The core is the most integral component for building full body functional movement patterns. The terms ‘core’ and ‘stability’ are tossed around in our health and fitness world and the meanings are sometimes misconstrued. For starters, you can imagine the true deep ‘core’ as four muscles forming a canister around the thorax. The core is bordered superiorly (on top) by the diaphragm, anteriorly (front) by the transverse abdominis, inferiorly (on the bottom) by the pelvic floor, and lastly posteriorly (back side) by the multifidus. Although it might sound like I completely made up a few of these muscles, that is because they are some of the deepest muscles lying in this region and sometimes go unmentioned. Regardless we must all appreciate the functions each of these muscles have and how recruiting them appropriately will improve your quality of movement while reducing the likelihood of injury. According to the Panjabi Model there are 3 contributing factors to spinal stability as shown below.

Although I will be discussing more of the active subsystem or musculature involved in this interaction, it should be noted that our passive spinal column and neuromuscular components should ultimately be addressed to optimally ensure this desired spinal stability.

Lumbar Multifidus

This muscle was originally thought to have had some function in producing lumbar extension but more recent studies have suggested a strong stabilizing role. Being composed primarily of type I or tonic muscle fibers we hypothesize that there is more of a postural role being played (Sirca & Kostevc, 1985). Aside from helping control the spine in its neutral zone, the lumbar multifidus tensions the thoracolumbar fascia further stabilizing the core and spine.

Transverse Abdominis (TrA)

The TrA is the deepest abdominal muscle with fibers that run horizontally. This muscle is unique because it has a feed-forward loop in which it naturally fires to stabilize the spine prior to any body movement. For example every time you are bringing an arm overhead to stroke while paddling on a surfboard the TrA is firing to stabilize the spine. Over time if we practice compensatory movement patterns such as allowing our global muscles (rectus abdominis and obliques) to “over fire” we can lose the ability to recruit TrA and in turn lose some of our stability. As neuroscience research has indicated those movement patterns that we do not use, we lose (Kleim, 2008). Therefore it is crucial to re-train our TrA to function optimally to promote a healthy spine.

Pelvic Floor

Although it is an easily undermined area of focus, the pelvic floor muscles play an integral role in promoting core stability. These muscles resist increases in intra-abdominal pressure, which helps our core manage more complex movement patterns where many muscles are firing at once. Whether we recognize it or not, these muscles of the pelvic floor are contracting countless times throughout our day and when facilitated in conjugation with the TA, multifidus, and diaphragm can help keep the spine in its most stable position (neutral zone).

Diaphragm

Aside from its vital role of managing our breathing, the diaphragm is the largest contributor to our spinal stability through intra-abdominal pressure. According to Hodges et al. 1997, this muscle is needed to prevent displacement of abdominal viscera so that the TrA can increase its tension. This is important for our understanding moving forward as we should practice appropriate breathing techniques while exercising to further strengthen this muscle.

These muscular components discussed above can help improve spinal stability by incorporating simple exercises to your workouts. In most cases minor adjustments can be made to exercise technique to promote further recruitment of these local stabilizing muscles.

• Prior to participating in sport activities, ask yourself if your body is as prepared as it should be and…
• If you have already experienced some back discomfort consider how you can modify your training to focus on complete core stability to better prepare you to prevent injury.

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Dr. Bryce Parrish

Physical Therapist

If you find yourself in discomfort or think you could benefit from a personalized exercise plan, talk to a Physical Therapist.

Let’s talk! We are here to help. Give us a call for a complimentary assessment.
Did you know there’s no prescription needed from a doctor to see us?
(949) 443-0713

If you have been referred to physical therapy after an injury or an illness, then you may have questions about what will happen. Most people visit a physical therapist because they are experiencing pain or difficulty with normal functional mobility. Your physical therapist may prescribe treatments and exercises to help you move better and feel better. One of the best ways to improve your overall mobility is with physical therapy exercises.

Therapeutic exercise should be one of the main treatments you receive from your physical therapist. It doesn’t matter if you are in a hospital, nursing home, school, or an outpatient orthopedic clinic. Physical therapists are movement experts, and exercise should be the primary tool your PT uses to get you moving better and feeling better.

When your physical therapist prescribes exercises for you to do, they should be considered as specific movement strategies to help your body change and grow in a positive way. The exercises you do in physical therapy are designed for your specific condition and are an integral part of your rehab program.

Should exercise be the only treatment you receive in physical therapy? Not necessarily. Some physical therapists use other techniques like massage, joint mobilizations, or modalities—like ultrasound or electrical stimulation—to help their patients move better and feel better. While passive treatments may feel good, they should not be the only treatment you get in physical therapy. There should always be an active component to your rehab program which includes various types of therapeutic physical therapy exercises.

Types of Physical Therapy Exercises

There are different types of physical therapy exercises that may be prescribed for you depending on your specific condition. These exercises may include:

• exercises to improve strength
• exercises to improve range of motion
• flexibility exercises
• balance and proprioception exercises
• functional mobility exercises
• cardiorespiratory exercises
• exercises for vertigo and dizziness

A physical therapy exercise program should be tailored for your specific needs. For example, if you are having difficulty walking after a total knee replacement surgery, your physical therapist may assess your quadriceps function and prescribe specific exercises to help improve the strength of this muscle group.

The type of equipment you use depends upon the specific exercises you are doing and the goals of each exercise. Sometimes, no special equipment is necessary for your PT exercise.

Exercises are typically done in the physical therapy clinic, but they can also be done in the hospital while you are lying in bed or sitting up in a chair. Your physical therapist may visit you in the hospital and work on improving functional mobility—like moving in bed or climbing stairs—so you can safely go home. One component of this in-hospital rehab program may be to complete physical therapy exercises.

Your physical therapist may also prescribe exercises for you to do as part of a home exercise program. This program can help you improve your condition while you are not in the PT clinic, giving you control over your injury or illness. Your PT can also show you exercises that can be used to prevent future problems from occurring.

Choosing the Best Exercises for You

If you have suffered a broken bone, also known as a fracture, then you may benefit from the skilled services of a physical therapist. Your physical therapist can help you regain normal range of motion, strength, and functional mobility after a fracture. So what does physical therapy and rehab entail after a fracture?

If you have had the unfortunate injury of a fracture or broken bone, then you may understand how painful this can be. A broken bone requires swift medical attention to ensure proper healing and alignment of the bone.

After a fracture, your bone will be set, or reduced, by a doctor. Reduction of the bone can be done manually. For more serious fractures, a surgical procedure called an open reduction internal fixation (ORIF) may be necessary to make sure that all the bone pieces are in the correct place and healing can occur.

Often after fracture, the bone needs to be stabilized or immobilized to ensure proper healing. This is usually accomplished using a cast. For simple fractures, your doctor may elect to apply a removable cast so that gentle motion can occur around the injury site. After complex fractures or an ORIF procedure, you may be required to wear a cast that is not to be removed. If you fracture your shoulder or arm, you may be required to wear a sling to keep the arm immobilized. Check with your doctor to ensure that you understand what is expected of you in regard to immobilization.

Starting Physical Therapy after Fracture

After a fracture, physical therapy may be ordered to help ensure you return to optimum function as quickly as possible. You may encounter a physical therapist at different times in the continuum of care after suffering a fracture.

In the Hospital

After you fracture a bone, a physical therapist may visit you in the hospital. If you break your leg or ankle, a physical therapist may instruct you in how to walk with an assistive device, like a cane or crutches. This includes how to use the device to walk up and down stairs or to get into and out of a car. Be sure to ask questions if you have any.

After a lower extremity fracture, your doctor may limit the amount of weight you can put on your leg. Your PT can help you understand weight bearing restrictions and can teach you how to move about while still maintaining these restrictions.

If you fracture your arm, you may be required to keep your arm in a sling to help with healing. In the hospital, your physical therapist may teach you how to apply and remove the sling.

At Home

When you return home from the hospital after a fracture, your doctor may order physical therapy at home. Home care physical therapy usually is reserved for people who are unable to leave the house as a result of their injury.

Your physical therapist can help you master using your assistive device in your home environment. You may also engage in exercises to help improve your overall endurance or to strengthen the muscles around the fracture site.

If you break your leg or ankle, your doctor may have specific weight-bearing restrictions that you must follow. Your physical therapist can help you maintain these restrictions to ensure that you do not put too much stress on the healing bone. Lifting restrictions may be in place after an arm or shoulder fracture. At your house, your physical therapist can also assess your home environment. He or she can make recommendations to make minor adjustments to allow you to move safely around your home.

If surgery was required to set your fracture, your PT may assess your surgical scar to ensure that things are healing properly.

In the Clinic

When you have recovered enough to travel from your home, your doctor may refer you to a physical therapy clinic to help with restoring normal function after your fracture. Usually, this occurs after the cast has been removed and you can start mobilizing the area around the fracture. You may still have to follow weight-bearing precautions or lifting restrictions at this point, so be sure to consult with your doctor so you understand what your limitations are.

Your first visit with your physical therapist will usually involve an evaluation and assessment. Your therapist will likely take measurements of body parts around the fracture site. This might include measurements of:

• Range of motion
• Strength
• Pain
• Flexibility
• Girth or swelling
• Gait (for lower extremity fractures)
• Overall function and mobility

After the initial evaluation, your physical therapist can work with you to devise a treatment strategy to help you recover fully. Physical therapy after a fracture often focuses on overcoming the negative effects of being immobilized by a cast or sling. Immobilization may cause loss of motion and strength and decreased functional mobility.

Physical therapy after fracture can also help you improve your functional mobility. If you have fractured your leg, your physical therapist can help you improve walking and help decide if you should walk with a walker, crutches, quad cane, or standard cane. If you have fractured an arm or shoulder, functional activities that focus on reaching and grasping may be included.

Physical agents or modalities may be used to help with pain and swelling. Electrical stimulation may also be used to help improve muscle recruitment. You should remember that while passive treatments like electrical stimulation or ultrasound may be used, you should also be engaged in active activities in your physical therapy.

If you have had surgery to reduce the fractured bone, you may have surgical scar tissue. Scar massage and mobilization can help reduce scar adhesions and improve mobility around the scar.

Exercises to improve range of motion and strength may also be started. Particular focus should be placed on the fractured area and the joints around the fracture. If you broke a bone near your elbow, mobility exercises should be included for your elbow, wrist, and shoulder. Likewise, a fracture of the tibia (shin) should include exercises for the knee, ankle, and hip.

How Long Should PT Last?

Everyone’s fracture is different, and everyone heals at different rates. In general, a fracture should be healed by about eight weeks, and you should be back to normal within 12 weeks of a fracture. Your rehab should normally take about six to eight weeks, but your program may be slightly shorter or longer. Your physical therapist should be able to give you an idea of how long your rehab program is expected to last.

If you find yourself in discomfort or think you could benefit from a personalized exercise plan, talk to a
Physical Therapist.

Let’s talk! We are here to help. Give us a call for a complimentary assessment.
Did you know there’s no prescription needed from a doctor to see us?
(949) 443-0713

{Reference: https://www.verywellhealth.com/physical-therapy-after-fracture-2696424}

Are you 50, nearing 50, or older? Did you know orthopedic pain is the leading cause of disability for this age group in the United States and around the world? (“Orthopedic” means a part of the body that moves is not working correctly or is painful, and “disability” means that someone cannot live their fullest life, like work normally, spend time with their family normally, or easily play with their grandchildren.) All of these issues are treatable and even preventable with the help of a qualified physical therapist.

Here are Five Reasons to See a Physical Therapist in 2019

1. You want to age greatly, not just gracefully.

Not every 70-year-old patient I see looks and acts the same. The ones that exercise regularly and include exercise as a lifelong habit look and act about 10-15 years younger than their peers. In the game of life, from a physical therapist’s standpoint, those who are able to move, walk and live freely without disability wins!

A physical therapist’s goal is to keep you moving until the very end with good power, good motion, good balance and a high quality of life. Good physical therapy is the key to your overall good health. Please refer to an earlier blog about How to Find a Good PT.

2. You want relief from orthopedic pain.

In a study published at Life’s Work Physical Therapy, physical therapy was found to be effective in treating all types of pain in all body parts for both new and older injuries. In fact, the patients in the study had more relief from physical therapy than from pain medications! And the best part is physical therapy is not addictive and you can’t overdose on it.

3. You want to get stronger, improve your balance or sports performance as you age.

Physical therapists know how to detect injury, and how normal aging is associated with typical orthopedic problems. Time and “miles” on the body create typical “wear and tear” issues related to aging. Starting in the third decade of life, people lose 5% of their muscle mass per decade if they don’t lift weights to counteract this aging effect. By age 50, we lose 10% of our muscle power if we do not lift weights or do resistance training to maintain our strength!

Physical therapists are specially trained to diagnose injury and prescribe exercises appropriate for your age, injury, and lifestyle. A physical therapist can assist with strengthening and flexibility to combat the effects of aging.

4. You want to treat or avoid orthopedic injuries.

When it comes to detecting small injuries in the orthopedic system, physical therapists are pros! Those wear and tear injuries like small rotator cuff tears or gluteal weakness are easily found during a thorough physical therapy examination. Identifying orthopedic weaknesses and issues before they become painful is key to injury prevention. In addition, physical therapy helps to not only strengthen or stretch trouble areas but prevent future injuries. Don’t wait until it’s painful, get ahead of your injury.

5. You want to invest in your long-term health.

What’s a healthy, working body worth to you? These days, with increasing insurance costs and more out-of-pocket expenses for patients, we hear patients make poor decisions about spending money on themselves when it comes to physical therapy. If it costs you $500 to $1000 to see a physical therapist who can help prevent or treat a rotator cuff tear, treat early arthritis of the knee to avoid joint replacement, help you run with no pain (or better yet, run faster), or help relieve back pain so you can pick up your grandchild, then it’s worth it! Skip the daily Starbucks, pack your lunches and invest in your health!

An excellent physical therapist makes all the difference in how you age. Find one that works well with you and keep them on your team. You can usually access a physical therapist directly without going to your doctor first. Research physical therapists in your area or ask a trusted friend/family member for a recommendation. At Life’s Work Physical Therapy, we often see patients referred to us from other patients. Because we take care of very complex and stubborn injuries and have an Annual Physical program, patients who have failed to improve with other treatments or who want preventative care seek us out. Most physical therapists accept insurance but be prepared to pay some out-of-pocket expenses. Remember, you get out of it what you put into it. Physical therapists partner with you to get the results you desire. Your effort is essential in recovery and prevention! Physical therapists love helping people get well, and it only works if you follow the instructions and advice provided by your physical therapist.

Let’s talk! We are here to help. Give us a call for a complimentary assessment.
Did you know there’s no prescription needed from a doctor to see us?
(949) 443-0713

{Source: https://lifesworkpt.com/2019/02/five-reasons-to-see-a-physical-therapist-in-2019}

The road to recovery can be a daunting road for clients as they navigate the sometimes challenging demands of physical therapy. However, PT need not be accompanied by apprehension or anxiety about falling down or losing your balance during treatment. We use the Solo Step Overhead Track and Harness System to supports individuals as they work on their mobility and range of motion. Ideal for clients overcoming a variety of ailments, from Parkinson’s to amputations, the suspension system comfortably and safely supports PT clients as they work through their therapy without risk of falling down or injuring themselves due to losing balance. The Solo Step Overhead Track and Harness System allows you to work smarter, not harder, in your recovery.

By implementing the Solo Step Overhead Track and Harness System in your recovery, we aim to achieve the goals of not only aiding our clients on their road to recovery but also to help eliminate or reduce pain, to help restore range of motion as well as to allow clients the opportunity to work on their recovery with confidence. The clients are securely fastened within a harness, allowing them the freedom to work through their therapy without fear of slips or falls. When there is one hundred percent safety from accidents, clients can work on balance, strength, and recovery in a controlled and safe environment, thereby expediting their recovery while allowing them a space to challenge themselves and the way their body moves.

The Solo Step Overhead Track and Harness System also helps those with neurological and orthopedic disorders as well as high-performance athletes. Its benefits are limitless and it aids in the recovery of many types of patients. It’s easy to use while reducing the fear of strain or pain, which allows the physical therapist to step away from the patient and monitor full-body alignment and movement. The Solo Step Overhead Track and Harness System is another tool our PTs use to access methods of treatments that help to aid in recovery while limiting risk and strain on the individual.

Pack PT has the systems and the knowledge to aid you in a speedy recovery! Our team of experts has both the passion and the experience to provide you with the support and the programming to get you back to feeling like your strong and capable self! Visit our Facebook page at www.facebook.com/PackPhysicalTherapy or give us a call at 949.443.0713 to learn about the ways we can get you back to feeling like the best version of yourself!