The Struggles of Being a Small Physical Therapist

No, this isn’t Elite Daily or Buzzfeed. I’m not going to tell you the 37 reasons why being a physical therapist is “THE BEST” while using completely opinionated rationales.

This blog post, however, is based off of my opinion as well as from my not-very-extensive-but-still-valid experience of how being a smaller person has affected how I treat patients, how I treat colleagues, and how I have overcome others’ opinions of what smaller people CAN do in this field. Just FYI – I’m a 5’2″ petite girl.

To get you in the right mindset and to help you understand where I’m coming from (especially if you’re a normal sized human being)… Let me first give you a few quotes that have stuck in my head and/or are repeated on a constant basis from either patients, patients’ visitors, nursing staff, and/or other health professionals:
1) “You can’t lift me, you’re the size of my thigh.”
2) “I don’t trust you to lift me with those spindly arms.”
3) “You didn’t bring anyone else to help you?”
4) **calls over family member/any male nearby and says to them, “come help this little girl”**
5) “Oh, well my children are much bigger than you so even if you can’t lift me, they will be able to. It will be different then.”
6) “YOU are going to help me stand up?”
7) “There’s no way you could catch me if I fall, I’d take you down too.”

LennyLarry

I think you get the idea..

So, we could go on a rant here about how “it’s so much better to be a small person than a bigger person in life” or “you don’t know how great it is to be tiny” yada yada yada. That would be another topic which I will not get into because frankly, every body type and size has their pros and cons. FACT. If you need more validation, I’m sure you can find a Buzzfeed article about whatever it is you need validation for. Again, I will not go further into that because I hope you all have an open mind and can appreciate what everyone, big, small, fat, skinny, etc. goes through.

As I am still a recent new grad of this year (May 2015), I realize I do not have a ton of experience. I do, however, hear quotes such as the above at least once a day. I’m not going to lie, it has been discouraging sometimes, but it is very important you don’t get personally offended in this job (as we may all know).

Welcome to Reuseit: Reusable Bags, Lunch Boxes, Water Bottles & More for Your Green Home

Let’s take it back.. As a young lass, a few years ago, entering PT school, I realized I was one of the smallest people in my class, as I have been my entire life. I didn’t realize how this would affect how I treat people when I first entered, until labs began. Instead of being able to muscle my manual muscle tests or physically lift someone with my arms, I realized quickly I had to master my own body mechanics in order to get the proper leverage needed to lift my patient/classmate’s leg to do an SLR or transfer them dependently from the mattress to the chair, etc. Here are some things I did in school/clinicals to help me adjust:

1) I worked with a variety of classmates (as I hope they would make you do in school to test different body types/sizes). A lot of the time I worked with males. Although I would generally end sweating, it was great practice for me to work with much larger legs/bodies in labs so that when it came time to see an actual patient with a larger mass, I would feel more comfortable. Would it have been easier to always be partners with other small people in my class? I’m sure it would. But, working with people bigger than me helped me to immediately figure out when I would need to use a stool (for example for mobilizations) or when I needed to stand up vs. sit down vs. kneel to get the proper angle and position my body so that I could utilize body weight.

2) Practice with high-low tables as well as without. Unfortunately, you may not always have an open high-low table pending where you work. In these times, you need to adjust and you need to be flexible, quick, and make sure you are effective with your treatment. There were times in school I would stand on two stools right next to each other because I was so short and needed to use my entire body weight to assist me.

3) If it hurts your back, STOP. Don’t lean over people, raise yourself up. Kneel down on the ground (I do this all the time now) instead of bending over. SQUAT SQUAT SQUAT also. Raise or lower the bed if you’re in an acute setting. If you are practicing something and you feel your back or neck or any sort of strain on any part of your body, STOP. Take a breath and take a step back. Look at what you are dealing with and re-adjust the environment. Remember you need to keep yourself safe in this profession as well, as we use our bodies A LOT to treat our patients.

4) Stop trying to muscle things, because most likely, pending the patient population you work with, you are going to end up hurting yourself. From my thoughts, the less I use my muscles and the more I use my body weight, the better off I am at preventing overuse injuries to myself. Because as much as I try to preach to my patients that they have muscular imbalances in their shoulders putting them at an increased risk for rotator cuff tear vs shoulder instability.. Am I really, honestly, out there making sure I don’t have any imbalances? I try, sure. But I know I am still predisposed if I overuse my deltoids, pecs, latts, etc etc. I’m not doing therapy for myself everyday… Make sense? So just take this risk away (or decrease it)!

//rcm-na.amazon-adsystem.com/e/cm?o=1&p=13&l=ez&f=ifr&linkID=5080e3e47d12afe5168a82efbbefa577&t=jenniferpalme-20&tracking_id=jenniferpalme-20

Now, to put these learned techniques into practice, I do a lot of the following:

  1. EDUCATION: Yes, I am small, thank you Mr. ___ for acknowledging that. Yes, you weigh 3x what I weigh, I get it. BUT GUESS WHAT? I am trained in this, I went to school for this, I came out with my DPT because I am competent in this area. I ALWAYS make it a point to educate to the patients and families what it is I do, what I plan on doing, why I am doing it, and how it will benefit them and help them progress towards their goals. Although I am sure they are still hesitant, it really helps to talk patients through what is going to happen so they have somewhat of an idea what is about to happen. Plus, then they know you know what you’re doing..
  2. Build CONFIDENCE: Be confident in your ability, SHOW the patient that you can do whatever task it is so they become confident in you, SHOW the nursing staff that you are capable of doing a transfer alone so that they build confidence in you. It’s all about confidence, people. When a patient sits up, stands up, does any sort of movement for the first time, I immediately start building confidence in them. Many times, patients feel that they are unable to do something because they have back pain or they just had surgery, etc. I acknowledge, “Hey, you did that and you didn’t even need my help, GREAT JOB!” Because that is generally the goal, to get them to become independent once again. Many patients are fearful and can become very afraid their first few times doing any sort of new activity that may cause pain. When they do it, though, and we acknowledge it, it is a whole new game and they (generally) end up being proud of themselves, more confident in themselves, and more willing to work with you in the future. In addition, showing the nursing staff (in the acute setting) that you are capable of certain transfers gives them confidence that you can assist patients and can work with different patients of different functional levels.
  3. DON’T TRY TO BE A SUPERHERO: If you can’t help someone and you feel one person isn’t a safe option to treat, call for help. Use a rehab tech or do a co-treat. Once again, this is for the patient’s safety as well as for yours. Don’t risk yourself trying to be the *one and only* – use help.

As I initially began hearing some of these comments from patients, I did become discouraged (a few years ag0). I even started doing more weightlifting because I wanted my patients to trust me that I could lift them. Of course, I enjoy working out and this was probably eventually going to happen, but this “small-PT-syndrome” was very much a trigger for me to build up a little more muscle. Of course, that is not for everyone. The best recommendation I can give is to not get discouraged. You have your cranky patients and you have your sweethearts, that is life. Be confident in yourself and the patient will feel confident in you. And if not, get help from someone else to show that you respect the patient’s views and want them to be safe.

Gaiam Restore Products Banner

I work in acute care currently, and I just had to share a side of really good news.. For the first time since I began PT school, last week a patient said, “You can’t lift me.” Her daughter then responded, “You can’t be deceived by her size, mom, she is trained to do this.” 🙂 #PTWIN. Obviously, that made my day. After treating this patient 2x/day for a week, the daughter and patient both told me, “You’re the only one I trust to help her move.” That was huge for me and helped me, as a new grad, build even more confidence in myself.

Again, I am very aware that I have limited experience compared to most people (besides my new grad friends), but I feel this is a topic that I have dealt with and had to manage from the beginning. If you are on the smaller size, I hope this helps you to become more confident in yourself as a “small PT” and helps you to not get discouraged, because there are plenty of us out here and we are very much capable of treating our patients effectively, too. WE GOT THIS!! 🙂

Jennifer Strack PT, DPT

Manduka Spring '17 Yoga Mats

Dynamic Stretching: Part 3 – Your right to stretch arms

Long time, no post! So here is the final part to my dynamic stretching trilogy – stretching out and warming up your arms! I feel like arms can be overlooked pre-workout. It seems like people always just stretch out their quads and hamstrings (myself included) and then go! That being said, there also isn’t as much research into stretching your arms, as again, people tend to not focus on them as much. Here are just a few that target the main upper extremity muscle groups you will be working.

1) Inchworm push-ups: This is a double-whammy! Not only does it warm up your pecs, biceps, and triceps (as well as your shoulder), but you are also firing your core (or should be) and getting a hamstring stretch in with it! You can also do this post-ankle injury to help promote more dorsiflexion mobility. All you do is flex (bend) forward at the hips and reach your hands to the ground. If you cannot reach, bend knees slightly until you can touch the ground. SLOWLY walk hands out a few inches at a time (hence, INCHWORM) until you reach a push-up position. From here, complete the push-up, then “inch” your way back and stand up. (Also, sorry my push-ups are sub-par — currently not supposed to be doing any upper body work outs, oops).

2) Pec swing: This helps to target your pectoral muscle(s) flexibility and can be specifically performed before you bench press or perform a push-up test to help loosen up those muscles. Either flex trunk forward while sitting or do while standing. Horizontally abduct arms (bring them out to the side) to ~90, then horizontally adduct (bring them back in to your chest). *Progress with chest on exercise ball using both or one leg to balance. This progression will help to engage your core. AND if you want to do this less as a warm-up and more as an exercise – try it with weights! Balancing on the exercise ball can get pretty interesting…

3) Tricep swing: This helps to focus on your triceps flexibility. Sit upright with elbow extended at 90 degrees of flexion. Raise arm to 180 degrees while fully flexing elbow. Return to beginning position. Make it harder by sitting on an exercise ball or standing on a bosu ball to help engage and warm up your core!

4) Shoulder rolls: This is just nice to loosen up your traps before you lift. Just remember with some lifts, you don’t want to pull that upper trap and compensate for the motion you are actually trying to accomplish (For example, shoulder flexion — don’t lean and shrug that shoulder if you can’t get the weight up! Respect your body and lower the weight until you get the proper form correct!)

PLEASE be mindful of your body when performing any upper body activity. It is so easy to get what is known as an “impingement” because of improperly balanced muscles in your shoulder region. If it hurts, stop and consult someone about it (preferably a physical therapist, but I am biased, but also honest).

Hope you all have a wonderful day! 🙂

-Jen

“The only thing that stands between you and your dream is the will to try and the belief that it is actually possible.”

How to Embarrass Your Friends (and Yourself) at the Airport

A few months ago I had the honor of traveling to Indianapolis from the east coast to present a poster with a few of my classmates on Tai Chi. Needless to say, I had not been in an airport in a long time (a few years at least). From what I saw, there was a decent amount of people moving around, but there was a lot more people sitting down and waiting for their next plane. Being who I am, I decided to investigate this tragedy by just doing a few exercises with the equipment available (aka a chair, some open space, a people mover, my luggage, and some human obstacles). Let’s be honest, if you’re about to be on a flight for a few hours, why do you want to be sitting for even longer!? Get up and get moving! Who cares if you end up sitting in the middle seat and you forgot to put on deodorant that day…

So here is what I did, with a few videos available for your convenience:

Cardio: There’s so much space to walk in an airport! If you are there super early or have a long layover – why not get your cardio in? Bring your luggage as an added bonus for some extra calories to burn!
If you have about 30 minutes to kill, try walking up and back down a hallway, alternating your luggage in your hand if you are pulling/carrying it with you. Try to walk at a pace that is a little faster than you would normally walk in order to bring up your heart rate appropriately.
Only have 10 minutes that you’re willing to spend? Perfect. Try some interval walking! You might look a little funny, but are you really going to see any of these people again? If you’re with your friends or family, they will still love you after… hopefully. Try walking at a very quick pace for about 60 seconds, then at a normal pace for about 75 seconds. Then repeat! (This type of interval training actually has been shown to improve your oxidative capacity of your muscles, your overall athletic performance, and your VO2 max – all while devoting less time than you would have to for a longer duration, endurance-style training. (1) There is still much research to be done in this area, but it looks promising!!)

Lol? Sorry, couldn’t help myself…

Lower Body: There are SO many things you can do here – but I think the better question is what are YOU willing to do in public? 😉 For me, I like to embarrass my friends and they know that. I also don’t get embarrassed too easily, so it all works out. Depending on what you are trying to accomplish (strengthening vs endurance) will depend on what luggage you have/want to work out with vs if you just do this without resistance. I kind of mixed it up, so feel free to go until it burns, and then at least another set! Generally for this, I tried to do at least 30 reps of everything (3×10) to promote more muscular endurance, pending time.

Step-ups/Heel taps – so I found this open set of chairs, which were a little squishy, but that’s okay! Since it was a little unstable, it required my muscles to work harder to stabilize my legs as I performed each activity. Just think about the difference of doing squats on a stable surface vs unstable (bosu, foam/airex, squishy pillow) – it changes everything!

The heel taps really help to work your thighs and hips. Try to make sure you’re doing this slowly with control for the best benefits.

Arms – So I just did basic things like some tricep dips on the chair as well as push-ups off the chair. Feel free to mix it up however you’d like, of course! Your legs need a little rest ya know!?

Upper body dynamic stretching will be my next post 🙂
Have a great day!

-Jen

1) Little et al: “A practical model of low-volume high-intensity
interval training induces mitochondrial biogenesis in human
skeletal muscle: potential mechanisms”, 2010.

Dynamic Stretching Part 2: For your luscious sore legs

As stated before, here are a few dynamic stretches and the demonstration for them. I will start off mainly with the lower body and the next post will be more with the upper body.

As I discussed previously, the dynamic warm up should be task specific. For example, if you are warming up for your swing in baseball, you may not be as concerned with your running mechanics and loosening up your lower body muscles as much as you would your upper body and core. On the other hand, if you’re about to run some amount of distance, you should probably focus on warming up your legs a little more (although arms are important in running, too).

Here is the video combining all of the stretches listed below. Don’t mind the non-matching-clothing-choice (hataz gon’ hate, hate, hate, hate, hate….):

1) Lunge, reach, and twist: Cross one leg across and lunge forward. Lean forward, stretching both arms out with a “reach” to the point where you feel a little unstable. Come back up and twist to the side of the leg that is forward.

What is this good for?: This can help to warm up your core, focus on balance and weightbearing on your front leg as well as stretching out your hip, knee, and ankle in the back leg. By keeping your core in nice and tight, you can also focus on proper neuromuscular firing of your abdominal muscles (which should always fire before you do any movements). This may be good to do to improve your any sort of hip flexibility issues, assist with decreasing low back pain, and help with any sort of knee strengthening issues as well as many other benefits!

2) Single leg deadlift walk into airplane: Maintain single leg stance on one leg, kick other fully extended leg back while simultaneously bending trunk and horizontally bringing arms out to side (like an airplane).

What is this good for?: This can help to stretch out your hamstrings as well as work on single leg balance and control while walking. Keep your core in nice and tight for this as well as it is required to help you maintain your balance and fire those muscles! This also can help to stretch out your pecs as well as working on firing your scapular stabilizers.

3) Single Leg Hop and Hold: Stand on one leg, reach down with opposite arm from stance side to touch ground (slow and controlled). Extend trunk to neutral while driving leg contralateral to stance leg into the air (flexed knee and hip to 90 each). Pause and hold, then repeat. *Add hop and focus on sticking the landing and holding for at least 2 seconds ONCE you have demonstrated proper hold with beginner level.

What is this good for?: Not only does this help to mimic your running man motion and provide a great stretch for your hips and knees, but it also helps to work on your single leg stance balance. Balance is always key to help appropriately fire muscles and promote neuromuscular recruitment that can assist in injury prevention. As you progress, this can really help with your landing (which should be soft!) for any sort of jumping/plyometric training you may be doing.

4) Knee to chest variations: Flex hip and knee up until you are able to hug knee against your chest. Continue alternating while walking. Progress by adding a twist to the side you flex instead of holding.

What is this good for?: This can help to stretch out those legs while also working on your core muscles! By tightening your core while you twist, you are working on more rotational core stability, which is essential and often overlooked.

5) Side Lunge Touching Heel: Place feet more than shoulder width apart so that you can lunge to one side by bending your knee, toes facing forward at all times. When you lunge, reach down with your hands for your heel. Alternate sides. (sorry mine is a little awkward, my legs were a little sore..oops)

What is this good for?: This helps with your single leg balance and strength, but is easy to offload if you just simply don’t lunge down as far (which is fine if you have knee pain like me). This really just helps to warm up and incorporate all of your leg muscles, focusing on your hips, some extra ankle motion, and a side to side motion (in the frontal plane) that may be overlooked. I mean, think about it, how often are you really walking sideways and doing things sideways in life!?

6) High knee to butt kick (I haven’t yet found/coined a fancy term for this): Combines your basic high knees and butt kicks to facilitate a motion that is more like the movements performed during running. Raise your knee up towards your chest as high as you can, lower it down to tap the floor, then kick your heel back to try to kick your butt. Take a step and repeat on the other leg.

What is this good for?: This definitely helps to warm up your quads, hamstrings, and hip flexors more than anything – with a little focus on core if you’d like, also. By performing a similar motion to what you would as you run, this is very task-specific and is perfect pre-run!

A few of these were taken from a program I used to help out with called “BodyArmor” at my college. If you are interested in seeing what they are all about, check it out here! –> http://godutchmen.com/sports/2011/10/6/bodyarmour.aspx

Thanks, everyone! Stay tuned for some upper body stretches next time!
-Jen

Who said shoveling had to be boring?

In honor of my first snow day this year, I decided that shoveling needed to be spiced up a little bit. Therefore, I decided to make this half-serious, half-kidding post. Shout out to my mom for not being super embarrassed and filming this short clip (you’re awesome!) I’m seriously wondering if my neighbors were watching and laughing out their windows. Or questioning if they should move sometime soon… Anyways, this is just a fun little snippet of some things you can do to have a little fun and get a little extra burn during your snow day shoveling extravaganza 😉 Yes, I was being a little goofy, but working out needs to be fun if we want to keep doing it, right!? 🙂

I know I barely shoveled any of that snow in the video, but that’s because we already shoveled it. Trust me, there is more to shovel now 😦

Then, you need to reward yourself..because you just shoveled your driveway and you are awesome. Just remember dancing is never frowned upon and can be an excellent cardio boost. Don’t hold back, get your groove on and burn some calories! 😉

Oh, and don’t forget that snowball fights are encouraged to help build up your arm strength and to help pay back your friends and siblings for all those embarrassing stories they’ve ever told about you.

In all seriousness, be careful in the snow, everyone! Don’t trip and fall, otherwise you might be going to see a physical therapist soon (and maybe you’ll meet me?) But really, you can get some very life-altering injuries from a slip! Drive safe and be careful!

Until next time..

-Jen

Dynamic Stretching: Part 1… “The Basics”

If you’re like me, you’ve been doing dynamic stretches practically forever. I grew up always performing “high-knees,” “butt kicks,” and “toy soldiers” before every practice and game. Of course, in college I actually had an idea of what I was doing, compared to when I was younger, but nobody ever told me why I was doing these. My coaches would just tell me to stretch and that it was good for me and I, as well as my teammates, accepted that. Lucky for me, I got into a profession where I can finally figure out why I am doing these sometimes-crazy-looking-stretches and how they are going to affect my performance. Let’s start off with the basics… but, beware, this is part of an in-service presentation I am giving, so it can get a little science-y.. (I left a “bottom line” portion at the end of each paragraph or so, if that helps)

What is dynamic stretching?

Dynamic stretching is a form of stretching that incorporates whole body movements in an active manner. Dynamic stretching does not involve bouncing movements that exceed comfortable ranges of motion. This type of stretching would be known as ballistic stretching and is not to be confused with dynamic stretching.1

What is the difference between dynamic and static stretching?

Static stretching is a prolonged, passive stretch that is generally held for a few seconds up to about 90 seconds. Static stretching is said to acutely depress the reflex activity of a muscle and increase muscle compliance. The increase in muscle compliance then increases the time to and decreases the force of a myofibril contraction during muscle performance. 1 In a comparison, dynamic stretching is said to help preserve this muscle-tendon unit stiffness in order to enhance muscle performance instead of stunt it. In a systematic review, static stretching of the upper body was shown to have neutral effects on power, whereas it was shown to negatively affect physiological outcomes (Ex: heart rate, vO2). 2 It is important to include static stretching in sports that require static flexibility; however, 90 seconds of static stretching has been shown to produce impairments on dynamic movements. 3

Bottom Line: Static stretching is okay to improve passive motion; however, it can impair activities that involve strength and power.

Why does it work? (#science)

One theory behind dynamic stretching is known as postactivation potentiation (PAP). PAP increases cross bridge cycling via an increase in myosin phosphorylation of the regulatory light chains. 3 In more basic terms, by performing similar muscle contractions, you are conditioning the muscle and its contractility so that it is more, in a sense, “ready” to perform more contractions. Essentially, you are progressively warming up the muscle so that it may contract more efficiently in the exercise that follows. 4 PAP is said to increase the rate and ability of a muscle to develop force; therefore, it influences and increases a muscle’s mechanical power. 4

Some other thoughts behind dynamic stretching include its ability to increase heart rate and increase core and muscle temperature. By doing so, the blood flow is increased throughout the body so that the body may move more efficiently during activity. 4 In addition, dynamic stretching is said to improve kinesthetic awareness and enhance motor unit excitability. 1

 Bottom Line: Dynamic stretching can enhance your performance in activities that follow by improving a muscle’s effectiveness and efficiency during muscle contractions. It helps get your muscles ready for the important stuff!!

How will this benefit me?

If you are performing any sort of active motion, you will want to initiate dynamic stretching instead of static stretching. While static stretching has been shown to improve static flexibility, most required functional tasks and/or exercises involve active movement, which requires dynamic stretching to improve.

Types of dynamic stretching are important to consider based on the tasks/activities performed after the warm up. 2, 4 The velocity and intensity of lower body dynamic stretching has been shown to impact and improve both vertical jump and long jump performance. 4 In a study by Chatzopoulos et al, dynamic stretching was shown to improve balance on a stability board whereas static stretching was shown to harm balance. This is attributed to the quick movements needed to maintain one’s balance.

It should be noted that if a person already has a way they like to warm up or some sort of stretching routine involving static stretching that they are not willing to change, static stretching deficits should not exceed 5% in comparison to no stretching. 6

 Bottom Line: When you move, you use your muscles differently than when you stand still. So why warm up by standing still? Get out there and MOVE to warm up! Also, just remember that some people are stubborn and won’t change their ways – they shouldn’t be negatively affected greatly by static stretching before exercise, but they will be affected (and YOU will be better than them, duh).

Does it affect the upper and lower body differently?

Currently in the literature, there are no articles to investigate the effects of dynamic stretching of the upper body and its impact on injury prevention. High-load dynamic stretching in the upper body (anything greater than 20% of maximum effort, ex: plyometrics) has been shown to improve strength and power with good evidence, flexibility, and delayed onset muscle soreness with moderate evidence . 2 In the upper body, there was also no benefit in performing low-load dynamic stretching (Ex: repetitively gripping a sponge) prior to exercise. Specifically for those who play baseball, dynamic task-specific warm-ups (swinging a bat) at the standard weight has been shown to improve swing speed more than using a heavier or lighter weighted bat. 2

One study of the upper body also demonstrated that a low-volume dynamic stretch of the pectoralis and triceps brachii muscles showed a decrease in the maximal isometic peak force during the bench press exercise. There was also no short-term effect on the time to maximal isometric force or the rate of force production following dynamic stretching. In the same study, there was a negative effect induced by static stretching when performing upper body tasks after. This must be taken with caution, again, as we do not know the proper load and duration to perform dynamic stretching. We must also consider that there are articles out there that say otherwise (that dynamic stretching improves performance). Additionally, the 2 dynamic stretches performed in this study may not have been appropriate in fully stretching or warming up the muscles in a dynamic, task-specific manner. 7

In regards to the lower body, a study by Curry et al. compared static vs. dynamic stretching in females in their mid-20s and its effect on lower body balance, force production, reaction time, and power output. In these females, who were recreational athletes, time to peak performance improved with both 10 minutes of dynamic stretching and a 5 minute bout of light cycling. These improvements were seen 5 minutes after stretching had occurred. 30 minutes after stretching had occurred, time to peak force began to increase with the basic cycling; however, it remained fairly steady in those who performed the dynamic stretching routine.

 Bottom Line: There is little to no research out there to show any evidence in dynamic stretching decreasing a risk of injury in the upper or lower body. While there is more research on the lower body, both the upper and lower body generally seem to have impairments of power and strength following static stretching while there are enhancements following dynamic stretching. Wade cautiously, though, some studies don’t have many subjects.. There definitely needs to be more research.

How long should I stretch?

For upper body dynamic stretching, there has been no research to determine proper load and duration that provides maximal effectiveness to improve strength and power. 2

In regards to lower body dynamic stretching, a study by Ryan et al. compared 3 groups who performed different warm-up activities: A-5 minute jog and 6 minutes of dynamic stretching, B-5 minute jog and 12 minutes of dynamic stretching, C-5 minute jog only. Those in group B who performed a longer duration of dynamic stretching showed a decrease in muscular endurance, attributed to a decrease in high-energy phosphates and a repeated high-intensity contraction to failure. Both groups A and B showed an increase in vertical jump height and velocity. Group C, who did not perform any dynamic stretching, had no effect on the vertical jump; however, did show an increase in flexibility. Overall, the most appropriate volume, as concluded by this study, indicates that 6 minutes of dynamic stretching after a 5 minute jog is adequate in stretching the hip and thigh musculature, improving vertical jump performance, and not affecting muscular endurance. To be noted, this study was performed with recreationally active men in their mid-20s.

 Bottom Line: Don’t stretch too little because you won’t see a great effect. Don’t stretch too long because then you’re going to have tired muscles. Simple as that. 6-10 minutes is most likely adequate; however, it will depend on how “in shape” or well-trained you are. The higher training you have, the more it will take before you fatigue.

But I’m not a young, 20 year old, competitive athlete?

This will still help you!! While most of the literature focuses on high-school aged to mid-20s recreational and competitive athletes, a study by Behm et al. recognizes the similarities and differences in dynamic stretching effects in regards to young and middle-aged men. The study mentions that dynamic stretching provides similar improvements to static flexibility as static stretching does. It also notes that static stretch-induced impairments and dynamic stretch-induced enhancements of the countermovement jump are not affected by the difference in age, meaning they respond similarly as the younger counterparts. The article also mentions previous literature that discusses that older, untrained women experienced a deficit in strength training following static stretching, similar to younger female athletes studied. While these demonstrate similar effects on middle-aged people, we must keep in mind the elderly and frail have not yet been studied in regards to effects of dynamic stretching.

Bottom Line: It doesn’t matter how young or old you are, dynamic stretching still works the same! Age is not an excuse!!

Is there anything I should be cautious about?

Caution should be taken when performing dynamic stretching prior to any activity that may have a higher risk of knee injury in regards to an improper hamstring:quadriceps ratio. 8 In a study by Costa et al, an overall decrease in hamstring:quadriceps ratio was seen, suggesting that the hamstrings may respond to this type of stretch differently than the quadriceps. The hamstrings provide a great deal of eccentric control in the last 3rd of the swing phase during running as well as assist the anterior cruciate ligament (that darn ACL everybody hears about..) in decreasing anterior tibial translation. As this study shows a decrease in peak torque of the hamstrings, caution must be taken in order to maintain a proper balance between muscles. While this is not a true contraindication and more of a precautionary measure, clinical judgment should be made before introducing dynamic stretching. As this is only one study, there should be further research to determine if there is a higher risk of injury in certain regions after performing dynamic stretches of particular muscles or if this study is merely an outlier.

Bottom Line: There is one study that says to be cautious performing dynamic stretching before activities that cause a higher risk of knee injury (basketball, soccer, etc.) HOWEVER, this is ONE study and to be conclusive to the larger population, there needs to be more standardization, subjects, and further research in general. Proceed with the same caution you would proceed with when performing any activity.. just use your noggin!!

So… now you know the basics. Stay tuned for some upcoming posts with different examples and what they are targeting, etc.

Have a great day! 🙂

-Jen

References

1Curry B, Chengkalath D, Crouch G, Romance M, Manns P. Acute effects of dynamic stretching, static stretching, and light aerobic activity on muscular performance in women.Journal Of Strength And Conditioning Research / National Strength & Conditioning Association [serial online]. September 2009;23(6):1811-1819. Available from: MEDLINE, Ipswich, MA.

2McCrary J, Ackermann B, Halaki M. A systematic review of the effects of upper body warm-up on performance and injury. British Journal Of Sports Medicine [serial online]. February 18, 2015;Available from: MEDLINE, Ipswich, MA.

3Samson M, Button D, Chaouachi A, Behm D. Effects of dynamic and static stretching within general and activity specific warm-up protocols. Journal Of Sports Science & Medicine [serial online]. June 1, 2012;11(2):279-285. Available from: MEDLINE, Ipswich, MA.

4Ryan E, Everett K, Fiddler R, et al. Acute effects of different volumes of dynamic stretching on vertical jump performance, flexibility and muscular endurance. Clinical Physiology And Functional Imaging [serial online]. November 2014;34(6):485-492. Available from: MEDLINE, Ipswich, MA.

5Chatzopoulos D, Galazoulas C, Patikas D, Kotzamanidis C. Acute effects of static and dynamic stretching on balance, agility, reaction time and movement time. Journal Of Sports Science & Medicine [serial online]. May 1, 2014;13(2):403-409. Available from: MEDLINE, Ipswich, MA.

6Behm D, Plewe S, Button D, et al. Relative static stretch-induced impairments and dynamic stretch-induced enhancements are similar in young and middle-aged men. Applied Physiology, Nutrition, And Metabolism = Physiologie Appliquée, Nutrition Et Métabolisme [serial online]. December 2011;36(6):790-797. Available from: MEDLINE, Ipswich, MA.

7Leone D, Pezarat P, Valamatos M, Fernandes O, Freitas S, Moraes A. Upper body force production after a low-volume static and dynamic stretching. European Journal Of Sport Science [serial online]. 2014;14(1):69-75. Available from: MEDLINE, Ipswich, MA.

8Costa P, Herda T, Herda A, Cramer J. Effects of dynamic stretching on strength, muscle imbalance, and muscle activation. Medicine And Science In Sports And Exercise [serial online]. March 2014;46(3):586-593. Available from: MEDLINE, Ipswich, MA.

Let me see you 1, 2 step

Hey everyone!! So.. I have been doing workouts on my steps for years (just ask my sister who I always woke up on Saturday mornings). There are TONS of things you can do on steps, but for this post, I will just focus on a few, specifically targeting the legs and hips. These are just easy things you can do without leaving home that still change up your workout a little bit 🙂 Also, sorry for the cat if you can see him… he is my shadow..

1) Heel Taps. These help to focus on the eccentric control of your quadriceps specifically, while also helping to encourage more ankle range of motion and gluteal stability to realign your pelvis to level as you come back up.

2) Single Leg Heel Raises. This will help to encourage more balance on your stance leg while focusing on your gastroc-soleus complex to assist with push-off during running, walking, etc. Try to not hold on if possible! Allow your heel to sink down past the height of the step and make sure to go slow and controlled as you sink down to focus on the eccentric contraction!!

3) Lunges. These are fairly simple and can be done forward, backwards, or to the side (as seen below). Go up and back down to focus on concentric and eccentric contractions of your quads, inner and outer thighs, and gluteal region. As you get better, feel free to go faster and change this to a more plyometric-style workout!

4) Stair squats. I’m not sure what these are actually called, but they are fun. Please disregard my form, I kind of hurt my ankle a little a few weeks ago so my ankle movement is super poor right now. Try to keep your heels down when you squat (not like me) and make sure you push your glutes back, trying to break at least 90 degrees to really emphasize better form. Try these slow at first so you don’t trip or fall (I have before.. not shown here, haha).

5) Monster Lunges. Again, not sure what to call these, but they look similar to monster walks so I think this is a good name. This will help to work on more of that side to side motion while still emphasizing all of the benefits and functional components of a lunge.

Not shown here: Running  up and down the steps forwards/backwards/sideways – try them all for a little cardio boost that is more entertaining than a plain old run at the gym. Plus, if you have pets that you are dodging, it’s an added bonus 😉

Have a great day everyone! I hope these are helpful and you can try them out soon! 🙂
-Jen

“Do something today that your future self will thank you for.”

Give me liberty or give me death! Or just give me food.

I’m sure you have all heard that exercise is not as effective without proper nutrition. I mean, think about it.. If you spend x amount of time working out and then get home only to find yourself eating a bunch of cookies, you are fighting a continuous battle against yourself! Recently I had a discussion with a few friends in regards to different smoothies, ways to use protein, recipes, etc. While this is not necessarily my “specialty,” I have a few recommendations based on the foods that I eat on a fairly regular basis for breakfast or a snack/dessert. These are just some quick and easy things that I do (because I’m usually on a time crunch) that are healthy and can be as packed with protein, or not, as you want! 🙂

Before I start this off, I just want to say that one of the most beneficial kitchen items I have ever bought is a personal Hamilton Beach blender. I use this thing ALL of the time! Obviously, you can pick any blender to make a smoothie in- but in case you want to see what I have, here is a link: http://www.hamiltonbeach.com/personal-blenders-single-serve-blender-with-travel-lid-black-51101b.html

20150122_085533
O
ption 1) Double Decker Protein Pancake Madness
There are 2 parts to this recipe. First, you have to make a few protein pancakes. Next, you have to build a beautiful (or not so beautiful) fortress of deliciousness. Here is the recipe I use for protein pancakes:

1/4 cup egg whites (equivalent to 1 large egg)
1/2 banana
Protein powder (any flavor depending on what you have!)
Cinnamon (optional, again depending on what protein you use)

Mix these 3 and then make it on the stove like a normal pancake! If you don’t have protein powder, you can easily substitute and just use 1 whole banana and 2 eggs to make the pancakes! There are literally SO many different ways you can make these – feel free to try throwing in oats, flax/chia seeds, other fruit inside the pancake – EXPERIMENT!! That’s what makes this fun 🙂

After making these protein pancakes, gather up a few of the following ingredients for part 2:
Plain greek yogurt, granola, flax/chia seeds, cinnamon, ANY fruit you like (blueberries, strawberries, more bananas, raspberries, etc).

Separate your protein pancakes, then layer them filling each layer with greek yogurt and whatever YOU want to add! I added bananas into each layer (pictured above). Then, once you put together your leaning tower of pancakes, top it with a little more greek yogurt, some granola, and more fruit. I also added flax and chia seeds because I like to add a little extra omega-3s to my life. Then, I sprinkled a little cinnamon on top to add a little flavor without adding any sugar.

Option 2) Don’t have anything to make protein pancakes? Or no time? Just make a yogurt parfait then, with all the ingredients from the second part of the above recipe! Just as great, slightly less protein-packed, but an awesome breakfast/snack nonetheless!! (See below – yum!)

20150115_083355

Option 3) Smoothies or smoothie bowls!

20150111_090405

Sweet vintage bowls, right? 😉 Above, I made a chocolate strawberry protein smoothie bowl. The ingredients I used are: chocolate protein powder, dark chocolate almond milk, a cup full of chopped strawberries, flax and chia seeds. Then, I put it in a bowl, cut up a few more strawberries and sprinkled some granola, and more flax and chia seeds into the mix. Super quick and easy! And if you don’t want to make the bowl, you definitely don’t have to!! You can just drink the strawberry-chocolate deliciousness by itself.

Like I said before, there are really no set recipes to these smoothies – have some fun and enjoy yourself! If you like the taste of something, throw it in there! Some items I throw in on a regular basis are:

Bananas – always gives a nice texture. Plus they are inexpensive (comparatively) and delicious!
Kale/Spinach – making a green smoothie always makes me feel a little better about myself.. just be careful and make sure it is completely blended up before you drink it!
Avocado- Just make sure it is not TOO ripe – because it then alters the flavor and can taste a little strange. I’d also recommend not using an avocado and a banana together because the smoothie may then become a little too thick for your drinking likes!
Oats – this tends to fill me up a little more when I have these in my smoothies.
Strawberries, blueberries – they are just always yummy and blueberries are packed with antioxidants, so why not?
Milk – whether it be almond milk (lower in fat), soy milk, or regular milk (higher in protein), I use milk as a base a good bit to help smooth everything out.
Coconut water – This helps to improve hydration even more than just regular water!

Just remember, when noting any recipe, you must realize that EVERY person is different based on the lifestyle you live, what activities you do, etc. Whereas a weightlifter or bodybuilder may be looking to have a high protein diet and at times disregard carbohydrates, a runner or endurance athlete may look to increase carbohydrates – especially the week before a race. It is also important to recognize how your body responds to various food types. Allowing at least 3-4 hours between a meal and a contest/race/competition may be necessary for those who experience any sort of anxiety or stomach aches, whereas a pre-workout meal 10 minutes before may be necessary for those who experience hunger during their workout – because hunger can be distracting!! Especially if you get hangry (so hungry, you get angry) like I do ;). Even with those who compete in all day tournaments, track meets, or other longer competitions, eating throughout may be necessary to keep energy levels high and maintain proper nutrition. (1) Make sure you listen to YOUR body and what it is telling you!

I will post more recipes that are easy to do as I make them! I have to admit it can be difficult to take pictures of the food, however, because I like to eat… and sometimes stopping to take a picture is just too long of a wait. 😉

Have a great day, everyone!! I hope you get a chance to experiment with some healthy foods soon. Maybe even try them tomorrow morning? 🙂 Look forward to more exercise moves next post!

1) Baechle, T. R., Earle, R. W., & National Strength & Conditioning Association (U.S.). (2008). Essentials of strength training and conditioning. Leeds: Human Kinetics.

“One cannot think well, love well, sleep well, if one has not dined well.” ―Virginia Woolf

All About That Bass

So we all know that Meghan Trainor is “all about that bass,” but did you know there are some great reasons to strengthen your booty than doing it just for the looks!?

The scoop behind your behind: You have probably heard of your gluteus maximus, but there are also quite a few more muscles that make up your “behind.” These include: gluteus medius, gluteus minimus, piriformis, superior gemellus, obturator internus, inferior gemellus, and quadratus femoris. I can be the first to tell you that the gluteus maximus is a huge part of this – I mean that guy is THICK (per a cadaver I cut up a few years ago…). Here’s a picture to show just exactly how complicated the gluteal region looks.

Gluteal Region

Pretty crazy and amazing, huh? So what can strengthening this gluteal region do for you?

nepal_bracelet_533a9b66-7251-48fe-bee7-9076f306e1bb_2048x2048

While there are many factors that may play into any sort of injury, it is well-known in the research that muscle fiber recruitment and strengthening in the glutes can help prevent injury to the hips, knees, and ankles (1). Many people tend to fire their hamstrings or low back in order to compensate for the improper firing of the gluteal muscles (and what they are built to do-hip extension, hip abduction, hip internal and external rotation); therefore causing a higher biomechanical risk for injury down the chain (somewhere lower in the leg) when performing many types of exercise. Pretend you are carrying a log with 2 other people and all of a sudden one person drops out, leaving only you and 1 other person left. Clearly, you are now able to carry the log, but you are stressing yourself more. This is what happens in the body! Some of these injuries that result from weakness at the hips include, but are certainly not limited to: patellofemoral pain syndrome (2), iliotibial band syndrome (3), patellar tendonitis, femoroacetabular impingement, ACL injuries…just to name a few. By focusing on this gluteal strengthening and proper neuromuscular recruitment, you can be well on your way to decreasing your risk of injury, keeping yourself fit and toned, and probably walking with a little more confidence 😉 Can you ask for anything better!? Maybe a fluffy kitten, but that’s a different subject…

Here are a few exercises that target your glutes and are KEY in strengthening your gluteus maximus and gluteus medius specifically. All of these can be done at home ON YOUR FLOOR without any need to go to the gym. AKA NO EXCUSES!! I even did them in my bedroom (don’t mind my closet) just to show you!

Single Leg Bridges.

This exercise can be done a few different ways; however, this is one variation. By keeping your leg out straight, the bent leg is required to perform hip extension, causing the gluteus maximus to fire. Additionally, you are gaining some rotational core stability since you should stay with your hips level at all times, fighting the urge to drop the leg that is sticking straight out!

Clams.

Since these can be kind of awkward, I definitely try to refrain from doing them at the gym. That being said, this is great at targeting your gluteus medius while inhibiting the TFL muscle (located on the front/side of the hip as well) and causing irritation to the IT band (which tends to then cause many problems). Try to go as high as you can and as slow as you can, keeping your belly button tucked in towards your spine at all times.

Donkey Kicks.

This simple pulsing exercise targets your gluteus maximus. By keeping the knee bent, you are making your hamstring muscle actively insufficient. What this means is that it is too short and already contracted, by the knee bending, that it is unable to assist in hip extension as much as it normally would. Taking out the hamstrings leaves us with all that leg weight resting on the gluteus maximus and making it work!

Fire Hydrants (with additional extension).

I prefer to do these with the hip extension as an added bonus (YAY). You are firing your gluteus medius as you abduct your hip out and up to the side, then firing your gluteus maximus as you kick back! Really make sure to focus on squeezing the glutes during this activity so that your hamstrings don’t take over.

Again, these are just a few of the MANY gluteal exercises out there. I plan to show and discuss a few more of the more advanced gluteal at-home-workouts in upcoming posts! And many other things, of course…

As always, if you feel you have sustained an injury or have any concerns, see a physical therapist near you to get properly evaluated so that you can return to your sport/activity safely!

Feel free to get in touch if you have any questions!
Have a wonderful day! 🙂

“Wow, I really regret that workout.” – said no one ever.

LennyLarry

(1) Powers, C. M. (2010). The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. journal of orthopaedic & sports physical therapy,40(2), 42-51.

(2) Souza, R. B., & Powers, C. M. (2009). Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. journal of orthopaedic & sports physical therapy, 39(1), 12-19.

(3) Fredericson, M., Cookingham, C. L., Chaudhari, A. M., Dowdell, B. C., Oestreicher, N., & Sahrmann, S. A. (2000). Hip abductor weakness in distance runners with iliotibial band syndrome. Clinical Journal of Sport Medicine, 10(3), 169-175.