How To Properly Use An Elliptical

One of the most popular pieces or cardio equipment is the elliptical. If used properly, it’s a great option when weather forces you to work out indoors and it can compliment a PRI program nicely. However, most people don’t maintain good mechanics on the machine. If you’ve ever had your toes go numb while on one, this pertains to you. 

Because this machine is challenging muscularly as well as cardiovascularly, our bodies are quick to use typical compensation patterns to make this activity ‘easier”. This typically involves letting our pelvis rotate forward which extends our lower back. This forces our body weight to go forward onto the balls of our feet (hence the numb toes). We also tend to pull the handles backward toward us or not use them at all. This is problematic as it puts into a generally extended pattern. This is the posture most of us with pain assume throughout the day. It causes us to overuse our outer quads, lower back, and pec muscles which cause muscle imbalances and pain. If you’re undergoing a PRI rehab, this can kill your program. Whether you’re undergoing a PRI program or not, it’s important to use any machine or piece of equipment properly to avoid an injury and make your work out as effective as possible. Get the most out of your work out by following these rules:

1) It’s essential to use the handles on the machine to maintain proper body mechanics. If we hold our arms steady on the equipment, the body’s momentum from our pelvis and legs suddenly stops in our lower backs. This can cause pain and misalignments in the pelvis, SI joint, and/or lower back. When you do use the handles, remember to push them away from you. This helps us to use our shoulder blade muscles on the pushing side as we as our abdominals on the opposite side of our bodies.

2) Keep your pelvis tucked. Thank about pulling you belly button toward your spine and contracting your abdominals. This will help keep our pelvis in a neutral position and disallow it from rotating forward. This takes unnecessary stress off of our lowers backs and allows us to use our glut and thigh muscles as we cycle our legs, and not just our lower back extensor muscles.

3) Keep your weight on your heels. When we walk or stand, our weight was designed to go through our heels. It is biomechanically incorrect to keep your weight on your toes and can cause nerve compression and pain. Putting weight through your heels also helps you engage your hastring muscles which stabilize your pelvis. 

4) Look around. When we stare at the computer or TV screen ahead of us, it tends to lock our body into the extension pattern mentioned earlier. If you feel like you need to watch TV to get through your work out, just remember to look around the gym every few minutes or so. This keeps our neurological system relaxed and fluid and working the way it should. 

Written by Lesley Callaham, MPT, PRC January 24, 2017

Success Is In The Details

A few weeks ago, I went to Ikea to search for a new couch. Now, as all of you who have been to Ikea know, this is no small feat. That place is designed to make you walk the entire warehouse so you buy as much as possible! I knew this ahead of time so I was prepared to go. As it was a very cold day, I wore warm, rigid soled boots, a heavy coat, and brought my purse full of credit cards.

As I was nearing the end of my five mile trek around the store, I began to notice that my lower back and right SI joint were hurting. At first, it wasn’t clear to me why. I was not wearing heels, nor was I lifting or carrying anything particularly heavy. In fact, I was pushing to cart at times. Then, I realized my problem. I hadn’t really prepared for this trip at all. I had made some small, but impactful errors. 

First, my shoes were all wrong. For the amount of standing and walking I was going to do, I needed proper tennis shoes (preferably PRI approved shoes). Although my boots were appropriately rigid through the midfoot of the shoe, they lacked the support to keep my spine aligned and allow my body to move with proper mechanics. 

Next, I wasn’t swinging my arms. Pushing the cart, carrying a purse, and even putting my hands in my coat pockets at times were causing my arms to locked into a position while my lower body moved. This not only causes a lot of tension as the mobile structures of the pelvis and hips meet the static structures of my ribcage and thoracic spine (hence my lower back and SI pain), it also causes a biomechanical mess. When we walk, our arms are meant to swing for a few reasons. It promotes momentum we can use to help propel ourselves forward and conserve energy. It also requires is to use the opposite arm and leg at the same time. This promotes normal mechanics and a lot range of motion to take place within the body while still staying balanced. 

The point is, daily, nagging pain can be made or broken in the details of what you do, how you do it, and what you’re wearing. If I had simply kept my hands swinging an wore proper footwear, I would have likely been pain-free for the trip - with the exception of my wallet of course!

That may be hard to see for people that have been in pain for some time. When our pain levels get to a certain threshold or we’ve been dealing with this pain for a long enough time, simple changes like these as well as active participation in your rehab exercises need to be practiced regularly in order for the painful tissue to heal. At this stage, you may not notice a large impact in your pain by swinging your arms, but remember that it makes a large impact in the overall time it takes your body to heal. Once your pain becomes intermittent, then you’ll be able to notice things that effect your pain such as footwear, positioning of your body, movement strategies, etc. 

Written by Lesley Callaham, MPT, PRC on January 16, 2018

Gloves: An Underrated Winter Accessory

Take a look outside and you’ll see the same thing over and over again - people walking with their hands in their pockets. Sure, you may only be outside for a few minutes or it may not seem like they’re totally necessary, but using gloves can do more than keep your hands toasty. They can help decrease your pain!

When we place our hands in our pockets it doesn’t allow our arms to swing when we walk. This is a very important part of the gait cycle for a few reasons; it helps us to utilize momentum and it allows our entire skeleton proper biomechanical activation and movement when walking. If we stop swinging our arms because our hands are in our pockets, holding something, or we have a purse under our shoulder, it eliminates this. This means our body has to work hard to move forward through space, the forces of walking cannot be easily transmitted throughout the body, and motion is essentially stopped in our lower spines and not able to move up through the spine and thorax as intended. This can cause malposition of our bones and joints, fatigue, and pain. 

So when you’re walking, try to maintain your arm swing as much as possible. Wear gloves, use a cross-body purse or messenger bag, and stop carrying unnecessary items in your hands. Making this simple change can have a huge impact on your pain levels. 

Written by Lesley Callaham, MPT, PRC January 9, 2018. 

Don’t Let Pain Cause You To Miss Out On Life

Don’t lose vacation days, or even pay, because of pain! Let Integrate 360 Physical Therapy help you on your journey to being pain-free again!

Even if you have tried physical therapy in the past, we can likely help. We are different from traditional PT as we are the only Postural Restoration Institute (PRI) certified clinic in the greater St. Louis area. All of our therapist are also PRI certified. Additionally, our patients see the same physical therapist each visit. We do not have therapy extenders. You will work one-on-one with your physical therapist at each visit.

PRI is a type of physical therapy that treats the source(s) of your dysfunction and pain, not just the symptoms. Regardless of the site of your pain, we assess and address (if necessary) your entire musculoskeletal and joint position and function. Just because your knee hurts, it doesn’t necessarily mean your knee is the problem. When an area(s) of your body isn’t able to move properly, it will find a way to compensate. Eventually, these compensation patterns break down because they are not biomechanically correct. As time goes on, your body finds other ways and areas of the body to compensate for this original dysfunction. Eventually, your will develop pain at one or multiple areas of compensation. Essentially, your neck may hurt because your right ankle doesn’t move well. If previous interventions and practitioners only addressed your neck and shoulders, it would make sense that you would not experience total relief.

Let us assess your entire body. We will then customize a therapeutic exercise program to treat the cause of the problem, just not mask the symptoms. Our treatment plan is different from traditional therapy as well. We typically give 3 or less exercises for your home plan, we ask you to do them only once a day, and we see our patients weekly or less. Our exercises are not simply strengthening or stretching exercises. They are movement patterns that teach your body how to move correctly via neuromuscular reeducation. We are able to see you less frequently than traditional therapy because we are essentially teaching your body a new skill, and skills take time to be learned. Once you have mastered that skill, we will then teach you a new one or continue to make it more challenging.

Let us help you reach your goal of wellness! Call us at 314-733-5000 or email us at Lesley@Integrate360PT.com or Nancy@Integrate360PT.com to set up your evaluation or simply allow us to answer any questions you may have. 

Written by Lesley Callaham, MPT, PRC on January 3, 2018