The 5 best local races for 2015

If you are the runner or cyclist in your family, chances are you will be unwrapping some new gear this holiday season and getting ready to shed some of the calories you’ve either intentionally or unintentionally put on during the holidays. Whether you are a competitive  veteran chomping at the bit to toe the line, or you are planing a training regimen for your first big race, one of the most exciting parts of doing a race is picking which one you’ll enjoy this year. The following is a list of some great local running races for you to gear up for, or to utilize as part of a training program for a bigger race.

1. Run through Redlands – March 8th 2015. 5K, 10K, 1/2M. This is a great run through some historic settings of Redlands. Prepare for some hill work as this run ascends from downtown through prospect park up to sunset before traversing back to the Redlands Bowl.

2. Highland Y Run – January 25 2015. 5K, 10K, and 1/2M. One of the best times to run in the Inland Empire is the winter while there are snow capped mountains and blooming citrus trees. All proceeds from this race go towards scholarships at the YMCA.

3. Citrus Heritage Run – January 10 2015. 5K and 1/2M. Ok, so maybe you should have already finished your training for this one. But if you are a seasoned runner, why not start the new year with an early run. This run is put on by a great local running group with proceeds benefiting local student athletes.

4. Redlands Chamber Night Light Run – December 27th 2014. 5K. The good news about this run, is not many people actually run it, rather they enjoy the show and move along a gradual pace. This run is in its 2nd year and the focus is have a good time while enjoying the lights around downtown Redlands. Look out for the Optimal Movement Physical Therapy Team this year!!!

5. Los Angeles Marathon – March 15, 2015. Marathon. If this race isn’t on your bucket list, it should be. It’s what most of the members of local run groups are training for and it is the best local marathon. The race course was changed several years ago to now incorporate a Dodger Stadium beginning and a Santa Monica finish (the one good thing Frank McCourt did for LA).

What local races are you looking forward to this year? Add your favorites in the comment section and let me know if I missed one. Remember to train safe and listen to your bodies rather than focus on a mileage goal. Also remember, you don’t run to be fit, you have to be fit to run. Let us know if you need our help with returning from an injury or optimizing your training plan to avoid an injury. Visit our website and get in touch with any running related questions you may have.

www.optimalmovementpt.com

How can Physical Therapy help with my Low Back Pain?

This post continues the discussion on how we as physical therapists can best treat our patients’ ailments. Check out the previous post regarding treatment and communication of a patient with knee pain here.

“Well, the reason for your low back pain is that you have degenerative disc disease.”

or,

“You have a slipped disc at L4/L5 which is compressing a nerve.”

or,

“the arthritis in your back is equivalent to a 90 year old.”

Pretty scary huh? How can physical therapy help with diagnoses like these? Can physical therapy remove the arthritis found on imaging?

No it cannot. But perhaps there are more important questions to ask. I would assume that the more meaningful question(s) may be; Can physical therapy eliminate the low back pain I experience when I am walking my kids to school. Can physical therapy allow me to lift items from the floor, and therefore allow me to perform my household duties? Can physical therapy eliminate the discomfort I experience while sitting for prolonged periods at work, and therefore allow me to be more productive? Can physical therapy eliminate the discomfort I have while I play recreational sports so that I can get back to playing basketball?

The answer to these questions is yes. But, look at the disconnect that many patients experience. Originally, they seek out a healthcare professional with a complaint during some type of meaningful activity. Rather than receiving an answer or a long term intervention, the original complaint gets warped into a diagnosis of “degenerative disc disease”, “arthritis”, or “stenosis”. Could it be that what’s causing the discomfort is not the diagnosis, but rather faulty movement?

Why do we rely on imaging to dictate the cause of our discomforts? Look at this research article performed on individuals without low back pain. This study utilized MRI images on individuals without low back pain. Only 36 percent of individuals without low back pain had “normal” findings. 52 percent had a disc bulge, and 27 percent had a disc protrusion. This, once again, begs the question, could it be that what’s causing the discomfort is not the diagnosis, but rather faulty movement?

This is actually great news for individuals suffering from low back pain. Nobody can treat  a diagnosis of stenosis or arthritis. But a movement expert can assess and implement a program to help individuals who have pain with specific activities. Treatment begins with identifying faulty movement, understanding the reasons for the poor movement, and specific corrective exercises to eliminate the poor mechanics.

For example, take a look at this diagram;

No diagnosis is causing this discomfort. Poor movement places a high amount of stress on the joint, the disc, the muscles, everything. Change the movement, change the pain. 

That being said, sometimes the desired activity requires more strength and flexibility than an individual has.

This individual likely does not have the core strength to lift appropriately given this quick movement screen. In order to lift appropriately, she may require a strengthening regimen. Every body is different and requires an individualized assessment and program prescription.  In order to get here, push your diagnosis to the side and begin identification of movements which may cause the discomfort.

Optimal Movement Physical Therapy is dedicated to helping individuals identify and treat their movement faults. Visit our website or e-mail us at alan@optimalmovementpt.com so that we may help answer any questions.

TRX Corrective Exercises for Pitchers

You don’t run to get in shape, you get in shape so that you can run. Simply running every day will not improve your running ability. Cross training, improving muscle imbalances through corrective exercises, and strength training are all required in order to improve performance with running, and minimize the risk of overuse injuries.

You can take the same concept with any activity which requires repetitive motion, especially pitching. Simply throwing every day as hard as you can will only decrease performance and increase the likelihood of injury. There is a certain amount of core strength, rotator cuff stability, hip flexibility, and lower quarter stability that is required to optimize the movement of an overhead athlete. When an athlete has reached a certain level of strength and flexibility, I encourage using a TRX suspension strap to train these elements of pitching. My favorite TRX exercises for pitchers are listed below, but with a disclaimer: as healthcare professionals, we cannot simply prescribe exercises without a thorough examination of the athlete. These exercises should only be performed after an assessment and under the instruction of your healthcare specialist.

1) TRX Side Lunge

The stride phase of the pitch may be the most important phase of pitching. The stride length of a professional pitcher is approximately the length of the pitchers height, and the shoulder has to move towards end range of external rotation. Needless to say, in order to maintain proper mechanics the pitcher requires a certain amount of trunk control. Therefore, the TRX side lunge becomes a great exercise to work on adductor length of the stance leg (ensuring increased stride length) and trunk control during this motion.

2. TRX W Deltoid Fly

This exercise is named for the large deltoid muscle which assists with the abduction of the shoulder, but I like to use it to work the external rotators of the shoulder. This is also important for the stride phase of pitching, and requires a certain amount of instruction without the TRX before it can be done appropriately. After a pitcher learns appropriate joint centration of the glen0-humeral joint (to be discussed in a future blog) he can begin to train the rotator cuff to maintain the stability of the joint during pure external rotation. Again, all of this is being done while maintaining trunk control.

3. TRX T-Deltoid Fly

The cocking phase of the pitch requires scapula adduction and full external rotation of the gleno-humeral joint. At this phase of throwing, the middle trapezius operates at approximately 50% Maximal Voluntary Isometric Contraction (MVIC) and the Infraspinatus works at 74% MVIC. This exercise places works on these muscles to place the scapula and glen-humeral joint in the appropriate position for this phase of throwing.

4. TRX Lunge

 

Of particular note, at this time all exercises have focused on  phases of pitching before the ball is released (showing the emphasis I place on the early phases of pitching). The most important component of the pitch after the ball is released is the follow through. Flexing through the hip and trunk can attenuate the force developed in prior phases from the shoulder. The TRX lunge can work on strengthening the gluteals and hinging from the hip to assist with this phase of throwing.

This form of training requires appropriate flexibility, strength, and supervision, but it can greatly improve your pitching mechanics. If you live in the Redlands area, a great spot for TRX training is at The Energy Lab. Check them out for their TRX classes and all fitness goals.

For rehabilitation, movement screenings, and to work towards your fitness goals, check out OMPT and email me at alan@optimalmovementpt.com

 

http://www.optimalmovementpt.com

World Physical Therapy Day!!!

World Physical Therapy Day is September 8, 2014!!!

World Physical Therapy Day is a day to recognize the profession and all the benefits a Physical Therapist provides to the community. Are you currently participating in therapy? Have you had therapy in the past? How has therapy helped you? How could therapy help you?

For most individuals who have participated in therapy they are aware of the importance of the Physical Therapist as well as the role a therapist can provide in improving movement and function. For those of you who are not aware, the benefit therapy can provide is different for every individual. Every person you encounter has their own concerns and fears. My profession gives me the time to really understand and empathize with concerns and fears, which opens a window into making a real change on the individual level.

Whether it’s running that extra mile, picking up a grandson, getting up the stairs at night, or simply making it through the work day, Physical Therapists help individuals meet their specific goals. A Physical Therapist is a specialist on movement and can help optimize performance, return from an injury, and prevent future injuries from occurring. Imagine the health benefits of having a Physical Therapist who knows you. Think about it, most individuals have their own personal Physician and Dentist. Why not having your own Physical Therapist who can screen and educate on proper movements to maintain optimal health.

Optimal Movement Physical Therapy provides these benefits to many resident in the Redlands area. If you need someone on your team, we would be happy to listen to your concerns. Check out our website here. If you would like to learn more about World PT day, check out the World Confederation for Physical Therapy website.

In celebration of World PT Day we’re holding a contest! If your life has been significantly impacted by a Physical Therapist, let us know in the comments for a chance to win a $25 gift certificate to one of our favorite stores that encourages movement – REI! Follow us on Facebook, Instagram and Twitter for additional entries! Please leave individual comments letting us know where you’re following us! Giveaway ends Monday, September 15th at noon PST. Winner will be chosen by random draw and will be posted Monday evening!

Disclaimer: we are not affiliated with REI in any way. We just really like them and what they stand for!

http://www.OptimalMovementPT.com

A winner has been chosen for World PT Day contest. Thomas has been selected via the website random.org. Please email me at alan@optimalmovementpt.com.

Pitching Biomechanics

There are 39 major league pitchers who have had or are scheduled to have Tommy John elbow reconstruction this year. THIRTY NINE! This includes some big name pitchers (and therefore big money pitchers) including Matt Harvey, Jose Fernandez, Matt Moore, and Patrick Corbin to name a few. The combined salary of these four players is over 2.5 million dollars in 2014 alone. The high amount of elbow injuries has become MLB’s “number one research priority” at this time. There have been several hypotheses regarding pitchers being overworked, pitchers focusing only on one sport starting in their youth and losing out on cross training, to even a varying amount of humeral torsion leading to a higher likelihood of elbow injury.

But what about their movement?

Not all pitchers throw the same. They all have varying amounts of biomechanics, some of which place excessive loads on the elbow.

Determining differences in pitching biomechanics becomes quite obvious when looking at the late cocking phase of throwing. At this phase of throwing and pitching, a pitcher should have maximum external rotation of the throwing arm. 

Take a look at Roger Clemens in the late cocking phase of throwing. His shoulder is at maximum external rotation and he is prepared to move into the acceleration phase of the pitch. Note: Clemens had a long career without much history of shoulder or elbow trouble.

 

Take it a step further and look at Greg Maddux at this phase of throwing. Another long career without a history of injury. His shoulder is also in external rotation when his lead foot makes contact with the ground.

Let’s compare the shoulder position of Maddux and Clemens with the shoulder position of some pitchers with a history of Tommy John. First, Mark Prior. Prior was an up an coming pitcher who along with Kerry Wood was meant to bring the Cubs back to the World Series. His career was shortened due to injury.

You can see that Prior actually has his shoulder in full internal rotation just before his foot hits the ground (showing the ball to the first baseman rather than second or third base).

Adam Wainright is another pitcher with a history of Tommy John. Just like Prior, you can see the internal rotation of his shoulder in late cocking.

Both of these pitchers are very talented, but their pitching biomechanics set them up for injury. Essentially, the legs are moving through the mechanics faster than their shoulder is, creating the need for the shoulder to “catch up” to their legs. The reason for pitching like Prior and Wainright is that the delay between the lower quarter and upper quarter creates more torque at the shoulder. More torque results in a higher velocity pitch as well as more break on the pitch. However, more torque on the shoulder can also lead to more shearing stress at the shoulder and tensile stretch at the elbow.

If trying to eliminate elbow injuries in pitchers, pitch count, appropriate rest, flexibility, and strength are all vital components. After all, Maddux and Clemens had to work at maintaining their long healthy careers. That being said, the biomechanics of the pitcher should also be taken into consideration.