Imagine there is a spool of thread anchored at the top of your skull, and you can pull the thread down; you pull it down through your shoulders, kidneys, pelvis, thighs, shins, and stop at your ankles. See it? That is your body’s kinetic chain. Why is the kinetic chain so important, you ask? Kinetic suggests movement, and when you are in the standing position, your body is confined to the force of gravity and your kinetic chain helps you to stay vertical and balanced so you can keep moving.

Now imagine that thread snapping at one, or two, of those places (note: two parts do not need to be connected with each other to be affected), your body will now compensate for the area of injury, meaning the healthier ones will work harder for the painful ones, and over a long period of time, your movement pattern may become hard-wired and more painful.

For instance, your neck hurts; this could be because of a shoulder injury or your pelvis is rotated, or both. Hey, you could have a leg length discrepancy causing your whole kinetic chain to be affected.

It is also important to point out that the kinetic chain is congruent with the musculoskeletal system (the framework of the body) which relies heavily on the other for precision alignment also helping you move pain-free. So, when there is a disconnect between the two, this can produce additional stress and strain elevating pain, and discomfort.

So, don’t let your pain become unbearable without knowing the root cause. You could have a break in your chain and not even know it!

Do you know that the largest joints in the human body are in your knees? Taking on their fair share of impact, these joints can only take so much.

You may know your body, including your knees, and your activity limits; but how well? For instance, you’re motivated, you’re moving and grooving with your activity of choice when OUCH! now you have pain in your knees. But you sucked it up, pressed-on, and have more pain.

What do you do? Do you risk making your pain, and the condition causing it, worse? Moreover, do you know if your knee condition is structural or inflammatory?

How can you tell the difference between structural and inflammatory knee problems? According to Charles Bush-Joseph, MD (Rush University Medical Center), Structural damage is present when knees are visibly swollen or cannot get into a squatting position with knees at 90-degree angles. Inflammatory damage is over-use of your knees caused by improper lifting of heavy objects, poor flexibility, bad shoes, muscle weakness, or starting a high-impact fitness routine without warming-up.

The Key? Know your limits. Knee pain is not discriminatory, “It can happen to anyone at any age,” says Bush-Joseph.

What’s next? STOP! Always let pain be your guide. If you start having pain, temporarily discontinue the activity. If your pain lasts longer than 2-weeks after starting back up, it’s a good idea to consult your physician for a proper diagnosis and treatment.

Remember movement is the key to your freedom! Staying active helps control weight and build muscle, both of which can help protect your knees from further damage when done properly. Because healthy, strong pain-free knees can make all the difference in the world!

The coronavirus outbreak has disrupted our lives and forced us to change our habits, including hindering most group fitness activities. Whether you like to do your own thing outside, take a class, or work one-on-one with a personal trainer, you might be feeling a little lost when it comes to staying active in your own home.

Exercising is important to our health in a variety of ways. It can improve strength, improve balance, give you more energy, prevent or delay disease, improve mood, and improve cognitive function. As long as your doctor says it’s safe for you to exercise, you should workout to improve the quality and increase the longevity of your life.

It may be daunting to start an exercise program at home, so we’ve broken down some exercises you can do with just one piece of equipment: a chair.

(Remember during this time that it’s important to keep your body moving and also to keep yourself safe, but never attempt an exercise routine without confirming with your doctor that it’s safe to do so. These chair exercises are a great way to strengthen your muscles and get your heart rate up in this time of “social distancing.”)

1. Calf Raises

There are two ways to complete this exercise. First, you can sit upright in a chair with your feet flat on the floor hip-distance apart. Make sure you’re looking straight ahead and engage your core. Start with your right foot and lift your heel as high as you can and raise up on your toes as high as you can. Complete ten reps on each side for three sets.

Another way to complete calf raises is to stand behind the chair and hold onto it for balance. Stand with your feet shoulder-width apart. Complete the same movement of putting your weight on your toes and lifting your heels as high as you can, but this time, do it on both legs at the same time. Complete ten reps for three sets.

2. Modified Push-Ups

Push-ups are an effective upper body exercise because they work so many muscles. By using a chair, you can decrease the difficulty of the exercise, decrease the impact on your joints avoid getting all the way down on the ground.

To perform this move, place the chair so that the seat is up against a wall to make sure that it’s not going to move while you complete the exercise. Stand behind the chair with your feet shoulder-width apart. You want to stand far enough away that you can extend your arms but close enough to feel comfortable and stable. Engage your core and keep your body as straight as possible. Slowly bend your elbows and lean your body forward to complete a push-up. Complete ten reps for three sets.

3. Modified Planks

Planks are one of the best exercises to work your core. To complete it on the chair, start in the same position as the push-up. The seat of the chair should be against the wall, and you should stand behind the chair with your hands holding onto the top of the chair with your feet shoulder-width apart. Take a step back so your body is at a slight angle. Make sure your hips are aligned with your knees and shoulders. Hold the position for 10 to 60 seconds – however long you feel comfortable, and then return to standing. Complete three sets.

4. Modified Squats

Squats are an effective lower body exercise that work your quads, glutes, and core. Stand behind the chair with your hands holding onto the top of your chair. Your feet should be about shoulder-width apart. Gently lower yourself down and imagine that you are sitting into a chair. The movement should be almost identical, but you can go however low you feel comfortable. Hold onto the chair for balance. Complete ten reps for three sets.

5. Seated Leg Lifts

Seated leg lifts are a great exercise for your core and your legs. Sit at the edge of the chair with your back straight. Start with your legs shoulder-width apart extended in front of you with just your heels on the ground. Hold onto the chair for balance, and slowly lift your right leg up as high as you can without moving your torso. Hold it at the top for a second and then slowly lower your right leg back to the starting position. Then complete the move with your left leg. Complete ten reps on each side for three sets.

6. Seated Shoulder Press

If you have a pair of light dumbbells, you can use those. You can also use objects you might find around your house, such as cans of soup or bottles of water – just make sure the two items you choose are identical in weight. You can also complete this exercise without weights. Start in seated position with your back straight, with elbows out to the side of your body. Your elbows should start below your shoulders with your wrist directly above your elbows. Your palms should be facing forward. Slowly extend your arms above your head as high as you can. At the top of the movement, they should be fully extended, but don’t lock your elbows. Slowly bring your elbows down keeping your elbows out. Complete ten reps for three sets.

By: Kennan Wyne, PT, DPT

Everyone has had constipation at some point or another and it is uncomfortable, painful and embarrassing.  Chronic constipation and/or straining can lead to excessive stress on pelvic organs and nerves.  This may contribute to bladder dysfunction, pelvic floor dysfunction, and/or prolapse (bulging of structures occurring commonly due to weakened supportive structures).  Constipation is defined as infrequent (fewer than 3) bowel movements per week.  Normal stools should be about the size, shape, and consistency of a ripe banana.*

Listed below are tips to keep your colon happy.

Tip #1: Avoid regular use of laxatives and enemas.

Tip #2: Discuss fiber needs with physician/pharmacist/nutritionist. Typical recommendations for fiber intake are 25-35 grams per day. If adding fiber to diet remember to DRINK 6-8 cups of WATER to move stool through the colon. You may experience a bloating feeling and/or gas when adding fiber to your diet, but this should pass in a few weeks.  This may be eased by adding fiber SLOWLY to your diet.

• • Examples of high fiber foods are bran, shredded wheat, whole grain bread, and whole fresh fruits with skin (apples, raw veggies).

Tip #3: Proper positioning: Position yourself on the toilet to allow for maximal relaxation of your pelvic floor muscles by using a Squatty Potty or stool to obtain maximal knee and hip flexion (similar to a squat position) and leaning forward and supporting elbows on knees. NO STRAINING OR HOVERING as this increases intraabdominal pressure and pressure on the pelvic floor.

Tip #4: Regular exercise helps stimulate a sluggish bowel.

*Any persistent change in bowel habits, such as increase or decrease in frequency, size of the stool, blood in the stool, or an increased difficulty in evacuating, warrants a medical consultation.

Musculoskeletal diseases aren’t just widespread— they’ve also become a significant factor in the economy, with associated costs estimated at an amount equal to 5.76% of the US gross domestic product. That’s just 1 of the insights offered in the latest edition of a detailed report on the impact of musculoskeletal conditions across the country.

Advance-published sections of the US Bone and Joint Initiative’s (USBJI) 4th edition of “The Burden of Musculoskeletal Diseases in the US” are now being rolled out at the USBJI website. The report compiles extensive data on a wide range of conditions, including low back pain, neck pain, arthritis, osteoporosis, and injuries both in aggregate and among special populations, and includes insight on economic impact. The latest edition also features a new section on neuromuscular diseases.

According to USBJI, more than half of all adults in the US now report a chronic musculoskeletal condition—a rate that outpaces the prevalence of reported respiratory conditions (24%) and circulatory conditions including high blood pressure (42%). Chronic low back pain, joint pain, and disability make up 3 of the top 5 most commonly reported medical conditions, the report states.

In turn, musculoskeletal conditions have become a major factor in health care costs—an estimated $332 billion between 2012 and 2014, according to USBJI, with costs likely to increase with an aging US population.

Three chapters of the latest edition are now available, with more to be released in the coming weeks. USBJI hopes that the resources will help to highlight the need for more resources devoted to addressing prevention and treatment of musculoskeletal disorders.

“In spite of [the overall prevalence and significant costs], research funding for musculoskeletal-related conditions remains substantially below that of other major health conditions, such as cancer and respiratory and circulatory diseases,” the report states. “If health care costs in the future are to be contained, musculoskeletal diseases must come to the forefront of research.”

Take home message:  Invest in Prevention, Diagnosis, and Treatment to Improve Outcomes and Lower Costs.

Source: New Data on Musculoskeletal Disease Highlight its Position as Major Contributor to Health Care Costs

Even though they are keeping fit, up to 14% of American runners experience low back pain (LBP) each year. But runners can reduce their risk by developing their deep core muscles, say authors of a recent study in the Journal of Biomechanics (abstract only available for free).

While many fitness enthusiasts focus on their abs, they may neglect the trunk muscles they can’t see. “Improper function of this musculature may lead to abnormal spinal loading, muscle strain, or injury to spinal structures, all of which have been associated with increased low back pain risk,” say researchers.

To test this idea, authors used motion capture technology to collect kinematic data from 8 participants with no history of back pain and no recent injuries. The data, gathered while the participants ran, was used to create simulated full-body models in OpenSim, a software tool for modeling movement.

In the simulations, researchers gradually weakened the models’ deep core muscles, both individually and together. They found that when deep core muscles are weak, superficial core muscles, particularly the superficial longissimus thoracis (LT), tend to overcompensate, which may result in muscle injury or fatigue. And since the superficial LT was most often the muscle overcompensating for weak deep core muscles, it may be “most at risk for fatigue or injury” if deep core muscles are not functioning properly.

The authors believe that certain deep core muscles appear to be more important than others in runners. “The deep erector spinae required the largest compensations when weakened individually,” note authors, who conclude that “it may contribute most to controlling running kinematics.”

When all deep core muscles were weak, or when only the deep erector spinae was weakened, there was a significant increase in both compressive and shear spinal loading in the upper back, with a decrease in the lower back. Over time, this could result in damage to the spine and increase the risk of injury, authors warn.

Authors suggest further research using simulated models to examine core function in running. The study, researchers observe, “is the first step in providing evidence to support the common notion that poor core strength and stability may influence a runner’s risk of developing injuries such as LBP.”

Source: PTinMotionNews 1.19.2018 Core LBP Runners

Historically, the physical therapy profession began as an adjunct to medical practice. Considered a specialty, physical therapists use mechanical force and movements to remediate impairments and promote mobility, function, and quality of life by providing their expertise of rehabilitation within healthcare dimensions of promotion, prevention, and intervention to people, communities, and populations. This conservative, holistic (patient centered) approach comprises of an active engagement model of 3–steps:

1. to listen actively;
2. to think reflexively;
3. to reason critically.

In addition to clinical practice, other dimensions encompassed in the physical therapy profession include research, education, consultation, and administration:

We bridge the gap: On one side of the bridge, we draw from the connections we make from your story to frame and recognize what seems important to you. On the other side (the clinical side), we draw from your referring doctors. Thus we will have a clear sense of both sides which allows us to engage with the appropriate types of moral reasonings, particularly since you and your doctor may hold different definitions of end goals during rehabilitation.

We take care of business: Your choice to come to Carousel is like a new job each time; we first have to be hired, receive a performance review, and be promoted accordingly—so, in essence, it is our #1 job to inspire you through treatment goals. Our performance review is based on your treatment progress, and our promotion is when you graduate from therapy!

We need to hear from you: Your success story is Carousel’s peer review. Each success story sent back to Carousel is a report card for US! They keep us humble but also help us to make the changes when and where needed. And, it also lets us know that our product/service is working….. because, what we don’t know CAN hurt us!

So keeping Carousel running like a well-oiled machine is essential for improving your quality of life from every single aspect: initial contact for treatment to a successful discharge!