I felt stuck

Times have certainly changed, haven’t they? Just look at all that hair! And it seems like they couldn’t do much about the sun glare on picture day either…

“I really need to stretch more. Should I try Yoga?”

“Everyone’s talking about how Pilates strengthens your core. Maybe I should take a class?”

“I know strength training is crucial, but where do I even begin?”

If you’ve ever had thoughts like these when thinking about exercise, you’re not alone.

The world of health, fitness, sports physical therapy, and injury rehabilitation can feel massive and even a bit daunting. I remember a time when I was unsure about how to approach my own fitness journey.

After wrapping up my college football career, I no longer had coaches designing my training plans. No more structured practices, conditioning workouts, weightlifting sessions, or recovery routines that typically involved stretching, foam rolling, yoga, and light cardio.

With no clear direction, I stuck with what I knew best: lifting weights, following my old off-season routine, and adding a couple of conditioning sessions each week.

After a few weeks of this, I stopped and asked myself a simple but important question: “Why?”

Why was I training this way? What were my goals now? And what were the most effective ways to achieve them? After reflecting and writing down my thoughts, I realized that my training program no longer aligned with my new goals.

My football days were behind me, and it was time to focus on staying healthy long-term.

At the same time, I still enjoyed strength training and the feeling of being strong. Plus, I was working toward becoming a Certified Strength and Conditioning Specialist (CSCS), so I needed to practice what I preached (this was all before I entered sports physical therapy school).

I ultimately designed a new strength training program that focused on increasing strength and muscle mass while also enhancing my mobility. The goal was to feel strong and stay healthy.

This approach worked because I took a moment to slow down and ask myself a few basic questions.

When was the last time you did that? Ask yourself these questions:

– What are the outcomes I want from my training? Do I want to be stronger? Have less discomfort? Improve my mobility? Be honest with yourself.
– What are the best methods to achieve these outcomes?
– If I don’t know the answer to the above, who can help guide me?

As question three suggests, you don’t need to figure it all out on your own. There are experts available who can help you reach your goals, but only you can determine what those goals are.

Once you have that clarity, our team of sports physical therapists in Bethesda and McLean is here to help. Along with being Doctors of Physical Therapy, our Performance Physical Therapists are also Certified Strength and Conditioning Specialists. We specialize in helping injured athletes recover and get back to doing what they love.

How to “Fix” Rounded Shoulders

As physical therapists, we often answer questions pertaining to “poor posture.” One of the most common reports from our patients in Bethesda and Chevy Chase is having “forward shoulders.”

The solution to this, which is often taught by other physical therapists, is to stretch the muscles in the front of the shoulders. The most common of these muscle groups is the pecs.

The logic goes something like this. “Your pecs are tight and pulling your shoulders forward. If you stretch them, your shoulders can move back and correct your posture.”

While this reasoning isn’t necessarily wrong, it is shortsighted. It fails to question why muscles like the pecs became tight in the first place. Simply stretching these muscles won’t correct the root cause of the issue.

The shoulder complex rests on top of the rib cage and the pecs attach to the sternum (ribs 1-7 attach to the sternum) as well as the ribs on the front of the rib cage.

As we breath in the rib cage should expand in 360 degrees and as we breath out it should do the opposite.

People with forward shoulders and stiff pecs often have difficulty expanding the front part of their rib cage during a relaxed breath in. This prevents the pecs from lengthening fully and often causes them to remain stiff, pulling the shoulders forward.

If you are looking to improve your posture and “pull your shoulders back”, the solution must include breathing exercises that emphasis relaxation and expansion of the chest/front part of the rib cage.

Here is an example from our YouTube page that illustrates this concept.

If you are looking to improve your posture or shoulder function, contact us now!

Photo Credit

“Orlando’s Poor Posture” by hewy is licensed under CC BY-NC-ND 2.0

Does Your Metabolism Actually Slow As You Age?

As we age it is common to feel that it is increasingly difficult to prevent injury or reach our fitness goals. We have spoken to many people in Bethesda that feel the help of a physical therapist is inevitable. Many challenges that are experienced are often attributed to a slowing metabolism.

However, this may not be the case.

There has been evidence that suggests that our metabolism doesn’t slow much, if at all, during adulthood. However, even if we later discover that some of these findings are misleading, a slowing metabolism is not the only reason that it takes longer to recover from injuries or fail to reach our fitness goals as we age.

Many of the challenges associated with aging stem from lifestyle changes.

In modern times humans have become more sedentary as we age. We no longer participate in organized sports, play outdoor games with our friends, and migrate to sedentary desk jobs for much of the day. This results in a large decrease in our daily energy expenditure and increases our risk of injury. Prolonged sedentary activity causes our body to become de-conditioned and less prepared for the rigors of life. As an example, this is why we suggest partaking in a running analysis prior to training for a race.

Another factor we may not realize is that as we get older, we take on a lot more responsibility.

Think back to your teenage years or time in your 20s. Did you have a lot of worries back then? A career? Family commitments? A mortgage? As these “adult things” add up, so do our commitments, resulting in less free time. Less time for exercise, less time for self-care, and less time for sleep.

Countless studies have shown us that as sleep decreases our health is negatively impacted in several ways, including an increased risk of orthopedic injury.

While it may be easy to see all of this as a negative, the good news is that many of the seemingly negative effects of aging are not as inevitable as we may have thought! Furthermore, feeling better and healthier doesn’t require you to be perfect.

As performance physical therapists, we help our patients identify the smallest possible improvement that will make the largest possible impact to overcome an injury.

Image Information

“Tiantan Park-life: The Elderly Exercising in China’s Parks – Parallel Bars” by _chrisUK is licensed under CC BY-NC-ND 2.0

Why We Need to Stop Comparing Adult Movements to Children’s

It has become common in fields of physical therapy and performance training to compare adult movement to the ways that babies move. You may have spoken to a professional that uses this comparison in their approach.

The logic usually goes something like this…“Humans were born with the ability to squat fully, and our modern lifestyles robbed us of that ability, so we need to regain it.”

Sounds understandable, right?

I thought so too. I even took a couple of continuing education courses based loosely upon this concept. The class instructors showed pictures of babies at various development stages and attempted to teach movements that mimicked these phases. The idea was to help adults gain back some of the movement capabilities that they once had as children and this new freedom of movement would help to alleviate pain and resolve injury.

Adults Are Not Babies

While I think we’d all love to be able to squat to the floor, crawl around all day, and never get tired, the truth is that we are not babies anymore.

Babies have a large amount of joint laxity that allows them to get into a variety of different positions, that we don’t have as adults. Babies also have a very large head in relation to the body, which helps to provide a counterbalance for easy squatting. In fact, according to Healthline, many of a baby’s bones are composed of cartilage, a type of connective tissue that is tough but flexible. This cartilage turns to bone as we grow.

Their bodies are still growing and changing. They fall often and make mistakes (essential for learning), which flexibility and mobility help with. Because of this, the ability to squat to the floor is normal for a baby. The same cannot always be said for adults.

Adults are not babies, and we cannot use a baby’s movement as a model for how an adult should move. Not only do babies have much different bone and structural compositions, but all adults have different movement capabilities due to variations in torso lengths and body proportions (among other reasons). Using singular movement standards would overlook this critical aspect.

It is nice to think that we could be able to squat to the floor like we once did when we were a toddler. However, adults are not babies, and our bodies are not the same as they once were.

Because of this, we do not expect our physical therapy patients to squat to the floor. It is essential for all of us to set realistic movement standards that will help to live pain-free and healthy lives. For help in the arena, talk to our experienced physical therapy team in Bethesda!

A Window to Cardiovascular Health

“Casual Runner” by Chris Hunkeler is licensed under CC BY-SA 2.0

Resting heart rate paints a vivid picture of cardiovascular health and impacts the body’s response to sports physical therapy interventions. RHR, or resting heart rate, is the number of times the heart beats per minute when the body is not physically active — such as when sitting.

According to the Mayo Clinic, the “normal” range for a resting heart rate is between 60 and 100 beats per minute (BPM), though resting heart rates vary from person to person based on various circumstances. For example, resting heart rate is significantly influenced by mood, environment, cardiovascular fitness, and stress.

As a rule of thumb — as cardiovascular health increases, resting heart rate tends to decrease. Therefore, athletes often have lower resting heart rates than those that do not regularly exercise. That said, resting heart rate is an important measure for anyone looking to improve their overall health.

What Your Resting Heart Rate Says About Your Cardiovascular Health

The heart is responsible for pumping blood and oxygen throughout the body. An elevated resting heart rate causes increased strain on the heart, often linked to high blood pressure, high cholesterol, and a higher risk of heart disease.

A resting heart rate of more than 100 BPM is called tachycardia, whereas an RHR below 60 beats per minute is called bradycardia.

Other than a few exceptions (for example, medications that lower the heart rate), a lower resting heart rate is an indication that the heart is more efficiently pumping blood, requiring fewer beats per minute to distribute blood throughout the body. Because each beat is more powerful, the heart is much stronger than one with a high resting heart rate.

Fortunately, there are many ways to improve resting heart rate, thus improving overall cardiovascular health.

How To Improve Your Resting Heart Rate

This is where cardiovascular exercise comes in handy. A recent study conducted at the University of Lousiville concluded that regular exercise effectively lowers resting heart rate, which reduces the risk of cardiovascular disease.

We think of cardiovascular exercise as strength training for the heart. Aerobic workouts, like walking, jogging, or swimming, train your body to use oxygen more efficiently, which gradually reduces your resting heart rate and breathing rate — both of which are important factors of cardiovascular health.

A more efficient heart can even help athletes recover quicker between grueling workouts. Plus, it allows many of our physical therapy patients in Chevy Chase and Bethesda to better adapt to the physical demands of their lives.

Final Thoughts

Resting heart rate is an important measure of cardiovascular health. A significantly high resting heart rate often correlates with many health problems such as cardiovascular disease, high blood pressure, and high cholesterol. Conversely, a low resting heart rate indicates a strong, healthy cardiovascular system.

If you’re struggling to improve your resting heart rate, try adding in regular cardiovascular exercise to gradually improve cardiovascular efficiency. Resting heart rate will improve as a byproduct.

If you’d like to work directly with a physical therapist in Chevy Chase or Bethesda to help you with this, please contact us today to schedule a free consultation!

The Surprising Link Between How You Breathe and Your Stress Levels

Stress is something we all face, and the causes are often familiar: work demands, family issues, financial strain, and health concerns. But there’s another, often overlooked factor that can significantly contribute to heightened stress levels—your breathing.

In recent years, research in athletic physical therapy has revealed that the way you breathe plays a critical role in your body’s stress response. According to Seth Oberst, DPT, the primary modes of breathing—through the mouth or through the nose—can either exacerbate or help mitigate stress.

Mouth Breathing vs. Nose Breathing: What’s the Difference?

At first glance, it might not seem like a big deal whether you breathe through your mouth or your nose, but the two are far from equal in terms of their impact on your body.

Mouth breathing, which many people subconsciously default to, can actually increase stress levels in several ways:

1. Head Posture and Airway Alignment
When you breathe through your mouth, your head tends to jut forward in an effort to keep your airway open. This seemingly small change in posture initiates a cascade of negative effects that ripple through your entire body. Poor posture can lead to chronic tension in the neck and shoulders, further aggravating stress.

2. Reduced Nitric Oxide Intake
When you breathe through your nose, your body naturally produces and mixes nitric oxide into the air you inhale. This compound helps dilate your blood vessels, allowing for better oxygen circulation and supporting your immune system. Mouth breathing, on the other hand, bypasses this nitric oxide production, forcing you to take in larger quantities of air to compensate—an inefficient process that taxes your system.

3. Over-Activation of the Sympathetic Nervous System
Breathing through the mouth tends to increase activity in the sympathetic nervous system—the part of your body responsible for the “fight or flight” response. This system, when overstimulated, can lead to heightened stress, faster heart rates, and increased muscle tension. Over time, this constant state of over-activation can make it harder to relax, leaving you feeling perpetually on edge.

4. Disrupted Sleep and Restless Nights
You might think that physical or mental exhaustion would automatically lead to a good night’s sleep, but mouth breathing can actually disrupt your ability to rest properly. Because mouth breathing is less efficient at delivering oxygen to the brain, you may find yourself tossing and turning at night, waking up still feeling tired and unrested. This lack of quality sleep further exacerbates stress levels, creating a vicious cycle of fatigue and tension.

The Power of Nose Breathing

In contrast to mouth breathing, nose breathing can have a profoundly calming effect on both your body and mind. The nose acts as a natural filter and humidifier for the air you take in, warming it and removing harmful particles before it reaches your lungs. Nose breathing also activates the **parasympathetic nervous system**—the “rest and digest” system—which helps reduce stress, lower your heart rate, and promote a state of calm.

Moreover, because nasal breathing supports better oxygen exchange and reduces the need for over-breathing, it prevents the shallow, rapid breaths that are often associated with anxiety and panic. Over time, habitual nose breathing can help to lower baseline stress levels and enhance your overall sense of well-being.

How to Shift from Mouth Breathing to Nose Breathing

If you’re accustomed to breathing through your mouth, switching to nose breathing might feel uncomfortable at first. But with practice, you can retrain your body to make nasal breathing your default mode.

Start by dedicating 3–5 minutes a day to intentional nose breathing. Find a quiet space, close your mouth, and focus on taking slow, deep breaths in and out through your nose. You may feel resistance or a bit of difficulty at first, especially if your nasal passages are slightly congested or if you’ve developed the habit of shallow mouth breathing. Stick with it—the goal is to gradually build comfort and strength in your nasal breathing muscles.

The Long-Term Benefits of Nasal Breathing

Incorporating nasal breathing into your daily routine can lead to a host of long-term benefits, including:

– Reduced stress and anxiety
– Improved sleep quality
– Better focus and mental clarity
– Enhanced athletic performance
– Lower blood pressure and heart rate
– Decreased muscle tension and fatigue

Need Help? We’re Here for You

If you’re struggling with stress or want to improve your breathing technique for overall wellness, our experienced athletic physical therapy team in Bethesda and McLean can help. We can work with you to develop personalized breathing exercises and techniques that will not only optimize your breathing but also support your physical and mental health.

Remember, while you can survive by mouth breathing, thriving requires that you breathe with intention. Take control of how you breathe, and in turn, take control of your stress.