Achilles Tendon Tears: Are you at Risk?

The Achilles tendon is the largest and strongest tendon in the body, but unfortunately the aging tendon undergoes various changes that put it at risk for injury. Some changes that increase with age include decreased collagen density, decreased glycosaminoglycans and water content, decreased tensil strength and increased stiffness.

A study of 891 ruptured tendons in humans revealed 97% of the changes were degenerative in nature and about 50% of them were Achilles tendons.

How can you keep your Achilles tendons healthy?

Know your risk factors associated with Achilles tendon disorders and schedule an appointment for a physical therapy evaluation to determine the likelihood of your developing an Achilles tendon disorder and to learn research proven treatment strategies to help strengthen and avoid surgical repair.

Risk factors include:
-abnormal dorsiflexion (increased or decreased ability to flex foot)
-abnormal subtalar range of motion (increased or decrease foot joint mobility- pronation or supination)
-decreased plantar flexion strength
-abnormal tendon structure
-medical conditions associated with Achilles tendon disorders: diabetes, obesity, high blood pressure, high cholesterol

Treatment:
Studies have shown and proven that eccentric exercises with a focus on slow and controlled movement is an extremely effective nonsurgical method to treating Achilles tendonitis/tendonosis. Below are some helpful exercises for anyone dealing with symptoms or has been diagnosed with this very common injury.

Eccentric Heel Drop on Step: (Achilles Tendon Strengthening)
Begin this exercise with both feet in a neutral position with only the forefoot on the step
Perform a toe raise with both feet
Remove the unaffected leg from the step and slowly lower the affected back to neutral, keeping knee straight
Perform 3 x 15 repetitions twice a day. This is maintained every day for 12 weeks.
As soon as 2 x 15 repetitions twice a day can be done pain free, the load should be increased.
Progression:  Loaded Eccentric Heel Drop on Step–now add weighted dumbells to increase difficulty and to build strength

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Coaches Injury Prevention Workshop

Join Megan Morgan, DPT, orthopedic and pediatric specialist, for a complementary workshop and learn the following:

• How to train proper biomechanics of the lower extremity to reduce ligament injuries
• How to incorporate a sport specific dynamic warm-up
• How to add a simple strengthening and plyometric exercises into each practice to help build strength, flexibility and proprioception
• When is it time to refer your player to seek further intervention for their injury?
Who
This complementary workshop is designed for athletics coaches and trainers working with adolescents in sports such as volleyball, soccer, lacrosse, tennis and basketball.

When
Wednesday August 30th (7:00-7:45pm)

Where
Active Marin Physical Therapy
421 Miller Avenue, Mill Valley

RSVP
Call 415-388-8166 or email info@activemarin.com to reserve your spot.
Ask us about private group lessons for your organization!

Travel Guidelines for a Healthy Back

 

Summer is a time where many people seek relaxation from life’s daily stresses through vacation.  Unfortunately, the journey to a relaxing getaway can be a lot of work, both physically and mentally.  Don’t let your travels cause you pain by following these simple  travel guidelines….

 

Tips for plane travel:

– Sit with your back against the seat, both feet flat on the floor
– If planning to sleep on the plane; have a good supportive neck pillow.
– When lifting luggage into the overhead, brace your abdiominal mucles and keep your chin tucked inwards to avoid hyper-extension of the neck and back;
-Ask for help if your bag is too heavy (or better yet, think ahead and check it at the gate….)
– When waiting at the airport;  stand up and walk around to get some movement.
– To reduce potential blood clots and joint stiffness, perform leg circulation exercises throughout the flight (i.e, Pump ankles by pointing/flexing foot, heel raises seated or standing, calf stretches, bend and straighten knees)
– Choose the aisle seat if possible and get up and walk when allowed


Tips for Traveling by Car:
– Sit with your back against the seat, both feet flat on the floor and your head against the head rest.
– Use a lumbar support pillow (as seen in picture) if your car seat does not feel supportive enough.
– Have your seat tilted slightly downward towards your feet to encourage more of a neutral spine alignment.
– Stop for breaks frequently every 1-2 hours if possible.
– On breaks; walk around for a couple mins, and stretch legs (calf stretch, quad stretch).

Myofascial Decompression

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Active Marin Physical Therapy is excited to offer Myofascial Decompression to help patients dramatically improve mobility and reduce muscle tissue tension.  This technique, rooted in Eastern Medicine, uses negative pressure cups coupled with functional movement patterns and Neuromuscular Reeducation.  Myofascial decompression is currently being used by Olympic athletes such as gold medalist Michael Phelps and US men’s gymnast Alex Naddour  for pre and post-workout recovery and detoxification.

What Is Myofascial Decompression?
It is used to decompress adhesions and scar tissue, relax muscles in spasm, decrease trigger point pain, and to reduce inflammation following trauma.  Over time, the treatment can be used to increase muscle endurance, circulation, and lymphatic drainage and to enhance the overall ability to recover from strenuous activity.
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What are the benefits?
1. Decompresses adhesions and scar tissue
2. Helps relax muscles in spasm
3. Stimulates oxygenation and detoxification of blood while promoting a feeling of lightness and relief of pressure
4. Helps separate the various layers of fascia and muscle under skin
5. Increases range of motion and promotes healing in scar tissue and chronic injury sites
6. Increases lymphatic drainage & promotes circulation
7. Enhances the overall ability to recover from strenous activity

What can it treat?
Myofascial Decompression has been shown to be effective for tight and stiff muscles as well as those suffering from back pain, sciatica, piriformis syndrome, IT band pain, rotator cuff injuries, and plantar fascitis.

 

 

Sleep and Its Importance For Healing Injuries

Sometimes when we are injured we forget to remember that the simple act of getting adequate sleep can be a huge contributor in helping us heal. The National Sleep Foundation’s sleep guidelines recommend 7-9 hours for the average adult with additional sleep and recovery time needed after injury and surgery.

Sleep is an active physiological process, one in which your body is busy carrying out vital activities while you are unconscious.  While asleep your body alternates between 2 forms of sleep, REM (rapid eye movement) and non-REM.  While REM sleep provides the energy needed to restore the mind, non-REM sleep is essential for restoring the body.

During the restorative phase of non-REM deep sleep, the blood supply available to your muscles increases, delivering extra amounts of oxygen and nutrients to facilitate healing and growth.  Additionally, deep sleep allows for scar tissue to form which the body needs to create and repair injuries and allows our pituitary gland to release growth hormone that is essential for increased muscle mass, bone strength and energy.Physical Therapists can teach you how to position your body in the most effective way while sleeping to promote productive healing.  For instance, if you have a low back injury it is helpful to keep your spine in a neutral position by putting a pillow under your knees while you sleep on your back or between your knees if you sleep on your side. Proper positioning techniques for shoulder or neck pain can also be instrumental in sleep comfort.

How Can Physical Therapists Help With Sleep?

Physical Therapists provide education about the importance of aerobic exercise to aide with sleep as well as teach relaxation techniques.  Diaphragmatic breathing is one such technique which helps relieve physical muscle tension, allows the mental function to slow and relax, improves blood flow to muscle tissues and activates parasympathetic nervous system.

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Sleep Hygiene Tips:

    1. Go to bed and get up at more or less the same time every day
    2. Sleep when sleepy
    3. If you haven’t been able to get to sleep after about 20 minutes or more, get up and do something calming or boring until you feel sleepy, then return to bed and try again
    4. Avoid caffeine, alcohol and nicotine for at least 4-6 hours before going to bed
    5. Develop a sleep ritual 15 minutes before bed each night to remind your body that it is time for sleep
    6. Eat a healthy, balanced diet
    7. Having a hot bath 1-2 hours before bedtime can be useful to , as it will raise your body temperature, causing you to feel sleepy as your body temperature drops again
    8. Avoid taking naps
    9. Regular exercise is a good idea to help with good sleep, but try not to do strenuous exercise in the 4 hours before bedtime
    10.  Avoid clock-watching which can reinforce negative thoughts such as “Oh no, look how late it is”

Recommended Sleep Positioning
It is recommended that you either sleep on your back with a pillow under your knees to protect your back or on your sides with a pillow between your legs and arms.  A body pillow can be a very nice purchase for proper alignment.  Sleeping on your stomach can be very aggravating for your low back and neck as the extreme rotation and hyperextension can cause tissue imbalances.
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Dynamic vs Static Stretching: Which Is Best?

This month I would like to discuss the benefits of dynamic over more traditional, static stretching when it comes to warming up before training or competition.

Most of us are familiar with “static stretching” which consists of various techniques to gradually lengthen a muscle for up to 2 minutes while the body is at rest.  Although this type of stretching has been routinely used as a way to loosen up muscles before exercise, research is now showing that static stretching can actually hinder one’s power output, joint stability, reaction time and coordination.  When you think about it, why would one stretch while the body is “at rest” when within minutes you might need to explode from a starting block or hustle up and down a basketball court?  Current research suggests that static stretching should be reserved for after work outs or sporting events and may have little benefit before your activity.

The use of “dynamic stretching” which involves stretching specific muscle groups while continually moving throughout a warm up is now considered to be a much more effective, efficient and fun way to warm up before intense exercise.

Benefits of Dynamic Stretching

1. Prepares your body for exercise by actually activating sport-specific muscles and joints you will be using during your workout.

2. Increases your muscles’ core temperature for improved power output

3: Helps you mentally transition from rest to competition by challenging your body awareness, balance and coordination.

4: Improves range of motion and flexibility around your joints which helps reduce chance of injury and improve performance