Here at C.A.R.E. Physical Therapy, we’d like to help you avoid back injuries this winter. We know that using the wrong body mechanics while shoveling can put extra stress on the lower back. Common injuries such as low back strain, disc herniation, and degenerative disc disease are often exacerbated by shoveling snow. Please consider the following tips to avoid low back injury.

Warm Up: Snow shoveling is strenuous exercise and should not be performed if your body is cold and/or stiff. Gentle stretches for the back, legs, and arms as well as 5-10 minutes of cardiovascular warm up is recommended. Get your body warmed up with a brisk walk or other exercise.

Minimize Risk of Falls: Since the surface you are shoveling is most likely slippery or icy, spread salt or kitty litter to avoid falling. Snow boots with rubber tread should be worn to increase traction with the ground.

Pick Your Shovel Wisely: Use a shovel with a curved or adjustable handle. This will minimize the amount of bending your knees and back will do in order to place the shovel on the ground. Pick a shovel with a small, plastic blade instead of a large, metal blade. This will make the shovel lighter because plastic will weigh less. A small blade is better because it will be less likely to pick up large amounts of snow at once.

Shovel Wisely:

• Grip the shovel with your hands at least 12 inches apart. This will allow for adequate leverage.
• Face the snow you wish to shovel with your hips and shoulders pointed in the same direction.
• Bend at the hips and knees. Try to keep your back relatively straight, with your abdominal muscles in control of the motion. Use your leg muscles to lift the snow.
• Pick up a small amount of snow. It should not feel like a very heavy load.
• Avoid twisting at your back and pivoting. Always turn with your entire body.
• Push the snow, if possible. Or, walk with the snow on the shovel. Avoid reaching and throwing the snow from the shovel.

Don’t Try To Be a Hero: Take a rest break every 10 minutes. Always stop shoveling if you feel fatigued or experience pain. If possible, only shovel 2-3 inches at a time.

Lindsay Lindquist, PT, DPT

Unlike acute inflammation, systemic inflammation can be harder to detect. It can develop slowly, involving blood vessels and various tissues throughout the body.  The degree of damage to the body’s tissues is proportional to the time inflammation lasts. Some of the common causes of systemic inflammation include: obesity, abdominal fat, insulin resistance, gum disease, parasites, infections, allergies, autoimmune disorders (such as Rheumatoid Arthritis), Alzheimer’s Disease, congestive heart failure, cancer, toxins (such as tobacco), diets high in refined flours, sugars, and fat.

It is important to understand the role of diet, and the factors you can control to ensure that inflammatory conditions are not exacerbated. Your body naturally produces both inflammatory and anti-inflammatory chemicals, called “prostaglandins” from nutrients in the food that you eat. An imbalance in your diet can lead to a disruption in the proportion of inflammatory prostaglandins, which fuel your body’s inflammatory response. The good news though, is that the consumption of certain nutrients allows your body to produce more anti-inflammatory prostaglandins, which it uses to reduce inflammation.

Common foods that reduce inflammation:

• Omega 3 fatty acids: salmon, tuna, mackerel
•  Protein: Lean poultry, halibut, whitefish, tuna, tofu, legumes, nuts
• Oils: Olive oil, flaxseed oil, hemp oils
• Herbs/Spices: basil, cayenne pepper, cinnamon, cloves, cocoa (at  least 70% cocoa chocolate), licorice, mint, oregano, parsley, rosemary, thyme, turmeric
• Vegetables: broccoli, cauliflower, onion, garlic, bell peppers, cabbage, chard, fennel bulbs, green beans, green onion, kale, leeks, olives, spinach, sweet potatoes, turnip greens
• Fruits: blueberry, cherries, citrus fruits, strawberries, papaya, avocado, fresh pineapple, kiwi      
• Beverages: water, 100% fruit juice, herbal tea, low sodium vegetable juice

Common foods that increase inflammation:

• Processed foods
• Meats:  bologna, hot dogs, sausage, ham, packaged lunch meats, bacon
• Carbohydrates: Sugary breakfast cereals, breads and pastas made with refined white flour instead of whole grains, packaged cakes and cookies
• Prepared meals: fast foods, fried foods, frozen fish sticks and frozen dinners that are high in sodium, canned foods with large amounts of sodium or fat, boxed meal mixes that are high in fat and sodium
• ‘Fake’ Foods: imitation butter, cheese, spreads
• Vegetable oil, trans fats
• Dairy
• Milk:  unless its raw, it is highly inflammatory and mucous-forming to the body
• Ice cream
• Regular cheese
• Protein: fatty meats
• Refined sugar: candy, soda, pastries, desserts
• Corn
• Potatoes (except sweet potatoes)
• Tomatoes (in arthritic conditions)
• Eggplant

If you would like more specific nutrient information, the Inflammation Factor (IF) rating scale has made it easier to determine which foods are best to eat to reduce inflammation. Foods with negative ratings increase inflammation while foods with positive numbers decrease inflammation. Note: The goal of the IF scale is not to eliminate all inflammatory foods.  If the sum of the food for one day is in the positive, it is okay to eat some foods on the negative list. Click here to see the list of IF ratings for some common foods.

Lindsay Lindquist, PT, DPT

Muscular flexibility is an important aspect of normal human functioning. Limited flexibility has been shown to predispose a person to several musculoskeletal overuse injuries. Athletes participating in activities requiring a large range of motion (examples include gymnastics or ice hockey goalie) require a freer movement pattern and benefit from a decrease in muscle stiffness or an increase in muscle compliance.

In the past 10 years, the relationship between muscle power output and stretching has been studied more extensively. It has been well established that applying a series of stretches to a relaxed muscle leads to an acute loss of strength after the stretching has been completed. Researchers concluded that athletes could not sprint as fast or jump as high after performing static stretches. Last year, the American College of Sports Medicine specifically advised against static stretching before workouts or competition. Stretching became unpopular among many coaches after these results.

This past month, Medicine & Science in Sports & Exercise published a comprehensive review of more than 100 studies of stretching. The conclusion: “detrimental effects of static stretch are mainly limited to longer duration”. Longer duration was defined as a stretch lasting more than one minute. Stretches held 30 seconds did not decrease athletic performance.

This has left many people wondering; If brief stretching is not bad for us, is it at all beneficial? Should we take the time out of our allotted workout time to stretch? In consideration of the current research on the topic of stretching, it is apparent that stretching should be considered on an individual basis. Personal fitness goals and level of participation need to be taken into account. Prior injuries and patterns of compensation should be evaluated to determine what muscles are restricted and need to be stretched.

We would be happy to provide a screen of your muscular flexibility and functional patterns of compenstation to help you establish a worth while stretching routine. Please contact us at (773) 472-2731 to schedule an appointment or to speak with a physical therapist.

Lindsay Lindquist, PT, DPT

1.    

A physical therapy prescription is a written order from a physician, podiatrist or dentist. It will include the doctor’s diagnosis, the duration of physical therapy recommended, and may include specific treatments the doctor would like the PT to implement.  

2.     Do I need a prescription?

By Illinois state law, a PT can perform an evaluation without a prescription. However, a prescription is currently necessary for subsequent physical therapy treatment.  Click here for state specific laws.

3.     Do I have to go to the PT my doctor prescribes?

No. Once you have a Physical Therapy prescription from a physician, podiatrist or dentist you are able to select your own PT.   Often times, physicians use prescription pads from specific physical therapy practices. This can be misleading for patients who are unaware of their right to bring their prescription to the location of their choosing.

4.     How should I pick a PT?

Chances are high that you will have a number of options in your insurance network and/or within close proximity to your home. Take time to do some research before you choose. Call and ask if the treatments will be individual. Verify that the physical therapist is licensed. Ask family and friends if they have recommendations.

We hope this clears up any confusion. Feel free to respond with any questions!

Lindsay Lindquist, PT, DPT

The most important feature that separates barefoot shoe wear from traditional athletic shoes is an altered walking and/or running pattern. In a traditional shoe, the technology is designed to absorb the forces as the heel strikes the ground first. In barefoot shoes, the forefoot or ball of the foot will come into contact with the ground first. The calf, ankle and foot are able to absorb the forces of the ground on the body.

When used correctly*, barefoot shoes provide many benefits:

1.      Increased leg and foot strength. Since the shoes have less structure than traditional running shoes, the entire leg is stimulated to activate more muscles. Increased use of foot and ankle muscles strengthens the muscles and can reduce injuries.

2.      Increased leg and foot flexibility. In addition to improved strength, the foot and ankle bones are able to move freely. This freedom of movement is linked to increased range of motion.

3.      Increased balance. As more nerves are stimulated in the foot, the brain is able to process this information more effectively. As a result, balance and agility improve.

4.    Improved alignment of spine and posture. By lowering the heel to millimeters off the ground, the spine is in optimal alignment. This allows for better bodyweight distribution from your heel to your toes.

5. Natural movement of the body and foot. Try them to feel how natural walking/running can feel!

*Transition to Running Without Injury: It is important to allow your body the time it needs to adjust to a new pattern of walking and/or running. If running barefoot is your goal, make sure to break in the shoes by walking only. When you are ready to start, run only 10% of the previous mileage you had been running for the first 2-3 weeks in your barefoot shoes. Do not run two consecutive days for the first 4 weeks. After 2-3 weeks, continue to gradually increase mileage by 10-20% each week. If you experience any pain, try taking several days off of barefoot shoes. Consult with a physical therapist if the pain persists or if you have any questions.

Lindsay Lindquist, PT, DPT

 The first step is to make an appointment with your primary care physician to have a physical examination. Be sure to discuss your specific running goals with your physician.  This appointment will allow your physician to screen you for problems that could jeopardize your health while running.

The second step is to establish an appropriate training plan. It is essential for your body to gradually work its way up to running the mileage you plan to race. For most runners, increasing your mileage by 10% each week is a safe way to progress. Training plans are available through local running clubs and online. Click here for examples of 5K and 10K training programs provided by the Universal Sole in Chicago, IL.

The third step is to take periodic inventories of any discomfort you may be experiencing as you train. Muscle soreness can be normal for a day or two following a run as your muscles acclimate, particularly if you are training on hills. Pain is not normal! It is your body’s way of telling you to stop. Pain can be related to poor mechanics, overtraining and/or inappropriate shoe wear.  Some areas of pain treated by physical therapists include: hip, knee, foot/ ankle, and low back.  Some of the most common diagnoses include: plantar fasciitis, patella tendonitis, and hip bursitis. Physical therapists (PT) are specialists in assessing movement of the human body. A PT can assess your running gait and note any compensation due to muscle or mechanical imbalances. This could include muscle weakness, inflexibility, poor posture and too much/too little joint mobility. Most PT clinics offer free screens to help you determine if physical therapy is appropriate. (Please keep in mind that by Illinois state law, PTs require a prescription from a doctor for treatment of any diagnosis.)

The fourth step is to have a safe race! On race day, be sure to pay attention to how your body feels. If you have any questions about your current medical status, be sure to contact your primary care physician. Three reasons you should not run include: if you have a fever or have had a recent fever, if you do not have normal blood pressure or have difficulty maintaining it, and if you have uncontrolled blood sugar.  Finally, make sure you are adequately hydrated. As a general rule, drink 16 ounces of water before you start and between 4 to 8 ounces every 20 minutes as you run.  

We hope you find this information helpful as you train this summer!

Lindsay Lindquist, PT, DPT

We’re excited to have a new forum to share with you the latest happenings at CARE Physical Therapy. Check back frequently to read the latest from the physicalt therapy front.

See you soon!

Lindsey Whiting