Need a Cure for Exercise Boredom?

Does your workout routine need a change?
Many of us repeat the same exercise routine day after day, week after week and month after month. We forget that there are so many different exercise options available to us these days. In fact, the American Council on Exercise encourages us to switch up our workout routines for two main reasons: 1)It eliminates the boredom of doing the same workout everyday and 2)It prevents yourself from reaching a plateau with your workout performance, which will effect your results.1 The body's physiological system adapts to a workout routine after six to eight weeks and once that happens the body is not getting the same physical challenge.1

With that said, if you are in need of a new workout to spice up your routine, we would like to invite you to test ours for FREE. What better time to change your workout routine than during the Holiday Season. By January 1, all of us will be wanting to work off the extra pounds that surfaced after the 3rd helping of Grandma's stuffing, the second piece of pumpkin pie or the fifth cup of egg nog. Set up a free 30 minute pilates and/or personal training session or reserve your free spot in a our group fitness class today.

What are the Group Class Offerings?
The Strength and Conditioning Class targets different muscle groups to strengthen the body’s core and improve functional movements which can also help with injury prevention. The class can be tailored to each person’s fitness level. The spots in the class are limited so please email Trainer Anthony Sanchez, CSCS to reserve your free spot today. anthony@hayashidaPT.com
Dates and Times of class Vary
The Pilates Mat Class incorporates the fundamental movements and principles of the Pilates Method. Mat work is adaptable to any fitness level with a focus on strength and stabilization. Spots are limites so please email Pilates instructor Erin to reserve your free spot today. Erin@hayashidaPT.com
Wednesdays at 12noon.

Interested in the solo training or pilates sessions?
The Personal Training with Anthony is a dynamic workout that can be created to target sport specific muscle groups, designed for weight loss, toning or general fitness. Anthony@hayashidaPT.com
Pilates is an anaerobic exercise that targets the body’s core postural muscles which are essential to providing support for the spine. Erin is a certified pilates instructor and will use both mat and reformer techniques to customize your workout so you can reach your individual goals. Erin@hayashidaPT.com


Don't wait too long to take advantage of this offer! It is for a limited time only.


1.Bryant, Cedric X. ACE Fitness Matters. November/December 2004.

Keeping Up With The Times!

It seems strange that just a few years ago blogging was only an idea in someone's mind, social networking sites had not been conceived and we were still using print newspapers to learn what was going on in the world. The rapid progression of technology has not just effected the daily lives of most living and breathing human beings but has had the same effect on medical knowledge and the findings available to professionals these days. For this reason, it is imperative those involved in the various medical disciplines make sure they are continuously attending courses that will teach the newest findings and techniques within their respective specialties.

At Hayashida & Associates, our therapists are not only regularly involved in these courses but also act as a host site for visiting therapists to come learn. This year we are excited to have partnered with Evidence In Motion (www.evidenceinmotion.com) for our continuing education offerings. Evidence in Motion is an education and business practice company whose sole purpose is to create as well as promote a culture of evidence based medical practice among physical therapy professionals. For those that do not know, the practice of evidence based medicine is demonstrated when a clinician integrates clinical expertise with the best available external clinical evidence from systematic outcomes.1 Our therapists at Hayashida & Associates work hard to practice this model of treatment. Therefore it was a high priority for us to partner with such a well respected group in order to further progress our own practice as well as the physical therapy profession in general.

Note: Next Course at Hayashida & Associates Goleta Clinic
Oct 10, 2009: "Evidenced Based Treatment & Selected Interventions for Patients with Cervical Spine Disorders"




1. Sackett, D., Rosenberg, W., Muir Gray, J., Haynes, R. Richardson, W. (1996) Evidenced Based Research: What It Is and What It Isn't. British Medical Journal, 312, 71-72.

3 Myths Debunked

Having been involved in the health care & physical fitness industry for the past three years, I've come across a wide variety of clients who have been more or less informed of the technological and scientific advances that have recently been made. Unfortunately for some, these advances disprove the same common myths that have been keeping them trapped in a commercialized world of gym routines, late night infomercials, and a mindset that will eventually lead to the downfall of their fitness goals. As members of the fitness community, it is our responsibility to help educate the fitness enthusiast to avoid these mistakes when possible.

Myth 1: Spot Reduction Exercising
One of the main ways people believe they can tone-up is to exercise the muscle directly beneath the part of the body they want to improve. They'll perform hundreds of tricep extensions for their flab arms before ever thinking about lifting heavier weights performing squats, or other total body movements. This concept, called Spot Reduction Exercise, does not work! As much as our conscious mind wants to believe in SRE, our genetic makeup and gender play the biggest role in deciding where and when to reduce fat after exercise. Men will typically lose weight in their mid-section last, while women will lose the weight in their hips and buttocks last. If you want to tone-up any part of your body, the best way to see muscle definition is to stick to a resistance training program, which will raise your metabolism throughout the day. In addition, think about weight loss in terms of calories in vs. calories out- if you're eating more calories per day than you're burning, you will gain weight.

Myth 2: Women + Weights = Bodybuilder
Women, do not be afraid to use weighted resistance programs! Due to an excessive amount of magazine publications displaying women of mass muscle, the public has been lead to believe that women who weight train will end up looking like a USC linebacker. What isn't mentioned in those magazines is the use of anabolic steroids to attain that same appearance! The prime reason why men and women can build muscle at different amounts is because of Testosterone. Men on average produce 10 times more testosterone than women, which is the most important hormone in increasing muscle mass. Women may naturally get some increases in muscle size, in addition to the other positive effects of exercise and weight-loss, but nothing near the same proportions of men doing the same type of work.

Myth 3: I run, therefore I'm perfectly fit.
I understand that most people have a favorite activity or exercise, and may often excel in the activity enough to believe that they're in the best shape of their lives. Let me additionally preface this myth revelation by saying that I am in full support of 'doing what works', meaning that if running 5 miles a day allows you to reach your fitness goals, then go for it.

BUT, there are many reasons why we see great athletes in physical therapy clinics, and sometimes that reason is because they only do what they do best- runners run, cyclists cycle, swimmers swim, etc. With each sport comes muscular imbalances leaving them susceptible to possible injuries, or with goals that are unattainable through their choice in sport. As a trainer, I have had plenty of athletes who appear to be in great shape, but after checking their hip or core strength, I came to realize their weaknesses in these areas are more prominent than to accept them as a true force in their sport. An example of this is for any person who sticks to one type of motion as their only form of exercise, i.e. running- typical imbalances & weaknesses may occur within the core musculature, hip abductors, adductors, arms, back, etc., because the sport primarily relies on use of the muscles that move your body forward (quads, hamstrings, gluteal muscles, etc.). To offset these imbalances, it would be best for the runner to incorporate some some form of resistance training that focuses on the mentioned weaker areas to help avoid injury. In addition, strengthening the non-dominant parts of your body will help improve your endurance and provide you with another opportunity to enrich your training.

So Long Everybody!

This will be my last post on the Hayashida blog and I just want to say how much fun I have had working here over the last two years. The entire staff at this clinic is composed of truly genuine, caring and just plain cool people that I am happy to say I got to work with! I hope everyone the best and will definitely keep in touch...maybe Katie will even allow me to write a guest post once in a while!

Peace out,

Tom, George, Ducky, The All American Blonde Boy or however else you may know me!

4 Ways to Ease Symptoms Associated with Sciatica

Sciatica describes a cluster of symptoms rather than a true diagnosis and involves irritation of the sciatic nerve and/or it’s branches as they exit the spine. These symptoms can include back and/or leg pain (usually just one leg), abnormal sensory symptoms such as numbness and tingling and weakness or difficulty controlling the affected leg. Most people do not present with all of these symptoms, but in severe cases all may be found.

As stated, sciatica is really a set of symptoms and can be caused by several insults including: disc herniations (bulges), spinal stenosis, piriformis syndrome or some external source usually related to postural habits. All of these causes involve some form of compression on either the spinal nerve roots or on the sciatic nerve itself and can eventually lead to irritation and pain. So, it makes sense that the goal of conservative therapy would be to alleviate this pressure and restore normal mechanics to the spine and pelvic region in order to prevent the condition from returning. In cases where severe spinal stenosis or a large disc herniation is present, physical therapy may not be effective and surgery may be the only option.

The following techniques can be used to alleviate sciatica and should not cause increased symptoms. If increased pain, numbness or weakness is experienced, then a medical professional (orthopedic physical therapist or orthopedic medical doctor) should be consulted.

#1 - Lumbar Prone Press-up
The lumbar press-up stretches the spine into extension and is often useful in reducing pain associated with disc pathology. However, extension of the spine may make symptoms associated with stenosis worse, so be sure symptoms are not increased while in this position. Perform as needed to alleviate symptoms and hold 15-45 seconds.

#2 - Lumbar Flexion Stretch
This stretch will round the low back, which will reduce pressure over nerve roots associated with spinal stenosis. Perform as often as needed and hold 15-45 seconds.

#3 - Piriformis Stretch
This stretch helps to loosen the piriformis muscle which is a rotator of the hip and located under the gluteal (buttock) muscles. The sciatic nerve runs directly under this muscle, so when it is tight extra compression can be caused over the nerve. Hold the stretch 30 seconds to 1 minute. Start with the stretch on your back and move to the stomach down version if the first one is too easy. Both pictures show a stretch of the left piriformis and should be felt in the buttock region.

#4 - Piriformis Self Massage
Using a foam roller or tennis ball as shown in the picture can be a great tool for easing piriformis tightness and reducing pain. The right piriformis is being worked in the picture. Spend 2-3 minutes on the roller as needed to alleviate symptoms.

5 Strategies to Rid Yourself of Tennis Elbow

Tennis elbow or lateral epicondylitis, as it is known in the medical world, involves irritation of the common extensor tendon at the lateral epicondyle of the elbow. That sounded a little technical. To put things plainly, the lateral epicondyle is a bony knob on the outside of the elbow where the tendon of the muscles that extend the wrist attaches. With overuse this tendinous attachment can become inflamed resulting in pain.

Due to the fact that tennis elbow is often an overuse type of condition, rest is usually indicated to fully recover and return to 100% of normal function. Besides rest, these 5 tips will get you on the road to recovery.

Strategy #1 - Ice cup massage
If you are currently experiencing symptoms of tennis elbow, a very inexpensive home treatment involves filling a dixie cup with water and placing it in the freezer. After the water has frozen, remove the cup, peel back the top until the ice is exposed and then slowly rub the ice over the lateral epicondyle. The recommended time is 5-7 minutes, no longer.

Strategy #2 - Transverse friction massage
Another home treatment involves finding the most tender spot along the tendinous attachment at the lateral epicondyle and rubbing back forth in a perpendicular direction with a moderate amount of pressure. After several minutes, the area should begin to feel less pain or even a numb sensation. If more pain is provoked then lessen your pressure. Limit the treatment to no more than 5 minutes and ice afterwards.

Strategy #3 - Stretch the wrist extensors
Because the wrist extensors and their common tendon are involved in this condition, stretching such tissue is important. Follow the picture and hold for 30 seconds. Repeat 2 times.

Strategy #4 - Strengthen the wrist extensors
Tennis elbow occurs when the wrist extensors cannot meet the demand being placed on them. So, increasing strength is vital to preventing this condition from returning. Pain should not occur with the strengthening exercise pictured below. If pain does occur lessen the weight being used or you may have to postpone strengthening a week or two until inflammation has reduced.

Strategy #5 - Use a tennis elbow brace
Another option to reduce irritation at the lateral epicondyle is to use a tennis elbow brace or band. These bands are worn just below the lateral epicondyle and work by reducing the amount of stress that is transmitted to the tendinous attachment at the lateral epicondyle.

Controlled Instability & Balance

Balance is a key mechanism to help any individual perform better and live more safely, as well as functionally keep your mind & body synchronized for daily living. In addition, it is one of the easiest parts of the neuromuscular system to train! Improvement for balance exercises has also been suggested as being one of the fastest mechanisms to adapt within a training program.

Unfortunately, balance is also one of the most underrated mechanisms in any individual's training program, which in-turn makes the person more susceptible to joint dysfunction and injury. Without the sensory skills and feedback to maintain proper alignment of the body throughout different planes of motion, the joint's connecting muscles may become tight and overactive, or weakened and underactive, which may lead to even more imbalances elsewhere in the body. Scroll down below for Tom's post The Hip Bone is Connected to the Knee Bone below for more information on such relationships, or what one of my favorite professors from UCSB referred to as "Interconnected-ness".

When starting a balance training program, please remember to always perform the exercises in a training environment that is as unstable as can safely be controlled, also know as controlled instability. If needed, practice near stationary objects of proper height, i.e. facing a countertop for quick hand support, or in an area free of smaller objects that may be easily tripped on. Many products are available to assist with balance programs, such as half foam rolls, Airex Pads, and Dyna Discs, and can mostly be found at Big 5 Sporting Goods stores, or online. Others may find it's easier just try and progress to balancing on couch cushions placed on the floor. Whatever you decide, try something like this to start off with, before moving onto a more challenging surfaces:

1. Single Leg Balance - 10 repetitions for 10 second holds each repetition

If able to successfully complete, move onto this:
2. Single Leg Balance - with free leg reaching forwards, then reaching to the side, then reaching backwards- one "round" without needing to touch the ground - 5 repetitions of 5 rounds

If able to successfully complete, move onto this:
3. Single Leg Balance - with arms moving from pointing to the ground, to pointing to the ceiling, like a slow-motion jumping jack without the jump. If able to complete this, grab some small free-weights (or soup cans) and attempt the same motion. 3 repetitions of 10 "jacks"

Proper cues for all stationary balance exercises:

• Do not lock your knee straight- always keep the knee slightly un-hinged as to not restrict blood flow


• When balancing, draw your navel in and activate your gluteal muscles- this will help!


• Chose a spot on the ground 5 or 6 feet in front of you to stare at when balancing, not the mirror or any moving objects


• When performing balance exercises, make sure the knee of the balance leg stays in lines with your toes- any pressure of the knee moving either way beyond the line of your toes may stress your knee


• Keep your hips and shoulders level, to maintain optimal lumbo-pelvic-hip complex balance


• Try and keep the arch of the balance foot up! Don't let the foot collapse flat to the surface. Try this by curling your big toe down, and then trying to raise the inside arch of your foot


• Always be progressive. Trying doing the above routine first as is, then progress to slightly more-challenging surfaces.

If you are unable to perform these tasks, just keep trying! That's the beauty of balance training- unless you know of predetermined conditions or are taking medications that will prevent you from completing these tasks, you will be able to adapt and improve your balance.

5 Tips to Avoid Travel Associated Aches & Pains

It’s summer time again and that means people are heading off on vacation to catch up on a little rest and relaxation. One would think that a week or two of relaxing would be the perfect prescription for nagging low back or neck pain, but in many cases the opposite may be true. Most trips include sitting for extended hours in a car or plane to reach a particular destination, increased stress at the beginning and end of the trip, eating junk food, drinking alcohol and most likely exercising less. All of these factors can lead to increased aches and pains and make your trip that much less pleasurable.

In order to reduce the effects on your system associated with travel, implement these tips and you will hopefully feel like a million bucks by the time you return home.

Tip #1 - Move Regularly

Whether traveling by car, plane, train or some other method of transportation, prolonged sitting is usually involved. Extended periods of sitting often results in tightness through the spinal, pelvic and lower extremity musculature and may ultimately bring on a pain response. Ideally, a person should plan on getting up at least once every hour and spending approximately 5 minutes walking and stretching.

Tip #2 - Stretch Muscles Prone to Tightness

1: Neck half-circles - roll the head from one shoulder across the chest to the other shoulder to maintain the flexibility of the neck musculature

2: Seated lumbar stretch - reach your right hand to your left knee and twist your spine to look as far behind you as possible. hold 10-20 seconds and repeat on the other side.

3: Standing hip flexor/calf stretch - stand in a lunge stance with one leg forward and the other behind you. Keeping your spine straight lunge forward until you feel a stretch at the front of the thigh and in the calf of the leg that is behind you. Hold for 10-30 seconds and repeat on the other side.

4: Standing hamstring stretch - with your knee locked out, bend forward toward your toes until you feel a stretch at the back of the thigh. Hold 10-30 seconds.

Tip #3 - Pack a back or neck support and use heat and ice packs

Using a portable lumbar or neck (cervical) support on long plane or car rides will provide stability to the spine’s natural curves and help reduce pain. Also, filling a small bag with ice or packing portable heat packs that warm upon opening can be great tools for reducing pain.

Tip #4: Pack light and lift with proper body mechanics

Heavy luggage is often a recipe for low back pain, so only take those necessary items. Once your suitcase is packed with only the essentials, make sure to lift slowly and in such a way that allows you to keep your back straight and requires that your legs do the work. On plane rides, don’t be shy to ask someone for help when loading into the overhead compartment. Lifting 45 pounds above shoulder level puts a great deal of stress on the low back, shoulder and shoulder blade/neck musculature and can cause an instant muscle strain if not performed in a controlled manner.

Tip #5 - Drink plenty of water and avoid alcoholic beverages

It’s definitely okay to consume alcohol, but make sure you follow up with plenty of water. Alcohol is known to inhibit anti-diuretic hormone, which leads to increased urination and dehydration. Our muscles, tendons, cartilage and most other structures depend on water for normal flexibility, so being dehydrated can contribute to increased stiffness and pain.

National Academy of Sports Medicine & The OPT Model

The National Academy of Sports Medicine was first introduced in 1987, and today is one of the top authorities in promoting tools and research for health, fitness, sports performance, and sports medicine. The Academy has helped thousands in their journey to become better athletes and healthier individuals. NASM is also one of the few organizations that will focus on Corrective Exercise Prescription, which focuses on the prevention and re-introduction of past injuries. It is for these reasons that I recommend NASM’s Optimum Performance Training Model, also known as the OPT Model, to any patient after completing physical therapy treatment.

The OPT Model
PHASE 5 Power Training
PHASE 4 Maximal Strength
PHASE 3 Hypertrophy
PHASE 2 Strength Endurance
PHASE 1 Stabilization Endurance

Each phase of the OPT Model contains particular exercises and set/rep schemes that are designed to progress you to the next level of performance. Phase 1 – Stabilization Endurance can often be the first priority when embarking on new fitness goals. Enhancing joint stability, increasing flexibility, improving reaction time, and enhancing control of posture are all to be focused on at this time. Once stabilization of the joint(s) is achieved and the individual can maintain stability, they may begin working on Phase 2 – Strength Endurance. This phase is designed to further improve stabilization, increase strength, improve work endurance and increase lean body tissue. It requires active flexibility and may be accompanied with moderate resistance exercise. The principles of these two phases are the groundwork to any individual’s health and wellness. We would all have a lot less low back pain, headaches, hypertension, and injuries if we focused on stabilization and strength endurance!

Phase 3 – Hypertrophy Training, along with phases 4 and 5, is where personal trainers can bring you closer to your new goals, avoiding the fearful thoughts of re-injury in a safe and controlled environment. This phase, along with Phase 4 – Maximal Strength Training, will help you achieve quicker reaction speeds, increase strength, and improve peak force and muscle use. As trainers, we consider these to be the most important part of post rehabilitation, because the stronger you get, the less likely you are to become reinjured!

Phase 5 – Power Training should be the goal for any healthy individual, as this phase can help not just with your daily lifestyle, but it improves your athletic performance. Phase 5’s purpose is to enhance neuromuscular efficiency, improve prime muscle strength, increase the rate of force power, and enhance speed strength.

Most athletes will cycle through each phase periodically so that the body is consistently adapting to an ever-changing environment, avoiding training plateaus. Whether you’re a weekend warrior training for a 10k run, or a competitive athlete looking for your next edge up on the competition, training the entire spectrum of the OPT Model will benefit your health and wellness, as well as prevent re-injury.

For more information on The National Academy of Sports Medicine, visit http://www.nasm.org/ or contact Zack Bertges at Zack@hayashidapt.com

Robotic Knee Orthosis Being Tested

Tibion Bionic Technologies has developed an electric knee orthosis that may be used to help patients suffering from a variety of conditions including neurologic disorders, surgery, generalized weakness and osteoarthritis. The orthosis has the ability to detect the user’s actions and assist them as needed whether that be with walking, getting up from a chair or going up and down stairs just to name a few options.

To read further check out the full article from MedGadget

The Hip Bone is Connected to the Knee Bone!

Have you ever experienced pain at the front of your knee when squatting or with prolonged sitting?

This type of pain can be due to various causes, one of which includes patellofemoral joint syndrome. The patellofemoral joint is formed by the articulation between the knee cap (patella) and the femur (large bone of the upper thigh) and relies on precise tracking of these two surfaces to function correctly (see image below). If the patella does not track correctly within the femoral groove then excessive wear and tear of the cartilage supporting this joint can result leading to inflammation and pain.



Because the knee joint is a hinge joint, meaning it only moves forward and backward (extension & flexion), it is highly dependent on control at the hip and ankle joints, which have more motion available. Numerous studies over the last several years have shown that strengthening and improved coordination at the hip and ankle can lead to improved knee mechanics, decreased patellofemoral joint symptoms and preservation of the underlying cartilage.

Try these exercise to strengthen your lateral hip musculature and you’re knee will thank you.


Exercise #1: side plank




Exercise 2: fire hydrant




Exercise #3: hip abduction

Who's the Musculoskeletal Expert...Your Physician or Your Physical Therapist?

I hope the answer to this question does not surprise you, but your physical therapist is the correct choice!

A study published in the BioMed Central Journal of Musculoskeletal Disorders tested physical therapists and physical therapy students and compared their results with that of physicians from a variety of specialties and medical residents on their knowledge of musculoskeletal medicine. The study showed that licensed physical therapists and physical therapy students in their last year of school scored higher than medical residents and all physician specialties except orthopaedic surgeons (see graph below).




With these results in mind, I ask that you support direct access legislation to physical therapy services in your state. Many states have passed direct access laws, which means the consumer can go directly to a physical therapist for musculoskeletal problems without having to spend extra time and money by having to see their physician first. However, some states have not passed direct access or have some limited version at this time.

For more information on direct access and to see what is going on in your state, please check out this link from the American Physical Therapy Association. At the bottom of the page is a link to a document showing current direct access laws in each state.

Sprain or Strain...What's the Difference?

Many of us have suffered an injury and been diagnosed as having either a sprain or strain. I often hear patients and individuals outside of physical therapy using these two terms interchangeably when really they refer to two very different injuries that affect two very different tissue types.

Sprains are injuries that affect ligaments, which are the passive stabilizers of our joints and cross from one bone to another bone. They usually occur when a given joint is taumatically pushed beyond it’s normal range of motion and will often result in a “pop” type sound. Sprains can be graded into three groupings (grade 1, 2 & 3) based on the pain and the amount of laxity found in a given joint upon clinical inspection.

Grade 1: pain and no joint laxity
Grade 2: pain and some joint laxity
Grade 3: no pain and complete ligament tear (very lax)

The diagram below shows a grade III ligament injury



Strains refer to injuries of the musculotendinous unit, which includes a muscle and the tendon that secures it to the bone.

The diagram shows the calf muscles (gastrocnemius & soleus) and the achilles tendon, which attaches these two muscles to the calcaneus bone of the foot.




Strains occur when the length or strength of a given musculotendinous unit is exceeded. Basically, if a muscle is stretched beyond it’s normal length or asked to support a load that it is not strong enough to support. When either of these things occur, small microtears will occur within the muscle leading to soreness. In severe cases the tendon can actually be torn away from the bone, which is termed an avulsion.

Hopefully this clears up the difference!

The Low Down on Stretching

When and how much to stretch is always a question that comes up in physical therapy. I will usually encourage my patients to perform a dynamic warm-up prior to their regular exercise of choice and then perform static stretches after exercising.

For those who are not familiar with these terms, a dynamic warm-up basically means you spend 10-15 minutes going through the motions of the exercise you are intending to complete, but at maybe 25-75% in order to make sure your tissue is warm. Static stretching, on the other hand, is what most of us think of as stretching and includes holding a particular stretch position for 30 seconds to 2 minutes.

A recent article from the Running Doc gives a good summary of current stretching recommendations that can be useful not only for runners, but for the rest of us as well.

Physical Therapy or Chiropractic

This question comes up very frequently and if you have ever experienced musculoskeletal pain you have probably considered both options. In general, the research of current times has shown that manual therapy, which includes any type of “hands-on” technique provided by a physical therapist or a chiropractor, can be beneficial for many conditions. Manual therapy, however, has its limitations and must be accompanied by an individually tailored exercise program in order for progress to be maintained and to prevent symptoms from reoccurring. Numerous studies have shown that if an exercise program addressing movement dysfunction is not implemented the patient will often come to rely on the practitioner for continuous treatment and never fully achieve complete symptom resolution.

It has been my observation that physical therapy practices tend to implement manual therapy and exercise together more often, whereas, many chiropractic offices rely mainly on manual therapy. In a situation in which exercise is not used, the patient will many times need to continually receive treatment in order to be symptom free. By no means does this observation apply to all practices, but I would definitely encourage anyone in pain to seek out a practitioner that communicates openly and implements both manual therapy and exercise interventions together.

I hope this helps!

Check Your Posture to Decrease Pain

I know we have all heard it a million times or more, but I would really like to reiterate how crucial correct posture is for optimal musculoskeletal health. This is even more important in jobs that require a great deal of time spent in static positions such as sitting. I would say that approximately 50% of the patients I see on a daily basis are having pain related to prolonged sitting while working at their computers! The question I always get is "I've been doing this job for a long time, so why would I have pain now?" My answer always relates to the "smart line" phenomenon, which basically states that each of us as unique individuals has a unique perception of how much and what kind of stimulus can be tolerated before the nervous system tells us that pain is occurring. For one person, sitting in a dysfunctional position for 4 hours my cause pain, whereas, another individual may be able to tolerate the same position for years before experiencing pain. Either way, most people will experience pain at some point and all will suffer from increased levels of tissue degeneration as compared to their more ergonomically correct counterparts if behavioral adjustments are not implemented.

Use this diagram as a guide to making your workstation more ergonomically friendly, which will reduce dysfunction and the pain that often follows.

How to Prevent Ankle Sprains

Nearly 25,000 people in the U.S. suffer an ankle sprain everyday and up to 70% of these individuals will go on to have recurrent sprains and other chronic symptoms. Recurrent ankle sprains can lead to joint laxity, weakness, diminished balance and impaired performance overall. A recent study published in the Journal of Orthopedic and Sports Physical Therapy identified four exercises that were proven to improve balance and performance and decrease one's risk for future ankle sprains. The exercises involve securing elastic band to one ankle and balancing on the injured leg while performing the four movements pictured below.

So, try these exercises to keep your ankles healthy and improve performance.








Reference:
Han K, Ricard M, Fellingham G. Effect of a 4-Week Exercise Program on Balance Using Elastic Tubing as a Perturbation Force for Individuals with a History of Ankle Sprains. J Orthop Sports Phys Ther. 2009;39:246-255.