Random Physical Therapy Advice

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My youngest son (and child), Connor Patrick, turned 3 months old this past week. To celebrate the occasion, Connor (a.k.a “Baby Thor”) started taking 2+ hour daytime naps while simultaneously regressing in his nighttime sleep habits to waking 3-4 times a night to remind Mom and Dad who really runs the roost. Thanks, son. I cannot wait until you’re sixteen and want to sleep in on a Saturday morning. Your chore list is already waiting for you. But I digress.

The main reason this post is going to read like a 10 Commandments version of useful advice from a veteran physical therapist is that my son’s sleep schedule has turned my brain into something I imagine has the viscosity of under-cooked oatmeal. You recognize it for what it is, and there’s some texture to it, but it’s a little loose in general. Such are my thoughts and words these days.

Here’s my laundry list of practical advice to solve your everyday aches and pains (and a few other problems) without having to wait three weeks to come see me (after you waited two weeks to see your orthopedic specialist, who you weren’t able to see until you had waited two weeks before that to see your primary care doc to get the referral to the specialist, who in his infinite wisdom “allowed” you to see someone who could actually help you, namely, me). Healthcare!

  1. Does it hurt to raise your arms overhead? Try this test: slouch over like a turtle, let your head hang forward and your shoulders slump forward and try to reach your arms overhead as far as you can. That probably didn’t feel too great. Now, stand up straight, squeeze your butt cheeks, tighten your abs, roll your shoulder back until your thumbs point forward, and raise your arms overhead again. Better? Great! Remember that your spine produces the power that allows you to move around the primary engines of your shoulders and hips. If you throw a kink in that system (the spine) by standing with crappy posture, it’s only a matter of when, not if, the engines of your shoulders and hips are going to explode. Your mom was right, stand up straight!
  2. Do your knees hurt when you go up and down stairs? Look down at your feet and knees before you start stepping. If your toes point out and your knees track inside your feet, you are about to starting grinding the life out of your knee cartilage. Point your feet straight ahead and keep your knees outside of your feet as you go up and down the stairs. Your cartilage will thank you.
  3. Sprain your ankle? Throw that R.I.C.E. (Rest, Ice, Compress, Elevate) technique out the window and try on M.C.E (Move, Compress, Elevate) if you actually want to deal with your swelling and not sit on the sideline for the next 4 to 6 weeks. Need more details? Check out our post about why icing injuries is soooo 1980’s PT.
  4. Having a hard time getting to sleep or staying asleep? Here’s the fix: a) turn off all your screens an hour before bedtime, b)Spend two minutes diaphragmatically breathing to slow your heart rate and calm down your nervous system. See the video example from our YouTube page here, c) make your room as dark and cold as possible. Repeat every night for 30 days
  5. And speaking of breathing, are you constantly trying to stretch out your tight hamstrings and getting absolutely nowhere? Try this-as you reach end-range and feel the stretch in your hamstrings, take a big breath in through your stomach and then exhale. Feel your body relax and let you go farther? No? Are your eyes closed? Open them. Are you clenching your jaw? Let it relax. Are you going to your happy place? Wake up, tune in, and let your body relax. Breath holding leads to tension, which leads to you making no progress in improving your mobility.
  6. Stop sleeping on your stomach. Unless you have a face cut-out in your bed that allows you to situate your neck, head, and face in the same direction your chest and hips are pointing. Otherwise, you are destroying your cervical spine (your neck). This would fall in the category of “not a good thing” for your spine.
  7. How often do you need to do H.I.I.T. (High Intensity Interval Training)? One time a week for beginners, two times per-week (non-consecutive days) for advanced athletes. More is not better with H.I.I.T. Also, pick challenging exercises. If your H.I.I.T. session is 20 seconds on/10 seconds rest of biceps curls, the likelihood of you revving your metabolic engine is minimal at best. Pick a complex, multi-joint exercise (or group of exercises) like body weight squats, lunges, push-ups, pull-ups, squat jumps, jumping jacks, burpees, med ball slams and get after it.
  8. When is it o.k. to play and when is it time to take yourself out of the game? If you’re sore, and upon warming up the soreness goes away, you’re good to go. If after warming up you feel the same or worse, it’s time to take a knee, champ.
  9. Healing from an injury is a complex ordeal. Here’s the order of importance if you’re keen on optimizing the process: 1) Sleep is King. 2) Nutrition fuels recovery. Sugar, bread, processed foods, fast foods, soft drinks, and alcohol slow the process. Eat real food, and know the difference between your mouth and a vacuum. 3) Movement. As much as I’d love to make you believe exercise cures all ills, if you don’t dial in #1 and #2, it doesn’t matter how much you do #3.
  10. Children are not miniature adults. If you’re using the same lifting program your high school football coach put you on for your middle-schooler, you need serious help. If your pre-teen is only playing one sport year-round (gymnastics is the only exception I make to this rule), you will burn them out before they finish high school. Research on kids participation in sports makes it clear that they enjoy sports for three main reasons: 1) They have fun playing the sport, 2) Their friends play the same sport, 3) They’re good at it. Notice the ideas of earning a scholarship or winning aren’t on that list.

Have a great weekend everyone!


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