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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

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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In response to “The Perils of Toughing It Out”

 

Dear Jane,

I just finished reading your most recent article and was pleased to see that you mention the importance of physical therapy.  For the past 30 years I have really enjoyed reading your articles and found them informative. I have been a physical therapist for over 40 years and witnessed the growth and need for physical therapy in our society.  More and more people are suffering from chronic pains especially in the back, knees, shoulders and neck and are searching for answers to cure their pain.  Unfortunately, recently I have been experiencing less and less support for physical therapy from the medical establishment and insurance companies. For this reason Physical Therapy has become less and less effective, most of the attention is placed on saving money and restricting treatments from the number allotted to the length of the session. In my professional opinion the patient should come first, not the insurance company. So, I would like to ask you what insurance company would accept that a doctor of physical therapy focus their full attention on a patient for at least 45min if not longer?

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Injury Treatment: Hot or Cold?

hot-coldDo you know when to use heat or cold therapy for an injury? If not, a recent review article by two University of Washington sports doctors, Matthew Karl, MD, and Stanley Herring, MD, can be your guide.

Drs. Karl and Herring point out that the application of superficial heat to your body can improve the flexibility of your tendons and ligaments, reduce muscle spasms, alleviate pain, elevate blood flow and boost metabolism. The mechanism by which heat relieves pain is not exactly known, although researchers believe that heat inactivates nerve fibers, which can force muscles into irritating spasms, and that heat may induce the release of endorphins, powerful opiate-like chemicals that block pain transmission.

Increased blood flow occurs in heated parts of the body because heat tends to relax the walls of blood vessels. That’s one reason why sports doctors recommend you steer clear of the practice of heating up already inflamed joints. Heat appears to be best for untightening muscles and increasing overall flexibility; the proper tissue temperature for vigorous heating is probably 104 to 113 degrees Fahrenheit (40 to 45 degrees Celsius) and the correct duration of temperature elevation is about five to 30 minutes. Although heating can reduce muscle spasms after a back injury, heat should not be used on sprained ankles.

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Pain!

The March 7, 2011 edition of Time Magazine was devoted to the discussion of pain and ways to treat it. From spinal cord stimulation by implants, through drug therapies and finally by complementary and alternative medicine that attempts to minimize pain with minimal damage to the body.

Implants and narcotic drug therapies carry risks along with the possibility of easing pain. We are all aware now that what was once considered an innocuous pain reliever, acetaminophen, is known to cause liver failure when used in large doses. And, ibuprofen and other anti-inflammatory medications, even aspirin, can cause stomach bleeding.

In the area of pain management, medications do not heal the body. But in the hands of a competent physical therapist, that is, one who is licensed and who has a minimum of 10 years of experience and who works hands on with the patient for at least 30 to 40 minutes, physical therapy can alleviate pain, whether it is from a structural problem, an injury, or has been longstanding and chronic.

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Your Assistance, Please!

It has been my intention to devote this Blog to topics of interest to my clients and others who seek out our Home page. I enjoy bringing you information on my practice, and on subjects related to the art of Physical Therapy.

Now I ask you to write and let me know what you would like to hear more about. We have a wide readership and it would be beneficial to know your thoughts on how we can better serve you through our Blog, or in any other way.

Your name will not be revealed unless you wish us to do so.

Please write to info@nyphysicaltherapist.com or contact our office at (212) 246-7308

I look forward to hearing from you.

Sincerely,

Shmuel Tatz

Verify… Then Trust!

I have been in practice for over forty years, and during those years I developed the name ‘body tuning’ to describe both the philosophy behind my work and the actual art of treating the body as if it were a delicate but out of tune instrument. I have spoken and written about it, articles have been written about my work and me. Physicians and prospective patients can research my background and training so as to feel comfortable recommending me or becoming my patient. Gratefully, I have a following of patients who value the work I do because they have trusted my expertise and experience and have been successfully treated for their particular problems. Over the years, the same patients return with varying complaints, knowing that they and I have been good partners in their healing before and will be again.

If a patient comes to me and asks for a massage. Or they give me a prescription from their doctor for a particular and specific kind of treatment; for instance, let us say, the doctor wants the patient to have 6 ultra sound treatments and exercises to strengthen the knee. What I tell the patient is that they do not need what I have to offer and refer them to other physical therapists for those treatments.

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