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3 Critical Questions To Ask Your Physical Therapist on the First Visit

Physical therapy (both in person and virtual physical therapy) is most effective when you are actively involved. While the physical therapist is responsible for identifying issues and developing a plan, the patient should be actively involved by asking questions and providing necessary background information. Here are three important questions to ask your physical therapist to get the most out of your session in Chevy Chase or Bethesda.

1. Why did this happen, and how can we ensure it doesn’t happen again?

Solving the underlying issue and resolving any pain or discomfort is essential when working with a physical therapist. But beyond that, you also want to ensure that the problems don’t resurface. By asking about the root cause of the injury or pain, you’re able to better prevent the problem from becoming a long-term issue.

2. What do I need to be doing at home?

Unfortunately, time with a physical therapist is limited. Outside of a few hours a week, most time is spent away from your PT. When meeting with a physical therapist, it’s vital to clarify any exercises you should or shouldn’t be doing at home. A great physical therapist will make sure you have the tools and exercises needed to take control of your health, both inside and outside of the session.

3. How can you be sure I’ll make progress?

If you decide to work with a physical therapist, the intention should be to progress towards your goal. Oftentimes the  healthcare system will establish general objectives, such as reaching a “baseline” or returning to ADLs (active daily activities). Although these standard guidelines are a good starting point, the purpose of physical therapy is to reach your goals, not the goals of the insurance companies! By asking this question directly, you set a clear intention for the results you desire.

Physical therapy works best when there’s an active partnership between you and the PT. The more engaged you are in your health, the more progress you will make. By asking these three essential questions, you’ll set clear intentions for your physical therapy and build a better working relationship as a result.

Why the rates of athletic injuries are on the rise

With the weather warming up, COVID-19 cases decreasing, and spring sports starting up again, many young athletes are looking forward to making their return to sport. While excitement is high to get back out there and compete, it is important to prepare your body correctly to avoid injuries and stay healthy. Proper performance training in the Bethesda and Chevy Chase area can be the difference between a dream season and being forced to watch from the sideline!

After a long layoff from sport, the inherent risk of sustaining an injury is high, as one’s body is not used to performing sport-specific athletic activities. That’s why it is important to take some time before the season starts to get your mind and body ready for healthy peak performance.

Studies show that strength and conditioning training in athletes reduces sports injuries by 33% and overuse injuries by nearly 50%. So, it is important to get started with some simple, comfortable exercises in order to get back into playing shape and stay healthy.

A great way to start preseason training is with individual sport-specific drills with an emphasis on conditioning. From here, the athlete can progress into sport-specific drills with a partner or opponent. Then, go ahead and ramp up the activity into team drills, scrimmaging, and finally, game play. You see this progression in professional and collegiate sports, as activity is gradually increased as the body is able to adapt to the increased culminating stress.

The best way to get a sport-specific program that meets the needs of an individual athlete is to see a professional who can create a program based on his/her unique strengths and weaknesses. So, if you’re looking for optimized programs after a long offseason or injury, look into performance training in Bethesda or Chevy Chase and get that dream season off to the right start!

Cheers to a great new season and be sure to have some fun!

An Essential Part of Athletic Physical Therapy: Strength Training for Runners

Many of the runners that we work with at CHP supplement their running with strength training. Strength training is a large component of athletic physical therapy and provides a host of benefits including, but not limited to; reduced injury risk, increased muscular endurance, and faster running times. Research shows that regular strength training improves a runner’s speed and VO2 max. VO2 max is a measure of the maximal amount of oxygen that a person can use during exercise.

However, there is one important caveat to all of these great benefits. A runner’s strength training program must be designed and executed appropriately, and according to the runner’s goals and individual characteristics.

Luckily, most runners have similar goals. They wish to run faster and/or farther, and avoid injury.

Strength training programs for runners should consist of exercises that improve qualities specific to running.

When running, there is never a time when both feet are touching the ground simultaneously. The arms and legs are constantly moving in opposite and alternating directions as the body transitions from one foot to the other.

Therefore, we commonly advocate for runners to include more single leg exercises into their training.

These exercises include, but are not limited to: lunges, single leg squats, split squats, and single leg RDLs (Romanian deadlifts). Simply adding one of these activities into each of your strength training sessions can have a large impact. Take a look at the videos below for examples of these activities.

https://www.youtube.com/watch?v=aazACzyUR-Q

https://www.youtube.com/watch?v=KK05iugeIDE

https://www.youtube.com/watch?v=EjDtPek261c

Furthermore, runners should not neglect upper body training. Arm drive is an essential component of running and helps to drive leg action. An effective runner cannot have one without the other!

A thoughtful and more scientific approach to strength training, specifically designed for runners, may be all that is needed to drastically improve your running performance.

Could this be the missing piece of your marathon training?

In a previous blog post, we introduced mat Pilates and how it helps people that are struggling with back pain.  However, many athletes use Pilates to improve other aspects of their performance and CHP’s own, Dr. Ciara Petry, uses it as part of her physical therapy treatment sessions.

As you know, Bethesda and Chevy Chase are packed with athletic people and runners of all levels. Many of these runners are preparing for a variety of races. Running volume increases as a runner prepares for a race, which increases the need for cross training. Cross training allows runners to enhance qualities that improve running performance.  However, it is important to avoid adding more pounding to the body in the process.

At Cohen Health and Performance, we have found Pilates to be incredibly helpful in this regard. Weekly supplementation of Pilates training helps to improve performance and/or reduce the risk of running related injuries.

Pilates includes low impact and multi-planar movements that enhance core stability, mobility, and other foundational components necessary for healthy running.

In an article published in 2018, Finatto et al performed a study measuring the effect of a 12-week Pilates mat program on running performance. The participants in this study were separated into 2 groups. Both groups participated in a run training program, however one of the groups also participated in classic mat Pilates training 2x/week for 1-hour per session. The study found that the Pilates group had been more resilient to fatigue when running. It was also found that runners in the Pilates training group significantly improved their 5-km times, thus suggesting that distance runners can transfer the gains made in Pilates to running!

Integrating Pilates into a runner’s performance training just 1-2x/week can improve running efficiency and performance. How cool is that?!

Here at CHP, we help our athletes conquer injury and optimize performance. Reach out today to schedule a running analysis with one of our performance physical therapists and to Dr. Ciara Petry, a certified Mat Pilates instructor, for personalized Pilates sessions!

Article for Reference: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0194057

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.

2 Simple Drills to Improve your Running Times

As a dedicated runner you likely have suffered an injury at some point. Perhaps it forced you to seek performance physical therapy. Whether you realized it or not, this injury limited your ability to train effectively.

At CHP, we consistently help runners in Chevy Chase and Bethesda overcome injuries that otherwise would limit their ability to train, ultimately causing disappointing results.

There is not a one size fits all solution to helping all runners; however, we often discover that runners are limited by their hamstrings.

Are you concerned that hamstring stiffness or weakness could be limiting your performance?

Your hamstring is responsible for keeping your heel close to your bottom during the heel recovery phase of the running cycle. This portion of the cycle occurs as you bring your leg back underneath your body to prepare it to strike the ground again. The closer you can keep your heel relative to your bottom, the better! This allows you to efficiently move your leg faster through space, resulting in faster times. Below is a drill we prescribe to many runners to improve this attribute.

 

 

When running the hamstrings also need the ability to lengthen as the thigh is in front of the body. This should be achieved without drastically changing the position of the pelvis. Many runners struggle to maintain control of their pelvis as the hamstring lengthens. This increases the stress placed onto a variety of soft tissues through the lower body and alters foot strike position. Below is a drill to improve these capabilities.

 

 

A thoughtful and more scientific approach to training, specifically designed for runners is likely all that you need to drastically improve your running performance. It may not even require you to train any harder, just smarter!