Author Archives: Daniel

How to Modify Exercises after Injury and When Can I Start Exercising Again?

Patient’s often ask, when can I go back to the gym? Can I take spin class? Can I do yoga? It would be great if there were some in depth analytics behind the answer or some quantifiable YES markers to measure. But the answer is unbearably simple and always the same:

You can do anything that doesn’t cause pain.

Pain means irritation, inflammation and tissue damage. Our body is even sometimes smart enough to give us pain BEFORE tissue damage happens but it’s still a sign of poor function and increased inflammation that will lead to stiffening/local swelling. So if you are injured, feeling pain at the sight of injury or anywhere related to it, is like scratching a scab that is trying to heal. It will set back the healing process and promote increased inflammation.

So don’t feel pain, but this is not to be confused with don’t move. The full correct answer on how to modify exercises or workout after an injury is: move the affected area as much as possible with NO pain. This sometimes means wiggling your ankle 1/2 an inch back and forth for 30 minutes. This would be a great way to help heal an ankle sprain as you provide circulation and mobility with zero pain.

It’s so simple yet so hard for people to accept and adhere by. There is only one modification once injured or when returning from injury, Don’t Cause Pain.

Hope this helps,
Daniel Padmos, MM, PTA

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.

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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: http://www.buteyko.co.uk/.

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

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Managing Pain and Function Following Joint Replacement Surgery

knee-scar

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.

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

health-insurance

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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