Stability: Another Key to Pain-Free Function and Injury Prevention

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Just because we can, doesn’t mean we should! We may have the ability to lift the laundry basket and carry it up a flight of stairs or run ten miles, but without proper body mechanics and stability, injury can ensue.

Prevention and rehabilitation from injury involve addressing mobility, strength, and balance. We discussed mobility last week. Achieving proper mobility of the tissues doesn’t ensure safety. In fact, some people have too much mobility but can’t support the joints or get power from their muscles. This causes them to compensate elsewhere and/or fail to support the joints. This is when injury can occur.

Let’s use another rubber band analogy. Imagine shooting an older rubber band that is super stretched out, maybe even saggy or brittle. When we pull back on it, the band stretches only a bit. The rubber band has lost power and elasticity, and it will not fly very far. Its mobility is useless because it lacks integrity.

In our mobility article we discussed how people who sit for long periods of time at desk jobs, lose mobility in key muscles on the front of the body with sitting. The opposite is true for the muscles on the backside of the body, namely the glutes (bum muscles). If poor posture is involved, the muscles of the back and the front of the neck elongate as well. These muscles are like the rubber band: they become too long and weak. As a result, they do not provide adequate support (stability) during activities like walking with the dog, kicking the ball with the kids, and playing sports. This is when injury is possible.

Many activities that involve holding a position for a long time can cause muscle imbalance and reduced stability. For example:

  • Wearing high heels often or for an extended period of time. This creates a long term stretch for the muscles at the bottom of the foot and front of the hip. These lengthened muscles weaken when engaging in activities like walking the dog, running, climbing steps, and attending exercise classes. Injuries such as pain in the lower back or the bottom of the foot can surface.

  • Participating in triathlons, as mentioned in our mobility article. Being in aero position for 100 miles stretches the back muscles and glutes for hours. These lengthened muscles are needed to support the back, and for power with push off for the 26.2 mile run segment.

  • Patients recovering from abdominal surgery, such as a cesarean section. It takes time for abdominal muscles and tissues to heal from surgery. Gradual strengthening is required. These weakened muscles cannot support the spine adequately for activities of daily living, including bathing and lifting the baby, or even walking. Injury of the back and hips can occur.

One of the first things I assess when evaluating a patient is how they move. I look for faulty movement patterns that could cause injury or worsen a current injury. Poor mobility or lack of stability (or both) may contribute to the problem. I attack a lack of stability with progressively challenging dynamic and functional exercises within the patient’s tolerance. I like to use a combination of proven exercises, with exercises that I create and personalize to each unique patient and case. When pain is contributing to weakness, neurological dry needling can be helpful. Active Release Technique may also be used to treat injured joints and ligaments that result from lack of stability.

Faulty movement patterns can also be the result of poor proprioception and balance. Stay tuned for more on that in our next post!

About Physical Therapy. Physical Therapy addresses function in daily lives whether it’s our ability to unload the dishwasher, walk without a limp, or run an ultra marathon. Physical therapists work not only with injured patients but also preemptively with patients to prevent injury. This can prevent long periods of pain and time off of sports and work. Periodic PT visits focusing on prevention save time and money on the higher frequency therapy appointments required with chronic injury.

Mobility: A Key to Pain-Free Functional Movement and Injury Prevention

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Prevention and rehabilitation from injury involve addressing mobility before strength and balance. Mobility is a prerequisite to strength. When joints, muscles and nerves don’t move properly, we compensate elsewhere. This is when injury can occur. 

Imagine trying to shoot a rubber band across the room. If it’s as dense as a tire, it will not go anywhere. It doesn’t have the ability to stretch and load energy. Any strength it has is useless because the structure lacks mobility. 

Many people have desk jobs that require sitting for long periods of time. Key muscles shorten throughout the day, namely the muscles in the front of the hip and the back of the thighs. If poor posture is involved, the abs, chest and muscles of the back of the neck shorten as well. These restricted muscles are at risk for injury when they are engaged for other activities like gardening, playing catch with the kids, and playing sports. 

Many activities that involve holding a position for a long time can cause muscle imbalance. For example:

  • Biking in a triathlon. The athlete is in aero position for 100 miles and then moves to an erect posture to run a marathon. 

  • Texting. The front of the neck, elbow, forearm and thumb muscles are held in a shortened position for hours throughout the day. 

  • Carrying a heavy backpack on one arm. This creates long term shortening of muscles on one side of the spine and the hip on the opposite side.

  • Carrying a baby on the same hip for an extended period of time. As with carrying heavy backpacks, this causes muscles on one side of the spine and the hip on the opposite side to shorten long term.

One of the first things I assess when evaluating a patient is how they move. I look for faulty movement patterns that could cause injury or contribute to a current injury. Then I determine which structures are preventing that motion such as muscle, nerve, tendon, fascia, ligaments or all of the above. Then we set about restoring mobility. This may involve the use of deep tissue techniques such as Active Release Technique, neurological dry needling, and/or dynamic stretching, both passively and actively. 

Strength, balance and coordination also come into play once a healthy amount of mobility is restored. More on this in our next post!  

About Physical Therapy. Physical Therapy addresses function in daily lives whether it’s our ability to unload the dishwasher, walk without a limp, or run an ultra marathon. Physical therapists work not only with injured patients but also preemptively with patients to prevent injury. This can prevent long periods of pain and time off of sports and work. Periodic PT visits focusing on prevention save time and money on the higher frequency therapy appointments required with chronic injury. 

#igotmyfixcapt

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National Physical Month is finally here, and at CoachAmyPT we want to celebrate by thanking our clients. One of my favorite parts of the job is hearing stories of your progress and accomplishments. This month we want to hear how you’ve gone from pain or injury, to getting back into the swing of your active life. By sharing your story, you’ll be entered into our contest to win a Scheel’s gift card. We’ll choose and announce the winner at the end of the month.

Here’s how to share your story:

  1. Post a picture of you doing what you love on our Facebook or Instagram pages.

  2. Write a short description of where you came from, and where you are now.

    • For example: I went from knee surgery and crutches, to skiing at Lake Tahoe nine months later!

  3. Must include the hashtag #igotmyfixcapt to be entered into our competition.

Don’t forget CoachAmyPT is offering fun, free events all month long.

Join Roadrunners of Kansas City for free group runs every Saturday in October with. Come one Saturday or every Saturday this month to kick-start or supplement your training program. Better results when running with buddies! Course maps and more details are provided on the events tab of the RRKC website. 

Foam rolling improves circulation and mobility, prevents injury and aids in recovery. Learn how and when to use a foam roller correctly for the best results at a free foam rolling clinic on Monday, October 7th.

I often get inquiries from clients seeking tips on injury prevention. Over the next four weeks we’ll be writing about four pillars of physical therapy that can prevent injury and promote a long-term healthy lifestyle: mobility, strength and stability, balance and coordination, and performance enhancement.

Thank you for being an important part of the CoachAmyPT and Roadrunners of Kansas City community this year. We can’t wait to learn with you and great stronger with you this month.

Ready to post your #igotmyfixcapt story? Click below.

Big Benefits of Running with Buddies

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It’s no secret that working out in a group produces better results than flying solo. Research shows that the healthy actions of others rub off on us. Benefits of working out with other people include improving consistency, and increasing the intensity and duration of exercise. The same rings true for running.

Tackling runs or a lengthy training plan with a run group not only improves individual accountability but also allows athletes to: increase mileage safely, avoid injury and mental burn-out, and gain moral support and stamina.

Roadrunners of Kansas City (formerly known as Personal Best) has been hosting group runs filled with positive support for over 25 years. We invite you to try out some group runs for free every Saturday in October to see for yourself the benefits of running with friends (and water stops)! Also check out our short promo video for a glimpse of the spirit of our group.

Coach Amy Parkerson-Mitchell as the owner and operator of this run club adds unmatched expertise. Amy is a certified Garmin Coach, has recently been featured in Runner’s World, and is a licensed physical therapist. Although run leads may fluctuate, Coach Amy creates all of the training plans and provides a world of knowledge for her runners.

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Whether you’re a first-timer, a seasoned runner, or anything in between, there is a place for everyone at RRKC. Ready to try something new? Join us for the month of October. It could transform your year. 

“Before I joined RRKC, I struggled to train consistently, battled injuries, and couldn't find my community of people that made me fall in love with running in the first place. RRKC has changed all of that for me. I train more consistently, have kept injuries at bay, and because of that managed to get faster, all while making great friends!”    -Melody

Free Events in October @ CoachAmyPT

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At CoachAmyPT celebrating National Physical Therapy Month means giving back to an amazing community that has provided so much enthusiasm and support. During the entire month of October Coach Amy is offering some fun, free events. Whether you’re a past or current client of CoachAmyPT, or have never been to the clinic and are just interested in checking us out, please join in on the fun. Come for one event, or for all, and bring your friends! Health and wellness activities are more fun with more faces.

All events will take place at the CoachAmyPT clinic at 4573 Indian Creek Pkwy, Overland Park, KS 66207.

Free Group Runs every Saturday in October with Roadrunners of Kansas City.

This dynamic group of runners will motivate you shoulder to shoulder on some long routes, with stocked aid stations along the way. Mileage listed is the maximum mileage each course will be set for, but you can run any distance up to that maximum amount. All runs begin at 6:30 a.m.

  • Oct. 5th: 10 miles

  • Oct 12th: 20 miles

  • Oct. 19th: 10 miles

  • Oct. 26th: 20 miles

RSVP required on below link. Course maps and more details are provided on the Events tab of the RRKC website

Free Foam Rolling Clinic: October 7th

Foam rolling improves circulation and mobility, prevents injury and aids in recovery. Fewer pieces of equipment pack this much punch. However, knowing how and when to use a foam roller is critical for results.

Make friends with your foam roller at one of Coach Amy’s And This is How We Roll sessions where she’ll teach you how and when to roll out. Space is limited, registration required.

Thank you for being an important part of the CoachAmyPT and Roadrunners of Kansas City community this year. We can’t wait to see you in October!

And This is How We Roll

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Most of us have a love-hate relationship with the foam roller. It’s a bit of a sore ride but so worth it. Foam rolling improves circulation and mobility of muscles, tendons and fascia*. It also prevents injury in the back, hip, foot and shoulder, and aids in recovery.

That’s a lot of benefit from a piece of high density foam! However, knowing how and when to use a foam roller is critical. Foam rolling incorrectly, too frequently, or with too much compression can cause bruising and injury to nerves.

Coach Amy’s high level “rolling” tips:

Start WARM. Foam rolling is best with warm muscles. For athletes, this is AFTER a workout. The less active individual should warm-up for 10 minutes prior to foam rolling. A walk is a great way to get the blood flowing a bit first. 

Time is MONEY. Conveniently shorter is better. No need to roll for hours. 1-2 minutes per area is long enough.

Go SLOW. Moving too quickly on the foam roller causes the connective tissue to fight back and tighten up: the opposite of what we want. 

MEET the tension. Going too deep with too much compression can cause damage. We want to stimulate, not irritate.

Want to know more? Want to see a licensed PT demonstrate the proper technique, and watch you foam roll to ensure proper form? Coach Amy is hosting two foam rolling clinics in October during National Physical Therapy Month. These “one-time” clinics will be FREE in gratitude and enthusiasm for keeping Kansas City active and injury-free.

*what the heck is fascia? It’s a thick and strong spider-web like mesh of connective tissue that wraps around muscles, groups of muscles, blood vessels, nerves and even organs! 

Does Coach Amy Treat Back Pain? Why, Yes!

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Back pain can affect people of all ages. Up to 80% of the population will experience back pain at some time in their lives. Small aches and pains often come along with age, major life events, or increased and varied activity; but sometimes we have no idea what triggers pain at all.

Coach Amy helps identify triggers and provides treatment for patients with back pain that interferes with work, sleep, everyday tasks and hobbies. More importantly, once pain and function is restored she helps patients develop a strategy to prevent future occurrences.

Anna, a CoachAmyPT patient, suffered from back pain at various stages of her adult life. “I was experiencing severe lower back pain while training for a half marathon, any time I ran longer than 6 miles or so. It didn't hurt while I was running, but the day after I'd run it would hurt so much I'd be in tears. I had shooting pain down my hips and legs too. 

I started seeing Amy for physical therapy sessions, including Active Release Therapy (ART) and a lot of strength training. It made a HUGE difference for me. After a couple of sessions I was mostly pain free, and I was able to continue to run and train for my half marathon.”

After the arrival of her first baby, Anna’s lower back and hip pain returned. “The lower back pain ‘post-baby’ was similar - shooting pain in my hips wrapping around to the front. At first it started as an annoyance. When the pain peaked, making my daily tasks like rocking or nursing my baby really uncomfortable, I finally decided to go get treatment.” 

With more ART and functional exercises, Coach Amy was able to help Anna eliminate lower back and hip pain, and slowly get back to running. They also worked together on a long-term training plan to prevent future flair-ups. “Amy is so sweet and knowledgeable - she always reassured me that it would get better, and it did. She is the best!” 

Coach Amy’s patients graduate from PT armed with a better understanding of the causes of their pain and a personalized plan that may include home exercises to help prevent injury in the future. And yes, she does treat back pain!

Runner's World Magazine Interviews Coach Amy

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Have you ever felt overwhelmed by the mountains of data you get from your device after a run? Me too! I review my workout and run data, so I know where you're coming from. I also help all my local and Garmin Coach clients understand how to use their data to achieve their goals. 

Runner's World magazine recently interviewed me about this very topic. Check out the article to learn more! 

A Case for Changing Cadence: Injury Prevention

Caption: Coach Amy evaluating a client’s running form. Video taping the runner is always useful in a personal run evaluation.

If you’re a runner, you’re probably familiar with most running “lingo.” Cadence is a measurement of run gait that we can easily measure with our smart watches, but knowing what do with the data is a mystery to most runners. A quick Google search reveals debate among coaches and scientists creating even more confusion. Avoiding injury is a runner’s number one goal, but what about energy cost and efficiency?

Read the latest Roadrunners of Kansas City blog post to see how Coach Amy solves the case of what to do with Cadence data, with some run coaching clues! 

Should I Get a Cortisone Injection? Dry Needling vs. Cortisone.

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Many patients in chronic pain ask me whether they should get a cortisone injection. In some cases a cortisone injection can be helpful to break a vicious pain cycle. I recommend it as a last resort, as long as it is followed up with a thorough evaluation and treatment of the causes of the pain and dysfunction. Simply decreasing inflammation isn’t going to solve a problem long term.

I caution against multiple cortisone injections as it can break down connective tissues (muscle, tendon, ligament and nerve). As you can imagine, this can lead to worse problems down the road. Before a cortisone injection is entertained, I recommend dry needling. With dry needling there are biochemical changes that occur resulting in an increase of blood flow to the treated area, including white blood cells which is our bodies’ natural healing agent. Dry needling acts as a non-pharmacological anti-inflammatory.

In a study released in 2017 in the Journal of Orthopedic Sports Physical Therapy*, researchers treated 50 painful hips. Patients were randomly assigned to receive either a cortisone injection or dry needling. During the 6-week study no other forms of treatment were provided. At the end of the study, patients in both groups had the same results for pain relief, ability to move and perform daily activities, and medication use. Patients who went to physical therapy for dry needling had the same outcomes as those who received a cortisone injection.

The results of this study show that patients can get similar results from dry needling as from a corticosteroid injection. Both groups experienced a decrease in pain and an improved ability to move and complete daily activities. Because the outcomes were similar, dry needling may be a good option for those worried about the potential side effects and risks of a steroid injection, or who want to try a lower-risk treatment.

*J Orthop. Sports Phys. Ther. 2017;47(4):240. doi:10.2519/jospt.2017.0504