevention and treatment is training the antagonist muscle groups (or the opposing/opposite muscles). As previously mentioned, climbers tend to overuse and overdevelop the forearm/finger flexors so working on strengthening the forearm/finger extensors to improve balance is important. Below you will find a few examples of how to strengthen finger extensors at home.

(L) Half Crimp Extensor Isometric, (R) Open-Handed Extensor Isometric

Resisted Finger Extension

As with any injury, thorough assessment of strength, range of motion, and body mechanics is key to a proper diagnosis and treatment approach. No two rock faces are the same, just like no two finger injuries are the same. If you have experienced a rock climbing injury or are interested in learning proper warm up and injury prevention techniques before your next climb, come see one of our experienced clinicians. Complimentary injury assessments are also available in-person or via telehealth.

References:

Ries, Eric. “It’s Lovely at the Top.” PT In Motion Magazine, June 2020

Ries. Eric. “The Free Solo Phenomenon.” PT In Motion, June 2020 

“Taking and Analyzing Risks with the Climbing Doctor.” The Prehab Guys Audio Experience 

podcast. Episode #47. 2 May 2020.

The Rockulus: Learn the Ropes. www.therockulus.com

Vagy, Jared. Climb Injury-Free: A Proven Injury Prevention and Rehabilitation System.

Getting Fit While You Hit

by Nick Strutz, Personal Trainer

This month, we've invited LSF personal trainer Nick Strutz to be our guest blogger.

A couple of years into my career as a personal trainer, I felt the need to expand my arsenal of tools to help my clients along their fitness journeys. I wanted something that was powerful and efficient in delivering results, as well as something that was dynamic and fun enough to make exercise something my clients could look forward to. That’s where boxing came in.

Boxing can be one of the most well-rounded approaches to getting into the best shape possible. Who doesn’t want to burn fat, increase cardiovascular endurance, target both upper and lower body muscles, improve coordination, release stress, and have fun all at the same time? Studies consistently show that, when done right, adding boxing to a fitness routine can decrease visceral fat, improve cardiac output or VO2 max, and lower one’s resting heart rate (1). In addition, boxing has been shown to be an effective treatment for the symptoms of Parkinson’s Disease. In one study, 83% of participants with Parkinson’s showed improvements in gait, balance, and overall quality of life (2).

It helps to do a little homework before jumping in. I wanted to make sure I didn’t hurt myself while learning the ropes and getting comfortable with boxing, and certainly didn’t want any of my clients to suffer injury, either. Here are a few helpful tips I’ve picked up along the way to make sure boxing is done as safely as possible:

• Those dealing with any injury or chronic condition, especially in the wrist, elbow, shoulder, or neck should exercise caution in trying boxing.
• As with strength training, circuits, or cardio, at least a light warm-up is helpful in preventing injury.
• Before getting the gloves on, it is important to wrap the hands. Wraps can either be attached quickly with a Velcro sleeve, or the old-fashioned way with long ribbon-like wraps. This provides cushion and stability to the small joints in the knuckles and wrists and helps absorb the impact of punches.
• When throwing a punch, be sure to keep the abdominal muscles engaged and the glute muscles active when necessary.
• Before the punch lands, whether on a speed bag, heavy bag, or your trainer’s focus mitts, you will want to clench your fists to provide additional stability to the wrist.
• When getting your head out of the way of a swipe as a defensive maneuver, be sure to step back with your back foot as opposed to arching your low back (bending at the low back to get out of the way).

Whether you want to blow off steam after a tough work day, learn self-defense, or incinerate body fat, there is something for everyone in boxing. When you feel ready to take your fitness to the next level, give it a try!


References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234943/ 
2. https://academic.oup.com/ptj/article/91/1/132/2735142

Additional resources:
Halbert, C. (2003). The Ultimate Boxer: Understanding the Sport and Skills of Boxing. Impact Seminars, Inc.

Working (on Posture) From Home

by Kelly Thomsen, PT

With millions of Americans working from home, ergonomics and posture are more important than ever. As many of us had to set up home offices quickly, we may be starting to feel the effects of working at a table that is too low, hunching over a laptop, or sitting in a chair that is too high. Let’s take a look at how to make working from home feel better through proper ergonomic posture.

 

Good posture, also known as keeping a “neutral spine,” is the result of the work of several muscles, with the shoulder blade and abdominal musculature being some of the most important. Scapular muscles (shoulder blade) need to be strong in order to keep the shoulders from hunching forward, which in turn keeps the neck in a neutral position. The abdominals, along with low back musculature, work to keep the trunk in an upright posture.

Unfortunately for us, sitting in a chair all day can cause joints to feel tight and stiff. Prolonged sitting can lead to tightness in the iliopsoas (hip flexor) muscle, as well as decreased blood flow to the gluteal musculature, which assist in supporting the spine.  Slouching can cause a strain on spinal ligaments and discs, leading to back pain and stiffness. Sitting for long periods also increases the likelihood of poor postural habits. When working on a computer all day, it is easy to fall into a hunched posture, with the neck forward and shoulders rounded.

To improve your postural alignment, try the following:

• Sit up straight and keep back and shoulders flat against the chair. Utilize a lumbar pillow or towel roll for extra support to your low back.
• Keep feet on the ground and avoid crossing your legs or ankles.
• Computer screen should be at eye level.
• Elbows should fall flush with the table, with wrists in neutral position on the table. 
• Be creative! Use items from around the house to create a proper workstation.
• Books to increase laptop height so it is level with eyes
• Stool to place under feet if feet do not reach the floor 

Proper posture can take some getting used to, so here are some exercises that can help train your postural muscles.

• Scapular Retractions – Squeeze shoulder blades down and back.
• Chin tucks – Slowly draw your head back so that your ears align with your shoulders.
• Bridges – Lying on your back with knees bent, tighten your lower abdominals, squeeze your buttocks and then raise your buttocks off the floor/bed as creating a "bridge" with your body. Hold, then lower yourself and repeat.
• Doorway stretch –  Standing in a doorway, place your arms up on the door jam of the doorway frame. Step through the doorway with one foot, and bend the front knee until you feel a stretch through the chest. Your upper arms should be parallel to the ground and forearms should lie up along the doorframe, perpendicular to the ground. 

Most importantly, get up and move! A study conducted by Diaz et al. (2017) showed that adults who sit for 1-2 hours straight without moving have a higher mortality rate than adults who sit for the same total amount of sitting time in shorter stints. In addition, prolonged sitting has been linked to chronic diseases such as diabetes, cancer, cardiovascular disease, obesity, and metabolic syndrome. To combat this, try setting a timer to remind you to stand up to walk around and stretch every 30 minutes. This will help keep joints and muscle from stiffening up. Working in a standing position at a counter or high table for part of the day can also help keep the body more limber.

 

 

References

1.     Columbia University Medical Center. “Long Sitting Periods May Be Just as Harmful as Daily Total.” ScienceDaily, ScienceDaily, 11 Sept. 2017, www.sciencedaily.com/releases/2017/09/170911180004.htm.

2.     Corliss, Julie. “Too Much Sitting Linked to Heart Disease, Diabetes, Premature Death.” Harvard Health Blog, 22 Jan. 2015, www.health.harvard.edu/blog/much-sitting-linked-heart-disease-diabetes-premature-death-201501227618.

3.     Diaz, Keith M., et al. “Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults.” Annals of Internal Medicine, vol. 167, no. 7, 2017, p. 465., doi:10.7326/m17-0212.

4.     Edward R. Laskowski, M.D. “Sitting Risks: How Harmful Is Too Much Sitting?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 May 2018, www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/sitting/faq-20058005.

5.     Pronk, Nicolaas P., et al. “Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011.” Preventing Chronic Disease, vol. 9, 2012, doi:10.5888/pcd9.110323.

6.     Zemp, Roland, et al. “Occupational Sitting Behaviour and Its Relationship with Back Pain – A Pilot Study.” Applied Ergonomics, vol. 56, 2016, pp. 84–91., doi:10.1016/j.apergo.2016.03.007.

Treating Back Pain: A Spine of the Times

by Jill Jonda, PT

You’re 34 years old with a 9-5 desk job, but you still regularly go to the gym and play a couple pick-up games of basketball a week. One day you wake up and have nagging, gnawing pain just to the right of your spine in the low back. You wait a couple days and it’s not getting any better: in fact it’s traveling into your right buttock. You think, “But I’m just 34 years old! What’s happening to me?”

Unfortunately, this is a pretty common internal dialogue. According to the NIH, about 8 of 10 adults will experience back pain at some point in their lives. Luckily, physical therapists are equally as used to diagnosing and treating back pain, and the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is a well-studied, noninvasive approach for diagnosing and treating pain of a mechanical origin (mechanical pain).  But what is “mechanical pain?” 

Mechanical pain is produced when a stress or force is placed on an anatomic structure and can be aggravated or relieved with greater or less deformation on those tissues. You can demonstrate this easily with just a finger: if you bend your index finger backward to the point of resistance, you’ll experience a strain. Initially, it’s uncomfortable but as you hold it there, pain – the brain’s way of saying to the body, “Stop doing that!” – starts to set in. Once you relieve the stretch on the finger, the pain should subside. The same is true of mechanical pain: many times it completely goes away once the mechanical stress is eliminated.

More often than not, back pain originates from mechanical stress. The spinal column consists of vertebrae and intervertebral discs, which sit between each vertebra. The disc is a very mobile structure consisting of 2 layers – an outer fibrotic layer and an inner gelatinous layer – kind of like a jelly donut. When we flex our spine (bending forward and rounding it), we put greater mechanical stress on the front portion of the disc. The disc becomes displaced backward to the area of least pressure. This generally isn’t a problem, but repeated force on the front portion of the disc can cause the back portion to weaken and start to bulge. The bulge can press on nerve and/or other tissues along the spine, causing pain in areas away from the spine, such as in the buttock or even into the leg (sciatica). Eventually, a bulged disc can lead to a herniation: the jelly center of the disc begins to squish out of the fried dough part, and that’s not ideal for donuts or spines.

As physical therapists, it’s our job to evaluate each of our patients and treat the not only the symptoms but also the cause of their pain, while also preventing similar pain to return in the future. I know my patients think I’m the “posture police,” but for those with pain originating from either the cervical or lumbar spine, I always recommend sitting with good lumbar support in a firm chair to promote a neutral spine. Sitting with slouched posture is bound to produce some sort of mechanical pain, either in the neck or low back, because of the stresses placed on the spine. Also, if sitting is bothersome, stand up and reverse the curvature in your spine by walking around for a few minutes.  Remember, you should see your PT or healthcare provider if your pain isn’t improving. We can help you stand (and sit) corrected!

Resources: 

Treat Your Own Back by Robin McKenzie

The Home Stretch

by James Bansberg, PT

Some of the most common advice we receive when we complain about a newly discovered ache or pain is to just “stretch it out.” But what does that even mean? How long do I hold it? When should I do it? Do I just throw my leg up on a table for a couple of seconds and beg the pain to go away?

Most of what we know about stretching is either a myth or based heavily on outdated science. Worse yet, when speaking to various health professionals, their recommended duration for stretching can vary greatly, which can be confusing and sometimes discouraging for their clients. Luckily, a 2018 study by Thomas et. al has helped answer some of these questions. The study focused on most effective form of stretching for improving range of motion, as well ideal stretch duration and frequency.

Despite its vilification in recent media, the researchers found that static stretching was more effective than other forms of stretching for improving range of motion long term. This doesn’t mean that static stretching should be the only form of stretching utilized in a regular workout program, however. Other studies have discovered the benefits of other forms such as dynamic and ballistic stretching, especially prior to activity.

As for duration, there’s good news for the more impatient types: a 30-60 seconds hold was as beneficial as other, longer durations (60-120 seconds and over 120 seconds). Consistency, however, was key: the research showed stretching more than 5 times a week was more effective than 2-3. Interestingly, 7 days of stretching per week did not yield better results than 5 days, making the sweet spot between 5-7 days per week.

The final portion of the study looked at optimal time spent per week stretching to maximize mobility changes. Surprisingly, a minimum of 5 minutes was required for significant changes, with the ideal time being anywhere between 5-10 minutes.

Ultimately, some stretching is better than no stretching, and recent studies have found benefits to other forms of stretching as well as foam rolling. However, even stretching has a proper dosage, so it is important we utilize available evidence to guide our decision-making so that we are able to reap the greatest benefit. 

References: 
Thomas E., Bianco A., Paoli A., Palma A. The Relation between Stretching Typology and Stretching Duration: The Effects on Range of Motion. Int. J. Sports Med. 2018;39:243–254. doi: 10.1055/s-0044-101146.

Keeping Knees Healthy this Fall

by Constance Taras, PT

 As fall is now upon us, so too is the season of football. For a few unlucky players, however, the season is already over, with preseason injuries benching them for the rest of the season. In the NFL, an average of 23 ACL injuries occur before the first game of the season is even played, and it doesn’t stop there: according to the ACL Recovery Club, a total of 51 players tore their ACL during the 2017 season. The good news is that current evidence strongly supports the use of knee and ACL injury prevention programs to decrease the risk of injury and ensure a successful (and long) season for any athlete.

The knee joint is a hinge joint held together statically by 4 main ligaments: anterior cruciate

ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). Although there are many, the main dynamic stabilizers of the knee consist of the quadriceps, hamstrings, calf, and gluteal muscles. The knee is meant to move in one plane of motion creating both flexion (knee bent) and extension (knee straight). It does, however, allow our bodies to move laterally, pivot, and change directions quickly when healthy. If the knee demonstrates decreased strength, muscle imbalance, range of motion, or flexibility in the surrounding tissues, it can be predisposed to injury.

To help prevent injury, the literature cites a combination of dynamic stretching, running drills, strength training, plyometric drills, and core exercises that should be included in knee injury prevention programs. These should be completed for at least 20 minutes several times a week, starting in the preseason and carrying through the regular season. Examples of each are outlined below.

Dynamic Stretching 

High knees, butt kicks, font/side leg swings, Frankenstein walk

Running Drills 

Forward running, backward running, zig zag cone drills, bounding

Strength Training

Double- and single-leg squats, banded hip strengthening, Nordic hamstring curls

Plyometric Drills 

Skater jumps, double leg and single leg hops, box jumps

Core Exercises

Front planks, side planks, bridges

Make sure to tailor your program to be sport-specific and elicit the help of your local physical therapist for ideas on your personalized knee injury prevention program!

Sources Cited:

“Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention” (J Orthop Sports Phys Ther. 2018;48(9):A1–A42.

“JOSPT Perspective for Patients Knee Injury Prevention: Exercises to Kepp You From Getting Sidelined” published in Journal of Orthopaedic & Sports Physical Therapy, 2018 Volume:48 Issue:9 Pages:734–734 DOI:10.2519/jospt.2018.0509

Direct Access for Physical Therapy in Illinois!

by Lauren Sweeney, Office Manager

August 17 was a day like any other in our office: we treated patients, we answered billing questions, we scheduled future appointments for care. But it was unlike any other day in one very important regard: we no longer had to ask patients, “Do you have a prescription from your doctor?”

Up until last month, Illinois state law required patients to have a doctor’s prescription prior to seeking treatment from a licensed physical therapist. On August 16, however, Governor Bruce Rauner signed into law a bill that allows patients in the state of Illinois to have direct access to physical therapy treatment. Patients seeking physical therapy may now simply book an appointment to do so, no differently than they would with their GP or dentist.

This is hardly a revolutionary idea, either. Illinois was one of the last states in the nation to adopt the bill, which is expected to reduce the need for unnecessary X-rays, MRIs, and opioid prescriptions. According to a recent BlueCross BlueShield study, direct access to physical therapy led to a 31% reduction in total health care costs and a 90% reduction in opioid use.

Research also reveals that patients who visited a physical therapist directly for outpatient care had fewer visits, leading to lower overall costs. A study published by the Journal of Orthopedic and Sports Physical Therapy discovered that patients who decide to choose physical therapy as their first treatment option for spine management saved an average of $1543 in their overall care as compared to patients who chose the traditional medical referral route. Both groups showed similar clinical improvement in their symptoms. 

That said, the law does come with stipulations: a physical therapist must refer a patient to a health care professional if the patient does not demonstrate measurable or functional improvement after 10 visits or 15 business days, whichever occurs first. Additionally, this law does not affect Medicare patients, who are still required to have a prescription for physical therapy prior to treatment per federal law. Most patients, however, now have the ability to seek treatment that is safe, effective, non-addictive, and non-invasive for many painful conditions.

Our physical therapy community is confident that with fewer barriers, the patient can choose physical therapy as a first treatment option, leading to a speedy, safe and less expensive recovery.

Resources:

https://www.jospt.org/doi/abs/10.2519/jospt.2018.7423

Improving Fitness with a Good Night's Sleep

by Chase Irons, Personal Trainer

This month, we've invited LSF personal trainer Chase Irons to be our guest blogger.

In my 10 years of personal training I’ve heard all sorts of bizarre and unusual questions and comments about health and fitness. A question that I get far too often, however, is something along the lines of, "How little sleep can I get by with while still being able to function optimally?" It isn't a question limited to personal training, either: at one point or another, all of us have likely wished we didn’t have to sleep so we'd have more time in the day to get things done. More than that, there are even all kinds of products on the market that claim to be able to help us keep going longer on less sleep. 

Luckily, scientific research on sleep and its effects on the body are plentiful. In a 2010 study, researchers sought to determine whether a combination of sleep deprivation and a moderate caloric deficit would affect results in body composition. For 14 days 3 women and 7 men were instructed to stay in bed for either 8.5 hours or 5.5 hours per night, and their meals were standardized at about 1,450 calories per day. Three months later, the study was repeated for another 14 days with the same participants.

At the end of the study the researchers found that both groups had a nearly the same weight loss of around 6.6 pounds. However, the 8.5 hour group had lost equal amounts of muscle mass and fat mass, while 80% of the sleep-deprived group's loss was lean mass while only 20% was body fat. That means that with all other factors held the same, only a fifth of the sleep-deprived group's weight loss was actually from body fat.

So what exactly is going on in the body to cause this phenomenon? In sleep-deprived individuals there are a few hormones that get knocked out of balance: they produce less leptin, more ghrelin and more cortisol. Decreased production of leptin can make the stomach feel empty. Increased ghrelin production triggers the body's tendency to store fat, reduce the amount of calories it burns, and stimulate hunger. Cortisol is a stress hormone frequently associated with fat gain and muscle wasting, and it also makes us crave sugary and fatty foods. To successfully lose fat we need to optimize leptin, ghrelin and cortisol, but sleep deprivation will make that nearly impossible.

Even if we stick to our diets and hit the gym, sleep deprivation makes it so that the calories we burn come from more from stored energy and less from stored body fat. Because of the muscle-wasting cortisol and the increased hunger because of the lowered leptin and raised ghrelin, it's going to take that much longer to see a positive change in our bodies.

So make it easy on yourself! Get the sleep your body needs so that you aren't working against your goals.

Additional Resources:

Insuffient sleep undermines dietary efforts to reduce adiposity, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951287/

Impact of Five Nights of Sleep Restriction on Glucose Metabolism, Leptin and Testosterone in Young Adult Men

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0041218

Influence of partial sleep deprivation on energy balance and insulin sensitivity in healthy women.

https://www.ncbi.nlm.nih.gov/pubmed/20054188

Sleep loss results in an elevation of cortisol levels the next evening.

https://www.ncbi.nlm.nih.gov/pubmed/9415946

Sleep restriction for 1 week reduces insulin sensitivity in healthy men.

https://www.ncbi.nlm.nih.gov/pubmed/20585000

Postural Restoration

by Stephanie Korso, PT

Although the human body may look symmetrical to the naked eye, the right and left sides of our body are actually asymmetrical. For example, we have a heart on the left side of our body and a liver on the right side. Our right hemi-diaphragm is larger and more domed than the one on our left, putting it in a better position to function. The left side of our brain controls the right side of our body and vice versa. Since the left side of the brain is primarily responsible for motor planning, most people are right side dominant, regardless of hand dominance. These asymmetries are balanced through integration of system imbalances. If the asymmetries are not balanced, then postural patterns can emerge. These postural patterns may then contribute to weakness, instability, and various pain syndromes. 

So…what’s a postural pattern? This is when our body gets stuck in a certain position. But we’re not just talking about bony alignment and how we look when we stand up tall or sit at our desks: we are referring to our body at any given moment in time. Posture involves coordination of multiple systems, not just the musculoskeletal system, and is constantly changing. Ideal posture involves a homeostatic state when nothing is working harder than anything else and where our overall body system can shut down. In this state of neutrality, we efficiently balance our various asymmetries. 

The Postural Restoration Institute has developed three main stages to restore optimal posture:

1. Reposition – this involves muscle inhibition
2. Retrain – this involves muscle facilitation
3. Restore – this involves restoring reciprocal and alternating function

Diaphragmatic breathing is often a key component in achieving a neutral posture. When learning to optimally use your diaphragm, fully exhale, ridding yourself of all the air in your lungs. Your exhale should last longer than your inhale. Then, attempt inhaling into your right chest wall and into your back without allowing the bottom of your rib cage to flare open. This full exhale allows your diaphragm to dome into its resting position so that it can efficiently work upon inhalation. 

Think you got it? Challenge your diaphragm by blowing up a balloon! 

Nail it? Then try a common repositioning technique developed by the Postural Restoration Institute! Click on the following video for instruction.

References:

Postural Restoration Institute. www.posturalrestoration.com

"Do Simple Better"

by Sally Fansler, PT

In the few short years he has been in our city, Chicago Cubs manager Joe Maddon has become a beloved figure.  His earthy, straightforward slogans, often referred to as “Maddonisms,” delight everyone from the most hardcore sports fans to the most casual observers. “Do simple better” is a particular favorite: in short, making the routine play, staying focused on the basics, and getting the job done. It’s meant to keep the players from overcomplicating their jobs, and Maddon regularly wears a t-shirt that bears this quote. 

We apply this at Lakeshore Physical Therapy by making every interaction with our patients easier and more streamlined. In the complicated flow chart of the healthcare arena, we know how refreshing it is to have an experience that is simple: allowing the patient to talk to a human being whenever possible, smiling throughout the day, and thanking our co-workers. We focus on the fundamentals of solid patient care and goal setting, making each customer service experience stand out.

Joe Maddon expresses succinct words of encouragement and a unique philosophy.  “Do simple better” can be a great lesson for a sports team and all business professionals, inspiring good ol’ fashioned hard work.

Plantar Fasciitis: More Than Just a Footnote

by James Bansberg, DPT

Feet: so far away and often overlooked…until you wake up one morning and realize it’s impossible to place any weight through your foot. Feet are our foundation - our body’s connection with the earth - yet we place them in tight, uncomfortably angled, or worn down shoes, and refuse to maintain them the way we do other body parts.  Considering that plantar fasciitis is the leading cause of heel pain, and affects more than 2 million people in the US, it may be time to give this hard-working appendage a little more love.  

The plantar fascia is made up of thick fibrous bands of connective tissue that act like a cable between the heel and toes. These bands work hard, acting as shock absorbers, foot stabilizers, and arch supporters. Since we can be so unforgiving to our feet, there are multiple impairments that can lead to aggravation of the tissue. So what kind of risk factors should you be looking for in order to get to the root of the cause?

• Poor ankle and toe mobility
• Ramping up activity too quickly (marathon training!)
• Obesity
• Age (typically 40+)
• High or low arches
• Stiff/cramping calf muscles
• Prolonged daily standing on hard surface
• Improper footwear (worn, poor fitting, high heels, low support)

The presence of any of these risk factors can lead to plantar fasciitis, and many of us have more than one. Fortunately, there are just as many options to reduce risk: stretching and strengthening muscles that may be cramping or that don’t get much opportunity to be fully stretched often helps, as does rest. Proper shoe fitting (as well as replacing stressful footwear with more supportive options) can dramatically reduce risk, and if obesity is a factor, weight loss may help as well. Depending on the severity of pain, your doctor may recommend other options, such as night splinting.

If you have foot pain, however,evidence suggests that physical therapy will help you recover faster and cost you less than if you do not receive treatment. Experienced therapists at Lakeshore Physical Therapy will administer a comprehensive evaluation to determine impairments and utilize current evidence and proper treatment to help lower pain and improve function.  

Resources:

“Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States” (J Orthop Sports Phys Ther 2017;47(2):49–55. doi:10.2519/jospt.2017.6999).