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What Touching Your Toes Really Says

Can you see the difference in these photos? The toe touch is a simple test that is often performed in injury rehabilitation and sports physical therapy settings.

However, important parts of this test are commonly missed. Simply touching your toes doesn’t tell the whole story. If you can touch your toes, great, however there are different ways that you can get there.

Have you stretched your hamstrings to such a degree that they allow you to nearly palm the floor? 

If you are a gymnast that may be a great thing. However field sport athletes (ex. Lacrosse, football, basketball, baseball) and weight lifters need a level of hamstring stiffness for explosive movement. 

Is your lower back straight or does it flex into more of a C curve to allow you to more easily touch your toes? Is your lower back bending in certain areas but not in others?

Your lower back consists of multiple bones (vertebrae) that are stacked on top of each other. Our backs are built this way to allow for movement of one segment on the next. However many times these small movements do not occur and the lower back moves as one unit. The result is a lower back that looks straight in places despite being bent over. Over time, a lack of lower back  movement can increase the risk for injury.

The toe touch is a great test and can be made even better when directed by a professional with a trained eye.

Contact us for more information about how a customized movement assessment may help you optimize your training and avoid injury!

Is Mobility Overrated?

Mobility has become a popular buzzword in the sports physical therapy community in Bethesda and Chevy Chase. While it is an important aspect of health and fitness, could mobility be getting more attention than it actually deserves?

What Is Mobility?

The term “mobility” refers the quantity of available movement — and how freely and efficiently you’re able to do so. Popularized by the sports physical therapy and training community, mobility is important for everyone, whether you’re an elite athlete or a busy working Mom.

Mobility is an important part of a well-designed injury rehabilitation and prevention program. It is also used to improve the quality of life for our physical therapy patients in Chevy Chase and Bethesda.

While very important, many experts feel that the booming popularity of mobility overshadows several other key health factors. In particular, the added focus on mobility often leads to a lack of attention on other important health factors, such as strength, cardiovascular health, and other global health behaviors.

What The Mobility “Craze” Makes Us Overlook

Although mobility is an important aspect of a healthy body, mobility alone won’t provide the quick fix you might be looking for. Instead, there are several complex contributing factors that need to be properly managed to improve your overall health.

Strength Training

Lean body mass and strength are some of the greatest indicators of the overall health of an individual. In fact, according to a study done by Harvard University, something as simple as grip strength can help measure an individual’s risk of heart attack, stroke, or cardiovascular disease.

Focusing on mobility alone overlooks the importance of strength training. According to The Mayo Clinic, strength training can help you manage or lose weight, increase metabolism, protect your joints and ligaments, and improve your ability to do everyday activities.

Cardiovascular Exercise

Another important measure of the overall health of an individual is cardiovascular fitness. A simple way to gauge cardiovascular health is by measuring your resting heart rate — the number of times your heart beats per minute when not physically active.

Although the normal range of a resting heart rate is between 50–100 beats per minute, a resting heart rate greater than 90-100 BPM can put unnecessary strain on the heart. A high resting heart rate has even been linked to high blood pressure, cholesterol, and even heart disease.

By solely focusing on mobility, cardiovascular health may be overlooked.

Global Health Behaviors

Outside of strength and cardio training, there are several other important contributing factors to an individual’s health — specifically sleep, nutrition, and social connection.

Sleep plays a crucial role in your physical health. Not only does sleep heal and repair your muscles, heart, and blood vessels, but a recent study discovered done by the National Heart, Lung, and Blood Institute discovered a link between sleep deficiency and an increased risk of heart disease, kidney disease, diabetes, and high blood pressure.

Final Thoughts

All in all, mobility is only one aspect of staying healthy and active — it isn’t the only thing that should be focused on. Health is achieved through the successful balance of multiple variables, including mobility, strength training, cardiovascular exercise, and various other global health behaviors.

If you’re looking for a comprehensive program to improve your health, fitness, and quality of life, our physical therapy team in Bethesda and Chevy Chase can help. Contact us today for a free consultation!

Why Some Warmups Aren’t Useful

As performance physical therapists in Bethesda and Chevy Chase, we work within a very knowledgeable and active community.  Our clients and patients understand the importance of warming up.

Warming up is commonly touted as essential for anyone wishing to avoid injury during exercise, performance training, or running.

We agree with this statement; however, warmup routines are often implemented in a non-productive way.

There is a time and place for everything, however this does not mean that you need to stretch, roll around on the ground, and perform “activation” drills prior to being ready for exercise.

In addition to increasing total body temperature, a warmup routine should prepare the body for the specific workout that is going to take place. For this reason, we call warming up “movement preparation.” The body is being prepared to move!

Movement preparation should include drills that train the skills necessary for the day’s workout. Many times, these drills will look similar to the exercises within that day’s work out.

If you are getting ready to run, perform activities that practice things necessary to run effectively. If you are going to lift weights, practice movements similar to the lifts you are going to perform (ie. If you are going to squat, then squat in your warmup!).

This advise applies regardless of whether you are healthy, injured, in performance physical therapy, or training for performance.

Below are 2 drills that we often use during movement preparation prior to running. Each drill practices single leg balance, the ability to shock absorb on one leg, and trunk rotation. These are all attributes necessary for running.

Single leg knee to chest
Forward lunge with cross connect

Furthermore, if you have been sitting at a desk for the majority of the day, you may need a more comprehensive warmup. On the other hand, if you have an active job requiring you to move in a variety of different ways then your warmup may not need to be as comprehensive.

Movement preparation is necessary, however it is essential to be purposeful, rather than mindlessly performing the same thing before every workout.

I wasted a lot of time stretching

My passion for the field of sports medicine and strength and conditioning began when I was 15 years old.

I was a solid athlete and football was my passion. At the time my dream was to play Division I college football. Although I was successful relative to my immediate peers, I knew that I would have to work my hardest to have any chance of getting to that level.

I trained hard and searched for every advantage I could find. I read books written by famous coaches, trainers, and athletes. One of the most common pieces of advice was to constantly be stretching.

Every morning upon waking, I would perform a 15-20-minute stretching routine. I would repeat a similar routine prior to and after training, as well as before bed.

I would feel more flexible for a short period of time after performing this routine, however, did not notice any improvement in my performance.

When looking back at this now I realize that I never asked myself one simple question. What am I trying to achieve by stretching?

I was simply stretching because people told me I should!

So, what are you trying to achieve when you stretch? Will stretching be helpful for you?

As with most things, the answer is that it depends.

A muscle will become stiff when it is consistently resting in a shortened position. This may be due to posture or a person’s daily activities. For example, someone that sits for an extended period of time is likely to have stiff muscles in the front of the hips.

Stiff muscles may also occur as a result of movement compensations or a lack of movement altogether.

Simply stretching a muscle without correcting the reasons it occurred in the first place, may result in a lot of wasted time. The first step may be to simply move around throughout the day. A simple walk to the water cooler can be enough to break up extended bouts of immobility.

Also, a muscle may become stiff in an attempt to protect against an injury. For example, those with chronic lower back pain often have stiff hamstrings as the hamstrings tighten to protect the lower back.

In this case, it is important to learn to protect the lower back with exercise. One of the first steps is to learn to properly “stack” the pelvis underneath the rib cage. You will feel your abs when you are “stacked” properly. Attempt to maintain this feeling during weight lifting drills.

Below is a great exercise to learn do just that! Have fun and let us know if you have any questions!

Heels Elevated Squat

-Dr. Zachary Cohen