Staying Healthy and in Shape at Home During Isolation…

If you’re like me, working out and being able to lift weights is much more than just picking a weight up and putting it down.  It relieves stress, keeps your body weight down and most importantly for me decreases mental fatigue and gives you an outlet. With all of the gyms closed, for now, you might be missing the euphoric feeling that you get from working out but do not worry, there are things you can do at home with bodyweight and a little creativity that will help keep you in shape and mentally strong!

Simple bodyweight exercises such as air squats, lunges, push-ups, and pull-ups are a great way to get your heart pumping and hit all of the major muscle groups.  A way to mix it up and include your pets is for every time you throw the ball for your pup, you perform 10 push-ups while they are bringing it back to you. Challenge yourself and your pet to see who gives up first. Spoiler alert: you will lose!  I challenged my chocolate lab and after 10 sets I was throwing in the towel and he was just getting his 4 legs loose.  

It is important in these uncertain times that we do something for our mental well being.  Turn off the news, turn off social media, put the phone down and get a workout in whether it be in your garage, back yard or go on a walk and have some quiet prayer time.  Stress and worry are thieves to happiness and both mental and physical well being. Control what we can control and that starts with our health.  

First Choice Physical Therapy is committed to not only the physical well being of our patients but also the mental and emotional well being of our patients.  We are doing all we can during this time to make sure all of our patients and staff are safe while we continue to provide essential and necessary care to everyone.  We are also committed to promoting and teaching healthy lifestyles at home. If you need suggestions on what to do at home for a safe and effective exercise plan then please feel free to email one of our therapists for help.    

Brannon Chester, DPT
Doctor of Physical Therapy
First Choice Physical Therapy

Upper Crossed Syndrome

What is upper crossed syndrome?

Upper crossed syndrome is a common abnormal posture associated with muscle imbalances in the upper body. This muscle imbalance consists of some weak/lengthened muscles (ie. the deep cervical flexor muscles and the lower trapezius) and some tight/over-developed muscles (ie. the pectorals or chest muscles and some of the muscles in the back of the neck including the upper trapezius and levator scapulae and cervical). 

What causes upper crossed syndrome?

There are several causes of upper crossed syndrome, but one of the most common is from poor posture while sitting at a computer or looking down at your phone. Over time, this can cause the muscle imbalance that leads to the rounding of the shoulders and forward head posture, where the head is shifted forward.

What is the ideal posture of the head and neck area?

When looking at the ideal posture in the sagittal plane (from the side) of someone standing up, one should be able to draw an imaginary line going down the external auditory meatus (AKA the ear canal) through the midline of the shoulder.¹

How do you fix upper crossed syndrome?

In order to fix upper crossed syndrome, you have to address the muscle imbalance. To do this, you will need to strengthen the deep cervical muscles and lower trapezius and other periscapular musculature. You’ll also need to stretch the pectorals, upper trapezius, and levator scapulae. Listed below are a few exercises that can help correct this poor posture. Come in to First Choice Physical Therapy for proper instruction with each of these exercises!

  • Chin tucks
  • Doorway stretch
  • Prone IYT’s
  • Rows
  • Upper trapezius stretch
  • Levator scapulae stretch

Call today, and let’s get your problem solved! 850-248-1600 – Dr. Ryan Bohn, DPT

References:

  1. Harrison, A. L., Barry-Greb, T., & Wojtowicz, G. (1996). Clinical Measurement of Head and Shoulder Posture Variables. Journal of Orthopaedic & Sports Physical Therapy, 23(6), 353–361. doi: 10.2519/jospt.1996.23.6.353
  2. Upper Crossed Syndrome. (n.d.). [Photograph]. Retrieved from https://images.app.goo.gl/Df3D6G9psvGqHMeP6

Choosing the right running/walking shoe for you!

Do your feet hurt during your morning jog or evening walks around the neighborhood? Does your calf, knee or hip hurt every time you get a mile into your run?  As a runner or distance walker, choosing the right pair of shoes can be the difference in developing a running/walking injury versus having an enjoyable, injury-free trip. Many people assume that comfort when trying on shoes in the store is the best way to choose a shoe. While comfort level is part of the process in choosing the right shoe, there are many other factors one should consider before making the final decision.

The first thing to determine when choosing the right shoe is the level of support you need. Most reputable running shoe companies will provide many different styles of shoes with different levels of support to accommodate their customers. You will generally have 4 levels of support to choose from; minimalist, neutral, moderate support, and maximum support. The salesperson should be able to tell you what level of support each shoe provides. If they are unable to provide this information, you need to find a different salesperson or move on to the next store.  The best way to determine the level of support needed is by looking at your arches while standing with your feet separated about 6-8 inches. Those with flat feet, where the arch is diminished or non-existent, require a shoe with moderate to maximum support depending upon body weight and how far your arches have fallen. Those of you with normal to high arches do not need as much support because you already have plenty of support that comes from the natural cantilever provided by your arch. Thus, a neutral shoe is ideal for those of you with normal to high arches.

After determining the level of support that is best suited for your feet, determining the quality of the shoe structure and design is paramount. Making this determination is done in 3 steps. The first step is to make sure the sole of the shoe has the proper combination of stability and mobility to allow your foot to bend at the toes when pushing off as you propel your body forward. A properly designed shoe will allow the toes (especially the big toe) to extend back in the proper fashion while providing support to the remaining portion of the foot. To test this combination, hold the shoe at the heel with the toes pointed down to a flat surface. Gently press the shoe into the ground and see where the shoe breaks down. A properly designed shoe will stop breaking down at the point where the toes meet the body of the foot just in front of the arch. See Fig 1.

Fig 1

A poorly designed shoe will break down completely into the midportion or arch of the shoe (see Fig 2) causing excessive stress on the midfoot. 

Fig 2

The next test to perform on the shoe tests the medial and lateral support of the shoe which helps with your balance.  This test involves twisting the shoe in both directions while holding the sides of the toe box with one hand and the heel of the shoe without your other hand. A quality shoe will give just a bit but should resist the twisting motion in both directions. A poorly constructed shoe will rotate excessively in on or both directions See Fig 3 and 4.

Fig 3
Fig 4

If the shoe passes both of these tests, it’s time to check to see if the shoe has any more defects. Even good quality designed shoes can have defects. Some estimates say roughly 5% of shoes will come out of the factory with a defect of some sort despite inspections. The most common defect is in the sole of the shoe which can be uneven on the horizontal axis. To check for this defect, place the shoe on a level surface. Looking from the back of the shoe (looking from the heel forward) at eye level, place your index finger on the outside edge of the heel tab and gently press down. See Fig 5. 

Fig 5

Each shoe should move slightly or not a all but, most importantly, should be symmetrical. If any excessive wobbling or asymmetry is noted, the shoe is defective and could likely cause you to develop a running/walking injury. I have had several patients in my 22 years as a physical therapist that developed knee, hip, or ankle pain while running or walking that was a direct result of this type of defect.  

Now it’s time to try on the shoe. A few factors should be taken into consideration before making your final decision. Obviously, the main factor is comfort. You must note whether the shoe crowds your toes, midfoot, or heel. Does the shoe provide an adequate balance of cushion and support for your entire foot?   Also, determine whether or not the sole of the shoe provides full coverage of your entire foot. A common error I see clients make is purchasing shoes in which the sole does not provide full coverage of the midfoot, heel, and arch. If your foot is wider than the sole, the shoe will not perform the way it was designed and can lead to foot, knee, hip, or even back pain. If the shoe “checks all the boxes” then it is time to purchase the shoe. However, purchasing the shoe is not the final step in determining if this shoe is the one for you. I always encourage my patients to take the shoes home and wear them in the house or go walk somewhere indoors for a couple of hours and see how the feet respond. I encourage my runners to run 15-20 minutes on the treadmill to see how their feet, knees, and hips respond. Any unusual pain or soreness in these areas indicate the shoe may not be a good fit and should be returned. Mild soreness in the feet is not necessarily a sign of an improper fit and is sometimes simply because the shoes are new and your feet are not used to the support a new shoe provides. 

If you develop a running or walking injury or just need a consultation to determine if you have the proper footwear for your feet, come see our Doctor’s of Physical Therapy at First Choice Physical Therapy.

Call today, and let’s get your problem solved! 850-248-1600 – Dr. Brett Frank PT, DPT

Knee Pain

Do you suffer from knee pain during an activity? Have you tried every brace, cream, footwear, and gimmick out there? Are you ready to get better by strategically attacking the cause instead of looking for a quick fix? See our Doctors of Physical therapy, let us perform a detailed assessment to identify your problem, and implement a treatment plan geared towards helping you get where you want to be.

Knee pain is common among all age groups and genders. The pain can be caused by a variety of biomechanical factors that are causing your dysfunction. In fact, knee pain tends to be a multifactorial problem commonly associated with strength deficits throughout the posterior chain (muscles in the back of your leg). These deficits can create an improper angle at the hip in relation to the knee or simply create muscle imbalances with increased shear forces on specific structures of the knee. Our bodies were made to move, and it will find ways to move even if the proper muscles are not being utilized, which creates compensatory movement strategies. If this occurs over a long period of time or through a repeated functional task such as walking, running, or climbing stairs, then these maladaptive movements are magnified, and you can end up with pain.

Another plausible cause to knee pain is the type of footwear and the support it offers in relation to your native anatomy, more specifically, the arch of the foot and position of the heel to the lower leg. Footwear can be a two-sided coin depending on whether the shoe offers too much or too little support. The position of the foot during weight acceptance, mid stance, and push-off are similar to how the angle of the hip affects the knee. It does so by the way the forces are transferred up the chain through the knee.

The big picture here is that many different factors can cause knee pain. Sure, you can have arthritis and tendonitis, but what is the cause of this? How do you know where to start? That’s where the experts at First Choice Physical Therapy come in. Let us analyze your problem so that we can help you get better.

Call today, and let’s get your problem solved! 850-248-1600 – Dr. John Gray PT, DPT