Exercise for Heart Health 

The heart is a muscle, which can get stronger with an active lifestyle.  It is never too late to initiate these changes.  Even small changes can make a big difference, such as lowering your risk for heart disease.

Where to Begin?

Once you are cleared for exercise by your doctor, find an activity that interests you.  Something such as brisk walking can be an economical choice, in that it primarily requires a good pair of shoes and space to walk.  If you are more motivated in a group setting, a gym could be an option or joining a group.  In many regions, there are groups, such as a Moms Run This Town, which is a group of running moms supporting other moms in all stages of the running process.

Cardiovascular exercise is very important, but there are other areas of exercise that will also benefit your overall health. 
Stretching is beneficial in reducing your risk for injury and allows you to become more flexible.  Perform stretching after a light warm-up or following exercise.  Stretching should feel good, but should not hurt when performed properly.

Strength training uses resistance to produce a muscular contraction to build strength, endurance, and muscle size.  Strength training does not necessarily mean getting “bulky.”  Strength training can help you to build strong bones, manage your weight, and improve energy levels.

Strength Training

Strengthening can also help to manage symptoms of chronic conditions, such as arthritis.  When individuals develop arthritis pain, this can lead to a decline in activity, which can result in additional problems. Although exercise can be painful initially, this activity helps to bring additional blood flow to the cartilage in that joint.  Also, exercises helps to make the muscles surrounding the joints stronger.  The stronger the muscles are, the more weight they can handle, which reduces the stress on the joint.  This can eventually lead to reduced pain.

You can use free weights, resistance bands/ tubing, or your own body weight for strength training.  These exercises can include lunges, push-ups, or squats, none of which require any special equipment to perform.  Choose a weight where your muscles begin to fatigue after ~15 repetitions.  If you are able to perform 30 repetitions easily, it is time to increase the amount of resistance used.  Allow at least one day in between strengthening routines. 

How Much Exercise?

The American Heart Association recommends “at least 30 minutes of moderate-intensity aerobic activity at least 5 days per week” and “moderate- to high-intensity muscle-strengthening activity at least 2 days per week” for overall cardiovascular health.  Start where you are able and work up to this guideline.

How Breast Cancer Patients Benefit from Physical Therapy

8 Benefits of Physical Therapy
Cancer treatments vary widely, depending upon the stage of cancer that has developed. Cancer is a debilitating disease that affects the body and an individual's self-image. Individuals may experience weakness, nausea and vomiting, along with hair loss or thinning and mouth sores.

Physical therapy can help people feel better by:
  • Easing pain
  • Reducing fatigue
  • Promoting bone density
  • Stimulating the immune system
  • Reducing stress and depression
  • Ridding the body of toxins
  • Decreasing swelling and inflammation
  • Treating lymphedema

People with breast cancer often lose their appetite which can lead to serious nutritional deficits and increases the risk of infections. Bleeding, diarrhea, anemia, and early menopause or infertility may also occur. Many individuals lose weight during breast cancer treatments, while others gain weight due to reduced activity levels.

Breast cancer has a strong emotional and psychological component that can be alleviated through physical therapy. Fear, poor sleep, worry and depression are common, along with loss of sexual function that further adds to an already stressful situation.

How Breast Cancer Patients Benefit from Physical Therapy
One in every eight women will be diagnosed with invasive breast cancer during their lifetime Another 61,000 women will be diagnosed with non-invasive breast cancer, along with 2,600 men. Physical therapy can help, ease the symptoms of treatment and aid in rehabilitation following reconstructive surgery.

The chance of developing breast cancer has a genetic component and those with a mother, daughter or sister who was diagnosed are at greater risk. Cancer doesn't just affect breast tissue. Patients may experience lung and breathing problems, bone loss and even cognitive impairment.

Painful joints and muscles are common, but even knowing what to expect during treatment can come as a shock when the effects begin to appear on an individual's own body. It's disheartening for breast cancer patients to discover that they can't perform ordinary household tasks due to fatigue or loss of muscle strength.

For advanced breast cancers that have spread into surrounding lymph nodes under the arms, patients may choose a mastectomy and reconstructive surgery. The method restores symmetry to the body and will require measures to maintain mobility and flexibility.

Treatment may also be required to address or treat lymphedema, a condition in which fluid doesn't drain correctly and collects in tissues. Well-known celebrity and two-time cancer survivor, Kathy Bates, has spoken publicly about her battles with lymphedema and the benefits of physical therapy for the condition.

A Breast Cancer Patient's Best Friend
Therapies for breast cancer will vary widely depending upon the needs of the individual and your physical therapist is one of the first lines of defense against the many symptoms associated with breast cancer treatment, surgical solutions, and the effects that can linger long after the cancer has been removed.

One of the most beneficial treatments for cancer patients is exercise to prevent bone loss and maintain strength. A customized exercise program will be created that factor in the type of cancer treatments you're receiving, your overall health and physical condition. It's important to remember that exercise doesn't have to be high-impact to be effective and assisted methods are available for those who lack strength or are unable to fully participate in the therapy.

Your physical therapist has multiple methods to help you attain the exercise you need, from yoga and tai-chi to clinical Pilates and hydrotherapy. Your exercise prescription will include movements that help build and maintain core strength, stability and coordination. Electro-stimulation may also be utilized.

If lymphedema is a problem, your physical therapist can help with treatments for drainage and compression sleeves to aid in reducing swelling and fluid retention. Physical therapy can also help you with shortness of breath due to fluid that may collect around the lungs.

Therapeutic massage addresses a multitude of symptoms associated with breast cancer treatment. It relieves pain and inflammation, stimulates your immune system, and relieves stress within the body. Another benefit is that it stimulates your body to release "feel-good" endorphins that relieves anxiety. Massage therapy is advantageous for addressing lymphedema, detoxification, stimulating the nervous system, and scarring that may occur during post-mastectomy and reconstructive services.

Your physical therapist can assist you with nutritional counseling and dietary supplements to ensure you're obtaining the right mix of nutrients. Supplements can be especially helpful if you have little appetite and fatigue prevents you from cooking. Help with assistive aids for sleep and mobility are also available.

Breast cancer strikes fear into the hearts of men and women who have been diagnosed, along with family and loved ones. Your physical therapist has treatments and therapies to help ease the effects of chemotherapy, radiation, mastectomy and reconstructive surgery. Breast cancer and associated treatments can be scary and have far reaching effects. Physical therapy can help you meet those challenges of the body, mind and quality of life.

LARD – Heart Healthy: Why You Should Be Cooking With It!!

Lard is made from pork fat. It is clarified or rendered through a process that involves heating the fat.

When used as a cooking fat, nutritionally speaking, lard has nearly one quarter the saturated fat and more than twice the mono-unsaturated fats as does butter. It is also low in omega-6 fatty acids which are known to promote inflammation.

There is a pervasive myth that animal fats increase the risk of heart disease. Our great, great grandparents consumed lard and butter and experienced extremely low rates of heart disease.

  • There is no evidence that saturated fat consumption raises the risk of heart disease.
  • A low fat diet, which is also a high-carb diet, can lead to an increase in blood triglyerides which potentially may increase your risk factor for heart disease.
  • Saturated fat intake raises HDL cholesterol which is associated with a lower risk of heart disease.
  • The diseases of modern “civilization” including heart disease and diabetes skyrocketed as animal fats were replaced by factory fats including vegetable oils and margarine.

Other benefits of lard include its neutral flavor. Some oils such as coconut may flavor your food while cooking with them.

Lard is very economical compared to many cooking oils.

Lard is high in Vitamin D. Lard is the second highest food source of Vitamin D after cod liver oil. One tablespoon has 1000iu's. Also important, is that Vitamin D is a fat soluble vitamin and therefore requires fatty acids-including saturated fatty acids-to be absorbed and utilized by the body. Lard provides the perfect package of Vitamin D along with the required fatty acid cofactor. One catch, however, only lard from pastured hogs contains Vitamin D since they must have access to
sunlight to synthesize the Vitamin D and store it in their fatty tissues. Purchase your lard from a butcher or farmer who can tell you how their pigs are raised.
In addition, providing cholesterol through quality fats reduces the burden on the body to produce cholesterol. Dietary cholesterol from whole foods like lard, supports inflammation management and hormone production.

Simple Advise for Avoiding Unhealthy Food

2 rules of thumb:

  • Avoid any food with a TV commercial.
  • Avoid any food that your great, great grandmother wouldn't recognize.

Recipe for Rendering Lard

  • Use a pot or crock pot.
  • Pour 1/2 cup of water into the pot.
  • Cut the pork fat into pieces.
  • Heat over medium heat.

It may take several hours for the fat to liquefy. When it has liquefied, you will notice some solids remain. You may remove these using a strainer or simply remove these pieces with a slotted spoon. Pour the lard into containers and refrigerate.

Did you know that February is National Heart Awareness Month?

Did you know that February is National Heart Awareness Month? Well, we are so excited to share some interesting facts on how to keep your heart healthy and happy. We have great meal ideas for you and your family to enjoy. Also, well as exercises to keep the blood pumping. There is so much to share that each week we will share a blog from one of our fabulous therapists. Our therapists will release on Monday mornings, along with a chance for you to ask them questions about that week’s blog on our “Live Stream Video” each Friday! How neat is that!?!?!?

I would like to start things off by sharing a great recipe that I found on “Pinterest”. Everyone is using this app and why not? There is so much to look at including heart healthy recipes. This recipe is called “Skinny Cajun Shrimp Skewers”. This is “oh so good” that just the thought of it makes my mouth water. What’s so great about this recipe is not only are you using grill (less dishes at clean up time) but really helps to get those fussy eaters to eat their veggies. One important key is it’s a low sodium meal but PACKS a punch of flavor and only 175 milligrams of sodium and 105 calories per serving. Plus, I just love to have a reason to fire up the grill no matter how cold it is outside.

Something else to really consider is your sodium intake. The 2010 Dietary Guidelines for Americans recommend an upper limit for sodium consumption of 2,300 milligrams of sodium per day for adults. Because the average American’s sodium intake is so excessive, even cutting back to no more than 2,300 milligrams a day will significantly improve blood pressure and heart health.

Stay tune for next week when Janet Keller, PT from our Spring Ridge office shares her thoughts on healthy heart and how to get the blood pumping. Also, her “Live Stream Video” will be on February 10th at 1:30 pm so mark your calendars!

Physical Therapy and Diabetes

9 Benefits of Physical Therapy
Physical therapy is beneficial for those who have been diagnosed with diabetes and individuals with pre-diabetes, also known as insulin resistance. Pre-diabetes occurs when glucose levels are elevated, but haven't yet reached diabetic proportions.

Physical therapy is effective for:

  • Better utilization of glucose
  • Lower blood pressure
  • Reduce the risk of heart disease
  • Weight loss
  • Reduced nerve disease
  • Fewer skin problems
  • Improved muscle function and flexibility
  • Pain relief
  • Lower risk of amputations

People with diabetes are at increased risk of numerous problems that accompany the disease. Damage to nerves is common, resulting in pain and disability. High blood pressure, peripheral vascular disease and stroke are very real concerns.

If not controlled, diabetes damages neurological systems that can cause blindness and one of the greatest threats to diabetics is kidney disease. Injuries heal slowly and can quickly transition into life threatening wounds that won't respond to antibiotics and limbs that must be amputated.


Physical Therapy - Your Weapon Against Diabetes
Physical Therapy - Your Weapon Against Diabetes
More than 29 million people in the U.S. have diabetes and it affects both adults and children. Diabetes occurs when the body can't make sufficient insulin, doesn't make any at all, or can't utilize what it does manufacture. Insulin is a hormone made by the pancreas that enables people to use the glucose (sugar) they consume in foods to provide energy for the body to work and play.

There are three types of diabetes. Type 1 is known as juvenile diabetes since it typically begins in childhood. It's an autoimmune condition in which the immune system attacks the pancreas resulting in little, if any, insulin production. Type 1 diabetes requires daily insulin injections.

Type 2 diabetes is often referred to as adult onset diabetes and individuals may or may not require daily insulin injections. Type 2 diabetes can sometimes be managed with exercise, diet and oral medications. It also has a strong genetic component and is exacerbated by high-carbohydrate diets and lack of exercise. It can occur at any age, but is often seen in older adults.

Gestational diabetes occurs during pregnancy and ordinarily disappears after childbirth, but the mother will have an increased risk of developing type 2 diabetes at any time thereafter.

Many of the symptoms of both type 1 and type 2 diabetes can be subtle, often overlooked, and are only discovered after long-term damage to the body has already occurred.

Patients with diabetes may experience:

  • Fatigue
  • Hunger
  • More thirst than normal
  • Increased need to urinate
  • Increased breakage and hair loss
  • Blurred vision
  • Dry mouth and itchy skin
  • Injuries and wounds that heal slowly
  • Yeast infections
  • Pain, numbness or tingling in legs and feet

People with type 1 diabetes often experience unplanned weight loss even though they haven't made any changes in their diet. In type 1 diabetes, the body can't utilize the food that's being consumed and the body begins to burn fat and muscle to produce energy. As the body burns fat, ketones are produced and when they build to dangerous levels, nausea and vomiting can occur.


Physical Therapy for Diabetes
Physical Therapy for Diabetes
Managing diabetes with physical therapy has multiple benefits ranging from more efficient use of glucose and weight loss to improved muscle tone and strength. Aerobic exercise and resistance training are highly effective therapies for managing diabetes and helps relieve pain, expand range of motion, increase flexibility, and improve balance and coordination.

Your physical therapist may choose clinical Pilates, yoga or tai-chi to address movement and weight problems. He/she can also provide nutritional counseling and dietary supplements that are specially designed for your diabetic needs. Assistance is available if you need mobility aids such as crutches, canes, walkers or wheelchairs.

Orthotic devices and shoes can be prescribed to lessen pain, alleviate sores, stabilize the gait and align the body. Your physical therapist can evaluate and care for injuries and show you how to protect your feet from wounds - particularly if you have little or no sensation remaining.

Exercise plans will be adjusted as needed as your overall physical conditioning improves. Your physical therapist has a wide array of therapies that can be used to provide you with the exercise you need to manage glucose levels, lose weight, and improve your health. Hydrotherapy is an effective treatment for improving the body that also relieves the effects of gravity and weight on the body, making it easier to move.

Therapeutic massage may also be utilized to stimulate the immune system, rid the body of toxins and reduce blood pressure. The therapy is beneficial for improving circulation, easing pain, and relieving the stress of dealing with a chronic disease.

Diabetes is a systemic problem that affects every organ in your body. Your physical therapist can help you manage the symptoms and health risks associated with the disease, assist in your continued mobility, and aid you in maintaining overall health.

Physical therapy had a wide variety of therapies that can be utilized to manage the symptoms and effects of diabetes.

Exercise is a key component in the management of diabetes and your physical therapist can create a custom exercise program that's tailored to your fitness level and mobility level.

Physical Therapy and Hamstring Health

Non-invasive healing
With proper care and physical therapy, a mild hamstring injury will take 2-10 days to heal, while a severe injury can take up to 10 weeks. Full rehabilitation can take up to six months, depending upon the severity of the injury.

Hamstring injuries are more prevalent in older individuals and adolescents whose muscles and bones grow at different rates, but can occur at any age. Physical therapy is an essential component of the healing and rehabilitation process and has a variety of benefits that include:

  • It's non-invasive
  • Eases pain and discomfort
  • Maintains range of motion and flexibility
  • Re-establishes muscle strength
  • Retrains the body in how to move properly
  • Rehabilitation if a surgical repair is required

Many people try to return to their regular activities too soon or place too much stress on the leg before the injury is sufficiently healed or full strength and mobility has been regained. It's essential that patients exercise patience to prevent re-injury and making the condition worse.

Physical Therapy and Hamstring Health
The body has three muscles (collectively known as the hamstring) in the back of the thigh that can be injured, with the most common cause being participation in sports and athletic endeavors. The hamstring muscle allows people to extend the hip and bend the knee and dancers and skaters are also at increased risk. Once a hamstring muscle has been injured, it can be up to six times more likely to be injured again.

Hamstring muscles are typically injured when an individual:

  • Rapidly accelerates or stops suddenly while running
  • Changes direction quickly
  • When jumping
  • Sprinting, hurdling or kicking
  • During heavy lifting

Individuals are at increased risk if they don't warm up and stretch sufficiently before engaging in new, unfamiliar or strenuous activities. Muscle fatigue, a prior injury and weakness in the hamstring or glutes are all factors that contribute to an injury. The damage can range from mild and feel like a cramp. Some people don't realize they've even sustained an injury until they rest or during the following day.

In a severe hamstring injury, the individual may feel a "popping" sensation or a sharp pain in the back of the thigh that extends into the buttock. The area may be swollen, bruised and tender to the touch and there may be difficulty sitting, lifting the leg or stretching it out fully. If the muscle is torn, surgery may be needed to repair the damage.

Physical Therapy for Happy Hamstrings
The exact course of treatment will depend on the severity of the injury and your ultimate goals. Your physical therapist may recommend alternating heat and cryotherapies, elevation, compression, or immobilization to prevent swelling and further damage until the injury has stabilized sufficiently to begin physical therapy.

Your treatment will typically begin with gentle stretches to maintain flexibility and range of motion. During your rehabilitation, you may require crutches or a brace to keep weight off the leg. As the healing process progresses, specific strengthening exercises will be added, along with those to stabilize posture, balance, and agility.

A wide range of complementary therapies may be employed to speed your healing. Your physical therapist can provide information and training on the proper way to lift, warm up and stretch before activities. If you require aids for mobility, your therapist will assist you in learning to use canes and crutches, walkers or wheelchairs.

Therapeutic massage may be incorporated into your treatment plan to improve circulation and maintain flexibility. It's effective for easing pain, stimulating the immune system, and helping the body expel toxins. It's beneficial for relieving the stress that many patients experience while they're healing and recuperating. Electro-stimulation, hydrotherapy and biofeedback may also be used.

During an injury, many people develop unusual or improper behaviors and patterns of movement as they try to protect the affected leg. Gait training is a critical part of rehabilitating a hamstring injury that helps the body relearn how to move the way it did before the injury.

The focus of your physical therapy will be to ease pain, heal and return your hamstring and leg to full functionality. You'll also receive information and methods to help reduce the risk of injury in the future. Physical therapy provides a pathway to healing and rehabilitation that allows you to return to your activities as soon as possible.

Heal the Heel

Easy Does It
An injury to the heel can have a variety of causes, from arthritis and heel spurs to stress fractures and tendon injuries. It's important for individuals not to overwork the heel. People who aren't accustomed to extensive running, jogging and similar activities should never attempt participation without proper preparation.

Physical therapy can prepare your feet for rigorous usage and relieve the effects of overuse. Physical therapy can help in multiple areas that include:

  • Foot or heel supports
  • Remedy gait problems
  • Reduce plain, inflammation and swelling
  • Identify mechanical dysfunction
  • Increased foot support
  • Improved flexibility
  • Build strength and endurance

Pain in the heel and bottom of the foot may be caused by micro-tears in the ligament that's responsible for supporting the arch. Any type of heel pain may develop over time and it can appear suddenly, representing an acute injury. If left untreated, heel and Achilles tendon pain worsens and can transition into a chronic condition.

Guy stretching his heels

Heel Pain and Injury: The Physical Therapy Solution
The feet bear the weight of the body upon them, but the heel of the foot receives little thought unless it begins to hurt. Pain can originate under the heel (plantar fasciitis) or the back of the heel in the Achilles tendon. Inflammation, swelling and pain are common complaints associated with the heel.

An injury to any part of the heel can be extremely painful, producing inflammation and swelling. Individuals may have difficulty flexing their foot up or down, standing on their toes, or even walking. A heel injury may also result in a tingling sensation indicating the need for immediate medical care that will often require rehabilitation with a physical therapist.

Everyone has an occasional pain in the heel after extensive walking, jogging or sports activities and it typically disappears within a day or so with rest. Heel pain that interferes in standing, walking, or lasts a week or more can be helped with physical therapy.

Plantar fasciitis is the most common cause of heel pain resulting from running and jogging, obesity, and excessive standing. Pain may be present when people take their first few steps in the morning or after sitting down for an extended period of sitting.

Guy stretching his heels

Treat the pain with physical therapy
Your physical therapist can help you reduce the risk of injuring your heel with specific stretches, exercises and warm-ups that will prepare your foot for action. He/she can help you choose the right shoes for specific activities. Footwear varies widely and a shoe that's appropriate for power walking won't be appropriate for jogging or running a marathon.

Many people have developed mechanical dysfunction in their gait that leads to improper foot placement. Your physical therapist can examine your gait while walking, jogging and running to determine if retraining or realignment is necessary. He/she can help if arthritis or chronic conditions are involved.

Orthotic devices can be prescribed to ease pain and distribute weight more evenly for comfort. If you're overweight or your employment requires extensive time in a standing position, your physical therapist can recommend accommodations and ergonomic solutions to relieve stress on the entire foot and the rest of the body.

Manual manipulation may be employed to improve flexibility and mobility. If heel pain is caused by a weakness in the lower leg, hip or core, you'll have access to technologically advanced methods to strengthen those areas and improve endurance. Pain in the heel can originate in the back and spinal adjustments are effective for relieving pain in any part of the body.

Therapeutic massage and electro-stimulation may be used to loosen tight muscles in the calf and foot, relieve pain, and reduce inflammation and swelling. Braces and assistive devices can be obtained to provide support. Your physical therapist may also use dry needling, acupuncture, and joint mobilization to treat and reduce the risk of injury.

You don't have to be a world-class athlete or compete in marathons to experience pain in your heel. It can result from an incorrect step, being overweight, or participating in active endeavors without the proper warm-up. No matter what the source, your physical therapist can help with preventative measures and treatment if an injury has already occurred.

Winter Fitness Secrets

Personalized Plans and Attention

Physical therapists are biomechanical specialists who can develop personalized programs that factor in past injuries, the specific type of activities in which people are involved, and their ultimate fitness and competitive goals ranging from marathons and team sports to running and bicycling.

A physical therapy practice offers a safe and therapeutic environment for patients with chronic disease to stay fit while addressing their particular health issues. Those with heart problems, diabetes and neurological conditions can benefit, along with patients who have diseases of the lungs.

The elderly and people with special health issues often refrain from healthy activities due to fear of falling or aggravating their condition. Physical therapists are specially trained in multiple health conditions and their services are effective and safe for pregnant women. Physical therapy is beneficial for more than treating and rehabilitating injuries – it’s a vehicle for lifetime fitness.

Winter Fitness Secrets

For those who dread trips to the gym or fitness center during winter’s inclement weather, physical therapy practices offer custom therapies, training and fitness programs to maintain health and fitness levels, reduce the risk of injury, and perform more efficiently.

Winter weather impacts physical workouts and affects mood, resulting in conditions that includes depression, fatigue and seasonal affective disorder. Physical therapists have techniques and methods to beat the winter blues, elevate mood, maintain fitness levels and prevent weight gain throughout the season.

A physical therapist has the experience and expertise to design a fitness program that maintains current fitness levels, prepares individuals for warmer weather and preserves competitive training schedules. Physical therapy practices also offer an effective alternative for the elderly, those with chronic conditions, and people who don’t feel comfortable within traditional gym environments.

Therapies for Fitness

Our physical therapy techniques address physical and emotional needs during cold winter months when activity and drive are at a low point. Therapeutic massage loosens muscles, increases performance and elevates mood. Massage therapy, acupuncture and dry needling increase energy levels, helps flush toxins from the body and boosts the immune system. It promotes restorative sleep, relieves aches and pains, and improves circulation throughout the body.
Aquatic therapy is an effective resistance training method for those with joint conditions, along with amateur and professional athletes. It’s beneficial for losing weight and allows people to perform motions not possible on dry land.

We offer multiple exercise programs including clinical Pilates, aerobics and yoga that build pelvic and core strength, stability and balance. We identify areas of weakness that need extra attention and perform gait assessments that pinpoints movement dysfunction that reduces efficiency.

Physical therapy practices offer the means to obtain professional training and guidance to stay fit during winter months, reduce the potential for injuries when activities are resumed in the summer and maintain professional training. Therapies are beneficial for relieving stress, anxiety, depression and seasonal conditions that often comes with winter, enabling individuals to greet summer with enthusiasm.

Muscles That Help Protect Our Lower Back While Keeping Our Tummies Flat

Many muscles work together to provide stability and movement in our spine. Keeping these muscles healthy and exercised can help reduce the incidence of low back pain LBP.

Let’s review the muscles on the anterior or front surface of our abdomen. Starting with the long, but sectioned rectus abdominus muscle. This is a paired muscle that gives us the proverbial “6 pack”. It is the major flexor of our trunk. It is the most active during sit ups and curl ups.

Next are the 3 muscles that make up the abdominal wall. All 3 help to stabilize our lumbar spine. They also help increase intra abdominal pressure for functions such as coughing, defecation and childbirth.

The first is the external oblique muscle. If you were to place your hands on your ribs with your fingertips pointed at your navel, you would have the idea as to how these muscle fibers are oriented.

The second muscle is the internal oblique. These muscle fibers run diagonally in the opposite direction to the external oblique. These two muscles contract strongly during a sit up when the trunk is twisted to the right or left. When twisting to the right, the left external oblique and the right internal oblique contract to assist the rectus abdominus in flexing the trunk to complete the movement.

The third muscle of the abdominal wall is the transverse abdominus (TrA). It is the deepest of the three and cannot be palpated. You can, however, feel and see the effects of this muscle being exercised by attempting to draw your abdomen back toward your spine which helps to keep your abdomen flat.

To start to exercise these muscles you must first learn how to recruit them and activate them. We will address the last, the TrA. Lie on your back or side in a neutral posture (gentle curve in your low back). Gently lift your belly up away from your pelvis. There should be no movement of your hips, pelvis or spine. Once you can isolate and activate the TrA, you are ready to move on to exercises to strengthen it.

Your therapist will be helpful in guiding you on how to connect to this muscle without activating other muscles. Proper technique is crucial to getting the full benefit from this muscle. Your goal is to teach your brain to remember to use this muscle in your everyday activities.

What is Direct Access?

Stephanie Wilfong, PT, DPT

Direct access can be thought of as self-referral to physical therapy. A doctor’s order used to be a universal requirement to begin therapy. Now, in the state of Maryland, you may begin physical therapy without a script from your doctor under direct access, with certain provisions. Direct access can be utilized if the physical therapist has a doctorate of physical therapy degree. A patient can be treated for up to 30 consecutive days before needing an official script from a doctor, nurse practitioner, chiropractor, or appropriate referral source. States differ in their direct access rules. Please refer to www.APTA.org to see if your state of interest allows direct access.

Direct access can allow the patient to stream line the process and likely be able to begin PT more quickly, as they don’t have to wait to get in to the doctor and then wait to see the physical therapist. Although physical therapists lack the ability to order certain diagnostic tests, such as an MRI, or prescribe medication, we are extensively trained in musculoskeletal and movement disorders. The education PT’s receive and the clinical training they undergo include the areas of examination, diagnosis, prognosis, and intervention. We are trained to recognize certain “red flags,” which may indicate the need for referral to a physician.

If you have any additional questions about direct access and how you may utilize this in regards to your care, please give us a call.