Leg Compression for Athletes Recovery

Athletes who undergo rigorous training often cause damage to their muscles and joints in which impacts further training and success. This damage can cause exercise-induced inflammation, repetitive stress and trauma to the muscles. Symptoms include soreness, swelling, and tenderness, in part secondary to local increased lactic acid resulting in decreased range of motion. Therefore, quick recovery is crucial for athletes to regain and strive for optimal performance in their sport. For athletes striving for optimal recovery and performance, mechanical compression has gained popularity, initially in the 2010 Olympics. Several research papers have shown usage of intermittent pneumatic compression may benefit recovery in athletes.

Physiology and Mechanism of Action synergy-3

Post exercise, the venous return is significantly reduced thus allowing for the build up of carbon dioxide, lactic acid and metabolic waste. The goal of compression is to massage and squeeze your muscles intermittently for a period of time. Research has shown this can decrease swelling and pain, enhance lymphatic return, and increase blood flow. This restore strength and endurance 10 times faster compared to rest alone. Compression is used to help flush out the lactic acid that can of build up after intense training. The use of intermittent pneumatic compression can help promote healing of the tissues by reabsorption of interstitial tissue and reducing metabolic waste. Proper recovery following exercise is important to repair the transitory and long- term impairments created by the stress of training and competition. Following rehydration, correcting the metabolic disturbances and restoring glycogen stores are paramount for recovery of exhaustive exercise. Theoretically, pneumatic compression can reduce the space available for swelling, hemorrhage and hematoma formation as well as providing mechanical support.

Usage

There are three primary treatment options available using compression. A typical treatment lasts no longer than 15-20 minutes.

  1. Pre-workout to benefit in warm up and promote blood flow
  2. Post-workout used to speed up muscle recovery, decrease muscle fatigue and stiffness
  3. Post rehab or injury to reduce edema and stiffness

Using this technique can speed recovery and relieve muscle soreness in a shorter period of time. Although research is limited in this field, the preliminary studies indicate this technique may help improve athlete’s ability to restore strength and endurance faster than rest. If you are interested in using lower extremity pneumatic compression pre or post-race, check out our newly opened Synergy Recovery Room. final-logo500pxYou may also visit our Recovery Room website by clicking on the logo to see other benefits of compression therapy and other services we offer to help take your training to the next level!

 

-Stephanie Kurica, SPT

Student Physical Therapist

Synergy Manual Physical Therapy – South

 

Squats: The King of All Exercises

The squat is one of the most popular exercises performed in gyms around the world. Squatting provides core, hip and leg strength along with endurance and injury prevention benefits. It also provides the health benefits of raising metabolic rate and helping to maintain a healthy body weight. Correct form is key when performing squats, whether you are using a weighted barbell or simply using your own body weight for resistance. The lack of proper form while squatting can lead to all sorts of injuries from herniated discs to torn ligaments.

Let’s break down the form needed to execute a safe and effective squat. To start feet should be just wider than shoulder width apart with the toes slightly angled outward. During the repetition the knees should not cave inward and should stay over the feet with the knees never shifting forward past the toes. The back should remain flat throughout the duration of the repetition. To help to ensure this, pull the shoulders back and keep your chest up. If your back begins to round forward while squatting, that is an indicator that you are either using too much weight or need to adjust how low you are squatting and not sink as low. It is also important to maintain a slow and controlled speed throughout the repetition. It is important to make sure to keep your weight on your heels, and not shifting your weight forward over your toes as this adds extra stress to your knees and can result in injury. If you are new to squats it is wise to practice them using just your body weight. And if you are worried about falling, use a sink or counter to hang on to with your hands and have a chair close behind you to catch you.

You can also check out the advice and tips we found on this YouTube video:

Squats are very functional exercises and are used in our daily routines. Whether or not you notice it, we all squat every day. We squat when we stand up out of bed and get up from chairs and couches. Not to mention that we squat when performing activities such as picking up and moving furniture. Along with strengthening muscles, weight bearing exercises like squats also strengthen tendons, ligaments, and bones. Weight bearing exercises also help to prevent osteoporosis.

In addition, squats burn a high number of calories because of the sheer number of muscles that are engaged during the exercise. The benefit of this is an increase in lean muscle mass, which helps to raise your body’s natural daily metabolic rate. This, combined with proper diet, can help to maintain a healthy weight.

As you can see, when the right form, weight and safety procedures are used while squatting, the health benefits from this exercise greatly outnumber the risks that are associated with squats.

 

Peter Hammersmark

Physical Therapist Technician

North Office

 

Exercising when sick

Man having a fluSo you’ve stuck to your New Years resolution to take better care of yourself. You’re feeling great, hitting your goals, and are finally seeing results…. then you get struck with an illness! Whether it is a cold, flu, or another illness, this will definitely put a thorn in your routine. But should you stop exercising when sick? As physical therapists we get this question on a regular basis during the winter flu season. And it is not just a simple yes or no answer unfortunately. But that is not necessarily all bad news depending on your symptoms.

The GOOD news

Exercise has shown to keep people healthy during the flu season. Researchers are even finding out that with a mild cold or flu exercising can actually help with your recovery! If you are experiencing cold-like symptoms without a fever or difficulty breathing, it can be safe to work out as long as you feel up to it. If you do decide to work out, you should continue to listen to your body. You may be more fatigued as your body is also working hard at fighting the illness. So take it easy and make it a light day. Don’t push yourself past what your body is telling you it can handle.

Break from exercisingThe BAD news

When you are sick the symptoms you are experiencing are due to your body fighting off the illness. But your body is also telling you what you should and should not do to help it. If your symptoms are so severe that you cannot get out of bed in the morning, you should likely stay in bed. You need to know your limits and listen to your body. If you feel up to exercising but then feel worse after 20 minutes into your workout then you should decrease the intensity or stop altogether. In a recent CNNhealth.com article they cite the common “neck rule.” The neck rule states that if your symptoms are above the neck (runny or stuffy nose, sore throat, sinus pressure, headache) then you should be good to go. Bu,t if your symptoms are below the neck as with body aches, fever, or chest congestion, then you will likely want to sit this one out and save your energy for fighting the illness. In the early period of an illness you are also more likely to be contagious. If hitting the gym is your workout, then you also need to make sure you are not spreading your illness to others. Make sure you are showing consideration to others by not putting them in the same situation you are in.

Everyone needs a break and an illness may just be your body telling you the time is right for yours. If you are still questioning whether or not you should hit the gym after reading this then perhaps it’s best you play it safe and take a day off. If you are truly dedicated then you will bounce back once you feel better and continue on with your healthy lifestyle. Better to play it safe and live to fight another day than to delay your recovery or risk injury from working out when your body is telling you to stop.

Michael Phillip, PT

Physical Therapist

Synergy Manual Physical Therapy – South Office

Training Through Pain

You’re in great physical shape, you’ve been spending the last couple months ramping up your training for the next big race….. and then it happens. It can start off as a small twinge of pain in your knee or as a soreness in your hips which you blow it off and keep running. Then a month goes by and it’s a little more nagging, and your frustration is growing. Now you are even closer to the race and become worried that it will affect your time. What do you do, keep training or stop?

Jogging injuryIf you have been competing for any length of time you have likely heard this scenario from fellow competitors or even have gone through this in the past yourself. So what do you do now? An injury whether big or small can not only cause physical stress but also mental stress as it may cause you to stop or slow your training for that next race or event that you have worked so hard towards. But if you push through an injury you may be doing yourself more long-term harm than good as pushing through an injury will often lead your mechanics to change and cause a breakdown of other structures. Deep down you know you should see a doctor or physical therapist to help you, but like many you may be in denial that it is a problem, you don’t want to be told to stop training, and you have high hopes that you can just “run it off.” But in reality you are just putting off the problem and likely growing it into a bigger problem in the long run.

In some scenarios it may be a simple fix like running on a different surface or the other side of the road temporarily, changing your footwear, or improving your flexibility or strength in your hips. Runner’s World posted an article in 2011 titled “The Big 7 Body Breakdowns” that reviewed the top 7 running injuries and how you should approach them. As this article points out in most cases where the pain stops you during a run or the pain is progressively getting worse, you need to seek the advice and treatment of a physical therapist before it turns into something serious.

It is better to get it taken care of as a small injury and possible only having to decrease your training a couple weeks early on than pushing through it and it potentially ruining your racing season. At Synergy Manual Physical Therapy in Colorado Springs, we focus not only on your pain but also on finding out what is the movement or mechanical fault is that began the breakdown in the first place. Call or stop in today to set up an appointment and create a new, pain-free, beginning to your training. We look forward to meeting you!

– Synergy Physical Therapy Team

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112

Specialization in Youth Sports: A Dangerous Game.

As an Athletic Trainer that has spent the better part of his career in the professional sports arena I am often times asked by well meaning parents what they can do to help their kid prevent injuries and get better at their chosen sport. They often times are taken by surprise when my answer is to give them the necessary rest and recovery period their bodies need to heal and develop their general athleticism by having them compete in sports or activities that are unrelated to their primary sport.  I am going to speak more directly about baseball because that is where most of my experience has been, but the principles can be applied to any sport you like such as swimming, soccer, volleyball, etc.

Due to many factors, just one of which is the continuing increase in the cost of higher education (I read once that college tuition costs are increasing at about 7% per year), many parents feel that to give their child a shot at a higher education they have to make sure that heir kid gets a full ride athletic scholarship. This leads them feel that they need to specialize and professionalize the child into a single sport at a very early age and focus all of their attention, year round, on that one sport. This has lead to a large increase in the occurrence of overuse and adult type injuries that require surgical intervention to repair, which the young athlete may never recover from. Dr. James Andrews, one of the premier orthopedic surgeons in professional sports and in particular Major League Baseball, stated in an article that half of injuries in youth sports stem from overuse and 30-40% of the Ulnar Collateral ligament reconstruction procedures ( the famous Tommy John procedure) he performs are on high school age kids even down to age 12.  Dr. Andrews recommends that kids take at least 2 months (3-4 months is preferable for overhead sport athletes) away from their primary sport to avoid these types of overuse injuries.

Another pressure that parents unfortunately run into is from the money vultures that have seen this trend of parents willing to do anything to make sure their kid succeeds, and they are more than willing to capitalize on this at the expense of both the well meaning parents and the kids. They get them with the promise of professional type instruction and maybe contacts to get them in front of college coaches and professional scouts. But they demand big dollars and full year round dedication to their program and their pocketbooks. Because of programs like this I often see kids who are competing on multiple teams during the same season.  The problem with this is that all of these teams are training like they are the only team the kid is participating in. A kid might pitch 6 innings for his high school team on Friday and 3 innings for his club team on Saturday then have to pitch at a college showcase on Sunday. Not even fully mature professional pitchers can maintain activity levels like that for very long without breaking down.

The long and short of it is that to avoid injury and give your kid a legitimate chance at achieving their full potential , their training regimen must  incorporate the necessary amount of rest and recovery. For throwers specifically, that means taking the ball away from them for a time. You don’t have to not do anything, but mix it up. Play basketball or soccer, or something. If your child develops as a more rounded athlete, they will make themselves better at their primary sport and probably remain a lot healthier too.

Jeremy Moeller, ATC

Athletic Trainer

Synergy Manual Physical Therapy

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112

Practical Strength Training and Stretching Tips to Help You Prevent Pain and Injury on the Slopes: Part 2

skiing bannerNow that ski season is nearly over, you may be wondering why we’re posting the second part of this blog.  Well, as PTs we figure it’s never too late to teach folks how to avoid pain and injury—and by now you may have discovered that a full day of skiing or boarding is leaving you with some aches and pains as you start your Monday morning.  So, that makes you a particularly captive audience!  Training (before you ski/board) and Recovery (during the day and before you get in your car to drive home from the mountain) are both important when you’re hitting the slopes.  Here are some tips:

Training

Before and During Ski Season:

Everyone knows that squats and lunges are the key to enduring a full day on the slopes.  But did you know that your quads and gluts aren’t the only muscles that are important to keep strong to ensure an epic day?

  1. Hamstring to Quad ratio:  Don’t neglect your hammies.  Research suggests that the hamstrings should be at least 50-80% as strong as the quads.  Skiing and boarding will naturally work your quads, so during ski season it’s important to continue to strengthen your hamstrings.
    1. Hamstring Curls on a Swiss Ball (see YouTube video)
    2. Hamstring Curls with a cable or theraband  (see YouTube video)
    3. Straight Leg Dead Lifts  (see YouTube video)
  2. Spine and Pelvis Stability:  Abdominals support spine and pelvis.  Latissimus Dorsi support spine and shoulders.  Skiing and boarding will naturally work your gluts, so during ski season it’s important to continue to strengthen your abs and lats.
    1. Swiss Ball Crunch (see YouTube video)
    2. Lat Pull Downs

Grasp tubing with arms wider than shoulder width.  Lean back slightly.  Depress shoulder blades.  Then pull elbows toward waist.

Recovery

During and Après Ski

If you can squeeze a few moments of stretching into your day (while in a lift line or when you’re taking a hot cocoa break) your body will feel much better by the time you get to the last chair.  And since most of us drive (at least a few miles) to get to the slopes, it’s also important to loosen up before you get in the car to drive home.

Kelli Crosby, PT, COMPT

Owner

Synergy Manual Physical Therapy – South Office

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112

Practical Self-Care Tips to Help You Prevent Pain and Injury on the Slopes: Part 1

Everyone knows that squats and lunges are great exercises to help you handle the steep and deep.  But did you know that preventing injury on the slopes starts in your bedroom?  Keep reading to find out the three things I teach my patients to prevent pain on the slopes—or even while doing yard work—these tips will help you prevent pain before it begins.

1. Preventing pain on the slopes starts…in the bedroom

The things you do to your body while you sleep at night, determine how your body performs the next day.  If you sleep in a twisted position all night long, it’s not hard to imagine why your back fails you during your 4th run on a powder day.  Sleep position is a common topic at our clinic because it can impact everything from neck pain and headaches to low back and buttock pain.  Here are some things to consider when you hit the sack:

If you are a stomach sleeper:

In order to breathe you must twist your neck to one side.  This is not an ideal position for your neck for a prolonged period (imagine sitting at a desk all day in that position—definitely a violation of ergonomic principles).  So, my usual tip to patients is to try to sleep on your sides or back, if at all possible.

If you are a back sleeper:

Make sure your neck is supported with a pillow that is not too thick or too thin, in order to maintain neutral alignment of the spine.  Try putting a pillow under your knees if your back bothers you in this position.

If you are a side sleeper:

Don’t sleep in a twisted position like the photo on the left below.  Also, the pillow choice advice above applies here too.

2. Preventing pain on the slopes starts…in your chair

We treat so many desk jockeys at our clinic it’s no wonder that when the weekend includes 6-8 hours of skiing (and sometimes falling), Monday arrives with pain.  Even if you don’t sit at a desk for a living, you most likely sit for prolonged periods using a handheld device—gaming, facebook, checking email, etc.  It is absolutely necessary to undo what you’ve done all week, such as prolonged sitting or slouching (ahem), if you want to reduce pain on the weekend and be ready for a powder day.

Posture 101:

Roll your hips forward to reduce pressure on your buttocks and restore the natural lordosis of the lumbar spine.  Don’t stick your chinforward or let your upper back and shoulders roll forward.  Instead pretend the hair on the crown of your head is being pulled upward toward the ceiling

Ergonomics 101:

For Pete’s sake don’t sit on the couch like this!  A laptop should only be on your lap if you are using it for less than 30 minutes; otherwise you need to create a docking station at a desk or table.  In general: sit up straight, support your low back, get the monitor at eye level, and make sure you are typing with your elbows at a greater than 90° angle.

 

3. Preventing pain on the slopes starts…in the home

Whether you realize it or not you are doing things every single day that make your back a target for injury.  Every time you bend improperly to unload the dishwasher or pick up your socks off the floor you are setting yourself up for pain on the slopes.  Don’t curve your back when you bend forward, instead bend your knees and hips and keep your back straight.

There you have it. Now you know simple things that you can change in your daily routine to keep you from setting youself up for a rough day on the slopes. The best way to keep injury and painfree on the slopes is to make sure that your postures and body mechanics off the slopes are not putting your musculo-skeletal system at risk.  This post is a part 1 in a series of 2 blogs that will help you prevent pain and injuries during your winter weekends on the mountains. Stay tuned to our blog or Facebook page to see the second part of this series on injury prevention. In the meantime, stay safe out there and stop in or call us if you have any questions on prevention or a current injury!

Kelli Crosby, PT, COMPT

Owner

Synergy Manual Physical Therapy – South Office

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112

Knee Pain and Your Kinetic Chain

The knee joint needs to be trained and strengthened properly to avoid excess wear and tear (arthritis) on the joint that can eventually lead to knee pain. Running, hiking, agility training, yoga, and even strength training improperly can create or increase improper knee mechanics leading to pain or even arthritic conditions. On the flip side, performing proper balanced exercise routines can help reduce knee pain and slow down the production of arthritis in the knees. Decreasing knee pain or joint break down can also help regulate energy expenditure, increase overall performance, and slow down the production of arthritis.

Stretching and strengthening are always good to increase joint performance and improve joint mechanics. Closed chain exercises (squats, lunges, and leg presses) are more functional for lower extremity joint strengthening. However, these exercises done improperly can create increased pain.  Ideally you should be performing these exercises with your weight in the heel and the base of the big toe to engage gluteus maximus which helps support knee function while decreasing forces being distributed in the knee joint. Two additional open chain exercises (exercises done without your feet planted on the ground) that can increase glute strength are the clamshell and side lying hip abduction (see pictures). Lastly, hip flexor and calf stretches held for 30 seconds or longer can complete a great routine for the biomechanics of the knee.

Mechanically the knees, feet, ankles, hips, and spine all coordinate to provide the linear motion and disperse the impact during walking or running so individual joints do not take all of the gravitational forces. Structurally, if all these joints are coordinating their movement and muscle firing patterns, then in theory no pain should exist and arthritic production will decrease.  If there is stiffness or tightness in spine or other lower extremity joints, it can lead to excessstress and impact on the knee joint during running, walking, or even standing. This is why when assessing a runners form, we typically begin in the hip and lower spine and move down the kinetic to the foot, then reverse this and assess the ankle/foot on up ensure the runner is able to maintain the proper lower extremity mechanics. To read more on the kinetic chain during running check out this article on RunningMechanics,com, “Running Injuries and Kinetic Chain Disruptions.

Decreasing knee pain can simply take a few extra steps to improve function and lower extremity mechanics. With these additions to a training regimen the lower extremity joints will perform better, improve knee pain and reduce the breakdown of the knee joint. So if you are suffering from knee pain, rather than just “running through it”, try a few of the tips I suggested above. If this doesn’t help within a few weeks stop by one of our clinics for a thorough assessment by one of our physical therapists trained in running and gait mechanics. We look forward to helping you!

- Brett Barnes, PTA

Synergy Manual Physical Therapy

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112

A Hip Flexor stretch you’ll truly love

Whether you run long distance, sit in a chair all day, or find yourself somewhere in between, our challenging modern lifestyles guarantees you may find yourself with tight hip flexors or living your life with an anterior pelvic tilt.

When your hip flexors become overly tight, everything may seem out of sync.  You may feel like you walk funny, can’t run without knee pain, your lunges and squats are “off”, and your low back may ache or fatigue easily.  Sound familiar? You may have tight hip flexors.

Hip Flexor Anatomy and Biomechanics

The hip flexors are a group of muscles on the front of the body that crosses the hip.  These muscles include the iliopsoas group, and the quadriceps group (specifically the Rectus Femoris).  The hip flexors work in concert with your legs while walking or running and are responsible for flexing (bending) your hip, or drawing your thighs toward your torso. Sitting up, kicking a ball, marching, and lifting a leg to climb a ladder are all activities that involve your hip flexors.

Issues and Symptoms

You might imagine that your hip flexors get tight from overuse, while this is true, your hip flexors can actually get so tight from underuse that they stop or inhibit other muscles in your body from working.

You may have tight hip flexors if you feel discomfort in the front of the hip that feels worse when moving your leg toward your chest or if you have difficulty taking your leg behind your body and feel your low back working in order to do so.

Chronic sitting also leads to short and tight hip flexors. Tight hip flexor’s pull on the pelvis rotating it forward (anteriorly).This changes your posture by causing excessive curvature of the lower back (lumbar lordosis), a protruding belly (we all want that right?), knee dysfunction, and altered weight bearing through the spine.  Tight hip flexors can even inhibit your glutes from activating when you walk. If this happens, not only can your bottom become flat and flabby, but back pain and or discomfort generally follow.

A true stretch for those tight hip flexors

Hip flexor stretching has become very popular in the fitness and sports performance world, and rightly so.  However, this seems to be one of those stretches that either is performed incorrectly or too aggressively.

So here’s a stretch for those hip flexors that has increasingly become one of my favorites. IT is the half-kneeling hip flexor stretch. It is a true hip flexor stretch because when done correctly it truly stretches the hip flexor and doesn’t just torque your body into hip and lumbar extension.

Key Points to the Half-kneeling hip flexor stretch

  • There is a difference between a quadriceps stretch and a hip flexor stretch. When your rationale for performing the stretch is to work on stretching the hip flexor, focus on the psoas and not the rectus femoris muscle.
  • Keep it to a one joint stretch.  Many people want to jump right to performing a hip flexor stretch while flexing the knee.  This incorporates both the rectus and the psoas, but I find that there are far too many people who cannot perform this stretch appropriately. They compensate by usually stretching their anterior capsule too much or hyperextending their lumbar spine.
  • Stay tall. Resist the urge to lean into the stretch and really extend your hip.  Most people are too tight for this, trust me.  You will end up stretching out your anterior hip joint and abdominals more than the hip flexor.
  •  Incorporate a posterior pelvic tilt.  Contract your abdominals and your glutes to perform a posterior pelvic tilt.  This will give you the “true” stretch you are looking for. Most people won’t even need to lean in a little; they feel it immediately in the front of their hip.
  • If you don’t feel it, squeeze your glutes harder.  Many people have a hard time turning on their glutes while performing this stretch, but it’s key to this stretch.
  • Use your hands to guide your hips.  I will usually start this stretch with my hands on my hips so I can feel the posterior pelvic tilt.  Place your fingers in the front and your thumbs in the back and cue them to posteriorly tilt to make your thumbs move down.
  • Engage your core.  Once you can master the posterior pelvic tilt, progress to assist by cueing core engagement. Do this by placing both hands together on top of your front knee and push straight down, or hold a “massage” stick or dowel in front of you and push down “into the ground”. The key is to have your arms straight and to push down with your core, not your triceps.

So there you have it. The half-kneeling hip flexor stretch is a great stretch for those tight hip flexors and requires no equipment other than your own body. This works great for those with low back pain, hip pain, and postural or biomechanical issues related to having too much anterior pelvic tilt.  Give it a try and if you still need guidance, stop by and talk to one of the therapists atSynergy Manual Physical Therapy.

 – Albert Song Levingston, LPTA  

Synergy Manual Physical Therapy

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112