Congrats to Elevate Runner Claudia Lane!

Claudia Lane recently won first place in the Foot Locker Cross Country National Championship, completing a 5k run in only 17:04.8! Congratulations on an amazing finish, from the entire Elevate team!

More photos from the race and all of the finishing times are posted on the Foot Locker National Championship website.

Dec 10, 2016; San Diego, California, USA; Claudia Lane (41) crosses the finish line and wins the Girls Milesplit Foot Locker National Finals at Balboa Park. Mandatory Credit: Orlando Ramirez-USA TODAY Sports ORG XMIT: USATSI-348782 ORIG FILE ID: 20161210_ter_rb5_057.jpg

San Diego, California, USA; Elevate runner Claudia Lane (41) crosses the finish line and wins the Girls Milesplit Foot Locker National Finals at Balboa Park. Mandatory Credit: Orlando Ramirez-USA TODAY Sports

Running is good for you… Fact or fiction?

runningWinter is wrapping up, New Years resolutions are still holding on for dear life, and the summer body is in full throttle. During this time of year, thousands of men and women hit the road in order to prepare for the LA Marathon. Running is the easiest, cheapest and most efficient way to build cardiovascular endurance. But is running safe for muscles, tendons, bones and joints?
It’s a popular belief that running is detrimental to cartilage health, and can lead to arthritis. In fact, research shows quite the opposite. A 2011 systematic review from the American College of Sports Medicine found that physical activity, including running, did not increase the risk of arthritis. Within that same review, a study from Sweden actually showed improvements in cartilage composition in runners! This is encouraging news for both avid, experienced runners, as well as the novice who is just trying to test the pavement.
Here are some helpful tips from Elevate to help you minimize injuries as you hit the open road:

1) “Everything is Good in Moderation”

While running has its benefits, doing too much too quickly can result in pain and injury. If you are a novice runner, start with shorter distances at a moderate pace (10-12 min miles), and consider a walk/run approach. The common rule of thumb is to increase your distance by 10% each week (If you are starting with 5 miles per week, the following week can be increased to 5.5 miles). Researchers found that a person who runs at a moderate pace for 30-45 mins, 3-4 times per week does not run a significant risk of cartilage damage or osteoarthritis. Moderation is the name of the game.

2) “Be Fit to Run, Don’t Run to Be Fit”

More than 70% of all runners will experience an injury that limits their function. Most of these injuries occur due to a poor foundation of strength and conditioning. Common injuries that runners experience include Iliotibial band syndrome, patellofemoral pain, patellar tendinitis, shin splints, or Achilles tendinitis. A big reason for these injuries is a lack of strength to meet the high demands of running. Common areas of weakness include the gluteal muscles, calves, and arch stabilizers of the foot.
Here are a few exercises from the Journal of Orthopedic and Sports Physical
Therapy to help prepare you for the road or trail. We will focus on some foundational hip extensor and abductor activation with the following 3
exercises.

Be sure to use proper form, and feel your posterior hip muscles turn on. Add
resistance bands at the thigh if necessary.

3) “Consider Your Shoes and Surface”

Footwear plays an important role in how the body absorbs shock. Make sure you wear a shoe that is conducive to your walking and running style. The number one variable should be comfort. If you don’t like the feel, you will hate it more when you run. Another variable is how your feet hit the ground. 75% of runners are heel strikers, 25% are mid foot or forefoot strikers. One pattern is not necessarily better than another. If you are serious about running, see a PT with experience helping runners. Knowing your strike pattern will provide insight into how you absorb force from the ground, and what is the best shoe for you. At Elevate, we utilize high-speed cameras and movement analysis software to uncover and correct faulty running mechanics leading to pain.
Surface needs to be taken into consideration as well. Harder surfaces create a large ground reaction force, which may place a higher load or stress through your joints and muscles. Start with running on softer surfaces, such as a flat grass field, or rubber track to decrease loading forces. Also consider that asphalt roads are harder than cement side walks. Trail running has is own perils due to the uneven terrain. This would be recommended for the most seasoned runner, as the incidence of ankle sprains rises significantly.

4) “Consider Your Current Fitness Status, and Injury History.”

Being overweight should not deter you from running, but here are a few things to
consider: According to a journal from the Computational Biomechanics of Medicine, with someone who is moderately overweight, there is around 40% greater pressure on the knees, hips and ankles during walking. With that in mind, during running, there can be anywhere from 2.5-8x a person’s body weight placed through the joint.
If you are someone who is looking to begin a weight loss program, consider shorter distances at slower speeds or the run/walk method, and allow ample recovery time (1-2 days in between runs). You can also consider other low impact exercises, like biking and swimming, to begin. As your body adapts, you will be able to increase both pace and mileage while minimizing injury risk.
The principles of moderation and strength building should be a top priority in order to run safely. If you are unsure about whether you should be running, come in to Elevate PT for a full movement evaluation, to help you get fit to run!

Neighmond, P. Put Those Shoes On: Running Won’t Kill Your Knees. National Public Radio: Your Health. Mar 28,

2011.

Urquhart DM, et al. What is the effect of physical activity on the knee joint? A systematic review. Med Sci in

Sports Med. 2011: 432-442.

Hinterwimmer S, et al. The effect of a six month training program followed by a marathon run on knee joint

cartilage volume and thickness in marathon beginners. Knee Surg Sports Trauma Arthr. 2014; 22:1353-1359.

Ramskov D, et al. High eccentric hip abduction strength reduces the risk of developing patellofemoral pain

among novice runners initiating a self-structured running program: A 1-year observational study. J Ortho Sports

Phys Ther. 2015; 45: 153-161.

Sanford BA, et al. Hip, knee, and ankle joint forces in healthy, overweight, and obese individuals during walking.

Comp Biomech for Med. 2014; 101-111.

This Is What Happens to Your Body When You Stop Exercising

Within four weeks: Your strength will start slipping

Dr. Hameed estimates that some people will notice their strength declining after about two weeks of inactivity, while others will begin to see a difference after about four weeks. The silver lining: Our strength probably diminishes at a slower rate than our endurance, and one 2011 study in theJournal of Strength and Conditioning found that when one group of men stopped doing resistance training, they still had some of their strength gains up to 24 weeks later.

Within eight weeks: You might gain fat

Dr. Hameed estimates that people will start to notice a physical change—either by looking in the mirror, or at the number on the scale—after about six weeks. Even elite athletes aren’t immune to the rebound. A 2012 study in the Journal of Strength and Conditioning Research found that competitive swimmers who took a five-week break from their training experienced a 12% increase in their levels of body fat, and saw a boost in their body weight and waist circumference. (We should also point out that these athletes weren’t totally sedentary—they still did some light and moderate exercise.) And a 2016 study found that elite Taekwondo athletes who took an eight-week hiatus from exercise experienced an increase in their levels of body fat and a decrease in muscle mass, too.

Health.com: 10 Reasons Your Belly Fat Isn’t Going Away

That said, there’s a difference between breaking up with exercise for good and taking a well-intentioned rest. The distinction: “You need to do some type of activity [every day],” says Dr. Hameed. For example, maybe you just ran the Chicago Marathon and can’t run another 16 miles, let alone 26—in that case, says Dr. Hameed, you should do some cross-training. (Think: cycling, using the elliptical, or even light walking.) Just don’t quit moving altogether—your body, brain, and waistline will thank you.

Tips, Drills and Advice from Elevate’s Youth Speed & Agility Class

Sunday’s workshop for youth athletes was wonderful, we have such amazing youth athletes in the ELEVATE family and they performed so well with the speed drills and running techniques that Joynier covered.

Everyone went home with a copy of his favorite tips and drills, and we’re posting a copy for you also to try at home, add to a workout, or share with an athlete you know!

Notes to remember:

The Spiderman Lunge and Inchworm are focused on range of motion and are best performed at the beginning of a workout as part of the warm-up.

Banded Bridges and the Side-lying Abduction are glute strengthening exercises and are best performed immediately after your warm-up, before any explosive drills. They can also be repeated anytime between workouts!

The Wall Knee-Drive and Hammer Punch Drills are best performed after the warmup is complete and glute exercises are finished. They can also be used prior to any competition as a way to enhance your turnover rate.

Enjoy!

screen-shot-2016-10-24-at-1-38-08-pm

Injury-Proof your Ankle

Ankle Sprains: Combination of Manual Therapy and Supervised
Exercise Leads to Better Recovery

Ankle sprains often occur when running, walking on uneven ground, or jumping. Sprains are more common in sports activities. Usually, people are told to rest, elevate the foot, apply ice, and use an elastic wrap to reduce swelling. This treatment is typically followed by exercises that can be performed at home. Although the pain and swelling usually improve quickly, more than 70% of people who sprain their ankles continue to have problems with them. In fact, up to 80% will sprain their ankles again. This suggests that it is important to better care for ankle sprains. One option is manual therapy, where the therapist moves the ankle and surrounding joints to help restore normal joint movement. A research report published in the July 2013 issue of JOSPT examines and compares the outcomes of a home exercise program with a more involved treatment program that includes manual therapy and supervised exercises.

NEW INSIGHTS

In this study, researchers treated 74 patients. Half of these patients received a typical home exercise program. The other patients received a combined manual therapy and supervised exercise program. The patients who received the manual therapy and supervised exercise program experienced about a 70% reduction in pain at 4 weeks and more than a 92% reduction in pain at 6 months. By contrast, patients who received the home exercise program only had a 39% reduction in pain at 4 weeks and an 80% reduction at 6 months. For those in the manual therapy and supervised exercise program, the ability to perform daily activities improved from 66% at the initial exam to 87% at 4 weeks and 97% at 6 months (100% is full function). Meanwhile, those doing just the home exercise program only saw improved function to 73% at 4 weeks and 88% at 6 months. The researchers concluded that the combination of manual therapy and a supervised exercise program was superior to a home exercise program alone in the treatment of ankle sprains, because the combined program provided better pain relief and improved function.

PRACTICAL ADVICE

81b6b461-e940-4a88-8e9d-62d7dc10c233Patients who have sprained their ankles may benefit from a physical therapy program that includes manual therapy and a supervised exercise program. Potential benefits are less pain and improved ability to perform daily activities and return to sport. Your physical therapist can perform a thorough evaluation to help determine if you are a good candidate for this treatment as part of a program designed to help get you back to full activity after an ankle sprain. For more information on the treatment of ankle sprains, contact your physical therapist specializing in musculoskeletal disorders.

 

http://www.jospt.org/doi/pdf/10.2519/jospt.2013.0504

Elevate Hosts Heavy Hitters for Baseball Symposium

PRESS RELEASE

ELEVATE PT & Fitness
1505 11th Street
Santa Monica, CA 90401
424-322-8585
concierge@elevateptfit.com

FOR IMMEDIATE RELEASE:

BASEBALL GREATS TO APPEAR AT SANTA MONICA SYMPOSIUM TO SHARE SECRETS ON HOW TO MAKE IT SAFELY TO THE BIG LEAGUES

ELEVATE PHYSICAL THERAPY & FITNESS HOSTS HEAVY HITTERS TO GIVE PARENTS, COACHES AND PLAYERS VALUABLE GUIDANCE

SANTA MONICA, Calif. (June 2, 2016) —Legendary Major League Baseball (MLB) players Tommy John and Tom House along with sports writer & author Jeff Passan, Dr. Kristofer Jones MD, and Dr. Anthony Ware DPT, join Kansas City Royals Director of Pro Scouting Gene Watson on Tuesday June 7, 2016 from 6 p.m. – 8:30 p.m. at ELEVATE Physical Therapy & Fitness in Santa Monica.

This baseball gold-star industry panel—together for the first time—will share tips and personal insights to guide parents and young players on how to avoid injury; how to stay competitive when injured; how to find rehabilitation strategies that work—as well as how to stand out to scouts for scholarships and tickets to ‘The Big Show’. A question and answer period will follow the panel discussion. Appetizers and refreshments will also be offered.

“We’re beyond excited to have this all-star baseball panel here! As former college athletes and physical therapists, not to mention moms to our own youth athletes, we are particularly passionate about injuries to this population. These injuries often come at a critical juncture in these kids’ lives—dashing their hard-fought dreams of becoming college and professional players,” says Meredith Soelberg, PT, DPT, MBA, and Brooke Mitchell, PT, DPT, owners of ELEVATE Physical Therapy & Fitness.

“We’re thrilled to be able to give back to our community. Our hope is to have parents, players and coaches take away critical insights into raising healthy players, and glean baseball secrets of success from the best in the business,” Drs. Soelberg and Mitchell added.

Tickets are $20 each. For questions, or to reserve your spot for this amazing event that is open for the whole family, call 424-322-8585 or email concierge@elevateptfit.com.

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Meet our Expert Panel:

Dr. Kristofer Jones, MD, UCLA Sports Medicine & Orthopaedic Surgery

Also a former college athlete, Dr. Jones is a board certified, fellowship trained orthopaedic surgeon at UCLA who specializes in sports-related musculoskeletal injuries of the shoulder, elbow and knee.
He understands the unique demands and concerns faced by athletes at all levels of participation, and has a special interest in minimally invasive, joint preservation procedures.

THE Tommy John, Former MLB Pitcher

A former pitcher in Major League Baseball, his 288 career victories rank as the seventh highest total among left-handers in major league history. He is also known for the revolutionary “Tommy John Surgery,” which was performed on a damaged ligament in his pitching arm. Despite his injury, well over half of John’s career wins came after his surgery.
He will be joined by his son, Dr. Tommy John. Their mission is to help reduce the number of namesake surgeries and preserve young athletes’ arms.

Gene Watson, Kansas City Royals Pro Scouting

Now the Director of Pro Scouting for the Kansas City Royals, Gene is in his 10th full season with the Royals. He has over 20 years of experience scouting Major League Baseball, the minor leagues, and the Dominican, Venezuelan and Mexican leagues. He is a major contributor to the Play Ball Initiative, which provides resources on best practices for baseball related health and safety for the youth player.

Dr. Anthony Ware, DPT and Detroit Tigers Player

A former player for the Detroit Tigers, Dr. Anthony Ware is a physical therapist at Providence Saint John’s Health Center’s Performance Therapy, where he specializes in both orthopedics and sports physical therapy.

Tom House, Former MLB Pitcher, Author, and USC Pitching Coach

Considered by many to be the “Father of Modern Pitching Mechanics,” Tom has been an MLB player, a pitching coach, and has dedicated the last 15 years of his life to performing research on all aspects of pitching. He is also the founder of the National Pitching Association and a motivational force for many young pitchers today.

Jeff Passan, Author of NY Times Bestseller, “The Arm”

Author of New York Times Bestseller “The Arm: Inside the Billion-Dollar Mystery of the Most Valuable Commodity in Sports,” an exposé on the incredible value of pitchers and the elbow ligament injuries that are sending teenagers and major leaguers alike to undergo surgery. He explores the injury crisis and what can be done.

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Movers to Athletes to Specialists

As their 13-year-old daughters played in their first soccer game of the spring season, the mothers discussed their dedication to their children, and their children’s dedication to the game. One mother spoke about her older daughter, a high-school sophomore, who missed the fall soccer season because of knee surgery. This caught my attention, and I scanned the field: Four of the 22 players – 12 and 13 years old – on the field wore bulky knee braces indicative of some form of injury. 

Another mother mentioned the ankle injuries of an older sibling, and a father mentioned the concussions. Each parent appeared to try and top the others with stories of their children’s injuries and surgeries from their participation in soccer, as though being injured and returning to continue one’s career was a badge of honor. The players who were revered were not the ones who capably moved around the field, avoiding tackles, and skillfully playing the ball, but the ones who limped around the field, showing their toughness as they returned to soccer from an injury, probably far too quickly.

Rene Wormhoudt, the strength and conditioning coach for the Netherlands Football Federation, said at the Seattle Sounders Sports Science Conference that children become good movers, good movers become good athletes, and good athletes become specialists, or skilled soccer players. These u14 girls appeared to have skipped the first two steps and moved directly toward the goal of becoming a skilled soccer player.

Mike Reinold's 4 Keys to Long-Term Athletic Development

Mike Reinold’s 4 Keys to Long-Term Athletic Development

The skill level was impressive for an early season game between 12 and 13 year olds. The players used tactics and skills that I never learned or tried in my 10 years of youth soccer. Players played the ball back to the goalie to avoid pressure rather than panicking with the ball in their defensive third. Goalies controlled the ball and juked on-rushing attackers rather than kicking the ball as quickly and as far as possible. Players used one-twos all over the field, and played the ball with their right and left feet. They kept their shape, talked to each other on the field, and showed a good understanding of the game.

Despite their game understanding and technical skills, the majority were terrible soccer players. Their skills were no match for the few athletic players on the field. The vast majority of players moved so poorly that the mere act of playing soccer was likely a risk to their health. The injuries discussed by the parents were no surprise after watching 20 minutes of their younger daughters.

Despite their sport-specific skills, they lacked good motor control. When they jumped to head or chest the ball, their arms flailed wildly. When they ran shoulder to shoulder with an opponent, one of the players inevitably went tumbling, unable to absorb any contact. When players landed from jumps, without jumping very high, their knees caved in (knee valgus), a common precursor to ACL ruptures. They struggled to decelerate or change directions to avoid collisions, and many fouls were symptoms of poor movement skills and body control.

Rather than becoming good movers initially and progressing to sport-specific skills, these players appeared to strive for soccer success. These teams dutifully performed the FIFA11+ warmup (below), designed to reduce injuries by teaching and training basic movements, but there was no concentration or corrections on the warmup. The coach set up the next drill as the players performed their warmup, and the players quickly moved through the exercises in order to get to the important drills, the ones with the ball. The warmups with the ball were primarily linear; they dribbled in a straight line and passed to another player, or they dribbled at the goal and took a shot. Very few of the movements in warmups engaged the players or challenged their movement skills.

Despite their soccer success, these girls were not good athletes. Based on the conversations of the parents, most played year-round soccer rather than compete in another sport. The year-round play may have helped with the early mastery of their sport-specific skills, but none of the girls had a long future in the sport unless they greatly enhanced their athleticism and movement skills.

In all likelihood, more of those 22 players will miss a season in their four years of high school due to an injury suffered while playing soccer than will extend their soccer career beyond high school. Adolescent females who specialized in one sport were 1.5 times as likely as those who participated in multiple sports to suffer from patellofemoral pain (PFP; Hall et al., 2014), and girls’ soccer has the highest rate of ACL injuries, with 11.7 injuries for every 100,000 athlete exposures (an athlete exposure is one athlete participating in one practice or competition; Comstock et al., 2013). Furthermore, youth soccer players who practiced four or more days per week prior to age 12, as did some of these girls based on the sideline conversations, were more likely to suffer cam deformities to their hip than those who waited until after age 12 to practice four or more days per week (Tak et al., 2015).

Rather than focus on more soccer and continuing to expand their soccer skills, these players would be served better by playing another sport, especially track and field. University of North Carolina head coach Anson Dorrance has said that he prefers to recruit sprinters because of the added speed on the field. These players are working backwards, as they originally skipped the correct progression of mover to athlete to player. Now, they must try to work backward from player to athlete to mover, and running track and field, and especially the sprints, would be one approach to learn better movement skills. Additionally, the players should concentrate in their movement warmup and expand upon this brief warmup with additional plyometics and strength exercises. Before trying to add another layer of skill, or another step-over dribbling move, they should master running, jumping, landing, and stopping.

When I was a child, playing and training was less sophisticated than it is for the current generation. However, in our sophistication, we have ignored the basic progressions. When I was a child, we played in the streets and at recess before we joined teams. We played tag, hopscotch, and other childhood games. From an adult training perspective, these games appear frivolous; however, this progression enabled us to learn basic movement skills first. When we joined teams, we had a better base of fundamental movement skills that we developed through these playful games. When children skip this natural learning and jump straight into sophisticated, sport-specific training schemes, they miss these learning opportunities. They may master technical skills or game awareness, but without the basic movement skills and athleticism, their performance eventually will stagnate because other children – often the multi-sport athletes or the late developers – move better and are more athletic. Sport-specific skill is important; however, the proper progression of mover to athlete to skill enables the greatest expression of the sport-specific skill in adolescence and beyond.

Orginally published in Los Angeles Sports & Fitness Magazine October 2015 By Brian McCormick, PhD

Your Brain on Exercise

Screenshot 2015-08-25 23.22.54We are all aware of the positive effects of regular exercise – weight control, aerobic fitness, the maintenance of muscular strength, blood pressure control, and the improvement of HDL (high-density lipoprotein). However, not nearly as obvious to most are the positive effects of exercise on brain function, especially as we age. What we have found out over time is that the brain is more “plastic” in function than we thought and our brain circuits are changing constantly depending on what we’re doing (or not doing) in the world. Dementia is the loss of the brain’s elasticity and it seems that the old adage “use it or lose it” applies to brain elasticity and circuitry. Exciting new research shows that exercise, both mental and physical, can help decrease the risk of dementia in adult life.

Peter Elwood of the Cochrane Institute at Cardiff University in the United Kingdom did a study of 2235 men (aged 45-59 years) over 30 years. The results showed that:
1. Eating a healthy diet
2. Having a BMI (body mass index) between 18-25
3. Not Smoking
4. Limiting Alcohol Consumption

reduced the risk of cognitive decline by 60%!

BUT, better than all those well-known healthy habits was EXERCISE! Biking 10 miles a day, walking 2 miles a day, or other daily vigorous exercise produced the best results.

Another study showed that walking at least 1 mile a day significantly enhanced the volume of several brain areas and a different study revealed that higher aerobic fitness levels were associated with larger right and left hippocampi and therefore better spatial memory performance.

Dementia and Alzheimer’s (the most common form of dementia) are devastating illnesses. The latest research showing the benefits of exercise on brain health gives us one more reason to make exercise a daily habit.

Pain on the Outside of Your Knee?? IT Band Syndrome

The IT band is a long, fibrous band that is the extension of the tensor fascia lata muscle (and slips from the gluteus maximus) that originates at the outside of the pelvis, and the “band” portion attaches just below the outside of the knee.

IT band pain site with TFL and glutes

The muscle moves the leg away from the body (abduction), bends the leg up (flexion), rotates the leg inward (internal rotation), and stabilizes the outside of the knee.   Wow.  It does so many things.  BUT, its work is affected by the BUTT (let’s call it “the hip” which is the joint that the BUTT muscles (now to be called “the gluteal muscles”) surround and operate).  Weak gluteal muscles / poor hip control can cause pain on the side of your knee called iliotibial band syndrome, or IT band syndrome.

How?  And what can you do?

In running, when the hip / gluteal muscles are weak or poorly activated, it can’t manage the very high rates of loading and force that running demands of it, so other, often-times smaller muscles that can do (some) of the same functions as the weak gluteals (like the TFL that becomes the IT band) are left to carry that load.  Then that muscle gets overused and often times, tight (because it’s being overused).  Because, as mentioned above, the TFL turns the leg inward (internal rotation), and the weak gluteal muscles can’t well counteract that internal rotation torque, the (tight) TFL and its IT band get stretched / stressed, and can experience greater friction against the bony prominence or fat pad of the femoral lateral epicondyle that lies just beneath the IT band near the knee.  This is (one) recipe for IT band pain at the outside of the knee.

What to do… you need to activate the gluteal muscles (especially the “work-horse” gluteus maximus) so they can do their critical job to control the hip to stop the hip from rotating inward and creating strain on the IT band.  Also, stretch the TFL and foam roll or actively release the muscle and IT band with a tennis or lacrosse ball.  This will decrease the tightness and, along with the ever-so-critical hip strengthening, will decrease the strain on the IT band.  An additional, very critical element is learning how to activate your gluteal muscles when you run.  It’s not enough to strengthen without learning how to use those (now stronger) muscles.  This motor learning of a new, biomechanically optimal movement pattern is what research now plainly shows is critical for long-lasting rehabilitation results of orthopedic and musculoskeletal injuries.

Think about it… if you strengthen and stretch and get manual work on your tissues, etc., but you don’t know how to use the muscles differently (it’s difficult since you’ve been using the same motor pattern for a very long time, not knowing of its potential ill-effects until the body reaches a threshold and the pain starts), you will continue with the motor pattern that your brain / nervous system knows and that got you into this mess in the first place.

The IT band pain can unfortunately be a nagging, sometimes very long-lasting problem for runners and often-times sidelines them over and over again for months at a time.  If you’re having knee pain, come in for a PT evaluation of the problem. We will move you through a customized program based on your particular knee issue.

There are numerous things to be done for IT band syndrome once the cause(s) of the pain are determined. The range of interventions includes: training adjustments (stop running through pain!), running analysis, modalities for pain, manual therapy, stretching, myofascial release, strengthening and movement re-training. Should weak hip muscles be a culprit, here is a great exercise:

FIRE HYDRANT: We love the fire hydrant!  It does a beautiful job of activating the gluteus maximus (as seen on EMG in research and in the practice setting with surface EMG), the big boy in this scenario that MUST be working to abduct and externally rotate the hip during the landing / weight acceptance phase of running and support the TFL / IT band so it doesn’t get overloaded.

Screenshot 2015-07-06 22.16.19

Note: the leg is lifting up and out at a 45 degree angle.  Back is flat. You should feel this in the back of the hip / gluteus maximus.  Try 15 second holds, alternating sides, for 3 – 4 minutes daily.  Add a resistive band (of lowest resistance initially) to progress yourself.  If the exercise is painful, stop and come in for PT!

Rethinking Movement: Why You Should See A Physical Therapist Every Year

Screenshot 2015-05-30 22.32.38Why is it that superbly fit athletes can find themselves in as much back, knee, or neck pain as their flabby fans, who sit at desks all day long then watch sports from overstuffed sofas?

“When you do an activity over and over again, your body adapts to that activity,” warns Dr. Shirley Sahrmann, professor emerita of physical therapy at Washington University School of Medicine. “If you play tennis, your arm gets bigger on that side; if you do karate you get adaptations in your hip and leg. Even if you just sit, you lean, you slump, your neck goes forward.” Either your body fails to build up musculature to support itself, or it overbuilds certain muscles and throws off the symmetry your skeleton craves.

That’s why Sahrmann wants to see an annual physical therapy exam become as routine as a dental checkup. “We go to the dentist twice a year and spend thousands to straighten our teeth, and all we do with them is eat and talk. Meanwhile the rest of our body’s just hanging out there.”

People think of PT as something generic their doctor orders after an injury, she says. But by analyzing the way you walk, bend, sit, and carry yourself, physical therapists can prevent injuries and head off future surgeries and chronic pain.

“Kids don’t sit correctly, they slump, so they wind up sitting on the middle of their back,” she says. “We have these little bones on our bottom where we are supposed to sit and keep our spine erect. When you slump, the muscles get stretched out, and they’re not going to function optimally.”

A temporary phase? Maybe. But “bones adapt to the alignment that you keep them in,” Sahrmann points out, “and your spine becomes shaped like that.”

Watching teenagers walk makes her crazy: “They are not using what we consider a normal gait. They walk without bending at the hip and knee and pushing off. They shuffle. And they sway back—their shoulders are behind their hips—so their gluteal muscles don’t work as much as they should. All of these little cultural changes in sitting posture, what’s considered cool—even the clothing.” For a while there, she says, “the new waistline was the gluteal fold! And how do you walk when your legs are strapped together with a belt? Their knees get caught in the crotch of their pants—it’s hysterical. But it’s also not good.”

In years past, there was little appreciation of how lifestyle affected your health. “My family thought they just got diabetes or hypertension; it had nothing to do with the cans of Crisco my grandmother cooked with.” The way we move and align ourselves is just as important as what we eat, she says. “There is complexity to movement, and you can do it right or wrong.”

I bring up ergonomics—surely that’s helped? “It’s not just whether the setup is right,” she points out. “It’s what you bring to that setup and what you do when you’re not there.” We’re designed to keep changing position, not sit frozen in the perfect chair. Even working out requires real knowledge, if you want to lift weights or do aerobic training without compromising the performance of all your other joints.

Sahrmann’s one of the nation’s pioneers in pushing the concept of a movement system, emphasizing the subtle, necessary interconnections of muscles and bones and nerves but also heart, lungs, and the endocrine system. Her career has spanned more than half a century, and its twists and turns led her to see the body whole. She began work at the end of the polio era and spent nine years taking care of patients who’d suffered head injuries or strokes. In order to understand the disordered motor control of patients with central nervous system lesions, she left clinical practice to earn a Ph.D. in neurobiology. Then serendipity sent her a different kind of patient: athletes who had musculoskeletal pain. Screenshot 2015-05-30 22.33.00

“I started teaching them to move differently, and they got better for reasons I didn’t understand,” she says. “I’ve spent a good many years with my colleagues at Wash.U. working to analyze these relationships between movement and musculoskeletal pain.”

She’s written two books and talked herself hoarse, urging people to see the body’s movement as systemic. Now that approach is finally catching hold, not just here but nationally and internationally. But she’ll know she’s really succeeded when PT evaluations are annual, and there are formal diagnoses based on movement patterns that consistently cause pain: flexion syndrome, when the back bows out; extension syndrome when it bows in and hunches you over; tibiofemoral rotation that can lead to knee problems.

“We all move differently,” she says. “I’ve seen patients whose feet are so callused I don’t know how they put their shoes on, and I’ve seen marathon runners with no calluses at all.

“You need to have an exam by a body expert at least once a year,” she finishes crisply. “Even if insurance doesn’t cover it, the cost is no more than you’d pay a personal trainer. I think we could substantially reduce the number of injuries and slow the process of osteoarthritis as people age.” She’s not saying arthritis can be eliminated altogether—but it can be delayed and its effects minimized. “There’s evidence that if a joint is lax, or you have injury, or your muscles are weak, you can get these arthritic changes.” Move right, and you lower the chance of injury—whether you’re an Olympian or a couch potato.

By Jeannette Cooperman May 11, 2015 / St. Louis Magazine