Does this Man have Arthritis? Research shows that over 70% of people have arthritic changes, but not all of these people experience symptoms. While the man above likely has arthritic changes that could seen on an X-ray, these changes would be completely normal for his age. More importantly, it does NOT mean he has to be experiencing pain! What is Osteoarthritis?Arthritis is the leading cause of disability in the United States, and osteoarthritis (OA) is the most common form of arthritis. OA is a degeneration (breakdown) of the joint cartilage that can lead to stiffness and decreased range of motion at a joint. It is common in weight-bearing joints including the low back, hips, and knees. What Osteoarthritis is NOT! While the degenerative changes associated with OA do not directly cause pain, they are often blamed as the problem behind the symptoms. In reality, the signs and symptoms of OA are a natural aspect of the aging process. Several studies have been published over the past few years that confirm pain is not related to the natural wear and tear in our tissues. For example, 34% of asymptomatic people >60 years old have been found to have rotator cuff tears (1). Crazy right? One in three people WITHOUT SHOULDER PAIN have a rotator cuff tear. These natural body changes do not occur only in the shoulder, but throughout the entire body. Two out of four people WITHOUT KNEE PAIN have degenerative changes in their knees. (2) Should these people sign up for surgery? I sure hope not. They do not even know there is an issue, and they are doing all of their activities without any problems. There would be no indication for surgery. These people should maintain an active and dynamic lifestyle. Therefore, we cannot confidently say that changes in our tissue are the source of pain or symptoms. Reframing How to Think about OsteoarthritisOA is more closely related to the natural wear and tear that occurs in our joints as we get older. For example, think about your mother, father, grandmother, or grandfather. Over time they have developed wrinkles and other age-related changes. Despite these signs of aging, they do not complain about face pain from the wrinkles or scalp pain from their hair turning from dark to light. The same is also true for our wrinkles on the inside (3). We age on the inside in a similar fashion to how we age on the outside!
Action Steps1) Get active! Have you ever heard the expression "motion is lotion" or "movement is medicine." These catchy sayings are true. One of the best things someone can do for arthritis is movement. At Heafner Health, we recommend a combination of flexibility and strengthening exercises to keep joints strong and mobile. 2) Diet and Weight Management. The Arthritis Foundation reports that "being just 10 pounds overweight puts an extra 30 to 60 pounds of pressure on the knees." (1) A small weight change have a big impact on the stress across your joints. 3) Visit a Doctor of Physical Therapy. Physical therapists are experts in joint mobilizations, movement eduction, exercise prescription, and pain management.  Heafner Health Physical Therapy is owned and operated by Dr. Jim Heafner in Boulder, Colorado.References:
1) Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. The Journal of bone and joint surgery. American volume. Jan 1995;77(1):10-15. 2) Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC musculoskeletal disorders. 2008;9:116. 3) Obesity and Arthritis. (2017) Arthritis Foundation. 9, February. 2018. Web access: https://www.arthritis.org/about-arthritis/types/osteoarthritis/articles/obesity-osteoarthritis.php 4) Term "Wrinkles on the Inside" was originally used by Dr. Tim Flynn
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 OverviewThis article will cover central spinal stenosis (not lateral (foraminal) stenosis.
What is It?The spine or bodies backbone consists of 31 separate vertebrae. The spinal cord is a bundle of nerves that travel down the entire spinal column. Spinal stenosis occurs when there is narrowing of the spinal canal, limiting movement of the nerves. Spinal stenosis can occur for multiple reasons, but is primarily due to age related changes, such as arthritis. For this reason, spinal stenosis is more commonly seen in individuals over 50 years of age. Other less common causes of stenosis include spinal fracture, tumors, or other trauma to the spine. Symptoms of Spinal Stenosis Since a major cause of spinal stenosis is osteoarthritis, symptoms typically develop gradually over time. Early on, individuals will complain of back pain, stiffness in the legs and thighs, and periodic numbness or tingling. Additionally a loss of sensation may be noted in the thighs or feet. As symptoms progress, gradual weakness or ataxia (incoordination) may be noted while walking. Typically, individuals with spinal stenosis feel better when leaning forward while performing activities. Bending forward creates more space in the spinal canal and decreases pressure on the nerves. As spinal stenosis progresses, the severity of symptoms typically progress as well. For this reason, it is beneficial to seek medical care when you start noticing symptoms.  Treatment of Spinal StenosisWhile treatment is varied across the country, most individuals with lumbar stenosis should receive conservative management (physical therapy, NSAIDS, injections) prior to more serious medical interventions. A 2015 study by Dr. Delitto and colleagues found that surgery compared to nonsurgical treatment of lumbar spinal stenosis yielded similar long-term results. This profound study has shown that surgery is not necessary (or at least not needed as commonly) if you are suffering from lumbar stenosis. At Heafner Health, I was recently working with someone diagnosed with moderate central spinal stenosis. During the initial evaluation, the client said, "normally I do not pay out of pocket, but this is my last option before surgery. I have had pain for 6 years without any relief from stem cell or steroid injections." This individual had pain every morning while getting out of bed. His symptoms would naturally lessen throughout the morning, but any prolonged sitting or walking increased his leg symptoms and affected his ability to work. Each evening his sense of stiffness returned, forcing him to take a muscle relaxer and CBD cream. Our sessions focused on a mobility approach, meaning we focused on the mobility of his spine and hips more than anything else. Within 6 sessions, he is no longer having leg pain during the day, and his morning stiffness decreases in minutes! While it is nice to show off our successes, more importantly it speaks to the point that surgery is not necessary. The proper interventions on a motivated patient will work! While this approach will be different from individual to individual, a good physical therapy routine should consist of trunk strengthening exercises, decreasing pain and nerve symptoms, maximizing endurance, and lower extremity flexibility exercises. For a full review of lumbar spinal stenosis, I highly recommend reading the American Physical Therapy Associations article on Physical Therapists Guide to Lumbar Spinal Stenosis. -Dr. Jim Heafner PT, DPT, OCS Owner at Heafner Health Physical Therapy References:
Delitto A, Piva SR, Moore CG, et al. Surgery versus nonsurgical treatment of lumbar spinal stenosis: a randomized trial. Ann Intern Med. 2015;162(7):465-473 "MRIs can paint a scary picture! Fortunately in many instances, degenerative disc disease (DDD) is NOT as daunting as it sounds. Physical Therapy should be the first line of defense in treating DDD." |
What is a Low Back Muscle Strain The muscles of the low back play an important role in both moving and supporting the spine. For example, the muscles must allow the spine to move when bending forward to lift a weight, and simultaneously protect the spine from excessive stress. Whenever the muscles are stretched too far or too quickly, an injury may occur. For this reason, bending, lifting, and twisting with poor body mechanics and poor preparation for movement may increase one’s risk of injury. Additionally, inactive people and smokers are at a higher risk of straining the low back muscles. |  |
Muscle Strain Symptoms
Following a low back muscle strain, people will often experience localized pain in the region of the strain. Spine and hip range of motion will likely be restricted as these movements can stress the injured area. Even simple motions such as rolling in bed or moving from sit to stand can cause significant strain. In an isolated muscle strain, the individual should not notice any neurological signs (numbness, tingling, muscle atrophy, or other symptoms down the legs).
Muscle Strain Treatment
 | Treatment of a low back muscle strain will be similar to muscle strains throughout the body. In the first few hours to days following the injury, gentle pain free movements are very important. The acronym ‘POLICE’ is a great strategy to recall the important steps following a muscle strain.
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Additionally, it is recommended to see a Doctor of Physical Therapy within the first several days following a lumbar injury. The Physical Therapist can help decrease pain and more importantly prevent injury from occurring in the future.
Bonus Treatment Advice
For previous articles on low back muscle strains, please read the following blog posts!
 | About Heafner Health: Heafner Health Physical Therapy is owned and operated by Dr. Jim Heafner. His evidenced-based treatment approach is different than your average physical therapist. As a residency trained Orthopedic Specialist, Jim identifies the cause of people’s pain and symptoms. His treatments combine hands-on techniques (including soft tissue work and adjustments) as well as corrective exercises, with the goal of getting people back to the activities they enjoy most. Jim strongly believes that pain is not permanent, and everyone should have the opportunity to be strong and healthy throughout their entire life. Heafner Health is conveniently located inside RallySport in Boulder, Colorado. All treatment sessions are 1-on-1. We treat everyone from top athletes to weekend warriors. No doctor’s referral is required prior to evaluation! Stop managing your pain and start your path to wellness. Learn more at www.heafnerhealth.com |
The Warm-up
Earlier this year, I started a personal challenge to deadlift 400# (lifting a weight from the floor to waist height). To accomplish this feat, I incorporated heavy leg training into my workout routines two to three times per week. Within weeks, I became significantly stronger, and after 30 days, I had increased my maximum deadlift by over 100 pounds. When training three times each week, I was often sore at the beginning of the workout. My muscles were rebuilding and adapting to new loads. For this reason, it was vitally important to warm-up my tissues prior to training.
In this post, I discuss four of my favorite exercises that I routinely performed before weight training. While I use the deadlift as the example exercise, the exercises and principles apply to all lower body movements.
In this post, I discuss four of my favorite exercises that I routinely performed before weight training. While I use the deadlift as the example exercise, the exercises and principles apply to all lower body movements.
Components of a Good Warm-up
A proper warm-up has numerous health benefits:
Each of these benefits relate back to one primary purpose: injury prevention.
- Improving blood flow to muscles
- Increasing core temperature
- Improving tissue elasticity
- Building muscle memory for movements that mimic your workout routine
Each of these benefits relate back to one primary purpose: injury prevention.
Example Warm-up Routine 1
Below are four warm-up exercises I performed prior to my deadlift routine.
| Single Leg Deadlifts prep the hamstrings and glutes for dynamic motion. Adding a kettlebell at chest height engages the posterior shoulders. | Hip Hinges using a dowel provide cueing to maintain a neutral spine position. Load through the hips and avoid rounding the spine. |
| Low Back Extensions warm-up the spinal stabilizers and improve overall spinal mobility. Perform in a 1/2 kneeling position to mobilize the front of the hip joint as well. | Standing T's engage the trapezius muscles, which are primary upper body pulling muscles. Keep the neck lengthened and squeeze the shoulder blades together! |
Example Warm-up Routine 2
While I regularly performed the four exercises above, I have also included another sample routine below. Incorporating full body movements such as squats, romanian deadlifts (RDLs), and treadmill jogging are great ways to raise core temperature and bring blood flow to the entire body.
As individuals get older, the tissue become less pliable and less elastic. Warming up the bodies tissue prior to any strenuous exercise is important for injury prevention. Invest 5-10 minutes in a foundational warm-up routine- your workout will feel stronger and your body will thank you afterward!
Post written by:
Dr. Jim Heafner PT, DPT, OCS
Owner of Heafner Health Physical Therapy
Boulder, Colorado
Post written by:
Dr. Jim Heafner PT, DPT, OCS
Owner of Heafner Health Physical Therapy
Boulder, Colorado
School is back in session! Are your children wearing their book bags safely?
Summer is nearly over and your child is likely a few weeks into their fall semester of classes. During this time, parents must be aware of how their children's activity levels, postures, and habits change. Instead of spending hours outside playing each day, your child will likely be sitting in the classroom much more frequently. If they are required to wear a uniform, they may be wearing more restrictive clothes or shoes. Additionally, they will inevitably be carrying around a book bag throughout their day. While these changes are not inherently bad, simple tips and prevention can speak volumes for your child's spine and overall health.
Book Bag Implications
In 2013, there were >5,000 reports of backpack related injuries in the United States! Additionally, 1 in 4 children between the ages of 12-17 years old reported having back pain for >15 days in a single year. (1) Twenty-five percent is an alarming amount of low back pain in our adolescent population! While a book bag does not directly cause pain or disability, it can certainly lead to chronic postural problems, balance issues, and/or alter how your child naturally moves.
"As a Doctor of Physical Therapy, the most common injury I see related to wearing a book bag is lower back pain or tension." Jim Heafner PT, DPT, OCS
| When wearing a book bag, there are several considerations to keep in mind. Total weight, positioning on the body, item distribution, and the child's size are all factors that must be considered before strapping up your young one. Each of these factors are independently important and should be assessed on an child by child basis. |  |
Proper Book bag Wearing Tips
1) Position the book bag between your shoulders and belly button. As you will commonly see, book bags often rest low onto a child's hips or buttock region. When the bag sits lower on the body, it can pull the child backward. This extra weight places stress across the child's low back, potentially causing low back tension or discomfort. Tightening the straps so that the book bag rests near belly button level helps distribute the weight near the center of mass.
2) Evenly distribute items in the bag with heavier objects toward the bottom of the book bag. Children often haphazardly stuff books, food, clothes, and more into their book bags. This method often leads to poor weight distribution of the objects in the bag. If the weight is not evenly distributed, certain regions of the body must work harder while carrying the bag. Overtime this can lead to asymmetries or extra stress placed across the body.
3) Avoid wearing the book bag on one shoulder. While it may look cool to sling the book bag over one shoulder, it is not the most practical option for carrying the bag. Not only is the one shoulder strategy inefficient, but constantly loading one shoulder can also create stress across the neck. At Heafner Health Physical Therapy, we suggest keeping the weight evenly distributed over both shoulders, especially if your child is wearing the book bag for long periods of time.
4) Bonus Tip. The book bag should only weight ~15% of the child's body weight. For example, if your child weighs 100#, they should have a 15# pack or less.
2) Evenly distribute items in the bag with heavier objects toward the bottom of the book bag. Children often haphazardly stuff books, food, clothes, and more into their book bags. This method often leads to poor weight distribution of the objects in the bag. If the weight is not evenly distributed, certain regions of the body must work harder while carrying the bag. Overtime this can lead to asymmetries or extra stress placed across the body.
3) Avoid wearing the book bag on one shoulder. While it may look cool to sling the book bag over one shoulder, it is not the most practical option for carrying the bag. Not only is the one shoulder strategy inefficient, but constantly loading one shoulder can also create stress across the neck. At Heafner Health Physical Therapy, we suggest keeping the weight evenly distributed over both shoulders, especially if your child is wearing the book bag for long periods of time.
4) Bonus Tip. The book bag should only weight ~15% of the child's body weight. For example, if your child weighs 100#, they should have a 15# pack or less.
Parental Homework
1. Educate your child on proper back pack wear using the tips above!
2. The information is simple, but effective! Use this information to keep your child's back healthy and strong.
3. Remember, the backpack alone is not the problem. Your child's posture and daily habits will play a significant role in how they move and feel throughout the day.
2. The information is simple, but effective! Use this information to keep your child's back healthy and strong.
3. Remember, the backpack alone is not the problem. Your child's posture and daily habits will play a significant role in how they move and feel throughout the day.
Movement is the key to longevity!
ABOUT HEAFNER HEALTH
Heafner Health Physical Therapy is owned and operated by Dr. Jim Heafner. His evidenced-based treatment approach is different than your average physical therapist. As a residency trained Orthopedic Specialist, Jim identifies the cause of people’s pain and symptoms. His treatments combine hands-on techniques (including soft tissue work and adjustments) as well as corrective exercises, with the goal of getting people back to the activities they enjoy most. Jim strongly believes that pain is not permanent, and everyone should have the opportunity to be strong and healthy throughout their entire life.
Heafner Health is conveniently located inside RallySport in Boulder, Colorado. All treatment sessions are 1-on-1. We treat everyone from top athletes to weekend warriors. No doctor’s referral is required prior to evaluation! Stop managing your pain and start your path to wellness. Learn more at www.heafnerhealth.com
-Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy
Boulder, Colorado
Heafner Health Physical Therapy is owned and operated by Dr. Jim Heafner. His evidenced-based treatment approach is different than your average physical therapist. As a residency trained Orthopedic Specialist, Jim identifies the cause of people’s pain and symptoms. His treatments combine hands-on techniques (including soft tissue work and adjustments) as well as corrective exercises, with the goal of getting people back to the activities they enjoy most. Jim strongly believes that pain is not permanent, and everyone should have the opportunity to be strong and healthy throughout their entire life.
Heafner Health is conveniently located inside RallySport in Boulder, Colorado. All treatment sessions are 1-on-1. We treat everyone from top athletes to weekend warriors. No doctor’s referral is required prior to evaluation! Stop managing your pain and start your path to wellness. Learn more at www.heafnerhealth.com
-Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy
Boulder, Colorado
References:
(1) Scolio Smart: https://www.treatingscoliosis.com/infographics/backpack-injuries/
(1) Scolio Smart: https://www.treatingscoliosis.com/infographics/backpack-injuries/
Have you ever been to a physical therapist, doctor, trainer, or anyone who evaluates your body or monitors how you move? If so, they have may told you that you have poor posture.
Poor posture! Yikes!! That sounds dooming. When we talk about poor posture, words like rotator cuff tear, disc herniation, trauma, injury, and more all come to mind. Scary stuff! In our society, we seem to be fixated on our posture. In our obsession, we blame posture for many of our problems.
What if I told you that there is no such thing as poor posture? It is time to buckle up. Sit in an upright or slouched position, and continue reading!
What if I told you that there is no such thing as poor posture? It is time to buckle up. Sit in an upright or slouched position, and continue reading!
"Poor posture is not the problem! A lack of movement is the underlying issue."
-Dr. Jim Heafner PT, DPT, OCS
What is posture?
A few years ago, I was driving from St. Louis, MO to Kansas City, KS. All things considering, it is pretty boring drive. As I was driving, I remember focusing diligently on my posture- tall spine, neck upright, knees shoulder width apart. One could speculate that it was the perfect seated car posture. Since I was sitting in a great posture, I told myself there was no need to stop for a rest break. Four hours later, I arrived in Kansas. Despite the perfect posture, I was sore. My muscles ached, shoulders were tense, and low back craved movement. Moral of the story: Even a perfect posture is not the solution. Movement trumps any isolated posture.
Posture is defined as “the position or bearing of the body whether characteristic or assumed for a special purpose.” In other words, it is the way we position our body for various activities. Those activities can include anything from sitting in a car to cleaning underneath your kitchen sink. Our posture is our body’s position during all those tasks. It is constantly changing and adapting to meet our current environment. When we confine our posture to a limited space, there is minimal adaption needed. Sore, achy, and fatigued muscles are a common result.
Posture is defined as “the position or bearing of the body whether characteristic or assumed for a special purpose.” In other words, it is the way we position our body for various activities. Those activities can include anything from sitting in a car to cleaning underneath your kitchen sink. Our posture is our body’s position during all those tasks. It is constantly changing and adapting to meet our current environment. When we confine our posture to a limited space, there is minimal adaption needed. Sore, achy, and fatigued muscles are a common result.
Bad Posture Gives the Wrong Message
When someone is told they have poor posture, they often have rounded shoulders, a forward head, slouched spinal position, etc… But what makes these postures bad? The forward head position is simply a movement the neck must perform when trying to get a closer look at something. Bending from the spine is a necessary movement when picking up a low object from the floor. These postures are not BAD; they are simply different MOVEMENTS.
From a neurolinguistic perspective, telling someone they have poor posture has it's consequences. The words 'good' and 'bad' have strong connotations that our deeply rooted in our biology. We are typically rewarded for good behaviors and somehow negatively punished for bad behaviors.
From a neurolinguistic perspective, telling someone they have poor posture has it's consequences. The words 'good' and 'bad' have strong connotations that our deeply rooted in our biology. We are typically rewarded for good behaviors and somehow negatively punished for bad behaviors.
Good= Green Light = Go
Bad= Red Light= Don’t Ever Do
Bad= Red Light= Don’t Ever Do
If certain postures are bad, we just hit a red light! Bad posture indicates that people should not perform those movements. The red light indicates that slipping into a rounded spine position could immediately predispose someone to injury. The stigma surrounding bad posture ultimately creates a fear of movement and only promotes movement in a 'good posture.'
The biggest problem with the stop light system:
Stating someone has poor posture does not provide adequate information into the person's environment, movement patterns, daily habits, or their pain behavior. It allows for easy blame to be placed on posture, which is only a small piece of the clinical puzzle.
The biggest problem with the stop light system:
Stating someone has poor posture does not provide adequate information into the person's environment, movement patterns, daily habits, or their pain behavior. It allows for easy blame to be placed on posture, which is only a small piece of the clinical puzzle.
| Classically Coined Good Posture  | Classically Coined Poor Posture  |
"Your next posture is your best posture!" -Dr. Mike Giardina
Poor Posture Does NOT Equal Increased Pain
The research does not support either good or bad posture. We cannot confidently say that poor posture causes problems OR good posture prevents problems. This is because posture alone does not equal pain. Several studies have been published over the past few years that confirm pain is unrelated to our anatomical tissues. For example, 34% of asymptomatic people >60 years old have been found to have rotator cuff tears. Crazy right? One in three people WITHOUT SHOULDER PAIN have a rotator cuff tear Should these people sign up for surgery? I sure hope not. They do not even know there is an issue, and they are doing all of their activities without any problems. There would be no indication for surgery. Therefore, we cannot confidently say that poor posture is the source of our tissue damage or pain response.
In the pictures below, you can see one of my clients squatting with his feet turned completely inward. For most people, this amount of stress of the outer ankle ligaments would cause an ankle sprain. My client can perform this movement because he has trained those tissues to be strong in that range of motion. He can squat with his feet inverted because his body has gradually adapted the tissue to handle that load. He created strong patterns of muscle memory to comfortably perform this movement so that his ankles were strong, mobile, and adaptable to the life activities he was performing.
In the pictures below, you can see one of my clients squatting with his feet turned completely inward. For most people, this amount of stress of the outer ankle ligaments would cause an ankle sprain. My client can perform this movement because he has trained those tissues to be strong in that range of motion. He can squat with his feet inverted because his body has gradually adapted the tissue to handle that load. He created strong patterns of muscle memory to comfortably perform this movement so that his ankles were strong, mobile, and adaptable to the life activities he was performing.
 |  |
"Our preparedness for the next posture is key!"
Is Sitting in a Slouched Position Fine?
As humans beings we are designed to move. You have probably heard the quote 'movement is medicine.' It is absolutely true! All movements are great as long as our brain and body are adequately prepared for the movement! To live healthy lives, we must have the capability to explore the bad posture positions equally as well as we can perform the good postures. It is important that we can move into a 'bad posture' to crouch beneath a low railing. It is equally important that we access 'good postures' to lift a heavy weight. In other words, we must have the ability to adapt our bodies to all of life’s postures.
So is sitting in a slouched posture fine? For short periods of time it is fine. However, I would not recommend slouching all day at work. At the same time, I would also not recommend sitting all day, period. Upright sitting is more biomechanically efficient, but having good posture alone is not solving any problems.
So is sitting in a slouched posture fine? For short periods of time it is fine. However, I would not recommend slouching all day at work. At the same time, I would also not recommend sitting all day, period. Upright sitting is more biomechanically efficient, but having good posture alone is not solving any problems.
The Case for More Movement
From both a physics and biomechanics standpoint, good posture does make sense. When our joints are aligned, there is more freedom of movement and less friction between the boney surfaces. Better alignment and good form should allow for more efficient movement. The one downfall of this philosophy is that physics and biomechanics negate the human brain. We are much too complex to deduce our bodies to machines. A one-size-fits-all package does not exist. Good posture for one person, may be slightly different than good posture for another individual.
Despite being amazingly complex, one thing is constant for everyone. As humans, we must move to survive. On a microscopic level, our cells are constantly adapting and changing. Externally our skin, hair, and nails are always growing. Neurons are always moving through our nerves to give feedback about our body position. In other words, we are designed to move.
The problem with many injuries is unprepared movement patterns. Unprepared movement means there is a disconnect between the output from the brain to the muscle. More simply stated, our muscle memory has been disrupted. The detailed GPS in our brain is no longer identifying all the roads on the map. Following a prolonged posture (good or bad), certain movements become less accessible. Using the GPS analogy, we could say these movements are similar to roads that are under construction. These movements must be retrained or else our brain will compensate by taking a side street. The detour eventually becomes overcrowded, overloaded, and unable to respond to stress.
A good posture may be more efficient than a bad posture, but it still does not solve the missing piece of the puzzle: MOVEMENT.
Despite being amazingly complex, one thing is constant for everyone. As humans, we must move to survive. On a microscopic level, our cells are constantly adapting and changing. Externally our skin, hair, and nails are always growing. Neurons are always moving through our nerves to give feedback about our body position. In other words, we are designed to move.
The problem with many injuries is unprepared movement patterns. Unprepared movement means there is a disconnect between the output from the brain to the muscle. More simply stated, our muscle memory has been disrupted. The detailed GPS in our brain is no longer identifying all the roads on the map. Following a prolonged posture (good or bad), certain movements become less accessible. Using the GPS analogy, we could say these movements are similar to roads that are under construction. These movements must be retrained or else our brain will compensate by taking a side street. The detour eventually becomes overcrowded, overloaded, and unable to respond to stress.
A good posture may be more efficient than a bad posture, but it still does not solve the missing piece of the puzzle: MOVEMENT.
Where To Go From Here
It may be frustrating to hear this information for the first time. I know I was upset. It felt like 3 years of Physical Therapy school was a lie. We have been programmed to believe posture is either good or bad. However, I urge you to take a positive outlook. There is freedom in this information. We no longer need to obsess over our posture. All we must do is move!
Take Home Action Items:
1) Sit less and stand more
2) Movement > Good Posture > Bad Posture
Movement is better for your body than sitting in a good posture and a good posture is better than a bad posture. If there is a 5 minute break at work, get up and walk around instead of doing a chair stretch.
3) Red light postures are NOT ‘don't ever do postures.'
Think of them as ‘don’t only and always do postures.’ While holding these positions for long periods of time may not be ideal, the posture in itself is not harmful.
4) Create or find a daily maintenance routine.
This routine should only take 10-15 minutes and should target the entire body. In the upcoming weeks, Heafner Health will be coming out with short daily maintenance videos. Stay tuned!
5) A body in motion stays in motion.
Many pains are only more common in the aging population because people change their activity levels. Adopt a diverse workout program that stresses the body in all directions. Stay active and stay dynamic!
Take Home Action Items:
1) Sit less and stand more
2) Movement > Good Posture > Bad Posture
Movement is better for your body than sitting in a good posture and a good posture is better than a bad posture. If there is a 5 minute break at work, get up and walk around instead of doing a chair stretch.
3) Red light postures are NOT ‘don't ever do postures.'
Think of them as ‘don’t only and always do postures.’ While holding these positions for long periods of time may not be ideal, the posture in itself is not harmful.
4) Create or find a daily maintenance routine.
This routine should only take 10-15 minutes and should target the entire body. In the upcoming weeks, Heafner Health will be coming out with short daily maintenance videos. Stay tuned!
5) A body in motion stays in motion.
Many pains are only more common in the aging population because people change their activity levels. Adopt a diverse workout program that stresses the body in all directions. Stay active and stay dynamic!
Author: Jim Heafner PT, DPT, OCS
Instagram: @HeafnerHealth
Websites:
The Student Physical Therapist
Heafner Health
Want to learn more from the author:
Check out his book and other online resources:
1) The Guide to Efficient Physical Therapy Examination
2) The Anatomy of Human Movement
(Save $10 on either above offering by using the promo code: Top10)
3) The Yoga Fix
Instagram: @HeafnerHealth
Websites:
The Student Physical Therapist
Heafner Health
Want to learn more from the author:
Check out his book and other online resources:
1) The Guide to Efficient Physical Therapy Examination
2) The Anatomy of Human Movement
(Save $10 on either above offering by using the promo code: Top10)
3) The Yoga Fix
"I was hiking downhill on the trail when I took a wrong step..."
If you have lived in Colorado for any length of time, you have probably told this story! The end result of the wrong step is often an ankle sprain. At Heafner Health I have listened to this scenario more than a handful of times. Fortunately, the majority of these injuries are only minor ankle sprains.
What is an Ankle Sprain?
Ankle sprains often involve the ligaments on the outer ankle, most commonly the Anterior Talofibular (ATFL) ligament. These ligaments are important for providing strength and stability of the foot and ankle region. During an ankle sprain ("roll your ankle"), the ligaments undergo a quick stretch.
Thankfully, the human body is an excellent self-mechanic. The whole body jumps on board to support the injured region.
Thankfully, the human body is an excellent self-mechanic. The whole body jumps on board to support the injured region.
- Pain signals send alarms to the brain indicating that activity needs to be modified
- The circulatory system (blood vessels) increase blood flow to the area creating some local swelling
- The immune system sends special nutrients to remove any stagnant fluid and replenish the region
- The musculoskeletal system (muscles and bones) stop activating to avoid further injury
How Long Will It Take to Get Better
While the time frame for full recovery will vary significantly depending on the severity of the ankle sprain, symptoms should begin to improve within the first few days. Gentle, pain free exercises are often prescribed within the first 24-48 hours to maximize early return to normal activities. Swelling and bruising is common. In fact, it is the bodies natural healing process to aid the injured area. The key is to manage any bruising, pain, and swelling so that normal movement can begin! If no complications arise, significant improvement should be seen in 4 weeks (It should be noted that 100% recovery can take months in more severe sprains).
Is Exercise Beneficial following an Ankle Sprain?
Early pain free exercises can help get people back to their normal fitness routine. You must perform the exercises on a regular basis to prevent stiffness or scarring from occurring. The exercises should not cause increased pain, but may cause soreness after completing the routine.
Below are several exercises that initiate movement following an ankle sprain. Please consult a local physical therapist for individual exercise prescription.
Below are several exercises that initiate movement following an ankle sprain. Please consult a local physical therapist for individual exercise prescription.
 Standing Calf Stretch Description: Place the injured foot behind the uninjured foot and keep the back knee straight, with the heel firmly planted on the floor. Lean forward against a wall so that you feel a stretch in the calf furthest from the wall. Hold each stretch for 1 minute. Repeat 3x. |  Heel Raises Description: Stand with your feet a few inches apart, with your hands lightly resting on a counter or chair in front of you. Slowly raise your heels off the floor while keeping your knees straight. Hold for about 3 seconds, then slowly lower your heels to the floor. Repeat 2 sets x 30 repetitions. |  Towel Scrunches Description: Begin with your foot flat on the floor. Using your toes scrunch the towel towards you. Scrunch the towel as far as possible, then straighten and repeat. Repeat 3 sets x 15 repetitions. |
Assuming you are healing properly, these exercises will be quickly progressed to more advanced balance and strengthening exercises. Below are 4 examples of more advanced strengthening that is essential in the later stages of rehabilitation.
How Do You Prevent Ankle Sprains in the Future?
Once your symptoms have decreased it is important that you take the necessary steps to prevent the injury from returning. Below are several tips for preventing ankle sprains.
1) Strengthen the muscles of the foot and ankle
2) Focus on balance and coordination exercises
3) Strengthen the hips and spine
4) Change environmental factors (shoe type, body weight, walking surface)
1) Strengthen the muscles of the foot and ankle
2) Focus on balance and coordination exercises
3) Strengthen the hips and spine
4) Change environmental factors (shoe type, body weight, walking surface)
What is Joint Mobility?
| Being flexible includes a combination of both good muscle length and joint mobility. In other words, the muscles must be able to stretch and the joints need to be able to absorb forces and move throughout various planes of motion. When someone loses motion in their joints, either stiffness and/or pain is the result. A common example occurs when someone loses mobility in their hips. As a result, the body compensates by moving excessively somewhere else. Typically the low back is the culprit, which explains why so many people have low back pain. | |
In this post, I am going to discuss hip joint mechanics and provide 3 valuable exercises to maximize mobility and minimize stiffness.
The Hip Joint
The hip joint is made of the head of the thigh bone (femur) and the round surface of the pelvis (acetabulum). Since the hip is a ball and socket joint, it has large amounts of available range of motion. This range of motion is essential for walking, climbing stairs, and squatting with proper form. Ligaments, muscles, and a thick layer of cartilage surround the joint to maintain strength and stability. If the hip joint is injured OR a person gradually becomes inactive, the range of motion will be limited.
Who Commonly Needs Hip Mobility?
1. People who sit for long periods of time
- Reason: the hip is designed for motion. Prolonged sitting decreases the opportunity for movement
- Clinically, I find that males more commonly have tightness and stiffness in their hip joints
- Due to the repetitive nature of running, the hips and ankles are prone to stiffness. Maintaining joint mobility is key for injury prevention.
Hip Flexor and Quad Opener
- Tuck the pelvis before leaning into the stretch
- The band provides extra resistance against the front of the hip joint
Banded Leg Raises
- Create tension in the band before raising the leg
- The band should be centered at the hip joint, providing an outer directed pull during the leg raise
Banded Heel Rocks
- Start in a neutral spine position
- Rock hips toward heels while maintaining the neutral spine
- While pressing forward, feel tension increase in the band
 | Heafner Health is a Physical Therapy clinic in Boulder, CO! As a residency trained Orthopedic Specialist, Jim identifies the cause of people’s pain and symptoms. His treatments combine hands-on techniques (including soft tissue work and adjustments) as well as corrective exercises, with the goal of getting people back to the activities they enjoy most. |
Can you keep your torso tall as you lower into the squat?
Do your heels pop off the ground?
Do your knees cave towards one another?
Do your heels pop off the ground?
Do your knees cave towards one another?
 | Squatting is a fundamental aspect of our lives. It is a movement we perfect as children but forget by the time we hit adulthood. A proper squat indicates that you have good motion at your hips, knees, and ankles while simultaneously controlling your torso. When you lose the ability to perform this basic functional movement, you put yourself at a higher risk of injury. This post gives you 6 mobility exercises to improve your squat form from head to toe! "Squats should be performed by people of all ages. I am not talking about loading weight onto a squat rack, but simply the ability to bring your butt below knees without falling over" -Dr. Jim Heafner PT, DPT, OCS Heafner Health Physical Therapy Boulder, Colorado |
What Do You Need to Know About Squatting
The squat is considered a compound, multi-joint movement that targets the gluteals, hamstrings, and quadriceps. When performed correctly, it activates over 200 muscles. The single leg squat shows exceptional muscle activation of both the gluteus medius and gluteus maximus (1). These muscle groups are extremely important in decreasing your risk of low back, hip, and knee pain.
The squat is considered a compound, multi-joint movement that targets the gluteals, hamstrings, and quadriceps. When performed correctly, it activates over 200 muscles. The single leg squat shows exceptional muscle activation of both the gluteus medius and gluteus maximus (1). These muscle groups are extremely important in decreasing your risk of low back, hip, and knee pain.
Essential Mobility Exercises
As I mentioned above, a proper squat requires coordinated movement in the ankles, hips, core, and middle back. Typically a loss of mobility in one of these regions is a contributing factor to someone's inability to squat. Below are the TOP 6 exercises I routinely perform to maintain good squat form.
As I mentioned above, a proper squat requires coordinated movement in the ankles, hips, core, and middle back. Typically a loss of mobility in one of these regions is a contributing factor to someone's inability to squat. Below are the TOP 6 exercises I routinely perform to maintain good squat form.
Mid Back MobilityKey Points
Ankle MobilityKey Points
Maintain an Upright PostureKey Points
| Calf and Hamstring MobilityKey Points
Outer Hip MobilityKey Points
The Full PatternKey points:
|
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