Watch the Video Below for Safe Instruction and Proper Lifting Technique.

Safety Tips When Lifting Heavy Objects

1. Stand close to the object & center your body with legs shoulder width apart.
2. Tighten your abdominal muscles (known as abdominal bracing).
3. Keeping your back straight, bend your knees and squat down to the floor.
4. Hold the object firmly with both hands.
5. Keep the object close to your body (i.e. elbows bent to 90 degrees and tucked at your sides) and use your leg muscles to stand up lifting the object off the floor. Avoid using any back muscles.
6. Do not twist your body when moving around with the object. Instead, you should take small steps turning until you get to your desired position.
7. Repeat the above technique bending at your knees to place the object down.

If for some reason it is difficult for you to perform a squat with both knees, you can do a half kneel to lift the object.

How to do a half-kneel

1. Assume a staggered stance close to and centered at the object i.e. stand with a wide stance with one foot in front of the other.
2. Bend your legs so that the knee of your back leg touches the floor and the other knee is at a 90 degree angle keeping your back straight the entire time.
3. Get a firm grasp on the object and place it on your knee and straighten your knees using only your leg muscles.
4. Carry the object close to your body and avoid twisting your back (as mentioned above).

Remember, safe lifting can prevent a lifetime of pain and suffering!

For more information regarding back an neck pain check our previous blog

• Do I need an MRI or can Physical Therapy heal my back pain?
• Sitting and Back Pain
• Pain and Your Posture

Emily Lesinski, DPT & Aruna Woods, SPT

The post Safe Lifting Techniques To Prevent Injury appeared first on Premier Physical Therapy.

As summer approaches many experience shoulder pain, typically due to increased activity. Whether you aspire to athletic endeavors such as golf, baseball, tennis or prolonged activities such as gardening, shoulder pain is often the first sign of a muscle imbalance and weakness.

Rotator cuff problems are one of the many injuries we treat and resolve at Premier Physical Therapy. The two most common questions patients have for us are:

1. What does this diagnosis mean?
2. How can physical therapy help me return to normal?

The shoulder is an extremely complex area of the body made up of four joints and a multitude of supporting ligaments and muscles. These structures work together to allow mobility needed to perform activities such as reaching to a high shelf or playing tennis. Since there is minimal stability within the shoulder, it is critical for all muscles to work together providing support during movement. When compromised, rotator cuff problems can occur resulting in pain with activity.¹ Changes such as tendonitis, muscle tears and bone spurs are common. Muscular imbalances and ligament tightness within the shoulder joint are often the cause and can be treated conservatively, without surgery.²

After completing a comprehensive evaluation, your physical therapist will create an individualized program based on their findings. Common goals of physical therapy are to help relieve pain, improve mobility and strengthen weak musculature while educating the patient on techniques to keep their shoulders “happy” and pain free.  One key area that can help to relieve shoulder pain is posture. It has become more common for people to spend long periods of the day sitting in front of a computer. This causes people to demonstrate a rounded shoulder posture due to adaptive shortening of their pectoral muscles and weakness/adaptive lengthening of their scapular stabilizer muscles. By elongating (stretching) the tight pectoral muscles and strengthening the scapular stabilizer muscles the scapula is able to be in its proper position on the body, which can help to improve mobility. As a result, there will be less stress on other structures within the shoulder reducing compression on the rotator cuff muscles. It is also common for physical therapists to focus on strengthening the rotator cuff muscles utilizing therapeutic exercises. This is critical since these muscles are extremely important to provide support during quick or extreme movements. As therapy progresses, you will begin to incorporate sport or recreational activity specific activities so that you can get back on your field of choice or into the garden.

Citations:

1. Neer CS. Impingement lesions. Clin Orthop. 1983; 173: 70-77.
2. Ellenbecker TS, Manske RC, Kelley MJ. The shoulder: physical therapy patient management utilizing current evidence. In: Current Concepts of Orthopaedic Physical Therapy. 2011; 3: 20-29.

The post Heal Shoulder Pain Before Summer Begins appeared first on Premier Physical Therapy.

Stand Over Height

When choosing a bike, you should be able to stand over the top tube with at least 1” of space with a straight tube, and 2” or more with a tube that slopes towards the back of the bike. You can test this by standing over the top tube and lifting the bike up to meet your body. There should be at least 1” space from the tire to the ground. Mountain bike riders sometimes have 3-5” clearance due to the extra demands of the landscape. Stand over height is important should you need to dismount quickly, and is the first step in sizing your bike. If your stand over height is not good, all the other measurements will not be 100% accurate.

Seat Height

The height of the seat will determine the amount of knee extension you have, and even affect the stability of your pelvic floor. Having a seat that is too high can diminish the power your legs can make, leading to excess stress on the muscles on the back of your leg. You may have too high a seat height if you’re rocking side to side on your saddle, which can cause undue stress on the glutes, spine, even your arms! Having a seat that is too low will increase the amount of knee bend, which increases the pressure on the knee cap. It also doesn’t allow the glutes/calves/hamstrings to work as efficiently as they should.

You can determine proper seat height (on a road bike) using the” Le Mond Method.” Measure your inseam (without shoes) and multiply that by 0.88 to get your seat height. Then measure from the base of the crank arm up along the seat tube to the top of the saddle, adjusting the saddle up or down to match that number.

Seat Fore/Aft Position (forward/backward)

The distance the seat or saddle is from the handle bar is known as seat fore/aft position. Too far forward can increase knee cap pressure, too far backward can over lengthen the glutes/hamstrings, making them less efficient during a pedal stroke.To measure proper seat fore/aft position, have someone hold the bike still for you and get on. With the crank arm (the lever that holds the pedal to the front gear/derailleur) parallel to the ground, the area right below your knee cap should align with the ball of your foot on the pedal. Cyclists who have poor hip mobility will need to be more forward/fore with their saddle. Your physical therapist can work on improving your hip mobility. Larger cyclists may be more comfortable more aft (backward) with their saddle.

Saddle Angle/Seat Inclination (tilt)

It is recommended that the tilt be kept at 0 degrees, though there is one study that demonstrated that a tilt forward of 10-15 degrees decreased the incidence of LBP in recreational cyclists.

Reach

This is basically how far your arms have to reach to touch the handlebars. This varies with rider and bike, however ideally a rider on a road bike without aerobars would want the back to not arch, pelvis to be rolled forward, have retracted shoulder blades, unlocked elbows, and relaxed upper arms with the elbows slightly bent.

Crank

This is the part of the bike that connects the pedal to the front derailleur. This is commonly overlooked on bikes, as most recreational bikes have a standard 170mm length. Shorter bicyclists (under 5 foot 6 inches) should have cranks less than 170mm as longer cranks can cause increased pressure on the knee and can result in knee pain. Riders shorter than 5 foot 3 inches should have a crank size between 167.5 and 165mm. Riders who are greater than 6 feet in height should have a crank that is around 177.5mm. It appears that riders who are average in height (5’7”-6’) do not need to worry about crank size.

Cleats

For those road bike warriors who use cleats, there are numerous brands, types and fits. Generally the idea is to have enough “float” or movement, to allow the cleat to detach from the pedal if needed (e.g. to get off the bike in a hurry) without too much excessive movement when pedaling, which is known as “slop.” Cleats transfer the force of your legs to the pedal/crank. Cleats should have a “low stack height,” which basically means the closer the cleat can come to the pedal the better, almost as if your foot and the pedal were one unit. A properly sized cleat “has a midpoint that the foot will sit at most of the time, with a small amount of force required to move off that midpoint.” The base of your metatarsals (the long bones of the foot just before the toes begin) should align with the axis of rotation of the pedal.

Enjoy the ride!

Vito Pinto, DPT

References:

Brukner, P., Khan, K., Bahr, R., Blair, S., & Cook, J. (2012). Clinical Sports Medicine (4th ed.,pp. 93-112). Sydney, Australia: The McGraw-Hill Companies.

Salai M, Brosh T, Blankstein A et al. Effect of changing saddle angle on incidence of low back  pain in recreational bicyclists.

The post Proper Road Bike Fit to Prevent Injury appeared first on Premier Physical Therapy.

Sitting for hours at a time, day after day can lead to a variety of injuries including:

• Neck and low back pain
• Carpel tunnel
• Muscle strain
• Nerve compression
• Diabetes/Obesity

The following are guidelines for an ergonomically-sound computer workstation.

• Keep your shoulders in a relaxed position (the use of arm rests is encouraged).
• Keep your arms positioned close to your body.
• Forearms and wrists should be parallel to floor.
• The top of the monitor should be directly across from your eyes.
• Allow for at least 16 inches between your eyes and the monitor.
• Keep your feet flat on the floor or slightly elevated.

Watch the video below by on of our Doctors of Physical Therapy for free tips on a proper ergonomic setup and positioning.

 Repetitive motion is simply performing the same motion over and over again without allowing for rest, thereby straining a body part. An example is typing without a break for hours on end. Non-neutral postures can be described as an imbalance of muscle groups (such as twisting), which increases stress on your muscles and joints. Static posture refers to holding the same posture or position for an extended period of time. Eye strain or fatigue can be caused by prolonged computer work and can result in tired eyes or headaches. Contact stress can occur when resting a body part on a hard surface resulting in internal stress to soft tissues such as nerves and blood vessels. These ergonomic hazards can be eliminated or at the very least minimized through proper ergonomic interventions.

Sit-stand workstations are recommended by physical therapists.

Our best tip… try to allow for a variety of postural changes throughout the day. Changing positions and moving every few hours is key. Even the most accurately designed ergonomic desk comes in second to healthy movement.

Movement is the best medicine!

Dr. Sharon Fong, PT, DPT

www.premierptny.com

The post The Corporate Athlete- Healing Injury In the Workplace [ergo consultation] appeared first on Premier Physical Therapy.

 Calcium and Vitamin D

Calcium is an essential mineral and is stored in our bones. Vitamin D is needed as it helps absorb the calcium we ingest. Without adequate Vitamin D levels, eating foods rich in calcium won’t help you out very much. Calcium is required for basic body functions including the ability of the bones to withstand force. Calcium and Vitamin D can be found in:

Calcium – dark leafy greens, dairy products (milk, cheese, yogurt), nuts, fish.

Vitamin D – produced by the body with exposure to sunlight without sunscreen for about 10-20 minutes.

Omega- 3 Fatty Acids and Antioxidants (Vitamins A, C, E)

Omega-3 fatty acids help reduce inflammation (swelling). As we use our joints more or if we have pain in our joints, the body responds with inflammation to the area as a protective response – however, this inflammation can further contribute to pain and reduce range of motion. Anti-oxidants help fight off free radicals, which can promote inflammation and can further damage joints. Found in:

Omega-3 – halibut, salmon, shrimp, nuts, whole grains, fish oil.

Antioxidants –fruit, dark leafy vegetables, carrots, almonds, avocado

Fiber

Fiber plays a role in reducing blood glucose levels, which have been linked to inflammation. In addition, foods high in fiber help digestion and typically make you feel fuller for a greater time, which in turn helps with weight loss. Found in:

Fruit, vegetables, beans, whole grains, nuts and seeds.

Protein

Protein is the essential building block for muscle, bone, and tissue including joints. Regular protein intake will ensure that the body has the resources necessary to protect its joints as well as the muscles that surround each joint. Lean protein is recommended as it contains less fat and therefore will help contribute to weight loss. Found in:

Chicken, turkey, free-range grass-fed beef, fish, beans, soy.

Water

Joints have fluid running through them to act as both lubrication but also a source of receiving nutrients from the blood. Remaining hydrated will ensure a greater blood volume with better delivery of nutrients to the joints, as well as increased lubrication for smoother and less painful motion. It is suggested to have roughly 0.5-1.0 oz of water per pound of body weight.

Supplements

Due to poor dietary choices and access the average American is deficient in many essential vitamins, minerals and other nutrients, which are the building blocks for healthy joints. Obtaining nutrients from organic, unprocessed foods should always be your first choice. However there may be times when your body requires additional nutrients via supplementation due to injury or poor diet. Here are the top two for joint health.

 Glucosamine and Chondroitin

Key components of cartilage, which makes up joint tissue. Although naturally produced by the body, supplementing may be necessary when joint pain or arthritis is present. Glucosamine/chondroitin has been scientifically researched and found to aid with joint health.

 Curcumin, Ginger & Bromelaine

Studies have shown curcumin, ginger and bromelaine to have anti-inflammatory effects, decrease pain an increase joint health. Curcumin is naturally occurring in the spice turmeric and bromelaine is an enzyme found in pineapple. Ginger is a commonly used in teas and stir-fry.

Now that you have a wide variety of foods to choose from, here are some suggestions for meals/snacks that will not only promote joint health, but also weight loss.

 Breakfast:

Low fat milk with low-sugar whole grain cereal

Low fat Greek yogurt with a berry medley topped with whole grain oats

2-egg omelet with spinach, avocado and low-fat cheese

Ginger tea

Orange Juice

Lunch/Dinner

Spinach and arugula salad with lean chicken, tomatoes walnuts, flax seed with freshly-squeezed lemon juice dressing

Grass-fed, free-range beef or turkey burger with whole-wheat bun accompanied with a dark-leafy green salad

Grilled salmon crusted with almonds served with a side of roasted broccoli and brussel sprouts

Tuna sandwich with a cabbage slaw

Lean grilled chicken with a cucumber-mint yogurt sauce wrapped up in flatbread with red bell peppers and cucumbers

Snacks and Sides (Instead of reaching for that bag of chips, try these)

Carrots, celery, and other crunchy vegetables with low-fat hummus

Low-fat Greek yogurt

Vegetable/Fruit Juices

Fruit (Apple, banana, pineapple, orange, etc)

Mixed nuts

These are just a few options but you now have all the ingredients to get creative and protect your joints at the same time. Remember! A program to rehabilitate an injured joint from trauma, surgery or disease should include physical therapy combined with sound nutrition principles. This will be the quickest path to healing.

In good health,

Mohit Birdi, PT, DPT, CSCS

References:

http://education.athletesperformance.com/articles-2/articles-from-ap-specialists/using-nutrition-to-support-joint-health/

http://www.arthritistoday.org/what-you-can-do/eating-well/arthritis-diet/eat-to-beat-inflammation.php

http://healthyeating.sfgate.com/bone-joint-nutrition-4741.html

http://www.naturemade.com/resource-center/articles-and-videos/joint-and-bone-health/food-and-nutrients-that-fuel-joint-health

The post A Recipe for Joint Health appeared first on Premier Physical Therapy.

What has your medical specialist recommended to decrease your neck pain? Pills or posture?

Pills are temporary and don’t fix the real ill. We all struggle with maintaining good posture. For some poor postural habits are caused by the computers, phones and tablets we are connected to each day. For others you are not getting the recommended amount of weekly exercise. Rarely is it due to age or degeneration. Your body was designed to move you through life. With a little care and maintenance pain will never be a chronic problem.

You can learn a few simple techniques to improve your posture and decrease your pain. If you work these into your program you might even abolish your pain for good!

Watch the video below to begin

This is a good starting place for most who struggle with neck pain.

For those who have had neck pain for greater than three months or the pain is radiating down your arm, to your fingers or into your shoulder-blade a full evaluation is recommended. Click here to schedule an evaluation with one of our physical therapists who specialize in cervical pain conditions.

Give this exercise a try for a few days and let us know how you are feeling

If you have questions you can reach out to us on our Facebook page or contact us.

Joe Tatta, DPT

www.premierptny.com

The post Gentle Exercise for Neck Pain & Improved Posture appeared first on Premier Physical Therapy.

Whether it’s in the heart of midtown, the historic Murray Hill district, the brownstones of the Upper Westside or the trendy storefronts of the Upper Eastside, Premier PT clinics are all strategically located in hotspots throughout Manhattan. We are close to public transportation, popular restaurants, and major shopping areas. Our newest clinic at Dey St. is at the center of the financial district which is making a great come back. We are proud to be one of the businesses helping to bring lower Manhattan back to life. Our Westchester County and Southern Connecticut clinics are also centrally located in downtown areas walkable to local cafés and other services. All of our 13 clinics are in convenient neighborhoods well-situated for the up and coming PT.

Scheduling Flexibility

As a Premier PT, you would be working at least two evenings per week, which means you’ll be able to sleep in a few days and hit the gym before coming in to work. On the other days, you’ll come in early and will be able to leave earlier in the day, to hit the gym again, or get home in time to prepare a tasty gourmet dinner for your friends or family. If you need to catch up on documentation, you’ll have the option for remote access from your home so you can finish up a patient file while checking Facebook. The flexible schedule provides the best of both worlds and gives you enough time outside of the office to get your life organized!

Mentorship

Your experience at Premier will include a transition period of mentorship, where you’ll be oriented to office policies and procedures have time to integrate yourself into the practice, practice manual therapy techniques, post-surgical protocols, sports progressions and meet with your clinic director for one-on-one mentorship meetings. This will also be a great time for you to get acclimated to the ever changing world of medical billing and insurance documentation. Also, clinics hold weekly in-services where PTs are able to bring back and share what they’ve learned at Continuing Ed courses, or a staff member leads a session on recent research or other topics. Whether you’re a new grad or a PT with a few years’ experience under your belt, our mentorship program and ongoing training is one of the top reasons to join the Premier team.

Watch Dr. Michelle Strauss’ Story Below

Variety

We’re an outpatient private practice that sees a vast caseload of patients. You’ll get experience in sports physical therapy, orthopedics physical therapy, manual therapy, some vestibular and neurologic physical therapy and pediatrics if you’re interested. As you progress in your career and hone in the areas you’d like to specialize in, you’ll have opportunity and support to seek certifications as an Orthopedic Certified Specialist. Therapists work one on one with patients and are right there with patients through progress and successes. Our patients expect a high quality of care, and our PTs are challenged and trained to meet these high expectations. As Sinatra (and Jay-Z) put it, if you can make it here, you’ll make it anywhere!

Team Premier

Our therapists works together in small and medium size teams. The environment we have is very much collaborative, creative, and open. PTs work closely with the front desk staff to provide the best health services possible to patients. We work with local student PTs and school PT programs and are fortunate to give back to the field and participate in the training of future PTs. We sponsor local charitable organizations like Crutches4kids.org and are involved in supporting our community. Premier PT has a strong team environment which promotes a good work experience for our staff, and we are ready to take on and adjust to the changing landscape of healthcare.

By Suzanne Jung, PHR, MA

For more information about careers or internships at Premier Physical Therapy & Wellness visit us at www.premierptny.com/careers/

The post 5 Reasons To Join Team Premier! appeared first on Premier Physical Therapy.

Posture and the Spine

Curves are a normal part of the spine’s structure. Looking at the spine from a lateral view, the spine resembles a soft ‘S’ shape.  A healthy back has three natural curves: a slight forward curve in the neck (cervical lordosis curve), a slight backward curve in the upper back (thoracic kyphosis curve), and a slight forward curve in the low back (lumbar lordosis curve). Good posture actually means keeping these three curves in balanced alignment. Long periods of sitting, especially in a slumped or slouched position, can alter those curves and increase strain to the body. Strong and flexible muscles also are essential to good posture. Abdominal, hip, and leg muscles that are weak and/or inflexible cannot support your back’s natural curves.

 A common condition contributing to neck pain is forward head posture. Forward head posture occurs when the neck protrudes forward placing the head in front of the shoulders. The continuous forward pull of the head over taxes muscles of the upper back and puts excessive strain on the vertebrae. This position is often accompanied by rounding of the upper back and shoulders.

Poor posture plays a large role in many cases concerning lower back pain. Prolonged periods spent in a slouched position causes atrophy of the abdominal muscles and increased strain to the stabilizing ligaments in your lower back, creating a spine that is vulnerable to injury. Furthermore, this position promotes the shortening and tightening of the hip flexor (psoas) muscles which alters the distribution of forces on the spine, increasing the risk for herniated discs in your lower back.

Ergonomics

The term “ergonomics” is derived from the Greek words: “ergon,” meaning work, and “nomoi,” meaning natural laws. Ergonomics is the science that deals with designing and arranging things so that people can use them easily and safely.

When we sit, we are at our most vulnerable for developing poor posture. An improper workspace setup can promote poor posture which can lead to an array of repetitive strain injuries to the body. Sitting with poor posture is a bad habit that can be avoided with proper ergonomics and self-awareness. You can maintain proper posture while sitting by:

POOR POSTURE———————-  CORRECTED POSTURE

Choose the right chair

• The right chair can make all the difference, especially if it’s a chair where you will sit for long periods of time. Make sure your chair adequately supports your back and allows you to place both feet on the floor.
• Sit on an unsteady surface such as an exercise ball to reinforce activity in your core muscles.

Proper positioning

• Keep your feet flat on the floor, slightly apart. Your knees should be bent at a right angle and should be even with, or slightly higher than, your hips.
• Make sure your weight is distributed evenly on both hips. Do not sit biased to one side.
• Keep elbows at your sides with slightly more than 90 degrees bend.
• Keyboard should be at the same height as your elbow with wrists slightly bent.
• Mouse should be adjacent to and at the same height as your keyboard.
• Eyes should be level with the top 1/3 of your computer screen.

Take regular breaks 

• If you’re getting neck and back pain from sitting at your desk, alternate between sitting and standing at your work station.  If possible stand up throughout the day and/or take walks every 30-60 minutes. 
• Avoid staying in one position for long periods of time; inactivity causes muscle tension and weakness.

Reminders

• Set an hourly alarm to remind yourself to check your posture.
• Have a friend or coworker check your ergonomic setup by taking a photograph of you sitting at your desk.

Assistive Tools

• When reading, use a document holder to prevent repetitive strain of the neck.
• Use a headset when using the phone.
• Utilize a small pillow or lumbar roll between the back of your chair and the small of your back, keeping your lower back properly aligned to reduce strain.

Physical Therapy

A physical therapist can evaluate your posture and develop a corrective exercise program. After a complete evaluation, a physical therapist can help you identify your particular postural and musculoskeletal problems. At that time you will be provided a personalized treatment plan and specific home exercises to correct them. A physical therapist will also be able to provide an ergonomic assessment of your workstation.Premier Physical Therapy is available for individual ergonomic assessment or corporate ergonomic services.

 In good health,

Peter Patumaranan, DPT

References:

http://health.usnews.com/health-news/articles/2014/03/25/low-back-pain-leading-cause-of-disability-worldwide-study

http://www.merriam-webster.com/dictionary/ergonomics

http://apps.washingtonpost.com/g/page/national/the-health-hazards-of-sitting/750/

http://www.apta.org/

The post Pain, Posture and Positioning appeared first on Premier Physical Therapy.

If you are interested in an internship, affiliation or residency program click here to apply.

We accept applications for internships in all our practice locations on a rolling basis.

Joe Tatta, DPT

www.premierptny.com

The post Doctoral Internship At Premier Physical Therapy & Wellness appeared first on Premier Physical Therapy.

How do you respond when you are really not hungry? Try these tips:

1)  The Professor: Use this as a teaching moment. Hold up your hand and make a fist. Say, “Did you know this is the actual size of your stomach? It’s amazing to think about how much we try to put in there!”

2) The Parent: It’s okay to say no. It’s as simple as that. Too often, we are afraid to put down limits. Say “no” politely, but with conviction. Practice when you are by yourself to make the words come out effortlessly. Other people easily push past a wishy-washy no.

3) The Therapist: Remember that the comments people make are often a reflection of their own fears and insecurities. Offering reassurance may help to take the pressure and focus off of you. Say, “It sounds like you would like another piece of cake. Go for it!”

4) The Magician: Try to divert and deflect. Be sure to hand out a compliment, “The cake is fantastic! Do you have the recipe?” This can redirect the focus from eating to learning how to make it.

5) The Comedian: Say, “No, thank you!  If only eating healthier was a “piece of cake.”  Keep it light-hearted.

Download the free Mindful Eating Pledge, 5 essential steps to stop stress eating and eating more mindfully today or sign up for the Mindful Eating Summit, online interviews with 20 top experts who will give their best tips and advice on eating more mindfully.

Today’s guest blog was written by Dr. Susan Albers, New York Times Bestselling Author of EatQ and Cleveland Clinic psychologist.  Learn more by visiting www.eatingmindfully.com

The post 5 Effective, Tactful Ways to Say ‘No!’ to Overeating appeared first on Premier Physical Therapy.