In the June 2011 publication of the Physical Therapy journal, a review of published literature was performed on the management of osteoarthritis in adults who are obese or overweight. The review looked at treatment strategies consisting of physical activity, diet and a combination of both. The review concluded that a program including both physical activity and diet modifications produced the most beneficial results (as compared with physical activity alone, diet alone, and no diet or physical activity programs). The review suggested that when combining physical activity with a restricted diet program there are reductions in pain and improvements in functional status for patients with osteoarthritis who are obese or overweight. Regular physical activity is also important in order to maintain muscle strength, joint function and bone health in the entire body – not just in the lower extremities.

An orthopedic Physical Therapist can prescribe optimal, individualized programs of exercise and activity that address strength, balance, endurance limitations, and mechanical problems with walking or other movement. It is possible to experience positive effects from Physical Therapy in a fairly short time – even in cases when osteoarthritis is already existent. Any initial improvements in pain level and joint mechanics can then be compounded as a person’s strength, balance, and endurance are improved – a process that is measurable by 4-8 weeks of supervised activity. In combination with a sensible eating plan, Physical Therapy can have an even more powerful effect on pain and disability.

Please contact S.T.A.R. Physical Therapy or your personal Physical Therapist if you have questions about whether or not you might personally benefit from formal care for Osteoarthritis. We would be happy to be of assistance.

The basis of Postural Restoration lies in an understanding of our anatomy and an appreciation that our bodies are not symmetrical and never will be. The fact that we have one of some organs (ie: heart and liver), as well as organs that are shaped differently on one side of our body compared to the other (ie: lungs and diaphragm), results in mild asymmetrical positioning of our bones and muscles.  Consequently, movement of our limbs, trunk, and spine tends to be easier or harder on one side in comparison to the other.  A good look in the mirror will reveal mild to drastic differences in the appearance of our rib cage, shoulder height, foot position, and even ears or eyes, when comparing right versus left.

A common question (and really the most important) is why an individual’s pain may have started seemingly out of the blue?  And why on one side rather than the other? When problems arise non-traumatically, the explanation usually can be found in a good analysis of how one moves.  The foundation of the issue may be how one moves differently on one side compared to the other and have one ultimately compensates for the differences – either well, or at times in a way that creates pain or pathology to the joints, ligaments, and other soft tissues.

A Postural Restoration-trained therapist will show you how your body is positioned or aligned and how this can relate to your pain. For example, you may have pain on the inside of your left ankle – perhaps diagnosed as a posterior tibialis tendonitis.  A probable explanation would be that your pelvis on the left side is positioned or tilted forward compared to your right.  This would orient your pelvis and spine to the right and ultimately shift your weight to right.  You would then tend to compensate in a way that causes more pronation, or flattening, of your left foot and more strain on the muscles and tendons that are trying to prevent that (such as the posterior tibialis, which is located on the inside of your lower leg and ankle).  Treatment from a Postural Restoration perspective would begin with repositioning your pelvis to neutral.  You would then work on developing the strength and flexibility in your hips that would stabilize you in a neutral position. Analysis would be done to determine if you have a tight or loose hip that might predispose you to this asymmetrical movement pattern. Factors such as how you breathe and whether or not your arms swing symmetrically would also be considered. And finally your foot mechanics would be assessed.  It may be that foot structure is so poor that even with a neutral pelvis, you would need extra support – either with a change in shoe type or with custom-made orthotics to support the feet.

The beauty of Postural Restoration is that, through systematic evaluation, we can determine how asymmetrical you are and how you are compensating.  We, as individuals, compensate in different and interesting ways.  The Postural Restoration approach will work to uncover the patterns and then to address them through a series of hands-on and exercise techniques.  In the end, though, the key to a successful treatment outcome is the patient’s understanding of these patterns and their ability to control the resultant compensation through acceptance in changing how they move - through awareness and performing regular exercises.

A spinal scoliosis rehabilitation program may incorporate techniques developed by the Postural Restoration Institute (PRI)™ in Lincoln, NE (www.posturalrestoration.com). Postural Restoration theory recognizes the inherent anatomical asymmetries in the human body and the possibility of developing postural deviations via trauma or simply from habitual or repetitive movements – including faulty respiratory mechanics and protective posturing or joint laxity. A PRI-based evaluation works to find the resultant postural patterns and PRI-based treatment focuses on reducing mucsuloskeletal and neuromotor imbalance using specific and precise motor activities.

During the course of treatment for scoliosis, neutrality of the pelvis can be gained via the performance of PRI-based repositioning exercises. Improved rib mechanics may be achieved with both manual (hands-on) and non-manual techniques. Once stability of the spine is improved, mobility can be gained through a tri-planar program of muscular inhibition and facilitation. Proper muscular balance will then allow for a more advanced program of dynamic trunk and hip rotation.

PRI techniques can be effective at reducing strain / torque and improving function in patients of any age with scoliosis. But it is thought that PRI techniques are most effective when initiated on patients between 7 and15 years of age, with curves that measure between 0 and 25 degrees. When patient and parent understanding of this treatment approach is high and a home program is consistently performed in conjunction with periodic supervised physical therapy visits, treatment can very effectively prevent a curve from progressing and may also possibly reverse it.

We would welcome the opportunity to further discuss the treatment rationale behind S.T.A.R.’s scoliosis program. Please feel free to contact us with any questions that you may have.

Misinformation has led to misconceptions about squatting. Our (Western) culture clearly under-utilizes proper squatting in our activities of daily living. On a regular basis we hear our patients say things like “I am not supposed to squat,” or that they were told that “my knees should never pass my toes,” when bending to squat or lunge. It is true that in degenerative joint situations one may need to be careful about how they are bending at the knees, but with improved joint mechanics and techniques, everyone should be able to squat. After all, our bodies were designed for it! Only in situations where joint mechanics have become irregular should the joint begin to break down and cause problems with such a basic human movement.

What are the advantages of squatting? There are many. One need only to look at Asian and African cultures to observe some examples. In these cultures, it is normal to see people of all ages, including the elderly, in a full squat (weight back on their heels, knees maximally bent, and spines in a fully flexed position). From this posture, they may be performing activities such as preparing food, socializing, or going to the bathroom. Incidentally, and interestingly, the rate of spine pain, gastro-intestinal disorders, and urogenital disorders (such as incontinence, colon cancer, and inflammatory bowel disease) is significantly less in these cultures.

Squatting is also a function maintained in our culture through our youth. The next time you happen to observe a two year old child, observe not only how he squats but also the frequency of which he performs this task. You will find that the young assume the same maximally crouched posture observed in adults of non-Western cultures. Whether we are two, fifty two, or even one hundred and two, we feel that for optimal physical functioning we should attempt to get back to this essential task.

Swimming for recreation has many health benefits. It is great exercise for the whole body – including the entire muscular system, as well as the heart and lungs. An added benefit is that in the water there is very little strain placed on joint structures. Swimming can build endurance, muscular strength, and cardiovascular fitness.

Swimming is good for your mind! The rhythmic nature of swimming can be calming and meditative. The relative calm of being in the water can also assist with stress reduction and global body relaxation – both of which can have a significant positive impact on pain syndromes and on other indicators of overall health and wellness, such as blood pressure or heart rate.

Swimming burns 3 calories / mile for every pound of body weight. This would translate to 900 calories per hour for a swimmer that averages 30 minute miles and weighs 150 pounds. This calorie burning is taking place while exercising all of the major muscle groups in the body – arms, torso, and legs. It’s good exercise for your entire body!

Are there “down sides” to swimming? Certainly. For instance, swimming does NOT meet the qualification of “weight-bearing exercise”. This means that it does not stimulate bone health as well as other forms of exercise. This would be important to you if you have been diagnosed with osteopenia or osteoporosis, or have a family history of the same disorders.

Injury can also occur during swimming, as with any other sport. For swimmers, the most common syndromes involve Repetitive Strain Injuries. For swimmers primarily using Freestyle or Backstrokes, it is possible to develop Swimmer’s Shoulder – a disorder involving the rotator cuff muscles. Breast Strokers may contend with Knee Tendonitis or Hip Pain related to Tendonitis or Bursitis. Swimmers that Butterfly may suffer from Swimmer’s Shoulder or from Back Pain Syndromes.

If you are experiencing pain related to swimming, you may be exhibiting signs that you have poor technique, strength imbalances, or that you have made training errors that are stressing your musculoskeletal system. You might benefit from Physical Therapy, which can help to manage symptoms, improve mobility, and correct form.

We invite you to contact S.T.A.R. PT with any questions that you may have about Swimming or other Water Recreation. We’d be happy to help you begin or get back to swimming successfully!

We hope that you will visit us at S.T.A.R. Physical Therapy. Please contact us if we can help you to meet your health & fitness goals!