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/

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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.

Do I have to be a good biker, runner, and Swimmer to do a triathlon?

You do not have to be a good biker, runner, and swimmer to do a triathlon. The most important part of a successful triathlon is safety.  Know your race course prior to the race and the rules. Stay well hydrated and practice proper nutrition.

In terms of the swim, is there a current in the water you will be swimming in and which direction will it go? 

A beginner triathlete should stay at the back and out wide of the swim pack since the start can be crowded and physical.  During the swim there are kayaks and boards in the water to grab onto should the triathlete run into trouble.

In terms of biking, are there any sharp turns, uneven surfaces or high traffic areas during your bike? 

Make sure you check out your bike before the race.  Make sure there is nothing in the tires that can cause a flat, and that they are properly inflated, and check the brake pads for wear and in proper position.The run is the safest which is why it is last.  You can always walk as needed. There are different lengths of triathlons so you do not have to be good at all the disciplines. Start off with a sprint distance and build up.  Make sure you are training each event properly and ensure you practice your transitions, especially the bike to run.

How far in advance should I start training?

That is dependent upon the length of the race you are training for and how in shape/active you are prior to beginning your training.  If you know the mechanics of the swim, bike, and run, are in fairly good shape and want to do a sprint race, give yourself a minimum of 2 months.  If you need to learn technique, are fairly inactive at baseline, or are planning for a longer race (ie full Ironman or half Ironman), more time is required. I would estimate anywhere from 6 months minimum to 1 year, also depending on race goals and weekly hours available for training.

Besides the obvious biking, running, and swimming are there a few exercises (weights) that I should be doing to avoid injury?

YES!!!  Cross training is very important.  Thinking about the demands of each event, anterior musculature gets very tight.  For example, pecs and anterior shoulder in the swim & bike, hip & neck flexors on the bike, and hip flexors, calves, quads with the run, just to name a few.  Quad, hip flexor, calf, pec, and neck stretching is very important, It is also a good idea to invest in a foam roller. In terms of strengthen exercises core stability is important:  planks (front & side), rotations with weighted medicine ball, etc.  For lower extremity I like a variation of squats and lunges, as well as resisted side stepping as to not neglect the gluteus medius which is really needed for stability during the events.

For upper body pushing activity for chest (push up, chest press), follow by pulling (rows, lat pulldowns, pull up).  I also like to add in scapular stability (ie external rotation & middle/lower trap T/Y exercises) This is widely neglected and can result in shoulder impingement symptoms during the swim and is needed for upper body support during the bike. Not all of these exercises & stretches need to be done in one session.  I would recommend one session of cross training per week, then incorporating the stretches and a couple of the exercises into each workout (ie, after a bike workout, stretch out the hips, quads and pecs, do a few sets of pushups and planks:  DONE!)

What equipment will I need to invest in?

A bike, helmet and all the bike support equipment.  You may want bike gloves as well. It is also important to learn how to fix a flat tire and keep spare inner tubes, tire levers, and a CO2 cartridge in a saddle bag under your seat. You should also have a good tire pump at home. For the swim, if it is open water you will want a wetsuit and goggles.  The wetsuit will keep you warm in cold water and provide buoyancy. Body glide helps to get your wetsuit on and prevents chaffing of the skin.
The run is easy:  running sneakers!

Any motivational training tips?

Have fun with your training, it can be a lot.  Have a good training plan to follow so you feel organized, but don’t get down if you miss a session or it doesn’t go as planned.  Also, remember to add in rest and active recovery days.  If your body is struggling, it is saying it needs a break and listen to it.  Your training will be better off for it.  The next session you will come back feeling stronger and more energized! Happy training and good luck!

With each triathlon I have participated in, I learn something new about myself and my training. Below is a picture of my dad and I after completing my first sprint triathlon. The following year I crushed by time by 13 minutes!

For more information on training tips and injury prevention visit us at www.premierptny.com

Charissa Morrisroe, DPT

The post The Transition to Triathlete- [A Physical Therapist Perspective] appeared first on Premier Physical Therapy.

Click here to learn more about internships and careers at Premier Physical Therapy & Wellness.

www.premierptny.com

The post Affiliation Experience at Premier Physical Therapy & Wellness [video testimonial] appeared first on Premier Physical Therapy.

• Pinched nerves
• Cervical herniated disc
• Stenosis
• Myofascial pain
• Thoracic outlet syndrome
• Carpel tunnel
• Radial tunnel
• Shoulder pain

Maintaining these (painful) postures for extended periods of time causes your neck to become stiff and tight. It’s vitally important to learn specific therapeutic exercises you can do to “undo what the day has done to you.” Since we spend most of our day looking down, reversing your posture and looking up can be like therapy. The best part is exercises that correct posture are easy and don’t require you to got to a gym or don shorts. They can easily be performed at your desk. Your coworkers won’t even know what you are doing!

Watch the video below to learn how to reverse bad neck posture.

Poor posture is not only a cause of musculoskeletal pain but also contributes to:

• Poor digestion- with poor thoracic posture our internal organs become cramped preventing digestive motility.
• Low energy- poor posture causes shallow breathing thus taking in less vital oxygen.
• Poor mood- poor posture reflects your outlook on life! If rounded over you are more likely to be depressed.
• Poor circulation- rounded postures cause joints to narrow constricting blood vessels.

When sitting, try to sit up tall, as tall as possible. Your chin should be tucked and back and your shoulders should not be rounded forward.  Try standing and moving once every hour for at least 5 minutes. Stand and do some gentle stretching at you desk.

To learn more about how to alleviate neck and back pain as well as improve you posture visit us at www.premierptny.com.

To perfecting your posture!

Joe Tatta, DPT

The post A Great Exercise to Heal Neck Pain & Correct Posture appeared first on Premier Physical Therapy.

Premier Physical Therapy & Wellness has a 15-year history of helping patients recover from injury, fight disease and return to a healthy life. As part of our practice mission we are preparing a new generation of doctoral candidates pursing physical therapy as a career. Physical therapists are needed in all area’s of health care and quickly becoming the practitioner of choice for wellness and prevention.

Doctoral candidates apply for intern positions each year and are carefully selected based on academics, experience and interview. Many interns choose Premier to complete their internship and continue their employment. Watch the video below to learn more about internships at Premier Physical Therapy.

A partial list of physical therapy programs with doctoral intern include:

• Columbia University
• New York University
• Hunter College
• New York Medical College
• Touro College
• Misericorida
• SUNY Health Science Center
• Sacred Heart
• UConn
• Hartford
• Quinnipiac
• Stony Brook
• Long Island University
• Northeastern
• UMass
• Boston College
• Rutgers
• Temple
• Arcadia

If your school is not mentioned contact us directly or your program CCCE.

Click here to apply for an internship or employment position at Premier Physical Therapy.

Joe Tatta, DPT

www.premierptny.com

References

http://www.apta.org/vision2020/

The post Seeds of Change- The New Generation of Doctors of Physical Therapy appeared first on Premier Physical Therapy.

Evaluate Your Restart

Bodies break down, despite our best intentions, and often at the worst possible time in your life.  Auto mechanics fix cars on both ends of the spectrum – from the most economical compact car all the way up to the sporty European racing car.  But if we just let the car sit in the driveway and rarely move it, our proverbial bumper sticker would read: “My other body is a Maserati”.  But what can we do to keep these bodies of ours from breaking down? Simply put: Prevention. But keep in mind: Prevention is not fail-safe. We cannot keep you from sustaining an injury on the court, but we can work to significantly decrease the likelihood of you incurring one.

Your physical therapist is a highly trained medical professional (Doctorate degree) who is ready to assess your full body movement patterns. I hear many of my patients talk about their pain in association with other aches and pains, but lift up their complaint to the mystical and ethereal “I know it’s all connected” Great Mystery of Life. Yes, it is, because it’s all happening in YOUR body. But what does it mean for your body and your lifestyle?  Come in for an assessment and find out.

Many injuries are due to movement dysfunction and muscle strength asymmetries. Small asymmetries (and, of course, large ones) may lead to joint, muscle, tendon or ligament breakdowns.  We all have small dysfunctions with our movement patterns, but we are able to adequately compensate for them.  Pain is a significant indicator that we are no longer able to compensate around these movement dysfunctions.  Pain is your brain sending you a memo: something is wrong and you need to take me to the shop to get it fixed.  We’ll use the Functional Movement Screen to reveal asymmetries and to explore how your segments work together – something we call Regional Interdependence.

Functional Movement Screen

Functional movement screening isn’t just for athletes – it is used to assess movement patterns in people from their teenage years into their twilight years.  Functional movement encompasses everything from lifting groceries to playing a few rounds of weekend hoops.  Further evaluation of individual muscles, joints and movement segments can reveal your weak points or movement dysfunctions.  This could encompass joint stiffness, muscle tightness, overall mobility restrictions or poor coordination of all of the components.

After working with your physical therapist, you’ll walk out with 3 things: a better understanding of your own body’s imbalances, a plan to improve it, and a sense of direction for your health. We develop tailored programs that fits into your schedule, addresses your issues and suit your personal needs – whether it’s improved posture, better balance, a stronger core so you can play with your kids, or more efficient athletic movement to improve your sport of choice.

Click here to schedule an appointment and begin!

In good health,

Mark M Lusk, PT, DPT, CFMT

www.premierptny.com 

The post How a Physical Therapist Can Prevent Injury [FMS] appeared first on Premier Physical Therapy.

• Healthy exercise
• How movement can heal injury
• What to activities to avoid preventing further injury
• How exercise can benefit you heart and blood pressure
• Stress relief techniques
• Healthy diet and nutrition
• A review of your medication history and implication on your injury
• How to create a successful plan for a full recovery back to health
• How to prevent chronic health problems

Physical therapists take the time to get to know you and your goals. We listen and help you create a plan.

We have helped tens of thousands recover from all types of health problems including:

• Sports injuries
• Surgery
• Strokes
• Diabetes
• Arthritis
• Tendon and ligament injuries
• Nerve injuries
• Workplace injury
• Joint sprains and strains
• Parkinsons and Multiple Sclerosis
• Vestibular disorders
• Birth injuries and pediatrics
• Accidents
• Issues related to longevity

Click here to request an appointment and learn more how a Doctor of Physical Therapy can help you.

www.premierptny.com

In good health,

Joe Tatta, DPT

The post How Can Physical Therapy Help Me? appeared first on Premier Physical Therapy.

Nutrition to Heal Your Injury

The inflammatory process is what initially happens when you are injured. Inflammation causes pain, swelling and redness. We have been taught (mostly through big pharma) that inflammation is bad- hence aggressive use of non-steroidal anti-inflammatory drugs prescribed daily. The inflammatory process should actually be called the HEALING process, as this is what is occurring on a cellular level.

The standard American diet is known to cause a pro-inflammatory state—not what you want when you are healing. A pro-inflammatory diet creates an unfavorable environment for tissue to heal. A diet high in processed foods, sugar and an imbalance of omega-6 to omega-3 fatty acids contribute to inflammation. Some of the foods and items that cause inflammation are:

• Refined sugar & artificial sweeteners
• High fructose corn syrup
• Hydrogenated oils and damages fats
• Processed meats (lunch, smoked)
• Commercial meat and dairy
• Farmed fish
• Processed Omega-6 oils (corn, soy, canola)
• Food additives (MSG, nitrates, nitrites)

Proper nutrition will keep the healing process moving. Poor dietary choices can lead to deficiencies in essential vitamins and minerals. Below are a few major players in the healing process that you should be aware of as you’re filling your plate with nutritious foods. Consider the following foods and/or supplements to help moderate inflammation and promote tissue healing:

Foods Rich in Vitamin C

Vitamin C plays an important role in collagen formation and is a powerful antioxidant. Foods rich in vitamin C are guava, red bell pepper, broccoli, green bell peppers, strawberries, grapefruit, kohlrabi, papaya, Brussels sprouts, kiwi, mango, oranges.

Foods/Supplements Rich in Omega-3 Fats

Omega-3 fats have been shown to decrease inflammation in patients with rheumatoid arthritis, improving pain and joint stiffness. Avoid farm raised fish as they have a high omega-6 content which can increase inflammation. Wild caught, cold water fish are high in omega-3 fatty acids. Other omega-3 rich foods are flax, chia, hemp, walnuts, leafy greens and fish oil.

You can supplement with omega-3 fatty acids daily. Here is the omega-3 we use in our practice.

Foods Rich in Vitamin A

Vitamin A modulates the inflammatory process and helps strengthen collagen cross-links. Some foods high in vitamin A are carrots, pumpkin, sweet potato, spinach, collards, kale, watercress, beets, winter squash, tomatoes, dried apricots, mango.

Foods Rich in Copper

Copper works with vitamin A to strengthen connective tissue. Foods with copper include: mushrooms, green leafy vegetables, barley, soybeans, tempeh, sunflower seeds, navy beans, garbanzo beans, cashews, molasses, beef liver, oysters, lobster, crab, chocolate, cocoa powder.

Protein and Amino Acids
Protein is needed to rebuild muscle, tissue and heal. Increased protein is recommended during times of tissue repair (post-surgical, physical therapy, strength building) from the normal 0.8 grams/kilogram to ~1.5 grams/kilogram. At a minimum 1 gram of protein per pound of body weight is needed. Branched chain amino acids (valine, leucine, isoleucine) are especially helpful to decrease inflammation, assist in muscle repair, prevent oxidative stress and minimize recovery time. Chose high quality, organic sources of protein such as meat, poultry, fish, eggs and dairy. Supplementing with a protein shake is another strategy for obtaining the necessary protein and branched chain amino acids required for healing.

Here is the vanilla protein shake we use in our practice. This shake is dairy and gluten free and has all three branched chain amino acids necessary to assist the healing process. It can be used to supplement you protein needs, as a post-work out shake or as a meal replacement for those decreasing energy needs with the hope of loosing weight.

Other Tips

Keep a food journal trying to correlate the foods you eat with an increase in symptoms of pain or inflammation.

See if you notice any correlation. When is your pain better or worse? Do particular foods make a difference?

Many people find when they remove inflammatory foods or foods they react to, they have less joint pain.

Looking for more advice on healing, nutrition and weight loss?

Contact us at www.premierptny.com for more information.

In good health,

Joe Tatta, DPT

References

Cruzat et al. Amino acid supplementation and impact on immune function in the context of exercise. J of International Society of Sports Nutrition. 2014, 11:61.

Seaman DR. The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002 Mar-Apr;25(3):168-79.

Vasquez A, Musculoskeletal Pain: Expanded Clinical Strategies. Gig Harbor, WA; The Institute for Functional Medicine 2002.

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