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What Does It Mean To Be “Out of Alignment?”

“My body feel out of alignment.”

“My <insert healthcare professional here> said that my hips are off.”

“I think I just need to be adjusted.”

These are examples of a few of the comments that patients may express in physical therapy or other injury rehabilitations settings.

The belief that we are like a vehicle that needs to be re-aligned is often the fault of the healthcare industry, including physical therapy.

In the past, healthcare providers would tell their patients that a part of their body is out of alignment and needs to be adjusted to put it back in place. They explain that this is the reason for any discomfort that may be present.

Thankfully, this is no longer taught by most healthcare providers as this thought process has been disproven.

Our bodies are incredibly resilient.

Our joints do not simply fall out of alignment. In fact, our bodies are designed to move and if we were constantly “in line”, it would be impossible to move anywhere!

So, what is happening when an area of our body feels “off”?

As we perform a movement repetitively, compensations and movement limitations become more noticeable.

One area of the body may be moving excessively, while another area of the body may be moving too little.  For example, if your ankle mobility is limited during a squat, you will move excessively at the hips to pick up the slack, causing more stress in that area. As a result, pain, or the feeling of being out of alignment may occur in the hips/pelvis.

If you feel “off” or have been told that you are out of alignment, the solution is likely to begin with discovering what movement limitations may have led to this feeling in the first place. This information can then be used to teach you strategies to move and feel better!

Are you interested in discovering what solutions may be right for you? Contact us to find out more about our physical therapy services!

Try this to improve your hip and trunk mobility

Who doesn’t want to loosen up their hips and trunk while building strong hamstrings and glutes?!

It is common to encounter youth athletes and active adults in athletic physical therapy and injury rehabilitation settings who have tight posterior hips and stiff rib cages. This limits the amount of rotation that they available through the trunk and reduces mobility in a variety of different directions within the hips.

As a result, more stress is placed onto the lower back, knees, and other areas of the body. Overuse injuries often follow that send people to physical therapy, including general lower back pain, lumbar disc injuries, knee arthritis, meniscus injuries, etc.

The good news is that the root causes of these kinds of injuries can be addressed and often do not require a boring home exercise program.

The Single Leg RDL (Romanian Deadlift) is a fantastic drill that you can implement into your workout routine to improve your hip/trunk mobility and strengthen your glutes/hamstrings.

This drill is particularly powerful for rotational athletes like golfers, tennis players, lacrosse players, and hockey players.

We typically start our patients and training clients with the kickstand version of the Single Leg RDL before progressing to the more advanced versions below.

Kickstand RDL (front leg emphasis)

Kickstand RDL with Foot on Wall

The key with these activities is to ensure that you feel the back of your hip, glute, and hamstring working (on the working leg), while also feeling your abs working. You should not be feeling your lower back at any point during the drill.

Are you interested in learning more ways that you can adjust your exercise program to correct old injuries, improve your performance and/or stay pain free? If so, simply contact us!

Do I Need Surgery?

This is a very common question in physical therapy and injury rehabilitation settings .

As humans we think of ourselves as machines. Something is broken and needs to be fixed.

However, we are not machines, and surgeons are not mechanics that fix something broken. In fact, they are closer to janitors “cleaning up” accumulated damage that was created by something else.

A recent literature review published in the prestigious journal, JOSPT, found no evidence to support having surgery versus non-surgical interventions and 9 different areas of the body were researched! The study can be found here.

Now before we jump to conclusions, surgery is an essential part of healthcare.

It is the best option after trauma occurs that causes structural damage which will prevent the body from functioning as required for sport or daily life. Examples include broken bones that are displaced, as well as tendon or ligament ruptures like ACL or Achilles tears.

Surgery may also be a solution to chronic pain or injury that has not improved with non-surgical interventions such as physical therapy.

In the instances described above surgery is utilized as a last resort or because of significant, clear structural damage which can be reliably repaired.

Research, such as the article referenced previously, commonly shows poor long-term outcomes for surgery because we are commonly led to believe that surgery “fixes” the issue.

Surgery does not address the root causes of an injury and it is essential to learn is what caused the damage requiring surgery in the first place. As a result, we can address the root causes of pain, injury, or tissue damage before surgery, hopefully avoiding it altogether. If surgery is still warranted, then the factors that lead to it must be addressed in the post-operative process. If not, we will continue to see more studies like the one referenced in this article showing poor outcomes from surgery.

As the saying goes, if we don’t learn from history, we are bound to repeat it!

Is Shoulder Clicking Dangerous? Can Sports Physical Therapy Help Fix It?

Do you ever experience rice crispys in your shoulder (snap, crackle, pop) when lifting your arm overhead or exercising? Ever wonder if this is something to be concerned about or if sports physical therapy can help to fix it?

There are many reasons that this may occur. The shoulder is a complex joint with the largest range of motion in the body. It is comprised of bone, ligaments, cartilage, and tendons that allow for ease of movement in many different directions.

Because the shoulder is the most mobile joint in the body, it has many ways that it can compensate, and become unstable when compensations are repeated over time.This is one reason (among many) why the shoulder often becomes injured.

However, before you assume the worst, ask yourself the following:

1) Is the popping I feel painful?
2) Have I experienced a recent shoulder injury?
3) Does my shoulder feel stable during activity?
4) Is it accompanied by any weakness?

Clicking and popping can occur for many reasons. If it is painless, it may be harmless joint noises known as crepitus, which is simply pressure being releasing from the joint.

On the other hand, clicking and popping may occur simultaneously with pain. If that is the case or you answered yes to any of questions 2-4 above, it is time for your shoulder to be assessed by a healthcare provider, such as a physical therapist or physician.

The most important thing to learn from your healthcare provider is the root cause of your symptoms. This information enables you to correct them once and for all!

If you are experiencing annoying clicking/popping in your shoulder, and you are ready to determine its root cause, contact us today!

How to Improve Your Mobility

Do your hips or lower back feel tight as you perform movements like a squat? Perhaps your shoulders feel stiff when trying to bring your arms overhead, or your ankles feel restricted. All of these are common reports in sports physical therapy field.

Regardless of where your mobility problems lie, it is your body, more specifically your nervous system that is intentionally causing this. The stiff muscle that you feel is the body protecting itself or adapting to the demands placed upon it.

I often think back to my previous experiences as a physical therapist and the players that I worked with in the National Basketball Association (NBA). Most of them had ankle mobility restrictions, which were an adaptation to constantly being on the balls of the feet. These athletes were constantly sprinting, jumping, and cutting with their heels rarely touching the ground.

As a result, their body adapted to make them better at these movements. The tissues around their ankles turned into tight springs that allowed them to remain explosive without expending too much energy.

Adaptations like this are beneficial for performance however occur at the expense of mobility. As these adaptations go too far the risk of injury increases.

How do we know that adaptations have gone too far?

When the body no longer has the prerequisite abilities necessary to perform the activities required of it. In this case the joints of the body have less mobility than life or their activities require. As a result, uncomfortable feelings of stiffness or injury occur.

For this reason, I encourage athletes and patients to perform daily exercises that practice movements outside of their preferred movement strategies. This way the body cannot excessively adapt to only one way of doing things.

Here is a drill that I recently gave to a patient with shoulder mobility limitations and this is a drill that I advised a runner perform within her daily routine.

Would you like to discover the daily essentials that will help you feel better and move better? If so, contact us today!

When You Should Be Using a Workout Machine

Workout machines like the prone hamstring curl are underutilized in the sports performance setting and often get a bad rap in the sports physical therapy industry. I have heard people (physical therapists, strength coaches, running coaches, personal trainers, etc.) say negative things about using machines for a variety of different reasons.

“Machines are not functional. Humans should provide their own stability and not rely on a machine to do it for them.”

“X, Y, or Z machine isolates only one area of the body and we do not move 1 area at a time in real life.”

The support that machines provide, allowing people to focus on working one area has many advantages when used appropriately.

Even athletes can benefit from using machines.

High level sprinting requires an athlete to have a great deal of hamstring strength as the muscle is in a shortened position (when the knee is fully bent).

During the recovery phase of sprinting (as the leg is being brought back to the front of the body) the heel should be as close to the athlete’s bottom as possible. As this motion begins, the hip is a relatively extended position.

The prone hamstring curl trains end range hamstring strength when the hip is in this position. Dr. Cohen even pauses briefly in this video when at the end of the movement to stress this position.

During this exercise, the machine will dictate the movement however remember to use your abs to prevent the lower back from extending during any portion of the exercise.

There is no such thing as a good or bad exercise. Almost every exercise is appropriate when used properly. The key is to be clear on the desired outcome of the drill and how to implement it most effectively into your training routine.

Would you like to learn how to design your training most effectively to best accomplish your goals? If so, contact us to receive a customized training program designed specifically for you!