Tag: Physical Therapy

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Injuries from falls can have a big impact on elderly adults’ ability to remain independent. A few simple PT exercises can improve strength and balance to reduce the risk.@HopkinsMedicine

Lora Durkin, Physical Therapist

Lora Stutzman, PT

Falls can have very serious consequences as we age. Each year, more than 25 percent of adults 65 or older have a fall, and 3 million are treated in emergency departments for fall injuries, according to the Centers for Disease Control and Prevention.

Fall Risks

The risk of falling in older adults is usually related to combination of factors, including:

  • Balance and/or walking problems. Balance can be affected by vision changes, vestibular problems and altered sensation in the feet.
  • The use of multiple medications. Studies indicate that when individuals take five or more medicines, the risk of falls increases.
  • Home hazards (including dim lighting and trip hazards)
  • Positional low blood pressure (such as orthostatic hypotension, when blood pressure drops upon standing.
  • Feet and footwear issues

Falls often occur in the bathroom when sitting or standing from the toilet or shower, or at night in a dark bedroom when getting up quickly and tripping on the way to the bathroom.

Exercises to Prevent Falls

While it’s not possible to completely prevent a fall, exercises that focus on balance and strength training can reduce the risk of falling. “We treat elderly adults for injuries sustained from falls, and other patients who feel unsteady while walking or standing and are fearful of falling,” says Lora Stutzman, a physical therapist with the Johns Hopkins Rehabilitation Network. “These exercises can help improve balance and build strength to help prevent future falls.”

For older adults, activities such as squatting, standing up from a chair and walking may be difficult or cause them to feel unsteady, which increases their risk of falling. The following exercises are intended for those who have a low risk of fall and are able to stand on their own without support from others. Always talk to your doctor or physical therapist first before starting new exercises, especially if you have weak balance.

Stutzman demonstrates two exercises below.

Sit-to-Stand Exercise

The sit-to-stand exercise builds leg strength and improves body mechanics and balance, which are all important in reducing falls.

1. Start by sitting on a sturdy chair of standard height, and make sure that it won’t slide or roll. You should be able to sit comfortably with your feet flat on the ground. Have a sturdy support surface in front of you, such as a countertop, so that you can reach to it for support if you start to feel unsteady when standing. Scoot forward so your buttocks is positioned at the front of the seat.

2. Lean your chest forward over your toes, shifting your body weight forward. Squeeze your gluteal muscles and slowly rise to a stable standing position.

Physical therapist showing exercises for fall prevention

3. Slowly sit back down to the starting position and repeat 10 times.

4. If necessary, place your hands on the arms or seat of the chair and push through your hands to help stand and sit. The goal is to not use your hands at all.

Physical therapist showing exercises for fall prevention

Perform 10 repetitions, twice a day. For an advanced version, hold hand weights to add resistance.

If you have pain in your knees, back or hips, discontinue and talk to your doctor or physical therapist.

Balance Exercise

This series of exercises helps if your balance is unsteady. Make sure you have someone with you in case you lose balance.

To begin, stand in a corner or have a kitchen counter in front of you to reach out to in case you start losing balance.

1. Feet apart: Stand with feet about shoulder-width apart, eyes open, and hold steady for 10 seconds, working your way up to 30 seconds.

If you find yourself swaying or reaching for the wall or counter frequently, just keep working on this exercise until you can do it with minimal swaying or support. Once you can hold this position firmly for 30 seconds, move on to the next exercise.

2. Feet together: Stand with feet together, eyes open, and hold steady 10 seconds, working your way up to 30 seconds.

Physical therapist showing exercises for fall prevention

Once you can do this exercise for 30 seconds with minimal swaying or support, move on to the next one.

3. One foot: Stand on one foot, eyes open, and hold steady 10 seconds, working up to 30 seconds. Switch to the other foot.

4. Eyes closed: If you can perform the first three exercises safely and with little support, try to do each one with your eyes closed. Hold for 10 seconds, working up to 30 seconds.

Physical therapist showing exercises for fall prevention

The goal for each exercise is to hold the position for 10 seconds and progress to 30 seconds, five repetitions (including five per leg on the one-foot exercise), two times a day.

Additional Steps to Prevent Falls

Remember, it’s important to talk to your doctor or physical therapist about fall prevention.

  • Discuss medications and changes in your exercise routine.
  • Tell your doctor if you fall.
  • Ask a friend or family member to help check your home for trip hazards.

“Keep in mind,” adds Stutzman, “it is always best to have company at home with you while exercising for safety and supervision and in case you need help.”

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Why a Strong Core Can Help Reduce Low Back Pain @ClevelandClinic #healthaware #physiotherapy

cleveland back pain a physical therapist

Cleveland Clinic
@ClevelandClinic

Back pain is a complex problem, but can strengthening core muscles with targeted exercise provide some relief?

If you suffer from back pain, you’ve probably heard that strengthening your core can bring you some relief. But is this always true? And if so, how do you do it? Physical therapist Patti Mariano Kopasakis, PT, DPT, SCS, answers common questions about what we should know about strengthening your core muscle group.

Q: What is your core?

When most people think about the core of the body they think of the abdominal or six-pack area just below the ribs. While the abdominal muscles are an important part of the core, we consider other areas important, too.

Your core includes:

  • Front abdominal muscles — the rectus abdominis.
  • Muscles along the side of your body — the internal and external obliques.
  • A deep muscle that wraps around the front — the transverse abdominal.
  • Muscles in your back that are located between your spine bones and run along your spine — the erector spinae and multifidi.

Your core also includes your diaphragm, muscles of the pelvic floor, hip flexors, and gluteal muscles.

Q: What is the relationship between core strength and back pain?

Theoretically, if your muscles around the low back are weak, your body will rely more on passive structures for stability, including ligaments — the tissue that connects bone to bone — as well as the spinal bones or discs which lie between the spinal bones. This can cause pain.

But some studies have shown that specific core exercises are not any more beneficial than general exercise for low back pain. What we know is that exercise in general can help, and focusing on core muscles may provide some additional benefit.

Q: What are some exercises for the core that can help with back pain?

Here are my top five:

  •  Side plank — Sit on the floor with your right hand below your right shoulder and feet stacked. Lift your body, keeping your legs long, abdominals engaged and feet stacked. Hold. Repeat on the other side. You can modify this pose by dropping your bottom knee to the floor for extra support.
  • Plank — Kneel on all fours. Pull in your abdomen and step your feet behind you until your legs are straight. Keep your hands directly under your shoulders and your neck straight. Hold your abdomen and legs tight and avoid letting your lower back sag. Hold and breathe for 30 seconds. You can modify this pose by lowering your knees.
  • Bird dog — Kneel  on all fours. Reach one arm out in front of you, draw in your abdomen, and extend the opposite leg long behind you. Repeat on the other side.
  • Marches — Lie on your back with knees bent. Take a deep breath in and as you breathe out draw your belly muscles in as if tightening a belt. As you do this lift one leg a few inches from the floor. Return to starting position and switch sides. Repeat for 8-10 repetitions on each side. 3 sets.
  • Upward dog — Lie face down with head slightly lifted and hands palm-down under your shoulders. Point your toes. Exhale, then press through your hands and the tops of your feet and raise your body and legs up until your arms are straight and your body and legs are off the ground. Keep your neck relaxed and long and thigh muscles tight as you hold and breathe.

For the plank exercises, start by holding them for 15 seconds to 30 seconds. For bird dog and scissors, try three sets of eight or 10 repetitions. For upward dog, do one set of 10 repetitions.

Q: Can you injure your back by trying to strengthen your core?

Any exercise performed incorrectly, whether it is core-strengthening or otherwise, has the potential to cause discomfort.

Twisting exercises or even incorrectly completing the exercises cited above can cause pain in the low back. But it’s highly unlikely that one repetition of an exercise will seriously harm your body, unless it’s an exercise using a very heavy weight.

The best way to keep your body safe is to listen to body cues such as pain during and immediately after an exercise, and the next day after exercising.

Q: When should you talk to a doctor about your back pain?

If any of the following is going on you should consult with your doctor:

  • Your pain has been going on for longer than a month, despite resting from activities that make it worse.
  • Your pain is getting worse.
  • Your pain wakes you from sleep.
  • Your pain is in your low back but also is going down one or both of your legs.
  • You notice that one leg is becoming weaker than the other.

Q: Where should you turn if you want help in creating a plan to address back pain?

Physical therapists train as musculoskeletal experts — they are the experts on muscles, bones and human movement. These professionals are the most qualified, aside from an orthopedic doctor, to assess back problems.

Since there are many factors that impact low back pain and many types of low back pain, it is a good idea to visit at least one time with a physical therapist for an evaluation and subsequent plan of care. This will give you an individually tailored plan with exercises that progress safely. The idea of core strengthening, while beneficial, is just one piece of the low back pain puzzle.

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5 surprising benefits of walking: @HarvardHealth #healthaware #physiotherapy





Harvard Health

@HarvardHealth
·



5 surprising benefits of #walking: Any physical activity is a boon to your overall health. But walking in particular comes with a host of benefits. https://bit.ly/3uyNvhI #HarvardHealth

The next time you have a check-up, don’t be surprised if your doctor hands you a prescription to walk. Yes, this simple activity that you’ve been doing since you were about a year old is now being touted as “the closest thing we have to a wonder drug,” in the words of Dr. Thomas Frieden, former director of the Centers for Disease Control and Prevention.

Of course, you probably know that any physical activity, including walking, is a boon to your overall health. But walking in particular comes with a host of benefits. Here’s a list of five that may surprise you.

1. It counteracts the effects of weight-promoting genes. Harvard researchers looked at 32 obesity-promoting genes in over 12,000 people to determine how much these genes actually contribute to body weight. They then discovered that, among the study participants who walked briskly for about an hour a day, the effects of those genes were cut in half.

2. It helps tame a sweet tooth. A pair of studies from the University of Exeter found that a 15-minute walk can curb cravings for chocolate and even reduce the amount of chocolate you eat in stressful situations. And the latest research confirms that walking can reduce cravings and intake of a variety of sugary snacks.

3. It reduces the risk of developing breast cancer. Researchers already know that any kind of physical activity blunts the risk of breast cancer. But an American Cancer Society study that zeroed in on walking found that women who walked seven or more hours a week had a 14% lower risk of breast cancer than those who walked three hours or fewer per week. And walking provided this protection even for the women with breast cancer risk factors, such as being overweight or using supplemental hormones.

4. It eases joint pain. Several studies have found that walking reduces arthritis-related pain, and that walking five to six miles a week can even prevent arthritis from forming in the first place. Walking protects the joints — especially the knees and hips, which are most susceptible to osteoarthritis — by lubricating them and strengthening the muscles that support them.

5. It boosts immune function. Walking can help protect you during cold and flu season. A study of over 1,000 men and women found that those who walked at least 20 minutes a day, at least 5 days a week, had 43% fewer sick days than those who exercised once a week or less. And if they did get sick, it was for a shorter duration, and their symptoms were milder.

Image: gradyreese/Getty images

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5 surprising benefits of walking: @HarvardHealth #healthaware





Harvard Health

@HarvardHealth
·



5 surprising benefits of #walking: Any physical activity is a boon to your overall health. But walking in particular comes with a host of benefits. https://bit.ly/3uyNvhI #HarvardHealth

The next time you have a check-up, don’t be surprised if your doctor hands you a prescription to walk. Yes, this simple activity that you’ve been doing since you were about a year old is now being touted as “the closest thing we have to a wonder drug,” in the words of Dr. Thomas Frieden, former director of the Centers for Disease Control and Prevention.

Of course, you probably know that any physical activity, including walking, is a boon to your overall health. But walking in particular comes with a host of benefits. Here’s a list of five that may surprise you.

1. It counteracts the effects of weight-promoting genes. Harvard researchers looked at 32 obesity-promoting genes in over 12,000 people to determine how much these genes actually contribute to body weight. They then discovered that, among the study participants who walked briskly for about an hour a day, the effects of those genes were cut in half.

2. It helps tame a sweet tooth. A pair of studies from the University of Exeter found that a 15-minute walk can curb cravings for chocolate and even reduce the amount of chocolate you eat in stressful situations. And the latest research confirms that walking can reduce cravings and intake of a variety of sugary snacks.

3. It reduces the risk of developing breast cancer. Researchers already know that any kind of physical activity blunts the risk of breast cancer. But an American Cancer Society study that zeroed in on walking found that women who walked seven or more hours a week had a 14% lower risk of breast cancer than those who walked three hours or fewer per week. And walking provided this protection even for the women with breast cancer risk factors, such as being overweight or using supplemental hormones.

4. It eases joint pain. Several studies have found that walking reduces arthritis-related pain, and that walking five to six miles a week can even prevent arthritis from forming in the first place. Walking protects the joints — especially the knees and hips, which are most susceptible to osteoarthritis — by lubricating them and strengthening the muscles that support them.

5. It boosts immune function. Walking can help protect you during cold and flu season. A study of over 1,000 men and women found that those who walked at least 20 minutes a day, at least 5 days a week, had 43% fewer sick days than those who exercised once a week or less. And if they did get sick, it was for a shorter duration, and their symptoms were milder.

Image: gradyreese/Getty images

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Strong core muscles help you maintain good posture. Why a strong core is important + exercises to try. @ClevelandClinic

cleveland evrything starts wit your core

If you’re planning to start an exercise program and wondering where to begin, start with your core first, says physical therapist Brittany Smith, DPT. People often think of the core muscles as being the abdominal muscles, but the core includes the muscles in the abdomen, back and hips, all working together as a group.

“The core muscles provide stability for the entire body as it moves,” says Smith. “These muscles are activated when you stand up, turn, bend, reach, twist, stoop and move in most other ways. Everything starts with your core.”

Strong core muscles help you maintain good posture, while weak ones can lead to slouching and slumping. Poor posture can be a cause of aches and pain, especially in the back.

Getting started with your core

To get your core muscles in shape, you need to exercise.

“Our bodies were made to move, so any physical activity is really important,” says Smith.

She recommends these specific core-strengthening exercises below.

The first one engages the deep muscles in the abdomen, called the transverse abdominis. “These muscles help hold us in a better position to stabilize our core, thereby stabilizing our arms and legs,” says Smith.

“The more you work on these muscles, the more it will become second nature to hold these muscles tight when you’re lifting grocery bags, doing yard work or any other kind of physical activity,” says Smith. This will help support your body.

Other muscles that tend to be weak are the gluteus maximus in the buttocks, and the gluteus medius and gluteus minimus on the side of the hip. The bridge and clamshell exercises can help strengthen these muscles.

Smith emphasizes that getting the proper position of these exercises correct is more important than the number of repetitions you do. “It’s better to take your time, maybe do fewer reps, but with better quality,” she says. For that reason, it can be helpful to have the guidance of a physical therapist to get started.

Move on from the core

Core exercises are the starting point of overall fitness because you need to hold those muscles engaged while you strengthen other muscles, such as the biceps in the arms or the quadriceps in the legs.

Smith suggests setting short-term goals (for about a month) and then more long-term goals. Once you have achieved short-term goals, such as getting around more easily, add other types of weight-training or resistance exercises to build muscle elsewhere.

With any exercise you do, always listen to your body, warns Smith. If you have pain other than muscle burn, take it easy. Reduce the number of repetitions, the weight or the duration of the exercises. Then build up gradually. “You don’t have to be in pain to make gains,” she says.

Beginner exercises for core strength

For each of the following, work up to one to two sets of 10 to 15 repetitions once a day.

Abdominal bracing

Lie on your back with your knees bent and feet flat on the floor. Contract your abdominal muscles, and press the arch of your back down toward the floor, pulling your belly button toward your spine. Hold for 5 to 10 seconds. Make sure your lower back stays flat on the floor. Relax and repeat.

Bridge

Lie on your back with your knees bent and feet flat on the floor with your arms at your sides. Squeeze your abdominal and buttocks muscles, push your heels into the floor and slowly lift your buttocks and hips off the floor. Keep your back straight. Hold for 5 to 10 seconds.

Clamshell

Lie on your side with knees bent in line with your hips and back, draw up the top knee while keeping contact of your feet together as shown. Don’t let your pelvis roll back during the lifting movement. Hold for 5 seconds.

https://health.clevelandclinic.org/planning-to-start-exercising-start-with-your-core-first/?utm_medium=social&utm_source=twitter&utm_campaign=cc+tweets

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Our best balance boosters #physiotherapy😉 @HarvardHealth

harvard balance boosters

Harvard Health
@HarvardHealth

Our best balance boosters. bit.ly/2rkMG0N #HarvardHealth

Image: Jacob Ammentorp Lund/iStock

Many older adults focus on exercise and diet to stay healthy. But one of the worst offenders to health—poor balance—is often an afterthought. “I see a lot of older adults who are nonchalant about balance,” says Liz Moritz, a physical therapist at Harvard-affiliated Brigham and Women’s Hospital.

Unfortunately, imbalance is a common cause of falls, which send millions of people in the United States to emergency departments each year with broken hips and head injuries. But there are many things you can do to improve your balance. The strategies below are some of the most effective.

Physical therapy

Physical therapy for balance focuses on the ability of the joints and brain to communicate, the balance system in the ear (the vestibular system), and vision. “We coordinate all three with exercises such as standing on one foot, first with the eyes open, and then with the eyes closed. We also work on joint flexibility, walking, and lower-extremity exercises on one or two legs,” says Moritz. Other exercises that boost balance include chair stands (see “Move of the month”) and squats. Make sure you get training before attempting these exercises at home.

Muscle strengthening

“Core strength is very important for balance. If the abdominal muscles in your core are weak, they cannot support your limbs, especially when you’re walking. If the gluteal muscles in your buttocks and hips aren’t strong, they won’t be able to propel you forward,” says Moritz. Muscle strengthening can help. Moritz suggests starting with gentle core exercises like a pelvic tilt (lie on the floor with your knees bent up, then roll your pelvis up) and then moving to more intense exercises such as wall planks (stand six inches from a wall, keeping your body rigid, then lean forward with your forearms flat against the wall, and hold the position for 20 seconds). Leg lifts will strengthen the gluteal muscles, and adding resistance bands to leg lifts makes the exercise even more effective.

Tai chi and yoga

“Tai chi and yoga are exercises that make you pay attention to the control and quality of movement, rather than the quantity, which improves your balance,” says Moritz. In tai chi, you practice slow, flowing motions and shift your weight from one limb to another. Yoga incorporates a series of focused postures and breathing. Both exercises increase flexibility, range of motion, leg and core strength, and reflexes. The result: you become better at balancing in a number of different positions, which helps you avoid falling if you encounter uneven pavement or obstacles in your path.

Vision correction

“If you can’t see where you’re going, your fall risk goes up,” says Moritz. “A lot of people I treat for balance are here be-cause they tripped when they didn’t see something on the floor.” The fix may be as simple as a new eyeglasses prescription. Get a comprehensive, dilated eye exam every one or two years if you’re 65 or older, every one to three years if you’re age 55 to 64, and every two to four years if you’re 40 to 54. If you have an increased risk for other eye conditions, you may need an eye exam more often.

Assistive walking devices

A cane or a walker can complement your balance and give you more stability and confidence walking. But don’t buy a device on your own. “If it’s too high or too low, that can cause a fall. You need to get it measured, and you need training to learn how to use it,” says Moritz. Training takes just a few physical therapy sessions. Walkers are available with wheels intended for different terrain, lockable brakes, seats, baskets, and other features such as headlights. Canes are available with various handgrips and bases.

https://www.health.harvard.edu/staying-healthy/our-best-balance-boosters?utm_content=bufferbc3b8&utm_medium=social&utm_source=facebook&utm_campaign=buffer

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A Strong Core is Your Best Guard Against Back Pain @ClevelandClinic

A group of adults are taking a fitness class together at the gym. They are working out on exercise mats and are holding a high plank.
A group of adults are taking a fitness class together at the gym. They are working out on exercise mats and are holding a high plank.

A physical therapist answers your questions

If you suffer from back pain, you’ve probably heard that strengthening your core can bring you some relief. But is this always true? And if so, how do you do it? We spoke with Cleveland Clinic physical therapist Patti Mariano, DPT, to find out.

Q: What is your core?

When most people think about the core of the body they think of the abdominal or six-pack area just below the ribs. While the abdominal muscles are an important part of the core, we consider other areas important, too.

Your core includes:

  • Front abdominal muscles — the rectus abdominis
  • Muscles along the side of your body — the internal and external obliques
  • A deep muscle that wraps around the front — the transverse abdominis
  • Muscles in your back that are located between your spine bones and run along your spine — the erector spinae and multifidi

Your core also includes the diaphragm and muscles of the pelvic floor. I also consider the gluteal muscles as core muscles.

Q: What is the relationship between core strength and back pain?

Theoretically, if your muscles around the low back are weak, your body will rely more on passive structures, including ligaments — the tissue that connects bone to bone — as well as the spinal bones or discs, which lie between the spinal bones, for stability, which can cause pain.

But some studies have shown that specific core exercises are not any more beneficial than general exercise for low back pain. What we know is that exercise in general can help, and focusing on core muscles may provide some additional benefit.

Q: What are some exercises for the core that can help with back pain?

Here are my top five:

  • Side plank — Sit on the floor with your right hand below your right shoulder and feet stacked. Lift your body, keeping your legs long, abdominals engaged and feet stacked. Hold. Repeat on the other side. You can modify this pose by dropping your bottom knee to the floor for extra support.
  • Plank — Kneel on all fours. Pull in your abdomen and step your feet behind you until your legs are straight. Keep your hands directly under your shoulders and your neck straight. Hold your abdomen and legs tight and avoid letting your lower back sag. Hold and breathe for 30 seconds. You can modify this pose by lowering your knees.
  • Bird dog — Kneel  on all fours. Reach one arm out in front of you, draw in your abdomen, and extend the opposite leg long behind you. Repeat on the other side.
  • Scissors — Lie on your back with your arms at your sides and legs pointed straight into the air above your hips. Press your lower back into the mat and tighten your abdomen. Lower your right leg until it’s a few inches from the floor. Raise your right leg up and begin lowering your left leg the same way. Continue switching right and left.
  • Upward dog — Lie face down with head slightly lifted and hands palm-down under your shoulders. Point your toes. Exhale, then press through your hands and the tops of your feet and raise your body and legs up until your arms are straight and your body and legs are off the ground. Keep your neck relaxed and long and thigh muscles tight as you hold and breathe.

For the plank exercises, start by holding them for 15 seconds to 30 seconds. For bird dog and scissors, try three sets of eight or 10 repetitions. For upward dog, do one set of 10 repetitions.

Q: Can you injure your back by trying to strengthen your core?

Any exercise performed incorrectly, whether it is core-strengthening or otherwise, has the potential to cause discomfort.

Twisting exercises or even incorrectly completing the exercises cited above can cause pain in the low back. But it’s highly unlikely that one repetition of an exercise will seriously harm your body, unless it’s an exercise using a very heavy weight.

The best way to keep your body safe is to listen to body cues such as pain during and immediately after an exercise, and the next day after exercising.

Q: When should you talk to a doctor about your back pain?

If any of the following is going on you should consult with your doctor:

  • Your pain has been going on for longer than a month, despite resting from activities that make it worse.
  • Your pain is getting worse.
  • Your pain wakes you from sleep.
  • Your pain is in your low back but also is going down one or both of your legs.
  • You notice that one leg is becoming weaker than the other.

Q: Where should you turn if you want help in creating a plan to address back pain?

Physical therapists train as musculoskeletal experts — they are the experts on muscles, bones and human movement. These professionals are the most qualified, aside from an orthopedic doctor, to assess back problems.

Since there are many factors that impact low back pain and many types of low back pain, it is a good idea to visit at least one time with a physical therapist for an evaluation and subsequent plan of care. This will give you an individually tailored plan with exercises that progress safely.

The idea of core strengthening, while beneficial, is just one piece of the low back pain puzzle.

https://health.clevelandclinic.org/2016/07/strong-core-best-guard-back-pain/