Tag Archives: physical therapy traverse city

Elite PT October Newsletter – Therapist Spotlight: Lydia Case

I can’t believe another month has flown by and it’s time for another newsletter.

Here is what you’ll find in this month’s issue:

  • Therapist Spotlight:  Lydia Case ATC
  • Back Pain and Sciatica Workshop has been moved to November 4th
  • Sports Medicine Clinic for High School and College athletes

Therapist Spotlight
Lydia Case joined Elite Physical Therapy back in July of 2015 and has been an invaluable part of our team ever since.  She works full time in the clinic plus during the school year she goes out to Kingsley High School two afternoons per week. She has been the athletic trainer at Kingsley for 11 years now.

Lydia has been practicing Athletic Training since 2006 in physical therapy and high school settings. She received her Bachelor’s degree from Northern Michigan University, where she had experience working with the Men’s football and hockey teams. Before transferring to NMU Lydia ran track & field at Aquinas College, but also worked with the Women’s volleyball and Men’s basketball teams at Aquinas. Lydia is a certified Kinesio Taping Practioner(CKTP). She believes that every patient and athlete is unique and that their treatment and workouts should be tailored specifically for their individual needs in order to achieve their best outcome.

1)  What got you interested in athletic training?

My love for sports is what initially got me interested in athletic training- I thought what a great fit- you work with athletes out in the field and can also work with the general public in a PT clinic- NO day is ever the SAME.

2)  What do you like best about being an athletic trainer?

I get excited about helping people and seeing how each patient/athlete is unique. I have worked with people from ages 3 to 98 and everything in between and have so much fun because everyone is so different as well as their injury.  I find it so rewarding to help someone accomplish their goals.

3)  What do you do for fun other than just work at Elite?

I enjoy spending time with my family – we love to be outside especially tubing down the Boardman River, taking our dog Gus for a walk in the woods, and riding 4-wheelers. I also like to play games, mostly card games like euchre. I also enjoy running with my friends and have completed 5 half-marathons, but prefer to run the 10k distance. I have been married to my husband Dave for 11 years and have two kids, Delaney (8) and Owen (5).

Testimonial:

“When I first came to Elite PT I was devastated because I had a running injury that literally prevented me from doing anything.  I was going from exercising 6 days a week, running 3-4 days per week, to barely being able to walk!

I felt like Lydia and Kristy were as excited as I was to get started with strengthening exercises.  I experienced such relief from my treatment, and the exercise plans they put in place for me helped support rebuilding my strength.

I felt like I had my own cheering squad every step of the way.  I am now back to my regular exercise program!”  – L.T. Traverse City

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Back Pain and Sciatica Workshop moved to November 4th!

We will be hosting our first workshop on back pain and sciatica on Saturday November 4th from 10 – 11am.  If you know someone who has been suffering from back pain and/or sciatica then be sure to let them know about this workshop!

Lower back pain is a huge problem in this country, but unfortunately most people feel like there is no ‘cure’ and they just have to live with it.  Check out this short video for more information on the workshop and to listen to how this is one of the biggest ‘myths’ in the health care industry.

The workshop is technically for those who have not been clients of ours in the past.  Past clients receiving this newsletter are welcome to call us with questions ANYTIME!  We are more than happy to answer any questions you may have and set up a time to get you in for a free screen if that is what is necessary.

Like I said, call us anytime!  231 421-5805
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NEW Sports Medicine Clinic Tuesday Afternoons

Many schools in our area don’t have access to athletic training services or team doctors at their games, so many young athletes with injuries don’t get the medical care they need.  We currently provide the athletic training services at Kingsley High School which has been extremely beneficial for our athletes.  The goal is to treat them early to keep them playing and also to keep them from more serious problems and costly treatment down the road.

Unfortunately, we can’t be everywhere, so on Tuesday afternoons we’ll be offering free screenings to athletes with nagging injuries affecting their performance or keeping them from playing altogether.  We can diagnose the injury and get the athlete started down the road to recovery.  Athletes with more serious injuries should see their family physician!

Appointments will be available between 3 – 5pm.  Parents should call to make the appointment as we will need your contact information and at least verbal permission to examine your child. We prefer that a parent be able to make the appointment especially if the athlete is under 18 years of age.

Give us a call at 231 421-5805 to schedule a time.

See you next month!

Joe Heiler PT

Solving Lower Back Pain – Find the Pain Relieving Direction

Just a reminder we’ll be hosting a Back Pain and Sciatica workshop November 4th from 10-11am.  If you are suffering from lower back pain and/or symptoms that go down your leg then this is for you!

One of the topics we will be covering is what we call finding a directional preference.  Many folks with lower back pain, including symptoms down one or both legs, will have a direction that their back prefers to move in.  It could be flexion (forward bending) or extension (backward bending).  Finding a definite preference can often lead to a significant reduction in symptoms on day 1.

What is also true on many occasions is that moving in the opposite direction will make their symptoms worse.  So avoiding activities that increase pain, or just adapting them to avoid certain movements, can also reduce symptoms quickly.

Check out the new video for more information including a mini-case study on how it can work.

At Elite PT we are trained to determine if there is a directional preference and then how to best take advantage of that for a quicker recovery.  This is just one strategy that we will discuss at our Back Pain and Sciatica Workshop.  For more information or to sign up just give us a call at 231 421-5805.

 

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.

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

Exercise of the Week – Wall Slides for Shoulder Pain

At Elite Physical Therapy we know that shoulder pain and rotator cuff dysfunction is often the result of multiple factors such as poor scapular stability, loss of cervical and/or thoracic mobility, and poor trunk stability just to name a few.  Wall slides are one of those exercises that will address each of these areas of concern in one shot.

I’ve featured wall slides here in the past with the back up against the wall, but in this version there isn’t the input for the wall to correct posture and there is more of a focus on scapular upward rotation.

  • Posture – get tall and press away from the wall. You’ll notice in the video how this even assists with a bit of cervical retraction.
  • keep the forearms vertical to keep the posterior rotator cuff and scapular stabilizers engaged – this will be much more difficult with the band.
  • only go as far as the forearms can stay on the wall – this forces you to work through the lats and stiff upper back muscles.

You should feel a lot of muscle activation in the back of the shoulders and between the shoulder blades.  At no time should you have shoulder pain.  If so, this exercise may not be appropriate and probably a good time to have your physical therapist or physician take a look.

Any questions feel free to email me:  joe@elitepttc.com or call 231 421-5805.

Originally posted on SportsRehabExpert.com

Trigger Points and Shoulder Pain – Part II

originally posted on SportsRehabExpert.com

Joe Heiler PT

Shoulder pain is such a common diagnosis that we’ll see here at Elite Physical Therapy, and there are a number of structures that can be pain generators to the shoulder and arm. Last month I talked about trigger points in the posterior rotator cuff (Infraspinatous and Teres Minor) along with their common referral patterns. Another common shoulder muscle to find active trigger points is the supraspinatous. Active trigger points in this muscles can refer pain to the deltoid and down the lateral aspect of the arm.

Check out the typical trigger points and referral patterns below:

Supraspinatous Trigger Point Referral

Check out the video below for a demonstration of dry needling to the supraspinatous:

Case study:

Feel free to check out this case study but it was originally written for physical therapists and chiropractors. Ultimately the point is that a combination of dry needling and soft tissue mobilization, in addition to corrective exercises, can significantly decrease pain while improving range of motion and movement.

Current patient of mine presents with lateral arm pain of 3 months duration. No known cause of injury but diagnosed with tricep injury/tear.

Pre-Treatment

SFMA dysfunctional non-painful patterns:

  • all cervical patterns (mobility)
  • R shoulder medial rotation extension (mobility) – FN to the L
  • MS rotation R (motor control deficit) – FN to the L.

    SFMA dysfunctional painful patterns:

  • R shoulder lateral rotation flexion
  • MS extension (R UE pain)

    Special tests:

  • Hawkins + on the R
  • Passive shoulder IR 20 deg.

    Palpation:

  • Tenderness with palpation of both trigger point in the supraspinatous with referral of pain down the lateral upper extremity to the wrist (indicates that is the pain he gets into the upper arm)

    Treatment on Day 1 consisted of Functional Dry Needling to the supraspinatous (x2) with electrical stimulation followed by more superficial Graston technique to the R upper trap, supraspinatous, infraspinatous, and teres minor along with light strumming at the supraspinatous insertion. Corrective exercise included 3pt. thoracic rotation (UE positioned in internal rotation – hand behind the back) with manual assist to hold/relax work until pt. was able to control the full available range.

    Post-Treatment

    Functional Non-Painful patterns:

  • R shoulder medial rotation extension
  • MS rotation B

    SFMA dysfunctional non-painful patterns:

  • all cervical patterns (mobility)

    SFMA dysfunctional painful patterns :

  • R shoulder lateral rotation flexion
  • MS extension (R UE pain)

    ***both are still painful although intensity has decreased while motion has increased***

    Special tests:

  • Hawkins + on the R but much less intense
  • Passive shoulder IR 50 deg.
  • Graston Technique – Treating the Painful Shoulder

    Here is the video I promised using Graston Technique to treat soft tissue dysfunction in the posterior shoulder girdle using and in particular the trigger points that can refer pain to the front of the shoulder and down the arm.

    If you haven’t read the previous article discussing why we would want to treat this area, you can check that out here:  http://www.elitepttc.com/blog/trigger-points-and-shoulder-pain/

    If you have any questions concerning Graston Technique, Dry Needling, or shoulder pain please contact us at 231 421-5805 or Joe@elitepttc.com

    Trigger Points and Shoulder Pain

    There are a number of manual therapy techniques we use here at Elite Physical Therapy and Sports Performance, including Graston Technique and Trigger Point Dry Needling, to address muscular pain.  What many people don’t realize is that taut bands of hyperirritable muscle (a.k.a. trigger points) can cause local and referred pain.

    This article is one I wrote for SportsRehabExpert.com awhile back showing how trigger points in the back of the shoulder, specifically the muscles of the posterior rotator cuff, can refer pain to the front of the shoulder and down the arm.

    If you have shoulder pain that has not responded to other types of treatment, then check out this article and please contact us with any questions you may have!

    Manual Therapy Technique of the Week – Treating the Infraspinatous and Teres Minor 

    Joe Heiler PT

    I’ve become much more familiar with trigger point referral patterns and treating these out the past couple years since taking the Kinetacore Functional Dry Needling course.  A couple of the more common trigger points I end up dry needling and/or using Graston Technique to treat in the shoulder are the infraspinatous and teres minor.  Active trigger points in these muscles can refer pain to the anterior and middle shoulder, and on occasion will also refer pain down the arm.

    Check out the typical trigger points and referral patterns below:

    Infraspinatous Trigger Points and Pain Referral Pattern

    Infraspinatous Trigger Points and Pain Referral Pattern

    Teres Minor Trigger Point and Pain Referral Pattern

    Teres Minor Trigger Point and Pain Referral Pattern

     

    Case Study

    Current patient of mine presented with R shoulder and scapular pain of 2 year duration.  MS rotation limited to 50% bilaterally (DP) and R shoulder medial rotation extension (MRE) reach only to L4 (DP).  Palpation of the infraspinatous trigger point (most superior and lateral) referred significant pain to the anterior shoulder and slightly down the lateral arm reproducing her typical pain.  The teres minor trigger point referred pain to the middle deltoid area.

    Post trigger point dry needling of these trigger points the patient’s MS rotation improved to 90% (dysfunctional still but non-painful) and R shoulder MRE to T9 (still DP but much less pain).

    It’s not always this dramatic but this is also not the first time I’ve seen the great results like this.

    I’ll get a video up soon showing how we use Graston Technique to treat the posterior shoulder to reduce this type of pain and improve shoulder function.

    In the meantime feel free to contact us with any questions:  231 421-5805 or Joe@elitepttc.com

    When Pain Happens

    Great blog post from my friend and former PT student Greg Schaible on understanding pain.  This is an exciting new area of study and lots of potential here to help folks overcome pain and restore function.  Enjoy!

    Greg Schaible PT, CSCS – On Track PT and Performance in Ann Arbor.

    Here’s a riddle.  Nobody wants it, but everybody has experienced it at some point in time. It acts oddly and seems to come on for no rhyme or reason.  It is vastly misunderstood by the general population as well as healthcare professionals from all fields.

    You guessed right, the answer is pain.

    If you are reading this post and currently in pain, I genuinely am sorry and have empathy for your situation.  But understanding pain is the first step in combating it, so you are in the right place.  My goal is to educate people on pain. In my profession I deal with pain every day, so in order to treat it, I need to do my best to understand its complexity. I have learned a great deal about the subject of pain from books by David Butler and Lorimer Moseley. These two guys are at the forefront of the research on this subject.

    So what is pain?…….  A short but loaded question.

    First let’s get some context. The body is constantly gathering information from sensory receptors about the body’s internal and external environments.  It is also interpreting how these two environments are interacting and how they relate to one another. All these signals are ultimately sent to the brain to make heads or tails of the information. These inputs can range from actual tissue damage, chemical changes, past experiences, emotional/psychological distress, lack of sleep, hunger, your mother yelling at you, or seeing a snake on a plane.

    Snakes on a Plane

    The brain’s job is to then interpret all of these signals and determine if a threat is present. If the body perceives there is a threat, a number of different responses are possible.  One of the possible responses is pain.

    Or in the case of snakes, call Sam!

    Pain is felt as a survival mechanism to encourage you to take action. However, it does not always mean damage has actually occurred.

    Consider this example Lorimer Mosley gives: A fractured wrist is often very painful until it is put in a cast. Once casted, the pain is almost always gone quickly thereafter.

    Interesting!

    The problem with this is that we know that bone will take 6-8 weeks to fully heal (depending on age and other factors).  Yet, pain is no longer present, and in some cases instantaneously gone once placed into a cast.  So why is this? Very simply, the need for protection is now gone because the cast acts as an external protective device.

    In this example the pain is gone but damage is very much still present. The opposite can also be true. The body can be in pain, but no longer damaged.

    We must consider other factors such as social influence, past history, fear, future consequences, stress to name a few. All these signals can trigger the body to feel it is under threat and notify you via pain. For this reason you can experience pain with no tissue damage at all.  I’m sure you have heard the term phantom limb pain.  Even though the limb is gone, the body still has the ability to sense pain in this area.  This reinforces the fact that if you can experience pain without a body limb, then tissue damage is not necessarily a prerequisite for pain. Furthermore, just because you are experiencing pain in a particular area does not mean that is in fact the source of the pain.  This is why it is important to find a clinician who does not focus solely on the area of pain, but looks for other areas of dysfunction which may contribute to the brains overall perception of threat.

    Another possibility is that tissue damage could have very well occurred which initially started the pain cycle.  However, because the body is great at healing itself at the cellular level. It is also possible that the tissue may have healed. Yet the brain still has the perception of threat because non-threatening inputs were never sent up to the brain to override the previously painful threats.  This may explain why people often feel pain long after normal tissue healing time has passed. This is also why it is important to not treat pain with pain.

    Here is some research that backs the theory: tissue damage does not equal pain. Jensen and colleagues performed a study titled: MRI of lumbar Spine in People without Back Pain. They found that 52% of people without back pain had at least one bulging disc or MRI abnormality.  Templehof and colleagues performed a study titled: Age-related prevalence of rotator cuff tears in asymptomatic shoulders.  The authors found that 23% of people with asymptomatic (non painful) shoulders actually had a rotator cuff tear. These are just two examples. Numerous other studies could be cited to help support that tissue damage does not have to cause pain.

    So the next time you experience pain, please understand that there may be a number of contributing factors. Remember that pain is perfectly normal, it’s your body’s alarm system. Pain can be present with or without tissue damage. Providing the body with novel non-threatening stimulus’s to remove the body’s need to produce a protective response is a great place to start if you are currently experiencing pain.

    Let’s take the example of elbow pain, lateral epicondylitis a.k.a tennis elbow. It’s not uncommon for lifters to experience elbow pain. I have noticed it becoming more prevalent now as people spend more time on their tablets using their fingers instead of a mouse.

    tablet

    Holding a tablet in one hand, and constantly using your fingers to swipe, type, navigate, etc. will place your wrist/elbow musculature on constant stress. Over a prolonged period, this can be perceived as a threat to the brain. Especially if you are lifting heavy weight in conjunction and require a high volume of grip strength for your workouts.

    So applying the knowledge we learned about pain, and how it may or may not relate to tissue damage.  Here is a very simple and extremely effective solution to a lot of cases.

    1st) Reduce the threat. In this example altering body mechanics while using a tablet and modify your workout routine with less grip intensive activities for the time being.

    2nd) Provide a novel and nonthreatening stimulus.  In this example, I will use a wrist extensor stretch.

    While this exercise may not seem like much, it’s very effective when applied correctly.  Flexing your wrist and turning it to the side obviously places a stretch on the outside of the elbow or to the wrist extensors.  In addition, you are also placing some tension and loading a nerve which flosses through the tissues at the elbow called the radial nerve.

    So we now have our novel/nonthreatening stimulus.

    3rd) Here is the kicker. You can do all the above, and get zero results unless you get this third step correct.  You MUST perform the novel/nonthreatening stimulus frequently.  To the tune of every 1-2 hours for best results.  Here is why it’s so important.  When the body is in pain, it is very good at making memories of pain.  This is because the body is very protective over itself, and rightfully so.  The only way to reduce the threat is to perform a stimulus frequently enough that if no longer feels the need for protection.

    This example can be applied to many other pain scenarios as well if you follow the steps correctly. 1) Remove as many threats as possible while in pain 2) Pick a novel/nonthreatening stretch or exercise 3) The exercise should be simple enough so that you can perform it frequently throughout the day (in some cases every 1-2 hours).

    Bio

    Greg SchaibleGreg Schaible is a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS), and runs On Track PT and Performance in Ann Arbor.  He attended The University of Findlay as a Student Athlete.  As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and a 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT).  Greg is an avid Lions, Pistons, and most importantly a Michigan Wolverines fan.  When you don’t find Greg in the clinic treating patients, he enjoys spending time with family and friends, living an active lifestyle, coaching, and playing sports.

    Elite PT Exercise of the Week – Landmine Front Squat to Press

    Joe Heiler PT and Nick Lucius SPT

    At Elite Physical Therapy and Sports Performance we’re always looking for new ways to challenge our patients and athletes.  The landmine squat to press is one of those exercises that can be used to really stress the entire system without having to utilize a lot of loading so it fits in nicely in higher level rehab and during the training process.

    Reasons to use this squat variation include:

    1)  Having the weight in front allows the athlete to sit deeper into the squat with a more upright trunk which is great for those dealing with, or recovering from, low back pain.

    2)  Keeping both hands on the bar keeps things more symmetrical with the squatting and pressing movement.  Stability requirements are increased with the use of this exercise but are balanced right to left.

    3)  Hold the bar in one hand for an asymmetrical loading pattern.  This will load the body differently demanding greater stability throughout the movement.  This is a more advanced technique so 2 hands on the bar to begin.

    Technique:

    1)  Do not squat lower than your mobility allows!  The weight in front often allows for a deeper movement but do not let the pelvis tuck under and low back to round out.

    2)  Heels must stay flat on the floor.

    3)  Elbows between the knees (this keeps the knees wide).

    4)  When using the asymmetrical single arm loading pattern, you must keep the body centrally aligned – no shifting, leaning, etc.

    Give this one a shot and you’ll see what we mean!

    BIO

    Nick Lucius PicNick Lucius SPT is completing his final year in the physical therapy program at UM-Flint.  Nick is a certified strength and conditioning specialist (CSCS) through the National Strength and Conditioning Association (NSCA), and also works as a strength coach at Barwis Method in Plymouth, MI.  After graduation Nick plans on returning to Barwis Method to work with patients affected by orthopedic and neurological conditions.

    Nick played Linebacker at Grand Valley State University in his undergraduate days, and now enjoys anything active from running to weight training, and is always going through a good book.