physical therapy

6 Ways To Improve Your Posture At Work

Published at In Category Back Pain, physical therapy, Posture, Stretching
6 ways to improve your posture at work

Neck and back pain are two of the most common diagnoses we treat here at Therapydia. While these symptoms are occasionally caused by an acute injury, more often than not they are simply the result of sitting for too long during the work day! Unfortunately, desk jobs are not going away anytime soon, so it is important to make sure that you are doing everything you can during the day to avoid the repeated stresses that bring so many into our clinic.

Here are a few handy tips to address your sitting posture during the work day:

  1. Sit with your feet flat on the floor

By ensuring that your feet are on the floor and not hanging or crossed, you are taking stress off of your legs and hips that can translate up to your pelvis and back. Moving your feet around during the day is fine, but make sure that your chair is low enough that your entire foot (heel and toe) can rest comfortably on the ground without having to strain or stretch. If you cannot fully reach the floor, or can only touch with your toes, your chair is too high!

2. Make sure your lumbar spine is supported

Most modern office chairs offer a good amount of lumbar support, but not all chairs are perfect for the individual sitting in them. Some people require a bit more support, while others may find that their chair doesn’t provide the required support in the correct spot in their back. Use a small lumbar support (either a lumbar roll, available online, or a rolled up sweater) to help provide a bit more support in the small of your back.

3. Adjust your monitor to eye level

One of the most common causes of neck and upper back pain is related to the flexed posture that individuals sit in during the work day. Whether this is from looking down at our phones, reading, or just staring at the computer screen, individuals with neck pain often have it because of sustained flexed posture. This puts more strain on most of the structures in the neck, along with the upper traps. By moving your desktop monitor up to head level so that you can look straight forward while working, you can significantly help to reduce the amount of strain put on your neck during the work day.

4. Keep your arms in a resting position

Some desks are too tall for the person working at them, which can lead to neck and shoulder pain! Ideally, your arms should be resting by your side while typing and working at a computer, not elevated or extended out in front of you. If you find that your arms are away from your body, try to adjust your keyboard and mouse (either in their position on the desk or by using a keyboard tray) to help reduce neck and shoulder strain.

5. Make sure everything is in front of you

When someone complains of neck or back pain only on one side of their body, it can sometimes be related to a repeated movement or position that is only done to that side. In the office setting, that can be something as simple as turning to pick up the phone, look at a second monitor, or turning to talk to a coworker. If you find that you are repeatedly turning to just one side, it may be worth reconfiguring your office space to make sure that you are working in both directions, or better centered to complete your daily work tasks.

6. Get up regularly!

Even those who start with perfect upright posture don’t always stay there for long. Slouching happens, and the best way to avoid sticking in that position for long periods is to stand up frequently throughout the work day. One helpful tip we provide many patients is to set a timer for every 30-45 minutes, then get up when that timer goes off. Even standing for 10 to 15 seconds and performing a stretch or two can make a huge difference in your overall posture, and how you feel throughout the day!

4 Easy Exercises to Reduce Running Injuries

Published at In Category physical therapy, Run Tags: , , , ,
Running Injury Exercises Stretches Physical Therapy Washington DC Running Stretches

Are you a runner? Chances are you have had some sort of leg pain or injury in the past. Some of you may have even sustained a longer-term injury. While there is no surefire way to prevent running injuries — trust us, we’d love to find that magic elixir as much as you would — there are ways to keep the body strong and limber enough to withstand all of the miles you are putting on it, whether you’re just going out a few times a week or training for your next marathon!

Exercise 1: Soleus Stretch

Let’s face it; most runners aren’t great about stretching, and the ones that are don’t always hit everything they should. The soleus is one of those oft-neglected muscles that could use some TLC, especially if you have had any Achilles issues in the past.

Running Injuries Physical Therapy Stretch

For this running stretch, position yourself like a normal calf stretch; move into a staggered stance, with one leg in front of your torso and one leg behind you. Keep the back heel down as you lean forward, but make sure to bend your back knee as you lean into the stretch. This one may feel a bit awkward at first, and you may need to have your feet a little closer together than usual. You can also put your big toe up on a small book or something similar to get more of a stretch in the soleus, Achilles, and even plantar fascia.

Exercise 2: Toe Yoga

Nothing is more important for a runner than taking care of your feet. Not only does this mean providing appropriate skin care and avoiding blisters, it also means keeping them nice and strong! Many runners who suffer foot or ankle injuries suffer from a lack of strength and stability within the foot’s intrinsic muscles. These muscles provide your base of support, and can affect everything else up the kinematic chain.

Running Injury Toe Feet Health Physical Therapy

For this exercise, you can either sit or stand with your foot flat on the floor. It is best to do this exercise barefoot at first, so you can see what exactly your foot is doing. Start by lifting your big toe up while keeping the rest of the foot relaxed and flat on the floor. Return your big toe to a resting position, and then lift your other toes up off the floor. You should be able to lift the other toes without the big toe curling; if so, your flexor hallucis longus (one of the muscles coming from your calf) is compensating for a lack of foot intrinsic strength. Keep working on this one until you can keep that big toe straight while lifting the others.

Exercise 3: Prone Hip Extension

Most PTs tend to focus on the hip abductors when evaluating runners for hip and knee pain, and for good reason! Runners only tend to move in one direction, resulting in weakness in the outside of their hips. However, their pain may not always be related to weakness in the gluteus medius, the main muscle responsible for hip stability on the outside of your hip. Instead, research is showing that weakness or a lack of firing in the gluteus maximus can result in hip and knee pain in runners.

Running Injury Prone Hip Extension Exercise Physical Therapy

For this exercise, lie face down and bend your knee up to 90 degrees or more. It may be a good idea to perform this exercise in front of a mirror at first to get a sense of where your knee is in space. Once in position, lift your foot straight up towards the ceiling, and focus on activating your gluteal muscles. If this gets difficult after 5 to 10 repetitions, keep working on it! Those glutes need to be nice and strong to keep you stable when running.

Single Leg Balance

If you break it down, running is merely the body jumping back and forth from one foot to another. You will never have both feet on the ground at the same time when running, so it is extremely important to have good balance on one leg!

Running Injury Single Leg Stance Exercise Physical Therapy

This one is as easy as it sounds. Stand on one foot! It may be better to do this barefoot at first, as you want to avoid your toes from “splaying,” or spreading out and trying to grip the surface you are standing on. If this seems easy, progress to standing on carpet, a pillow, or a piece of cushy foam to create a more unstable surface, forcing your foot and leg to stabilize even more.

How to Prevent ACL Injuries for Athletes

Published at In Category ACL, physical therapy Tags: , , , , , , , , ,
Washington DC Physical therapy soccer ACL injury recovery injury prevention

By Robert Rogacki, PT, DPT, CERT. MDT

If you play soccer — or have played on a team in the past — chances are you know someone who has torn their anterior cruciate ligament, or ACL. It’s just a matter of probability, really; female soccer players are 4-8 times more likely to suffer an ACL injury compared to the normal person, and the injury rate is higher than average for males as well. While surgical interventions have come a long way in helping athletes recover from these injuries, wouldn’t we be better off preventing them in the first place?

What is the anterior cruciate ligament?

The ACL is a ligament within the knee that is essential for stabilization during running, jumping, cutting, and twisting; basically, everything that soccer players are doing on the field. Most ACL tears are non-contact injuries, and occur while cutting or changing direction.

Why do ACL injuries occur and how can we prevent them?

Most ACL injuries occur as a result of valgus forces at the knee, or an inward movement of the knee when jumping, landing, or cutting. Avoiding these movements is not easy. It takes concentration and practice to learn correct movement patterns that avoid putting excessive stress on the knee and the ACL.

Here are a few easy exercises that will help soccer players (and other athletes!) decrease their risk of ACL injuries.

Side-lying Hip Abduction

Lie on your side with your bottom knee bent for support. The top knee should remain straight, and in a straight line with your torso. It may be helpful to lie with your back against a wall at first to get a sense of the proper hip position. Once in position, keep your top knee straight and toe pointed forward, and lift your leg straight up into the air (think about lifting with your heel). Stop when you start to feel your pelvis rotate. It may be helpful to keep your top hand on your hip during the exercise.

Why it’s important: Knee and leg strength are important for injury prevention, but so is hip strength. Strengthening the hip abductors (or the outside of the hip) can keep the hip in a more neutral position, which will in turn help knee the knee more neutral as well.

Standing Squats (With Proper Form!)

Squatting is a normal functional movement, but people have a lot of trouble with correct form when squatting for exercise. There are two key points to note here: (1) keep your knees from bending inward when squatting. The kneecap should stay even with or slightly outside of the toes.

Also (2), it is important to keep the knees from moving too far forward relative to the foot and toes when squatting. Many people have trouble activating their gluteal muscles when squatting, leading to a forward position that puts excessive force on the front of the knee, including the patellar tendon.

Why it’s important: Proper squat form is a precursor to proper knee bending form when running, jumping, and other high-impact movements. By learning how to activate your glutes and “sit back” into a squat, you will avoid putting excessive stress on the knee joint.

Standing Reach and Row

Stand on one leg with your knee slightly bent and either a weight or a band in front of you. While maintaining a slight knee bend and level trunk, lean forward to grab the weight or band. Allow the opposite leg to come up, ensuring you are hinging at the hip. Prior to rising back up, focus on elevating your glutes (on your stance leg) to help you return to a vertical position.

Why it’s important: Maintaining proper form when running, jumping, and cutting isn’t just about strength; balance and stability are important too! This exercise is a nice catch-all for many of the things PTs focus on when rehabbing patients with ACL injuries, and is beneficial for those looking to avoid injury as well. It helps improve standing balance, forces the athlete to focus on maintaining proper knee position, and strengthens the hip and glute muscles all at once!

Strengthen Your Abs Without Getting Back Pain

Published at In Category Back Pain, physical therapy Tags: , , , , , , , ,
ab-exercise-no-back-pain

In most cases, strengthening is pretty easy. Find a weight, lift it up and down several times, and move onto the next exercise. But abdominal strengthening has continued to vex people, leading them to persist with the same standby exercises: sit-ups and crunches.

However, studies show that these exercises can lead to back pain and most people don’t even use their abs for sit-ups! Full sit-ups involve heavy use of the hip flexors; while it’s important to strengthen this muscle group too, this exercise isn’t accomplishing the desired goal.

So, skip the sit-ups! Here are a few exercises that are both easier on your back and harder on your abs, giving you more bang for your buck while helping you avoid low back pain.

planks-ab-exercise

Exercise 1: Planks

These may look easy, but planks are a challenging full body exercise that force you to activate your entire core. Prop up either onto your elbows (low plank) or hands (high plank), maintain a rigid core and hold! The amount of time is up to you but you should stop when your abdomen starts to drop toward the floor; this is a sign of fatigue. If possible, perform this exercise alongside a mirror at first so you can gauge proper hip and pelvis position.

 

side-plank-ab-exericse

Exercise 2: Side planks

When working on abdominal strengthening, most people neglect their obliques, or the muscles along either side of your abdomen. One good way to strengthen them is with side planks! Start by lying on your side, then prop onto your elbow or hand and lift your hips off the ground. Again, the hold time is up to you but you should stop when your abdomen starts to droop. Make sure you stay nice and level too! Most people tend to lean too far forward. Performing this exercise in front of a mirror at first is a good way to learn proper side plank position.

 

bird-dog-abs-exercise

Exercise 3: Bird dog

Patients who have seen a physical therapist for low back pain before might be familiar with this one. Bird dogs are a great exercise for many muscle groups, including your lower back and core. Start in a kneeling position with your hands on the ground (or a mat). Extend one arm and the opposite leg while contracting your abdomen to maintain a level core. Slowly lower both extremities to the floor and repeat with the other side. Ideally, the extended arm and leg will be completely horizontal but the most important part of this exercise is keeping your trunk nice and stable.

 

bridges-abs-exercise

Exercise 4: Bridges

Bridges are another old standby exercise for hip and core strengthening. Start on your back with your knees bent. Squeeze your glutes and your abdomen and lift your hips off the ground. Push all the way up until your abdomen is completely level, hold for a second or two and lower back to the ground. Longer holds are OK too but could put unwanted stress on your lower back if you don’t maintain a tight core. For an additional challenge, try flexing one hip and performing the exercise on just one leg!

Get to Know Your PT: Rob Rogacki, Therapydia DC Physical Therapist

Published at In Category physical therapy
Therapydia DC Physical Therapist Rob Rogacki Physical Therapy

Therapydia DC physical therapist Rob Rogacki takes some time to talk about his always-changing music taste, the importance of being personable and what he wishes everyone knew about PT.

“One of my old mentors always says “motion is lotion.” Find something you enjoy doing and stay active!”

When did you know that you wanted to be a physical therapist?

I originally wanted to go to business school but thanks to an internship during my freshman year of college, I realized that this field was NOT for me. I started shadowing people in other professions, including my high school soccer coach who was a physical therapist. Seeing the positive impact PTs can have on people in such a meaningful way resonated with me, and the rest is history.

How do you like to stay active?

Even though I live in D.C., I love being a tourist! There’s always a monument or a museum to walk or run to.

What is the biggest challenge involved in being a PT?

Probably everything outside of the actual evaluation and treatment of patients itself, or what I call the “extracurriculars” of working as a PT. From paperwork to scheduling to dealing with insurance, it can all become a distraction if too many things get in the way.

What’s your favorite song to get you motivated?

“Whole Lotta Love” by Led Zeppelin. Ask me again next week though, it will probably change!

What surprised you the most about the physical therapy profession?

Honestly, it was a pleasant surprise to learn just how much information physical therapists can obtain from a simple evaluation. From differentiating between different types of injuries to determining where exactly in your back that nagging pain is coming from, PTs can learn a lot just by listening to your story and watching you move.

Are you currently pursuing any further education/certifications?

I just finished my McKenzie certification and will be getting my dry needling certification soon. I also plan on becoming an Orthopedic Clinical Specialist and am always looking to improve my manual skills through different continuing education courses.

What do you wish everyone know about PT?

I wish more people knew how helpful PTs can be when healthy, not just when a person is injured or in pain. Physical therapists are uniquely trained to assess a person’s overall musculoskeletal function and can often catch injuries or sources of pain before they become a problem.

What’s your go-to breakfast?

I’ll eat anything i can get my hands on during the week but on weekends I like to make a breakfast scramble with eggs, grilled onions, peppers and potatoes.

What is the most important personality trait that PT must have?

A good PT absolutely has to be personable and down to earth. Relating to people and creating good rapport with patients is crucial to the rehab process as it allows patients to relax and be more comfortable with their therapist and their injury.

What do you do to de-stress/unwind?

I’m somewhat of a homebody so hanging out with friends or watching movies would be on my to-do list. Bonus points if there’s food involved.

Finish this sentence: On Saturday mornings, you can usually find me…

Relaxing at home with a hot cup of coffee. In the summer, it will be iced coffee and somewhere near a pool.

What is your favorite piece of wellness advice?

One of my old mentors always says “motion is lotion.” Find something you enjoy doing and stay active!

Click here to learn more about Rob and the other physical therapists at Therapydia DC.