Unexpected Gifts

This time of the year can be challenging for me to get out of bed in the morning, especially when my down comforter keeps me so cozy! Our dog Sherman loves his morning walks, so he helps me find the motivation to get going each day. He does this by coming over to my side of the bed, nudging my arm and hand with his cold, wet nose, and batting his tail against the mattress until I respond. At first my response is a groan, but when I hear his sweet, happy noises, my response turns into a slight smile.

This week was a little wet at the beginning, so I especially dreaded taking our walk on Monday morning. I reluctantly put on my wet-weather gear, opened my huge umbrella, and huffed and puffed as I trudged out the door. Of course Sherman is so non-judgmental and unconditional that he runs outside, tail wagging, as if this is just like any other day. I slowly make my way down the driveway and down our hill, looking down at the wet ground from under my umbrella, listening to the consistent pitter-patter of rain overhead. Then there was Sherman, prancing along, not phased at all by the rain! As we turned the corner at the bottom of the hill, I looked up from under the umbrella and gazed out over the trees and saw the most beautiful sight--the WHOLE sky was the most beautiful shade of orange with pinkish undertones. I literally dropped my jaw and said "WHOA!!!" and looked around with a smile on my face to see if anyone else was there to witness this beautiful scene. Nope, it was just me and Sherm. I wanted this moment to last forever, but as we continued forward on our walk, I noticed the sky starting to change. From orange and pink, to purple then blue, I saw the sky slowly transform before my eyes. I never did see the sun come up officially that morning, as I had to get in the house to continue my daily routine, but knew that the sun was responsible for the glorious gift of color and beauty in the sky. I felt like this was a personal gift sent to me that cold, wet, rainy morning, as a reminder that even in unpleasant circumstances, there is always an unexpected gift.

As a Physical Therapist and Muscle Activation Techniques Specialist, I work with clients every day who are faced with their own challenges or unpleasant circumstances. It is difficult for some clients to find motivation to move through the painful sensations. It is my privilege to help them uncover their imbalances, re-activate their body’s healing potential, and realize the gifts the human body offers, which are often taken for granted. One of the unexpected gifts often received by my clients as they work through a painful experience is a deeper appreciation of how our bodies are capable of changing for the better, with the proper individualized care.

It truly is a gift to have the bodies we do!  When we cut our finger, we don’t have to think twice about our body’s ability to heal itself. When we want to get up and grab a bite to eat in the kitchen, we walk over to the fridge and choose from an abundant selection. When we want to get together with a friend, we hop in our car and drive over to the restaurant to meet them.  When we want to exercise, we lace up our shoes and hit the pavement, or show up to our favorite group exercise class to participate. When we want to lift our kids and grandkids, we reach down and pick them up with ease. It usually isn’t until our body doesn’t respond in a favorable way that we even notice the complexity of some of these everyday activities.

Did you know that walking is one of the most challenging neurological activities that the human body can perform? We are all so lucky to be able to stand upright against gravity and walk all over the planet. How often do we stop and think about this? When traveling home recently from our Thanksgiving visit with family in California, I noticed a man in a wheelchair at the airport. Initially I thought to myself, “What a challenge it must be to travel in this capacity.” Then we made eye contact and exchanged friendly smiles. Upon further thought, I realized “What a gift it is to be alive in a time where technology has advanced as much as it has, and people with disabilities are able to travel and move around our wonderful planet to enjoy their life to the fullest!” His smile and my thought correction were other unexpected gifts that day.

When you are shoveling snow, walking your dog in the rain, or finding the motivation to face your challenges of the day this holiday season, take a moment to reflect on the unexpected gifts you find along the way, and the gifts your body presents to you each and every day. Move well, my friends.  

Are Your Daily Movements Helping or Hurting You?

Picture this...You reach for your alarm clock as another day begins. You roll yourself over and use your abdominal muscles (or momentum) to sit up at the edge of your bed. Up you go, thanks to your legs, down the hall to the bathroom, where you perform yet another duty of the day.  Then, you walk to the kitchen to prepare your first meal of the day, often standing and moving about the kitchen, bending down or lifting up onto your toes to reach for things in the fridge or cabinets.  Finally, you get to sit and enjoy your breakfast. 

Most of us don't think about how we are doing any of these activities (especially first thing in the morning...) let alone think about if we are doing them correctly or in ways that could be stressing out different muscles or body parts. And this is just the beginning of our day!  I haven't even begun to mention what we do with our bodies to get ourselves showered, dressed, and ready for our day, then take care of others to get them ready, get ourselves where we need to be each day, perform our tasks, eat, use the bathroom, do housework, yard work, socialize...The list goes on and on. We just go, go, go, and assume that our bodies will be along for the ride. It isn't until one of these daily activities becomes difficult or painful that we start to wonder what went wrong!?!

Think about all of the activities listed above and how much longer they would take if you had to rely on someone else to assist you through these activities. How would that make you feel? Leave it to the "muscle nerd" to think about these activities, and share with you some helpful information to make sure that your muscles are being respected and appreciated, and you can continue to perform these functions independently for as long as possible.

After working several years with clients suffering from advanced Knee Osteoarthritis, I have realized that getting up and down from a seated position can be very challenging for them. If this activity is not performed efficiently, it can actually add to the wear and tear already happening at the knee joint, as we all perform this activity many times per day.  I take the time to instruct my clients in the proper way to position themselves and use their body's weight and momentum to efficiently raise and lower themselves. Then, each time they do this, it becomes an exercise instead of another activity that may be slowly wearing down the joint surfaces and stressing the body. Like any other new activity, it takes some extra time to think through how to do this efficiently at first, but with practice, the efficient movement pattern becomes automatic. 

Would you like to be sure you are raising from and lowering to the sitting position appropriately? Here are the step by step instructions I teach my clients regularly, and they find it very simple to change their ways!

1. Be sure your  hips are at the edge of the sitting surface from which you are rising. 

2. Position your knees hip width apart, and place your feet directly under your knees with both feet pointing straight ahead. 

3. Hinge forward from your hips while keeping your spine straight until your nose goes over your toes. 

4. Use your buttocks muscles to bring your body into an upright standing position, allowing your knees to straighten last. 

Doesn't that sound simple? It gets even simpler when I say "Nose over toes, use your butt to come up!" You know PTs--we are always abbreviating everything, so why wouldn't I abbreviate these instructions too! :) 

You may be saying, "I already do it this way," and to that I say "BRAVO!!" I will likely NOT be seeing you for knee related issues anytime soon, and to that you may be saying "GOOD!" 

For those of you who feel you need to use your arms for support or to boost you up, you can place your hands on your thighs, the arm rest of the chair you are sitting on, or the bathroom counter. Just remember to let your buttocks be the main muscle working to get your body standing straight. 

If you like these helpful instructions and are wondering if you are performing your other daily activities with the most efficient biomechanics, you may be interested in attending my upcoming workshop entitled "Movement is Medicine".  In this active learning workshop we will be exploring how natural movement is a form of preventative medicine, and can also be a form of healing medicine for injured or stressed out muscles and joints. We will discuss and practice the proper technique for sitting, standing, walking, bending, lifting, raking, shoveling, carrying little loved ones, driving, and other daily activities.  It is my goal to be sure as many people as possible are practicing "preventative medicine" with their daily movements, and they will remain independent as long as possible!  For more information or to register, click:  http://www.1212bodyworks.com/resources.html

Move Well! 

Confession: I have a drinking problem...

I'm apologize if this comes as a shock to you, as I am sure none of you had expected this from me. My husband only recently found out about this, in fact. I've been struggling for a while and decided I really need to do something to overcome my problem. I was not doing well last month and put off writing last month's blog post because I am ashamed, as if putting it off somehow helps me to go on with my life, pretending this is not affecting me as much as it does. Believe me, this is really hard for me to admit. The first step in healing is admitting we have a problem, right? Thank you for being allowing me to be "heard."

My drinking problem has caused me to feel tired, achey, depressed, and downright old!  Some days, I don't like what I see looking back at me in the mirror.  I used to be able to carry out my way of living with seemingly no negative symptoms, until the past few years. It just seems to be getting worse and worse, with new ailments popping up as time goes on. I'm supposed to be practicing good health, as I preach everyday to all of you. I have been a hypocrite. I need to come clean about this problem and stop the madness once and for all.

My drinking problem... is that I don't drink ENOUGH water. There. I said it. Whew! I feel better already! Seriously. I never realized how HUGE of a problem this has been for me for many years and how many of my aches, pains, and body issues are linked to too little water in my system. I'm lucky if I drink 32 oz of water in a day. As a Physical Therapist, I see many clients during a work day, and often don't want to take the time to take a break between clients to use the restroom. Several years ago, when I was working for a PT clinic and saw a new client every 30 minutes, I would finish working 8-10 hours, and realize at the end of the day that I had not had ANYTHING to drink all day long!! My big problem is that I much prefer coffee and red wine (in moderation, of course) over plain water. I've tried putting fresh squeezed juice into my water. Didn't help. Tried some Essential Oils. Slightly helpful, but still having a problem. I even bought a water bottle that had numbers and a dial on it to keep track of how many times I filled it up during the day. Didn't work. I figured, I must not be the only one who has this problem.

I started taking a poll at my office, and have been asking my clients how much water they are drinking on any given day. I was talking with one client, Jacki, and she agreed that she too has a "drinking problem." I felt a little better about myself, knowing I wasn't the only one, but then I began to wonder "How many others of you out there also have a drinking problem?"

Did you know that our muscles don't work as well when we are not properly hydrated? And that our joints rely on proper hydration levels to keep them well-lubricated? Pretty much EVERY body organ and system slows down when hydration levels are not optimal. Not drinking enough water can lead to thicker blood and elevated blood pressure, higher cholesterol, obesity, Type 2 Diabetes, Cancer, Asthma and allergies, skin problems, kidney stone development, constipation, digestive disorders, joint and muscle pain and fatigue. Any of these sound familiar? Maybe you have a drinking problem too!

An article on Webmd.com reports the amount of water we need in a day "depends on your size and weight, and also on your activity level and where you live. In general, you should try to drink between half an ounce and an ounce of water for each pound you weigh, every day. For example, if you weigh 150 pounds, that would be 75 to 150 ounces of water a day. If you’re living in a hot climate and exercising a lot, you’d be on the higher end of that range; if you’re in a cooler climate and mostly sedentary, you’d need less."

For the past month or so, I truly have made a conscious effort to drink more water at home before I leave in the morning, while I am at work, and once I get home. I do feel a difference already. I know I may have "good days" and "not-so-good days" but I am CERTAIN that I cannot have a relapse with my drinking problem! My muscles and my health are depending on me to overcome this problem. Thanks for your support!

An Easy Way to Resolve Mid Back Pain

This is not another boring blog post!

Thank you in advance for choosing to read this blog post. I must begin by apologizing for the past 6 months of this blog. I have taken some time to reflect recently, and let's face it...the first 6 months of blog entries were down-right boring. Of course, being a Certified Muscle Activation Techniques Specialist and PT, I totally geek out over all of the ins and outs of muscles and their functions, but I do realize that most of you are not with me on this. That is ok! My intention was to educate, but I have decided to educate you in a much more practical, useful and enjoyable way for the second half of the year! Are you still with me? Good! 

I have been personally struggling with something recently, and I have seen many clients for this same issue over the past 16 years of PT practice. Luckily, I have stumbled upon something helpful in finding some relief. My problem for the past 4 years or so has been some chronic mid back pain. I have a client who refers to her similar pain as "Kitchen Back" as she often feels this when working around her kitchen. You may be familiar with this too. Have you ever experienced pain or weakness in the mid back and all of a sudden your shoulders are scrunched up toward your ears? Well, if you too are familiar with this feeling or have pain in your neck or shoulders, you will appreciate learning the exercises below. 

I'd like to introduce you this month to the wonders of the Rhomboid muscle. This is the part of the blog where I would usually spout off the origins and insertions (snooze....) but I believe Wikipedia does this well, so here is a link to what they have to say about good old Rhomboid Major: https://en.wikipedia.org/wiki/Rhomboid_major_muscle

For those of you who like pictures, here it is highlighted in red below:

The Rhomboid muscles help to keep our shoulder blades against our ribcage to allow our arms to function throughout full range of motion with a stable base.  As we reach forward to lift or grab something, the Rhomboids help to keep our shoulder blades stable and connected to our "core," so our other shoulder muscles are free to intricately move the arm around through space. Try squeezing your shoulder blades together behind your back. That will get your Rhomboids shortening, or contracting. Reaching your arm across your chest will bring this muscle into an elongated position. 

As I was seated in my desk chair typing this post, I came upon an easy way to target this muscle and resolve some of the back pain I have been experiencing. In doing the following exercise, I could feel circulation flowing through this area that has felt restricted and tight for years now. Let me know about your experience.  

Active Movement Exercise:

1) Sitting up straight in a desk chair with arm rests, place your straight arms against the outside of the arm rests with your palms facing the chair. Gently press your arms into the arm rests and hold for a count of 10 seconds. Rest and relax for 5 seconds. Repeat 5-10 times. 

2) Now do the same as above with your palms facing away from the arm rests, with the chest open, and the upper arm bones in an outwardly rotated position. Gently press your arms into the arm rests and hold for a count of 10 seconds. Rest and relax for 5 seconds. Repeat 5-10 times.

Are you curious about other exercises that can target this area? If you are a gym member, the Seated Row machine and Lat Pull down machine will do the trick. At home, you can perform Plank exercises, Push Ups or you can perform doorway Rows with some exercise tubing or band. 

Only 5 months left of the Muscle of the Month Blog! Let me know if you prefer this format over previous posts. Also, I'd love to hear from you regarding any questions you may have, or issues you have been experiencing and I would be happy to include some helpful hints about the muscles that may be involved in up-coming posts. 

Move well my friends!

June 2015 Psoas

Psoas

The Psoas muscle is one of the most important muscles in our body, as far as I am concerned. Once again, the "P" is silent, so that is pretty cool too.  This deep hip flexor muscle is often blamed for lower back pain when it is tight or chronically contracted.  Most health care practitioners and fitness professionals are focused on stretching or releasing tight Psoas muscles. The Psoas is responsible for many bodily movements, so it is much more important to be sure that the Psoas muscles are active and functioning properly on both sides of the body. We'll discuss this in more detail and how you can be sure your Psoas muscles are working their best for your body. 

Where is the Psoas muscle located?

The Psoas muscle has a deep portion, which attaches on the transverse process of the lumbar vertebrae (L1-5). The superficial portion spans from the side of the body of the lowest thoracic vertebra (T12), the top 4 lumbar vertebrae (L1-4), and some of the intervertebral discs. The Psoas muscle runs down through the pelvis and inserts onto the lesser trochanter of the femur, located on the inside, or medial aspect, of the the upper part of the thigh bone. The Psoas shares this part of its attachment with the Iliacus muscle, which covers the front of the iliac bone of the pelvis. Together, they are referred to as the "Iliopsoas." A large group of nerves, known as the lumbar plexus, travels near the Psoas. This area of the body is also known as the "Solar Plexus" and is an energy center of the body. 

What functions do the Psoas muscles provide?

The main function of the Psoas muscle is hip flexion, which refers to bringing the femur bone toward the front side of the trunk of the body. This motion occurs each time we lift our leg and swing it forward when we walk. The Psoas muscles can work together as trunk flexors, bringing our trunk forward toward our thighs, like when doing a sit-up exercise. The right Psoas is involved in bending the lower spine to the right, and the left side bends the spine to the left. The Psoas is also involved in rotating the trunk to the same side and to the opposite side. There is activity in the Psoas muscles during hip External or Lateral Rotation, and some would argue that there is muscle activity also during hip Internal or Medial Rotation. 

How can I feel my Psoas muscles working properly?

One way to feel your Psoas is to lie on your back with your legs straight out. Slide your right leg out to the side about a foot and a half. Keeping your knee straight, turn your leg out from your hip joint, then lift your leg up to a 45 degree angle with the floor. Feel the Psoas muscle deep inside the abdomen and at the inside of the upper part of the thigh contracting. Hold that position for a few seconds, then bring your leg back down to the ground. Did you feel it? Try it on the other side and see if you notice any differences between your 2 sides. Is one side easier to lift, or does one side feel heavier? Do you notice any pain in your groin, thigh, or lower back?

What symptoms may I feel if my Psoas is not functioning properly?

If you have weakness with the above exercise or you feel pain in the front of the hip or in the lower back, your Psoas may not be working properly. When you are in a seated position for a long period of time and you stand up, you may feel some Psoas tightness in the front of the pelvis and it may be difficult to fully extend your spine to stand up straight for a minute.  Another common symptom of Psoas dysfunction is groin pain. You may also notice a sideways curve in your spine or a sideways lean if the Psoas is weak on one side and tight on the other. If you have any difficulty with these activities or are curious about any asymmetries you may notice, be sure to contact your Muscle Activation Techniques Certified Specialist to assist you in achieving your goals. 

What are some common exercises that can be done to target and strengthen the Psoas muscle?

Once you are certain that your Psoas muscles are active and ready for exercises, you can perform some of the following activities: Walking, Biking, Elliptical trainer, Rowing machine, Knee to Chest Marches while lying on your back, Hip Flexion/Marches (knee toward chest) while standing, or lying down with legs propped up on Exercise Ball, Abdominal  Crunches, Planks, Mountain Climbers, Downward Facing Dog, Forward Fold, just to name a few. 

Here's to your happy, healthy Psoas muscles!!

May 2015 Pterygoid

PTERYGOID

I love any name with a silent "P," and that includes "Pterygoid."  This jaw muscle and I go way back. In my early years of practice as a Physical Therapist, I worked at a clinic specializing in Temporal Mandibular Joint (TMJ) Dysfunction, commonly known as "jaw pain."  Since this muscle is involved with opening and closing the jaw, it can really cause problems when it does not function properly. 

There are 2 divisions of the Pterygoid muscle, the internal or medial fibers, and the external or lateral fibers of the Pterygoid. The Internal/Medial pterygoid has 2 heads, one deep and one superficial. The deep head inserts onto the side of the sphenoid bone, which sits behind our eyes. The superficial head originates from the palatine bone on the roof of our mouth and the maxillary tuberosity which is a bump behind the top back teeth. Both of these heads insert onto the inside angle of the jaw bone, or mandible. The medial pterygoid works to close the jaw and move the jaw from side to side for chewing. 

The External/Lateral Pterygoid originates from the great wing of the sphenoid bone and pterygoid plate, and inserts on the condyloid process of the mandible, which is the part of the jaw bone that rests inside the joint, beneath a disc made of cartilage, and serves as the hinge point or axis for opening and closing the jaw. When the external/lateral pterygoid contracts, it works to open the jaw, protrude it forward, and move it side to side, along with the internal/medial pterygoid. 

What signs or symptoms result from problems with Pterygoid? Headaches, facial pain, ringing in the ear, or ear pain are some common symptoms people experience when their pterygoids are not working properly. Clicking in the joint is common when the disc is sliding inefficiently within the joint space. If the disc gets dislocated, the jaw can get stuck open or closed. The Temporal Mandibular Joint (TMJ) gets swollen from the improper mechanics of the muscles around the area, which adds to the discomfort. People who clench their teeth or grind them at night often have trouble with their pterygoids, and may also have imbalances in some of the other jaw muscles. Chewing, talking, and even kissing can become very difficult for people with TMJ Dysfunction. None of that is very fun, as you can imagine!! 

What causes problems with the Pterygoid? Muscular imbalances throughout the head, spine and pelvis can contribute to postural alignment imbalances that affect the position of the head and jaw bones, and put added stress on the pterygoids. People often injure their jaw in car accidents, or with a direct blow to the jaw or face. Some people have stress, tension, and unresolved anger issues and clench their teeth habitually. This puts a lot of stress on the joints and can worsen the symptoms noted above. 

How can we feel the Pterygoid working properly? You will feel a subtle muscle contracting inside the jaw joint as you open and then close your teeth gently. You can really feel the pterygoids inside the jaw joint as you move your jaw back and forth from side to side, gently.  You can place your fingertips on the outside of the jaw joint just in front of your ears and feel the disc slide along with the lower jaw bone. Notice if you feel one side or the other move forward more quickly or if you feel the disc popping as you move. A normal jaw will open to between 40-50 mm of opening if all goes well. 

Here's hoping your Pterygoids are doing well and keeping your mouths and heads happy as you enjoy yummy, nourishing foods and laugh and socialize with your family and friends!

April 2015 Piriformis

Piriformis

Advice on finding, feeling, and freeing up the Piriformis muscle for its full potential

Good Old Piriformis.  Even if you don't know much about muscles, most people have heard of this one. Any one who has had trouble with this muscle knows right where this guy is located!! This small but very important "pear-shaped" muscle is one of 6 deep hip rotators, located underneath the buttock muscle, gluteus maximus, on the back of each hip. Piriformis attaches to the front of the sacrum then extends deep through the back of the hip to attach onto the top of the hip bone, on the "greater trochanter" of the femur. This muscle runs right over the Sciatic nerve, which is the huge nerve that runs throughout the back of the leg, allowing us to feel and move all the muscles on the back of the leg.  

"What exactly does the Piriformis muscle do for our bodies," you ask? Well, a lot! The Piriformis muscles help to keep our sacrum stable and in a balanced position. When the hip is extended, this muscle is a hip "external rotator," meaning it rotates the hip and leg outward.  Think about the motion required to cross your leg and place your ankle on your opposite knee...thanks Piriformis! The Piriformis also works to abduct the hip, or move the leg out to the side, when the hip is flexed. This motion is important during walking to maintain our balance and help us shift weight to the other side of the body so we don't fall. What I think is particularly fascinating about this muscle, is that as we "flex" the hip up to bring our thigh toward our chest, the function of Piriformis reverses to be a hip "internal rotator." Think of the motion involved at the hip as you put your shoe on or take it off with one hand while standing.  Now, I'd say those are some pretty important functions!

Want to feel your Piriformis working? Lie on your stomach with your knee bent to a 90 degree angle. Slide your bent knee slightly away from your opposite thigh. Using the Piriformis muscle deep in the hip, allow your lower leg to come across to the back of the opposite leg while still maintaining the 90 degree angle. Feel the muscle contracting in the center of the buttock area? Pretty cool, huh? Another way to feel it is to lie on your back with your knee bent all the way up toward your chest.  With the knee bent and your lower leg parallel with the floor, rotate your hip inward so that your foot moves out to the side, away from your body. Now can you feel a muscle in the back of your hip working for you? That is your Piriformis, my friend.

What happens when Piriformis is not working correctly? This poor guy gets the blame when folks have tightness or pain in the center of the back of the hip, or when they feel weakness or pain extending down into their leg. These symptoms are also known as "Sciatica" symptoms. Some people's Sciatic nerve, or parts of it, pierces right through this muscle, so that can create some of the same symptoms.  One of my biggest pet peeves is when people are told that the Piriformis muscle should be "released," or stretched to the max, as is often recommended in traditional Physical Therapy sessions or group fitness classes. Maybe the Piriformis muscle just wants to be understood, not stretched!!! Sometimes Piriformis is crying out for help as it compensates and tightens up, when the other bigger, more efficient hip rotators are not performing at their full potential. Sometimes it is crying out as to say, "Dude, STOP sitting on your wallet!!!"  Other times, the Piriformis becomes compromised if the pelvis is not in an ideal position or alignment due to other muscles not functioning properly. It may just need a little reminder of how is is designed to work properly throughout its entire range of motion, followed by some re-education activities.  A whole body assessment must be performed to truly identify if the symptoms in the hip and leg are from an injury to the actual Piriformis muscle itself, or if the symptoms are simply your body's way of getting your attention to help a bigger issue.

Over the past 16 years of Physical Therapy practice, this muscle has been the recipient of many of my treatments. Ever since becoming a Muscle Activation Techniques (MAT) Certified Specialist in 2010, I have changed my approach to assess for weakness and then specifically re-activate and correct the imbalances in and around the Piriformis, which has taken my clients results to a whole new level. I have to say that it is a whole lot more fun for all of us than the old way I used to treat, using my elbow to dig out the tightness, followed by a stretch. For those of you who worked with me prior to 2010 for your Piriformis issues, I do apologize for any discomfort I may have caused you.  I promise to make it up to you should you choose to try some new and improved Muscle Activation Techniques treatments... :)