Elite PT July 2017 Newsletter: Lower Back Pain, Employee Spotlight – Jesie Bott, Exercise Tips and more…

Hope you’re having a great summer and surviving the craziness that is northern Michigan in July.

This months newsletter features:

  • Employee Spotlight – Jesie Bott
  • Lower Back Pain – 80% of us are going to have it!
  • Exercise Tip of the Month

Employee Spotlight
Jessica “Jesie” Bott was our very first employee starting back in 2012.  She took a bit of a hiatus after giving birth to her daughter but she’s been back a couple years now and we love having her around as much as possible.  Jesie home schools her two children and works Fridays during the school year but in the summer we’re blessed to have her 2.5 days per week.  She’s got a ton of energy and really loves to get to know her patients and clients.  She does a great job for us here at Elite Physical Therapy so we wanted to tell her story.

Jesie is an Athletic Trainer and licensed massage therapist, graduating from Grand Valley State University in 2005.  Jesie has worked in the outpatient orthopedic setting since graduation, and also worked as the athletic trainer at Kingsley High School for 5 years.  Jesie is a Graston Technique Certified Clinician, and trained through Functional Movement Systems giving her the ability to critically analyze a person’s movement ability and develop exercise programs that really work!

Why did you become an ATC/LMT?
“I had an inclination toward sports and health and wanted a career that kept me physically active and challenged me mentally.  Athletic training was a perfect fit!”

What do you enjoy most about the job?
“What I truly like best about my job is helping people feel better. I’m passionate about it.  I want to see people get results and I’m happy to be a part of that.  At Elite, I enjoy the one on one experience with each patient as well as having the freedom and ability to use my knowledge and creativity to problem solve and do everything I can to help someone feel better.”

What do you do for fun?
“Other than working at Elite….:)  I enjoy spending quality time with my family.  We love to be outdoors, camping, playing in the water and playing with our sweet puppy.”

Jesie has been married to David Bott for 13 years and have two great kids – Chase and Clare.  Jesie also owns Freedom Massage Therapy and currently sees clients at Elite PT on Tuesdays and Fridays. You can call her at 231 357-0151 for more details.

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Did you know that lower back pain will affect at least 80% of us at least once in our lifetimes.  Depending on the research article, once you’ve had a back pain episode, chances are between 60-80% that you’ll have recurring episodes beyond that.  Not great odds at all.

Here at Elite PT, lower back pain is the most common diagnosis that we treat.  There are numerous causes of lower back pain – some easier to fix than others, but it’s our job to figure that out.

One of the more common causes is Spinal Stenosis.  Stenosis literally means ‘narrowing’ and in this case the narrowing can cause compression and irritation to the nerves that leave the spinal cord and go out to the lower back, hips, and legs.  This causes pain across the lower back and can also produce symptoms into one or both legs.

spinal stenosis

How do you know that you may have Spinal Stenosis?

  • 50+ years old
  • Standing and walking increase symptoms
  • Sitting and lying down relieve symptoms
  • Leaning on the cart at the grocery store allows you to walk with less back pain

Spinal stenosis, like most types of lower back pain, is something that can absolutely be treated in physical therapy.  Certain muscles being ‘tight’ can create more compression and narrowing and therefore must be address using soft tissue techniques like massage, Graston Technique and dry needling.  Exercises must also be incorporated to stretch those tight muscles and improve how our joints move around the back and hips.

Other muscles tend to be ‘weak’, specifically the abdominals and glutes.  When strong and working with the right timing these muscles can reduce damaging forces across the spine.

A comprehensive physical therapy program that addresses all these factors can be extremely beneficial.

Here is what one of our former clients with spinal stenosis had to say:

Patient Testimonial
“I came to Elite taking medication to numb the pain in my back and legs so I could make it through the day.  Thanks to Jesie I have no more pain and know how to strengthen the muscles to help prevent the pain from returning.  She is a great therapist and I will use her again in the future if the need arises.”
– D.B. from Traverse City

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Exercise Tip of the Week

Child’s Pose is a common yoga pose that produces flexion through the hips and spine.  For someone with spinal stenosis this movement frequently decreases or eliminates the person’s symptoms.  If it relieves your pain, then do it whenever you need relief!

Child's Pose

Try to sit back on your heels – unfortunately my knees don’t bend that far!

In the bottom position, take 4 breaths in through the nose and out through the mouth.  Breathing in this manner decreases tone through the back muscles and also calms the nervous system bringing further relief.

For those with knee pain who can’t perform this exercise, try the seated floor press below.  It’s basically the same movement but with more body weight (usually fine but can be too much if you’re really sore).  Use the same breathing technique but be sure to put your hands on your knees to push yourself back up when you’re done.  This just takes some extra pressure off your back.
Seated Floor Press

You may find these simple exercises can make a huge difference in how you feel and how long you can be on your feet throughout the day.  If so, just keep doing them and you may just be able to keep yourself out of pain.

If you have all the signs and can only get temporary relief with the exercises then you probably would benefit from physical therapy.  Call us if you have questions (231 421-5805) and we could tell you if PT is for you.
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Have a great month of July with hopefully more warm weather to come.

We can be reached at 231 421-5805 or through email:  Joe@elitepttc.com if you have questions or if you just want to let us know how you’re doing.

Hip Flexor/Ankle Dorsiflexion March

Elite PT June 2017 Newsletter – Dry Needling for Ankle and Foot Pain, Athlete Updates, and more…

Welcome to this month’s issue of the Elite Physical Therapy and Sports Performance newsletter.  Check out the short article and demo videos on dry needling, see what some of our graduating athletes will be up to in the Fall, as well as our ‘Exercise Tip of the Month’:

I can’t believe it’s already June and school’s just about out!

Here’s what’s new at Elite Physical Therapy this month:


Kristy Ockert MSPT just completed her first Functional Dry Needling course down at Grand Valley State University a few weeks ago.  She had a great time and learned some cool new techniques.  Since then she’s been practicing on Lydia and myself to fine tune her skills.  Follow the link below to see how its going!

We’ve seen numerous clients lately with calf pain, Achilles tendonitis, and plantarfasciits who’ve had great results with the combination of dry needling, Graston Technique, and exercise.  Here is what one of our clients with Achilles tendonitis had to say:

“I had issues walking at work and limited mobility in the ankle before therapy.  I can now walk all day at work and have no pain or swelling in the ankle area.” – K.W. from Grayling

In this case, PT was the last option prior to surgery.  Thankfully we were able to avoid surgery and get her back to work without pain.

There are certainly plenty more conditions that can benefit from dry needling in addition to the other physical therapy techniques that we employ.  Relieving pain and improving muscle function are big benefits of this technique.  To see more on dry needling, how it works, and a demonstration for treating neck pain and headaches, click the link HERE to check out the video on our home page.

If you have any questions about the technique or if you’re wondering if dry needling may work for you, feel free to give us a call at 231 421-5805.  Ask for Joe or Kristy.
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Athlete News

I want to acknowledge some of our past and present clients that will be moving on at the end of this school year to further pursue their athletic dreams.  These guys are a hard working bunch and will be missed!

Chris Kolarevic from St. Francis High School – will be playing football at the University of Northern Iowa.
Michael Hegewald from St. Francis High School – will be playing football at the University of Dayton.
Alec Trautman from Elk Rapids High School – will be playing football at the University of Dayton.
Will Russell from Traverse City East Middle School – will be attending the Steamboat Mountain School in Colorado skiing on their U16 Alpine Team.

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Exercise Tip of the Month

We’ve been talking about treatments for the lower leg and foot the past couple months so I thought I’d stick with this commonly injured area one more time.  Last month I showed a great way to improve the way the foot and ankle move – if you missed it just let me know and I can re-send that to you.  This month we’ll look at an easy way to begin strengthening.

Ankle Marching with mini-band

Place the band around your feet with the feet just wide enough that there is a small amount of tension on the band.  Bring the knees up toward your chest and flex the ankles back as far as possible.  Kick one leg out straight but keep the opposite leg motionless.

Hip Flexor/Ankle Dorsiflexion March

Hip Flexor/Ankle Dorsiflexion March – Start Position

 

Hip Flexor/Ankle Dorsiflexion March

Hip Flexor/Ankle Dorsiflexion March – Finish Position

The leg that remains motionless will actually be the leg that is working the hardest.  Do not let this leg follow the other!  Not only will you feel the muscles in the front of the lower leg working hard but you’ll also feel your hip and stomach muscles.  This exercise is typically done after stretching out the calf muscles and is done for 2 sets of 10 on each side.
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Have a great month and talk to you again in July!

Joe Heiler PT

 

 

Elite PT May 2017 Newsletter/Plantarfasciitis Treatment

In this month’s email newsletter we’re going to talk about treatments for foot and heel pain, a.k.a plantarfasciitis.

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April was a super busy month with our first ‘Free Screening Day’.  We had 20 former patients come in plus a few new folks. It was great to catch up in addition to helping some of our former clients with their current injuries.  Big thanks to everyone who could make it out!

We’ll definitely be hosting another ‘Free Screening Day’ later in the year so we’ll keep you posted.
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Treatment Spotlight – Plantarfasciitis

It’s that time of year when we start seeing more and more folks with that stabbing pain into their arch and heel, better known as plantarfasciitis.  As we get more active in the nicer weather the muscles and tissues on the bottom of our feet can take a beating resulting in significant pain that will limit walking and running.

Fortunately there are some really cool things we can do treat this condition that you aren’t going to find elsewhere in northern Michigan – specifically Graston Technique and Dry Needling.  Check out the video below to see how we use Graston Technique to treat this condition.

http://www.elitepttc.com/graston-technique-and-plantarfasciosis

We’ve had great success treating these conditions.  Here’s what one former patient had to say:

“I’ve had foot pain since June of 2016 and 3 cortisone shots which never even touched the pain.  I started at Elite PT in February which has helped me to regain full use of my foot without any pain”. –  M.B. from Traverse City (March 2017)

Physical therapy can often be quite successful even when more aggressive measures like injections, bracing, and casting have failed.  This client of ours is back to standing at work all day and going back to the gym without pain.

If you are suffering from foot and heel pain, give us a call (231 421-5805).  We can help to relieve the pain and get you active again.

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Exercise Tip of the Month
One of the keys to relieving arch and heel pain is to improve the mobility of the ankle joint.  This is one area where most of us are lacking and it can predispose us to problems like plantarfasciitis.

Stretching the tissues of the calf and foot are great for improving ankle mobility and below is a picture of how we often have our clients self-stretch at home.

Hold the stick either at the tip of the middle toe (easier) or fifth toe (harder).  Keeping the heel down, glide the knee forward but around the outside of the stick.  You’ll notice how much more difficult it is to go around the stick versus just straight ahead or to the inside.  This is part of the trick to improving mobility of the ankle and it also strengths the muscles of your foot. Doing the stretch barefoot works best too.

This is a great exercise to not only treat plantarfasciitis but also to prevent it!
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Have a great rest of the month and talk to you again in June.

Joe Heiler PT

 

ACL Injury Prevention 101

ACL injuries (anterior cruciate ligament) have been an epidemic in sports but even more so in women’s athletics.  Females are 3-4x more likely to tear their ACL than men.  A few of the main reasons are:

– poor mobility/flexibility
– insufficient strength levels
– improper jumping and cutting mechanics

ACL Injuries

Poor Landing Mechanics!

At our ACL Injury Prevention clinic you will learn the fundamentals of strength training, flexibilty, speed and agility, and jump training to become a better athlete while also decreasing the risk of devasting ACL injuries.  See our recent blog posts for more information on ACL injuries and examples of how we teach landing mechanics.

Athletes will work in small groups with our expert staff addressing each of these problem areas. They will also learn drills and exercises that can be done at home or within school training programs to continue to develop athletically.

Come ready to work and learn!

Cost is $10 per athlete

Who:  Middle and High School Female Athletes

Where:  Elite Physical Therapy and Sports Performance – 4177 Village Park Dr. Suite B Traverse City (next to Wuerfel Park)

When – February 11th 10am – noon

What to bring:  athletic attire, water bottle, and your energy!

Space is limited to 24 athletes so sign up today!

Bonus:  we’ll be offering a free movement screening session to attendees who would like to participate.  Screening consists of the Functional Movement Screen (FMS), Y Balance test, plus jump and hop testing.  Exercise programs are then individually developed based on these test results.  Those interested can schedule their free screening by calling us at 231 421-5805.

UPDATE: The clinic was a big success and we definitely plan on doing it again. Here is what some attendees thought about the clinic:

“It was a lot of fun and I learned a lot of new exercises” – A.R.

“I never realized how hard it would be to do some of these exercises. Or that my right leg was a lot stronger than my left leg” – A.H.

“The girls had a good time. It was really eye opening to see some good athletes struggle with controlling their landings. Thanks for doing this” – J.W. Parent.

We can also set up an ACL injury prevention clinic for your team. If you are interested just give me a call at 231 421-5805 or email Joe@elitepttc.com.

ACL Injuries and Prevention – Jump Training Part 3

Here is video #3 in our series on box jumps and how we use them here at Elite Physical Therapy and Sports Performance to decrease the risk of ACL injuries and also to improve jumping performance.

Don’t forget this Wednesday Dec. 28th – the Northern Pride Sports Academy is running a basketball clinic for 6th – 8th grade girls at Kingsley High School from 2pm – 6pm.  We will be taking athletes through our jump training progressions, injury prevention techniques, as well as what the athletes can be doing at home to continue to get better.

Here is the link to sign up:  http://www.northernpridesportsacademy.com/december-28th-clinic.html

Stay tuned as we’re planning on hosting an ACL injury prevention clinic at Elite PT in February.  I’ll have dates and times coming soon.

Joe

joe@elitepttc.com

231 421-5805

ACL Injuries and Prevention – Jump Training Part II

Last week I talked about some of the main causes of ACL injuries and why they occur at a rate of 3-4x more often in female athletes.  You can find that article along with our first jump training video here:

This week I’m posting the second video in a series of three showing how we begin jump training to a box.  This type of training can be used for ACL injury prevention and to enhance sports performance.  It’s also what we do post-surgically to get the athlete used to jumping again and landing safely.

The great thing about box jumps is that the forces on the knee are quite low because you are not coming all the way back down to the floor.  It’s also much easier because of this for the athlete to work on proper landing technique.

Before I get to the video though I thought I’d post a picture of what you don’t want your athletes knees to look like.

ACL Injuries

a.k.a. valgus collapse of the knee

Check out the video below for more:

Looks fairly simple but let me assure you it can be quite challenging for many athletes – boys included.  Learning to jump and land correctly has been proven to help prevent ACL injuries and it must also be a huge focus of any post-surgical ACL rehabilitation program.

If you have any questions feel free to contact me Joe@elitepttc.com or 231 421-5805.  We also do injury prevention and return to sport testing which does include a number of jump/hop tests.  If you’d like to know where you stand in relationship to other athletes in your sport we can definitely set that up for you.

ACL Injuries and Prevention

ACL injuries (anterior cruciate ligament) have been an epidemic in sports but even more so in women’s athletics.  Females are 3-4x more likely to tear their ACL than men.  There are several proposed theories on why this is so but for the purposes of this article and what we address here at Elite Physical Therapy we will discuss the following:

  • Poor movement quality
  • Strength deficits
  • Landing mechanics

I’ll go more in depth in subsequent articles but for now here are the basics:

Poor movement quality

There are just certain joints in our bodies that need to be very mobile in order to get us through our daily activities and especially sporting activities like running, jumping, and cutting.  Don’t get me wrong – all of our joints need to move through their full range of motion for us to be efficient movers.  Some just need to be emphasized a bit more because of their tendency to become stiff while other areas of our body need a bit more stability/motor control.  Check out the picture below to get an idea of how this works – it’s called the Joint – by – Joint theory.

Alternating sequence of mobility - stability through the entire body

Alternating sequence of mobility – stability through the entire body

It’s a very simplified way of looking at things but it does often work out this way.  The knee joint needs to have a great deal of stability in all directions to prevent injury.  If the ankle and hip joints above and below are moving well then the knee joint will more likely stay within it’s accepted range of motion during athletic movements.  If the ankle and/or hip are stiff then the knee may just have to go outside of it’s normal boundries to land from a jump or decelerate while cutting.  This is where things can go south in a hurry!

Strength deficits

There is plenty of research out there in the medical and physical therapy journals showing that strength deficits can lead to knee injuries, and in particular ACL tears. Years ago the main concern was the ration of strength between the quadriceps and hamstrings, which if it was below a certain level it could inhibit an athletes ability to decelerate correctly leading to injury.

Lately the focus has been more on the hips and muscles of the ‘core’ and how weakness or lack of control in those areas can contribute to injury.  I’ll get more into the ‘how’ and ‘why’ in another article but it is a reality that needs to be addressed.

At Elite Physical Therapy, we know that a comprehensive strength program must be implemented to assist in the prevention of ACL injuries.  Quality movement is critical for effective strength training as well.  Being able to combine these qualities is what we do best, and definitely one of my favorite things to talk about so more to come for sure!

Landing mechanics

It is also well documented that female athletes land and cut differently than the male athletes.  Women tend to land stiffer and higher than the men who typically land in deeper hip and knee flexion angles.  Stiffer and higher landings are more dangerous as far as the knee joint is concerned.

Strength and movement quality again play a large role in this.  Some athletes can’t even get into a good position to perform complex athletic movements.  Big problem!

Many don’t have the strength to get into the proper positions.  Another big problem.

As the athletic activities get faster, more complex, impose higher forces, etc it becomes more and more challenging to perform them using good technique.  Fortunately all of these qualities can be addressed through physical therapy and proper training techniques.

Check out the video below showing how we start teaching athletes to jump correctly using box jumps.  The nice thing about landing on a box is that you don’t really have to come all the way back down.  Much less strain on the knees and an easy way to work on jumping and landing technique.

I’ll be posted a new video every few days showing more of the progressions we use.  We will also be hosting some ACL prevention clinics in the near future so if you’d like to learn more and get some hands on assistance than please contact us.

Here is what we have coming up:

December 28th from 2 pm – 6 pm at Kingsley High School with the Northern Pride Sports Academy.  6th – 8th grade girls basketball skills camp.  We will be teaching a session on jumping progressions to improve athletic performance and reduce injury risk.

In February (date to be determined) we will be hosting an ACL Injury Prevention clinic here at Elite Physical Therapy and Sports Performance.  Topics will include mobility training, strength training, and jump training progressions. More on that to come as we continue to line up speakers and instructors.

For more information you can contact us at 231 421-5805.

Joe Heiler PT

Back Pain and Sciatica – Part 2

Last month I posted a case study showing how we treat back pain and associated ‘sciatica’ like symptoms here at Elite Physical Therapy in Traverse City.  You can find that article here:  http://www.elitepttc.com/back-pain-and-sciatica-physical-therapy-treatments/

This month’s case study is a little different in that the presentation and location of the pain were quite different but it still comes down to playing detective to determine where the patient’s symptoms are really coming from.  Before we get started here, I’m re-posting the picture of the dermatomes of the body (basically the sensory distribution of the nerves from the spine) so be sure to check that out.  Pretty cool how we were created for sure!Dermatomes

Case Study #2

The patient in this case presented to our clinic with pain shooting into the front of his hip and groin as well as down the front and side of his thigh.  He also reported minor back pain but it was nothing compared to the pain in his leg.  The patient reported having this pain on and off over the past couple years especially when exercising but recently it was much more constant and severe.  In the past he had been diagnosed with IT Band syndrome (pain laterally in the hip and thigh might make you think that), and more recently with a hip flexor strain (could also make sense now that he was having more pain into the front of the hip and groin).

Exam

  • minimal tenderness to the ‘hip flexor’ muscles anteriorly, slight weakness with manual muscle testing but no pain (probably not a hip flexor strain).
  • moderate tenderness and active trigger points in the lateral hip musculature that referred pain down the lateral thigh to the knee (could be part of IT Band syndrome).
  • springing of the lumbar vertebrae at L2 and L3 reproduced the typical symptoms  he felt into his anterior hip/groin as well as lateral thigh (Bingo!)

Treatment

Dry needling was performed at the levels of L2 and L3 along with electric stimulation for 10 minutes, and followed up with Graston Technique (GT) to decrease tone and improve mobility of the superficial fascia and muscles of the mid and lower back.

A couple exercises were given to maintain, and hopefully even improve, the mobility gained through the spine and hips as a result of the dry needling and GT.

Results

The patient reported a significant decrease in the anterior hip and groin symptoms as well as a moderate improvement in lateral hip and thigh symptoms.

During the second treatment session I decided to treat the muscles of the lateral hip as well since they also referred pain into the lateral thigh.  This was done with by dry needling + e-stim just like we had done in the low back.

By the third treatment session a few days later the patient was reporting a significant reduction in lateral hip and thigh symptoms as well.

Final Thoughts

It took a few more treatments to completely resolve this patient’s symptoms but it’s nice to see an immediate decrease in symptoms to know that you are treating the right areas.  With a thorough evaluation process it wasn’t hard to figure out that the patient’s symptoms were primarily coming from his spine which was quite a different diagnosis than what was previously thought.

A little detective work plus effective treatment tools like dry needling and Graston Technique can make a huge difference in patient outcomes especially in these ‘sciatica’ cases.  If you have similar types of symptoms or pain that just doesn’t ever seem to get better then give us a call!  If you have any questions feel free to email me:  joe@elitepttc.com

Back Pain and Sciatica – Physical Therapy Treatments

This month I figured I’d post on a couple case studies related to back pain and sciatica, and how we evaluate and treat cases like this at Elite Physical Therapy.  We’ve had a lot of great success with these folks so thought I’d share a couple examples.

Back pain, and associated leg pain, can be difficult to treat but we like a challenge!  Playing detective can be fun if you know what to look for.  Check out the pictures below that show the paths the spinal nerves take throughout the body.  Leg pain (or what many people like to call ‘sciatica’) can follow a number of paths down the leg and sometimes that can be a dead give away to identify exactly where the pain is coming from.

dermatomes

***The letter and numbers above correspond to a particular spinal nerve, i.e. L4 means lumbar spinal nerve #4 ***

There are other ways to narrow down the location of the problem as well:

  • the muscles will be painful to palpation at a specific vertebral segment and may even refer pain down the leg when palpated with deeper pressure.
  • reflexes may be diminished.  A slow or non-existent patellar tendon reflex corresponds with lumbar spinal nerve #4.
  • Muscles may test weaker on the affected side which may indicate an injury to a particular spinal level or nerve.  An example of this would be weakness in the calf muscles (can’t lift up on to the toes) which are controlled by the first two sacral nerves (S1 and S2 on the chart).

So here’s a great example of a number of these factors all lining up and how quickly the pain and loss of function can be addressed.

Case Study #1

The patient in this case had left sided low back pain and pain running down through the back of her hip and leg to the mid-calf.  She felt a ‘pop’ in her back and immediate leg pain as a result of pushing and twisting trying to put a heavy object in the back of her truck.  She is an avid runner but even standing and walking significantly increase her pain after 10 minutes.

Exam

So here is what I found:

  • Symptoms following the S1 and 2 dermatomes down the back of the left leg
  • Increased muscle tone/spasm at the S1 and S2 levels of the spine, and these muscles are tender to palpation.
  • ‘Springing’  or pushing down on the S1/S2 vertebrae reproduced the symptoms into the back of her hip/upper thigh.
  • She could do only 12 calf raises on her left leg while doing 25 on the right side (this muscle corresponds with S1 and S2 nerves).
  • Achilles reflexes normal (S1 reflex)

It’s nice when everything points back to a specific level or two like that.  Doesn’t always work that way but when it does it makes me much more confident that we can knock this out quickly.

Treatment

In this case I chose to use dry needling to address the muscles at the S1 and S2 spinal levels on both sides of the spine.  Once the needles were placed I attached an electrical stimulation unit and she just relaxed for 10 minutes.  Dry needling in conjunction with e-stim are shown in the research to decrease tone within the muscles as well as alleviate pain through a number of local and global factors.

The patient was instructed in two exercises that had multiple purposes:

  • decrease pain through relaxation of the over worked muscles of the back and anterior hip
  • facilitate improved stability through the lumbar spine and pelvis

Pretty simple exercises that are beyond the scope of this article but lots of bang for your buck when they only take 5 minutes 2-3 x per day.

Results

The patient had near full resolution of symptoms for two days after the first session.  Her exercises relieved her pain at home and she could walk as much as she wanted.  She tried to run on the third day but was unable due to pain.

We repeated the same dry needling + e-stim treatment during the second visit and followed it up by progressing her exercise program.

The patient cancelled her appointment the next week as she reported being completely pain free and back to running.

Final Thoughts

Sometimes it just works that well but I certainly won’t make that guarantee in every case!  Back pain and ‘sciatica’ cases can be quite complex but knowing how to put together all the puzzle pieces definitely helps.

That’s probably enough to wrap your head around for this time.  Next month I’ll post another case study but with a different symptom presentation.  In the meantime if you have any questions just shoot me an email:  joe@elitepttc.com or call 231 421-5805.

Occlusion Cuff

Blood Flow Restriction Training

Blood Flow Restriction training, aka BFR, has actually been around for awhile now but its finally starting to make its way into professional and collegiate sports as well as physical therapy.  Johnny Owens has been the driving force behind BFR in the U.S. after successfully using this technology with veterans recovering from devastating combat injuries.  Since that time he’s been training numerous professional sports teams in the use of blood flow restriction training including the Detroit Lions and Detroit Red Wings.

What the heck is it?

BFR training utilizes a tourniquet-like device which is placed proximally on a limb to limit arterial inflow to the limb while blocking venous outflow.

I should add a word of warning sooner rather than later.  There are commercial devices out there used by trained professionals for this type of training.  Do not make your own tourniquet and try this at home!

Benefits

I’m going to go a bit scientific on you here but just for a moment:

  • Training loads used are only 20-35% of 1 rep max, and often times are just body weight.  The same effects with weight lifting alone must be at least 70 – 85%.  Translation:  same results with less load = happier joints.
  • Higher release of growth hormone, insulin-like growth factor, and other substances known to speed tissue repair and create a positive environment for muscle hypertrophy.
  • Increased recruitment of Type II (fast-twitch) muscle fibers even with sub maximal loads
  • Increased muscle protein synthesis through the inhibition of catabolic substances.
  • Cell swelling : shift in fluid balance into the muscle cell creating a protective response to adapt and grow

Check out the chart below from Dr. Mario Novo at the LiftersClinic.com

LiftersClinic.com

Pretty cool stuff isn’t it?  Even with all the science thrown in.

How do you use it?

We work it into our rehab and training sessions closer to the end of the workout.  The build up of lactic acid will reproduce the ‘muscle burn’ sensation pretty quick causing a good amount of muscle fatigue with only body weight activities.  Body weight squats are usually a great place to start.  They are performed for 30 reps:15 reps:15reps:15 reps with 30 seconds between each set.  These will be the toughest body weight squats you’ve ever done!

The number of exercises performed and time training with blood flow restriction is gradually increased.  So far we’ve seen a rapid increase in tolerance to exercise among our athletes allowing them to do more and more work with BFR.  The results have been excellent too with quicker gains in muscle hypertrophy and strength.  If you notice the last column in the chart above – time to adaptation.  Within 2 weeks we are beginning to see positive changes compared to the traditional higher intensity training.

It might sound like I’m down playing the effects of higher intensity training regimens but I’m not at all.  There are tremendous benefits to lifting heavy and creating a great base level of strength.  BFR just offers a great way to increase training volume and intensity while decreasing load.  Over time the heavy weights will wear down your body – ask any collegiate or NFL football player – but this allows for a certain amount of unloading to happen and still reap all the benefits.

I know you want to try it!

Blood flow restriction training is safe when used with the right person at the right time and monitored appropriately.  It is also a pretty intense workout so definitely not for the faint of heart.

We are currently using BFR with athletes and patients post-knee injury, hamstring injuries, shoulder injuries, ankle sprains, and more.  Athletes that come in strictly to train have been having great success with it as well.  If you’ve struggled to make progress as a patient or hit a plateau in your training this would definitely be worth asking about.  We have a number of unique techniques to promote tissue healing and strength/power gains, and this is just one reason we have been setting ourselves apart from the competition!

Occlusion Cuff Shoulder

If you’re really into the science behind blood flow restriction training and would like to learn more, you can check out the two podcasts with Eoin Cremen (creator of the OcclusionCuff) on SportsRehabExpert.com

Questions?  Joe@eliteptt.com or give me a call at 231 421-5805