Physical Therapy for Runners: Tuning the Ankles for Lighter Running

Do you want to feel lighter and more free when you run? Then you need to ask yourself, do you know where the front of your ankle joint is? Find the tibiotalar joint labeled ankle in the picture below. This is the front of your ankle. Notice how in the picture on the right, the soft tissue that covers that area is being displayed. All those tendons are what you see pop off your foot and ankle when you bring your toes and foot towards your shin (dorsiflexion).

If you want to be able to run lighter, you need to be able to feel softness in this area and learn how to release the muscles and tendons along the front of the ankle joint when you walk and run.

Take a look at the trailing leg of each of the elite runners above. They are each about to start swinging their back leg forward by flexing the knee and hip. At this moment, you can see how the first thing they have to release before swinging the leg forward, is the front of their right ankle. They have moved into a more pointed foot position not by pushing with their toes into the ground but by releasing the front of the ankle.

By keeping their ankles soft, these great runners able to run lightly and allow their ankles to pass through a greater range of motion than most of us take advantage of. This helps maintain ankle mobility and also limits the amount of calve tension that builds up. The front of their ankles will remain soft for as much of their stride as possible.

If you are constantly dealing with tight and sore calves from regular running, it’s very probable that you are gripping in the ankle.

Try this body tuning exercise to help develop ankle freedom and independence:

First stand comfortable with one of your arms bent at the elbow to 90 degrees. Now shake your wrist out so that it flops all over the place. Nothing specific, just shake the hand and wrist and notice how easy it is for the hand to relax and get thrown around by the bigger muscles around the elbow and shoulder.

Relax and consider if you can do the same thing with your ankle. Try balancing on the right leg with the left foot held comfortably around mid-shin level. First notice, is your left ankle relaxed and dangling in the air, or is it flexed in order to help lift the leg? Then try shaking the left ankle out like you did with your wrist by using the muscles of the knee and hip. Does it feel as floppy as the wrist or do you feel the ankle is like one block?

Notice how the horse above has released the front of its front left ankle in order to swing the front left leg forward, rather casually I might add. This action doesn’t come from pushing the toes into the ground and contracting the calves. It comes from releasing the front of the ankle and allowing the bigger muscles of the hip and knee to take the ankle for a floppy ride. Don’t worry, your ankle will be in the right place when it’s time to land.

Next time you go for a run, use some of your mindfulness to observe the front crease of your ankle. If you can’t feel it releasing before you try to swing your foot forward and your ankle feels heavy, pull over and give yourself a tune up with the shaking exercise.


Best Breathing Method for Health

Buteyko Breathing Method

The goal of this breathing method is to affect not only the muscles in the body, but also the physiology of the body. While this breathing technique will produce relaxation and energy, it is important to remember that the fundamental concept is to limit your breath. If you would like to understand more about the physiology of this technique, you can start here:

While it is best to do focused sessions of 15-20 minutes to help recalibrate your natural breathing rhythm, we find that any amount of this breath work will begin to improve your overall health.

How to Perform the Exercises:

All breathing should be done through the nose with mouth closed at all times. The mouth is for eating and the nose is for breathing. Focus on taking the smallest and most silent breath possible. Ultimately your breathing should be unnoticeable.

1. Begin by gently exhaling with little to no force. Don’t try to squeeze any air out, just let yourself deflate. If you exhale too far, you will feel your abdominal muscles contract to push extra air out, this is too much effort. Only release the air until you reach a natural resting state

2. Now, simply sit in this resting state. Do not immediately breath in. Feel the pause of stillness at the bottom of the exhale. Spend 2-3 seconds in this pause. You will notice how relaxed your body is and that you don’t actually NEED to breath in immediately.

3. After a second or two you will feel a slight urge to breath in. It is very important at this point to use as little effort as possible and to take the smallest breath possible. You can think about taking a small sip of air. Just enough to satiate your urge but not enough to cause any obvious muscular contraction, especially in the ribs. If you feel your upper ribs lift, you are taking too deep of a breath. Over time you will become aware of the subtle movement in the middle of the abdomen that produces your effortless small inhale.

4. At the top of your small inhale, immediately release the air as if performing step 1 again. Do not hold the air in your lungs. After you inhale, you need to immediately release. If you hold even the small breath in, you will notice tension creep into the entire body. At this point the cycle has begun again.

5. It is important to understand that if you stay in the resting pause for too long, you will develop too strong of an oxygen debt to maintain effortless small breathing. You will feel your ribs lift and an overwhelming urge to take a deep breath. If this happens, you need to shorten your resting pause period so that you can resume gentle in/out nasal breathing. No matter what, do not breath through your mouth.

It is best to think of this cycle in two parts

I. Sip air in and immediately release

II. Rest in the pause at the bottom of the exhale until you feel a slight urge to repeat step one. Mindfully observe the relaxation of all breathing muscles during the pause.

As you practice you will notice that the time it takes for you to develop the urge to breath will gradually get longer. This means you are making progress. You will also notice that when you release your breath into the pause, that many muscles relax as if you were sighing, especially around the upper ribs and neck area. Notice how the shoulders begin to slide down the back with each gentle exhale.

Your main goal is to spend more and more time in the pause cycle of breathing. Perhaps you can recall a time when you were reading a book and then suddenly thought to yourself, when was the last time I took a breath? This is actually proper breathing. Unobtrusive with long periods of rest between gentle efforts of in and out.

This is the basic breath reduction exercise that we recommend practicing throughout the day.

Managing Pain and Function Following Joint Replacement Surgery


More than 1 million patients undergo total knee or hip replacement surgeries each year in the US and numbers continue to climb. The trend might be easily explained by an increasing number of elderly people, but reports are showing that there is a growing trend for younger patients to opt for surgery.

No matter how old you are when you go for surgery, one thing is certain: you will feel pain.

For most patients this is not a new sensation. The majority of patients seek joint replacement surgery because they have been living with pain for extended periods of time. It is easy to think that surgery is a quick fix and in some ways it is. The new joint is ready to function immediately and many patients are beginning their physical therapy rehabilitation on the same day as their surgery. But what most people do not expect is how much recovery it will take to overcome the damage caused by the surgery.

The nature of joint replacement surgery involves deep penetration into the body that requires tissue cutting, splinting, stretching, stapling, nerve severing, and bone scraping/removal to name a few. Having a clear understanding of what you are getting into, and how much pain to expect following the surgery, will help you recover quicker and help you manage post-operative pain more effectively.

Pain that is left unaddressed negatively impacts our healing capacities by causing mental and physical stress which leads to slower and incomplete recoveries. Education on the types of post-operative pain that will be experienced as well as group rehab classes with patients that underwent similar procedures has shown to improve pain management and recovery outcomes. Immediately after surgery pain killing drugs such as opioids have proven to be beneficial for long term outcomes as it allows the patient to begin moving their new joint through greater ranges of motion and even bearing weight through the new joint without such intense emotional and physical discomfort.

Patients are urged to move beyond opioids or limit their intake as soon as possible because of the risk of addiction which can cause serious mental and physical damage. But what do patients move on to?

Often times patients move on to anti-inflammatory drugs like Ibuprofen to help them manage their pain but inevitably they rely on physical therapy to get them pain free and functional once again. Research has proven that Cryotherapy and Electrical Stimulation are effective modalities to reduce pain, inflammation and swelling in the effected joint.

While these modalities are essential to post-operative pain management at the joint, at Body Tuning & Physical Therapy, we take the more holistic approach to restoring the body by also improving the function of the surrounding joints to alleviate pressure on the prosthetic as well as destressing the nervous system to optimize the natural healing capacities of the body. Our Body Tuning techniques can reduce the traumatic impact of joint replacement by not only directly managing pain at the surgical site, but also by using the rest of the body to support the newly acquired hardware.

The nature of opting for joint replacement surgery implies that there was a serious pathology in the patient’s original joint. It has been well documented that when people are experiencing pain, the body tries to protect itself by restricting range of motion through a mechanism known as “muscle guarding.” This is the body’s subconscious way of putting a cast on an effected area. When the hip is painful, the body will opt for compensatory movement in the spine and other lower extremity joints. Surgery does not undue these compensations. While the prosthetic hip joint itself may be new and functional, the affected areas in the spine and lower leg will need to be retuned before your body can move normally with the new prosthesis. Our Body Tuning exercises as well as our manual therapy skills allow the body to release its guarding and learn to move in a fully integrated and natural way once again. Taking a more holistic approach to recovery after joint replacement is essential to long term success and pain free living.

Is your in-network insurance going to cost you more for physical therapy than going out of network?


When you decide to go to a physical therapist, you have taken the first step toward feeling better. Admitting you need help with your body from a professional is a big decision — but then what?

You ask Google who the best therapist is. You turn to friends and family for suggestions. Maybe you even call a few places to see if your insurance covers treatment there. Sooner or later you find the great divide in our healthcare system. Do I stay in network or do I go out of network?

When most people hear “out of network” there is a cringe response followed by dollar signs fading into the distance. This gut reaction exists because information on how insurance companies can dictate your treatment is largely swept under the carpet, leaving the consumer undereducated and under-served.

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Treating wrists and forearms hurt from playing the violin



我是由於拉小提琴傷了手腕及前臂。我看了西醫物理治料而感到它們慣例的伸展活動和超聲波沒有效, 而Tatz醫生這樣完全明白。他第一眼見到我已經說我整身體緊。這個我已經知道,而我都下意識知道這個問題對我平常一舉一動有挺大的影響。可是,從來都沒有人(過去的物理治料師,健身教練等等)跟我應對過這個全面的問題。

Tatz 醫生會動生幫你按摩及鬆解你的肌肉。第一天他沒有對我的手腕或前臂做任何東西,他跟我說不想一天醫好我,而他只按了我的腰和背部。他也教我一些超輕柔的“運動”,是很微細的整體左右擺動。每次最後的15-20分鐘,他會放你在一部磁性機器下“睡覺”。下來的預約,他有按鬆我超繄的肩膀,腿等等,及教我多些擺動的運動。第三個預約,他按了我的手腕(不是無痛的!),而我的手腕這大半年沒感到過這樣好。但是, Tatz 醫生也說,“We have a big project” (我們有一個大工程)。他要我用八星期,二十次見他。

Tatz 醫生是一個好人,也想醫好你。 他會多說,人愈用腦多,身體就愈繄。他多強調,我們的身體自然懂得動。他也說,身體放鬆“loose”,比強的身體好。

Dr Tatz’s style seems like a mix of Eastern and Western philosophies. He takes a holistic approach like Chinese doctors, but he also uses modern technology and doesn’t rely on tradition totally.

I hurt my wrists and forearms from playing the violin. I had been to a physical therapist and found that their prescriptive methods of stretching and ultrasound useless, and Dr Tatz understood completely. The moment he looked at me he already said that my whole body was tight. I was already aware of this, and I already had a suspicion that this affected a lot of what I did in life. But, no one (including previous physical therapists, fitness instructor etc) had ever addressed this for me.

Dr Tatz heals you hands-on, massaging you out and loosening your muscles. Our first appointment he didn’t do anything to my wrists or forearms; he said he didn’t want to heal me in a day, and he worked on my core, front and back. He also taught me some super mild “exercises”, which were sort of micro movements that involved shaking/twisting left and right fairly quickly. The last 15-20 minutes, you are almost always put under some magnetic machine to “sleep”. Our next appointments, he loosened my shoulders which are super tight, and my legs, etc, and gave me more similar exercises .On our third appointment, he massaged out my wrists (it wasn’t painless), and over the last 6 months my wrists haven’t felt better. But, as Dr Tatz says, “We have a big project.” He wants me to come for 20 sessions over 8 weeks.

Dr Tatz is a nice man, and he wants to get you better. He says often, that the more you use your brain, the tighter your body. He emphasizes that our body naturally knows how to move. And, he also says, that a loose body is better than a strong body.

Physical Therapy: The Ancient Practice and Overlooked Modalities of Insurance Companies


It was the Ancient Greek Doctor and Founder of Western Medicine, Hippocrates, who first introduced Physical Therapy as a form of healing. But it wasn’t until the 1970’s that Western Medicine would formally allow Physical Therapists to have their own practices. Before then, most Physical Therapy was done in hospitals.

Alternative therapies these days are referred to as just about anything outside Western Medicine and hospitals, such as Acupuncture, Chinese Medicine, Ayurvedic Medicine, Naturopathic, Chiropractic. The list goes on. But lost somewhere between medicine and alterative is Physical Therapy: PT shouldn’t be overlooked, as it is one of the true and natural modalities there is.

A skilled Physical Therapist can examine, evaluate and treat patients from chronic illnesses to severe and mild injuries. Physical Therapists are known to reduce or eliminate pain. Benefits of PT can include recovering from falls, injuries and fractures; recovering from strokes; managing vascular conditions including diabetes; heart and lung problems; headaches and migraines; age related limitations including arthritis, facial nerve paresis, fibromyalgia, gastritis, insomnia; as well as ankle, knee, back, disc, shoulder, neck and TMJ pain. The list goes on and on.

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Holistic Mind Body Treatment: Relieving Head, Knee and Hip Pain

My aches and pains have been steadily diminishing since seeing Shmuel Tatz, PT, PhD for the first time but they hadn’t vanished completely – yet. Only because it’s been a long and winding road of minor injuries over the decades. This being my tenth visit, I didn’t know what to expect since there are a variety of problem areas in my small frame. Tatz, usually a man of little words, surprised me when he sat down and spoke at length before my treatment began. He was insistent that I understand, “People don’t always want to hear what their real problem is.” I was a little worried he had something unpleasant to tell me about my own health, but I listened.

First he told me that sometimes people have psychological problems and not physical problems. “I always tells my patients the truth but sometimes they get upset with me.” Very recently, he told one of his patients that she might want to consider talking to a professional about her emotional problems; she left in tears. He explained in cases of the mind, doctors such as bestselling author Dr. John Sarno are very good at helping people understand that they can heal themselves by addressing underlying emotional issues. He also noted that can only happen if there is not an underlying physical problem. He was very concerned about this patient of his.

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Alternative Physical Therapy Treatment for Dislocated Elbow

Bonnie had been a regular patient of Shmuel Tatz, PT, PhD for twenty-plus years. She has enjoyed an active life of dance, hiking and yoga and only used to go see Tatz for tweaking her aches and pains away. Always successfully. She recommended Tatz to her friends for years. It wasn’t until Bonnie was injured that she fully appreciated just how truly gifted Tatz is.

It was a typical snowy, icy, New York City afternoon. Bonnie was carrying too many heavy bags, going back to her office, when she tripped over a pothole in the sidewalk. She tried to regain her balance, but the bags made her into a twirling top and she spiraled into a terrible fall dislocating her elbow. She was in excruciating pain and her arm swelled up two times its normal size.

Bonnie immediately went by ambulance to the emergency room, where her orthopedic doctor took x-rays. He told her to gently move her arm up and down, then to go see him again when he returned from traveling in two weeks time. Nothing more, no physical therapy other than his suggestion to move her arm up and down. That turned out to be laughable as her arm was so swollen and so tender, she really couldn’t move it all.

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Headache Follow Up Treatment on Neck and Jaw

I arrived a bit early for my eighth visit with Shmuel Tatz, PT, PhD. His waiting room is a constant, relaxing oasis. There are three red velvet orchestra seats to choose from, numbered 13, 15 & 17. Or, there’s also a comfortable piano bench to sit on. Prominently placed in the waiting area is a beautiful bronze sculpture of healing hands. His two assistants are always kind, smart and soft-spoken. I’d had success with Tatz’ previous treatment, in essence with all his treatments, but last time Tatz had made a leap with my headaches. The head pain had disappeared for a few days and it hadn’t come back in its usual way. This time, my head was sore versus piercing.

Tatz whisked me into one of his private rooms, had me lie face up, and immediately placed cold laser therapy instruments on both sides of my neck and disappeared for at least twenty minutes or so. I’d become accustomed to the cold laser treatments from Tatz. From my understanding, the cold laser was first developed in Europe: A noninvasive form of light amplification. On this particular treatment I fell fast asleep.

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