Joint Ventures' Blog

What Are Your Physical Therapists Credentials?

Fri, 17 May 2013 13:30:00 GMT

When your physical therapist hands you his or her business card, do you ever look at the credentials after the name and scratch your head? OCS? CSCS? DPT? ART?

What do those letters mean anyway? In many cases, they represent years of study and preparation that your physical therapist has completed in order to bring you the best and most effective care. They can indicate physical therapy education as well as advanced training in a variety of areas. Let’s translate some of them for you:

The Education Basics

PT, MPT, MSPT, or DPT: These letters represent the graduate degree that your physical therapist earned. The field has evolved with time. For many years, therapists earned a bachelor's degree prior to becoming licensed. Colleges and universities later transitioned to master's degree programs. If your therapist has the letters MPT or MSPT, this indicates a master's degree in physical therapy. Most programs today now train therapists for a DPT degree, which stands for doctorate of physical therapy.

Beyond these basic education credentials, there are a slew of other letter combinations you may find.

Many therapists earn specialty certification from the American Board of Physical Therapy Specialities, overseen by the American Physical Therapy Association. About 13,000 therapists in the U.S. have earned this. To earn specialty credentialing, PTs often need to have a minimum of 2000 hours of direct patient care in the specialty area, or to complete a residency. They also need to study for and complete a competency test.

You may see the following letters indicating that your therapist is a “specialist” in one or more of the following areas:

OCS: Orthopaedics

CCS: Cardiovascular and Pulmonary Rehabilitation

GCS: Geriatrics

NCS: Neurology

SCS: Sports

ECS: Clinical Electrophysiology

PCS: Pediatrics

WCS: Women’s Health

And the list of possible letters continues. Therapists with ART after their name have full certification in Active Release Technique. The ATC tag means that your therapist doubles as a certified athletic trainer. CKT indicates certification in the KinesioTape technique. CSCS recognizes individuals who are certified strength and conditioning specialists through the National Strength and Conditioning Association. A therapist can become a CMPT, “Certified Manual Physical Therapist,” or even better, a COMT, “Certified Orthopaedic Manual Therapist,” through advanced courses and testing from the North American Institute of Orthopaedic Manual Therapy.

Physical therapy is an ever changing field with new research-based programs and approaches incorporated in daily treatments all the time. So the next time you see some of these letters after a therapists name, you can be confident that you’re receiving the highest quality, most up-to-date care. Please contact me at Sophia.Maines@JointVenturesPT.com, if you have any other questions about PT credentialing!

New Ways To Test Your Muscles

Wed, 15 May 2013 17:39:00 GMT

Muscle strength testing is a basic component of a physical therapy evaluation. Some more specific muscle tests have been developed to help clinicians evaluate strength in patients in more detail than with previous testing positions. There are several benefits to this type of testing for you, the patient.

Let me start with a few concepts that help to explain why this specific muscle testing can be helpful:

Our bodies work on a basic premise of energy efficiency. We often create movement patterns or adopt certain positions or postures that minimize muscle activity and conserve energy. From a survival standpoint this is a functional process. Today’s societal norms include a large amount of postural challenges and repetitive activities both in the vocational and recreational setting. These activities usually fit into this concept of energy efficiency as well and often lead to repetitive strain of certain tissues. Muscle tissue is fantastically dynamic and, for the most part, can adapt to these repetitive demands. We accommodate for this demand by increasing the strength and endurance of the muscle tissue being used to help accomplish this. The commonly used muscles get strong, and efficiency leads us to recruit and use those muscles that are stronger more than those that are weaker. All tissue has a point at which it cannot handle the demand without some irritation, strain, or breakdown. This is a classic overuse scenario leading to tendonitis, bursitis, tendinosis and can be found in the wrist, elbow, forearm, shoulder, hip, knee and ankle regions. These postures, habitual patterns of movement, and drive for energy efficiency commonly lead to this overuse situation.

These techniques of more specific muscle testing help to identify the muscle tissue that is sore and painful and those tissues that are weaker and not being used and/or strengthened regularly. With this information, physical therapists can treat the injured tissue with techniques meant to decrease the inflammation and pain, as well as advise appropriate levels of relative rest to optimize healing. Strength exercise can often be started in the weak muscles during this period as well, as long as more soreness is not created in the overworking muscles. It is vital to the long term outcome to progress away from pain and overuse slowly, to allow strength to gradually develop in the weak, underutilized muscles to allow return to the desired activity without continued compensation and overuse. It is a case of really needing to fix the true biomechanical issue to solve the problem. Gradual return to more functional exercise simulating the desired activity, while insuring good balanced muscle firing is key to getting back to the sport, job or activity that you want.

If you have any questions regarding this specific muscle strength testing or feel that you may benefit from this type of care, please do not hesitate to contact me:

Christopher Clock, MSPT Chris.Clock@JointVenturesPT.com.

3 Exercises to Avoid to Prevent Shoulder Injuries

Fri, 10 May 2013 13:44:00 GMT

Now that Spring is upon us, and everyone starts coming out of hibernation, I want to offer my advice to those without exercise experience. There are certain exercises I highly recommend you do not perform. I say this from my own personal experience and because I've seen many patients with injuries specifically related to poor exercise execution and gym routines. It should be stated that there are probably people that have been doing these exercises for years and without issues, but that doesn't mean that these exercises are not RISKY! All exercises have risks, just like all sports have risks. Example: Football players take the risk of head injury and skiers take the risk of knee injury. I recommend that if your goal is to lose weight and get into better shape, or to start working out, you need to reduce the risks of injury with your routine. Here is a start.

AVOID THESE SHOULDER EXERCISES:

1.) Upright Rows: With this exercise, you essentially grip the bar and lift it up toward your chin while keeping your elbows higher than your hands. This places the shoulder is a poor position to work and essentially compresses the structures that pass under the acromion process. If you have even slight discomfort with this exercise, it could lead to tendonitis and even a rotator cuff tear.

2.) Lat Pulldowns Behind the Neck: This exercise also places the shoulder in a poor mechanical position to work and forces your neck forward. If a patient has a compromised cervical spine or has a history of shoulder discomfort, this exercise can make it worse. Now I love the lat pulldown, but it must be performed in front of the head. I love pull ups even more, so work your way up to them.

3.) Bench Dips:This exercise is easy to perform, and I even do some here and there. But if you don't have shoulder strength and stability, this exercise will ruin you. Don't be stubborn and think you have strength if you haven't been working out consistently for the past few months.

Overall, these exercises are risky and damaging to the shoulder. Since there are better ways to strengthen your shoulders, these exercises should be avoided. Now, time to fix your workout! If you have questions about these exercises, or what other exercises are better choices for a healthy shoulder, please contact me at Mike.Pellegrino@JointVenturesPT.com.

Aquatic Physical Therapy For Back Pain

Wed, 08 May 2013 13:20:00 GMT

The idea of getting in a pool in front of others, or when you are in pain can be a difficult concept to accept. But when dealing with back pain I think those suffering should consider all their options, including aquatic physical therapy. Over the last three months, I have found that my patients coming in for treatment due to low back pain have tried every other option for pain management, but nothing has helped. They are in pain, looking for some form of exercise, and are tired of doctor appointments. Due to the duration of time they have been dealing with this day to day pain, they are stressed out, not sleeping well, and struggling with day to day activities. Getting in the pool and working with a skilled professional to find a pain free form of movement can motivate an individual and possibly lead to a return to exercise in a land based setting.

Treatment in aquatic settings may vary from clinician to clinician, and varies according to each patient’s presentation. Most approaches consist of allowing the patient to become acquainted with the temperature, environment, and perhaps moving when being vertical. This warm up can be as simple as walking in multiple directions or stretching. Most strengthening for the back is focused on challenging the core’s stability. By moving your extremities while attempting to recruit deeper abdominal and back stabilizers, the patient can gain strength in areas they didn’t realize were weak. For example, a plank completed properly in the clinical setting on land is one of the most difficult abdominal exercises to perform. But technically, nothing is moving and the abdominals are firing to an extremely high level to provide stability. The same type of approach can be used in the aquatic setting by challenging a holding pattern.

When a patient gets the advice, “Lift with your legs,” it’s an assumption that they even have enough strength in their legs. Having strong arms and legs are essential for activities such as lifting, carrying, pushing and pulling, and having a strong core is essential for stabilizing YOU while doing these activities. Part of the treatment for low back pain is also strengthening your arms and legs, but most patients have a difficult time completing upper and lower extremity strengthening techniques due to low back pain. In the aquatic physical therapy setting, the patient has options for strength training in a buoyant, low to no impact setting. Having the property of hydrostatic pressure, the water can help control blood flow. The viscosity of the water provides a gentle form of resistance and the buoyancy assists in movement. Unloading the spine while being in the water decreases pain caused by compression (chest deep water can take away about 75% of the bodyweight load on the low back). Strengthening your extremities as well as the core is key to successful movement patterns.

Seeking treatment in the aquatic setting for low back pain can be a great alternative to land based physical therapy. Water therapy (sometimes called hydrotherapy, or pool therapy) offers some of the same and some different approaches to creating a tailored plan of care.

If you have any questions in regards to aquatic physical therapy, please contact me at Jessica.Simbro@JointVenturesPT.com.

Joint Ventures After The Marathon Bombings

Thu, 02 May 2013 04:00:00 GMT

Two weeks ago, Boston was changed forever when two bombs were detonated at our beloved Boston Marathon finishing chute. The Joint Ventures family has many patients, friends and colleagues who were affected, and we are working through these challenging times as a family. We’d like to give you a glimpse into what we have seen, and share the goals that are helping us heal physically and mentally.

From Jessica Douglas, MSPT, OCS:

"As a Physical Therapist, my first thought was trying to track down my friends, teammates, and patients that were on course. I was watching from Mile 24, and had seen most of them go by. I had gotten high fives, waves, and hugs and now just wanted to make sure they were all okay. Luckily, through my network of friends and the wonders of email, I was able to hear from them all in about 24 hours.

My next thought was, “What about next year?” I am a runner and triathlete, but have never really had an interest in running a marathon. For about a minute, I thought maybe 2014 would be the year I changed my mind. Then I realized that my dream is not to run Boston, but for so many it is. So, I have decided to volunteer at the medical tent, or a water stop, or somewhere, to help make those dreams come true for others. Maybe I’ll see you out there!"

Something that we can all do now is donate to the OneFund to help offset medical costs for the victims of the attacks. Another option is OneRun, a free event being organized by representatives from several running clubs, teams, events, businesses and organizations in the Greater Boston area. The goal of OneRun is to give runners and spectators an opportunity to experience the final mile of the marathon while also bringing hundreds of thousands of dollars in consumer spending to the Back Bay on Mother’s Day. Go to www.bostonrunners.com for more details.

Next, I would like to speak about one of our JV family members, Lee Ann Yanni. She was injured in the first explosion, and after a week in the hospital and a few surgeries, she is home and on the road to recovery. She has amazed us with her composure, positive attitude and sheer strength in these last two weeks. We miss seeing her at JV, and can’t wait until she is back in the office cracking her usual jokes. We have been amazed at the generosity of our friends and family, as we have raised over $5000 (at last check) for Lee Ann and her husband’s medical expenses related to these injuries. If you would like to learn more about how she is doing or to donate, please visit her page here.

In her own words, Lee Ann said, “I just want to thank all the first responders and medical staff and ancillary personnel on site and at Tufts medical center for all the great support and skills that will bring me back to my goals of running again!” We can’t wait to see her back on the road again!

LeeAnn Yanni and her husband Nick Yanni being interviewed by the Today show.

Finally, a story from one of Joint Ventures Administrative Assistants, Toni Mariano, who was running the Boston Marathon.

"The 117th Boston Marathon was the first marathon I have ever participated in. I grew up in Boston and attended Boston College, so I was an experienced fan of the race, but had no idea what to expect as a runner. After training for months in the cold weather, I couldn't have asked for a more perfect day! The sun was shining, there was a refreshing wind, and people from all over came out to support the runners. I entered Kenmore feeling strong and anticipating the finish line. When I reached the underpass where they began stopping the runners I was confused and looked to the spectators to answer all my questions. I was told that there was a bombing and my first instinct was to call my family, whom were on there way to the finish line. My family was on the the train when the explosions occurred and were stopped by Boston University. I was so thankful that everyone I knew was safe. I immediately signed up for another marathon in Green Bay, Wisconsin on May 19th because I am determined to complete my first marathon. I also plan to run the Boston Marathon again next year."

Toni Mariano(Far Right) ready to begin the race in Hopkington.

Toni Mariano reuniting with her family.

Get Ready To Roll

Fri, 26 Apr 2013 14:27:00 GMT

Maybe you have walked in to your gym and noticed people rolling on a piece of foam, or one of your running buddies, says “you should get a foam roller, they are great!” So, you might ask, what are these foam rollers all about and why should I use one?

Foam rollers come in various sizes, densities, looks and colors. If you are first starting out rolling, I would recommend less dense foam. As you advance, you may need harder foam to get the results you are looking for.

The purpose of foam rolling is to assist your body with stretching. It can improve muscle tension and flexibility, improve muscle imbalances, increase joint range of motion, and help prevent injury. Repetitive activity with decreased flexibility can increase the tightness in muscles and fascial layers, limiting the range of motion in your body, and in turn set you up for potential injury. Foam rolling is a form of self-myofascial release. By using your own body weight to roll along the muscles and fascial layers, you will begin to loosen and elongate the restricted tissues.

If you have yet to try foam rolling, give it a chance. But, as a warning, the first time you use the foam roller, it may be quite uncomfortable. Roll and apply as much pressure as tolerable. Also remember to avoid rolling over bony hard surfaces. Start off with five minutes total for both legs. If it is too much to start with, take a break in between. As you tolerate more, you can increase your time and pressure. Usually 10-15 minutes a day for both legs is ideal. Please note: if you are experiencing increase in pain, please discontinue use.

Here are the top five suggested techniques for the foam roller:

1. Iliotibial band (ITB) A band of fascia that runs down the outside of your thigh.

- Lie on the roll on the outside of your leg with your top leg bent with the foot on the ground over the leg on the roll. Forearms and hands on the ground.

- Gently roll up and down the side of your leg while walking your hands forward.

- You may find that mid thigh is quite tender. This is common.

- Do not roll over the knee bone or hip bone.

2. Quadriceps

- Lie on the roll on the front of your thighs with forearms and hands on the ground

- Roll up and down the tops of both your legs at the same time. You can do each leg individually if you would like.

- Do not go over the knee cap.

3. Calves

- Place the back lower portion of one of your legs on the foam roller and place the other leg on top of that leg.

- Place your hands behind on the ground and lift your buttocks off the ground. This will help you roll.

- Use the top leg to put pressure on the leg that is on the roll.

- Roll up/down the lower portion of your leg.

4. Hamstrings

- Place the back upper portion of one of your legs on the foam roller and place the other leg on top of that leg.

- Place your hands behind on the ground and lift your buttocks off the ground. This will help you roll.

- Use the top leg to put pressure on the leg that is on the roll.

- Roll up/down the upper portion of your leg.

5. Piriformis This muscle is part of your gluteal stabilizers and a common area of tightness.

- Sit your buttocks on the foam roller and place your hands behind you on the ground.

- Bend the knee and take the lower leg on one side and place it on the other thigh above the knee. You will be making a figure four.

- Shift your body weight to the side of the leg that the foot is off the ground, and roll on the buttocks.

If you have any questions about foam rolling, please contact Jaime Herrmann, MPT, CSCS at Jaime.Herrmann@JointVenturesPT.com.

Is Functional Training For You?

Tue, 23 Apr 2013 04:00:00 GMT

If you would describe yourself as an athlete, mom, or simply a human being... Functional Training is a valuable tool to incorporate into your daily exercise regimen. When performing awkward positions of bending, lifting, balancing, and twisting, Functional Training (FT) helps to ensure that you handle these activities with greater stability, less effort and less fatigue. The focus of FT is on movement, not on isolated muscle groups. Practicing movement patterns helps you to perform everyday activities safely and efficiently. In other words, if want to get better and stronger at an activity, then you should rehearse the activity.

Physical therapists rely on FT to promote a quick recovery from injury and to ensure an individual is ready to get back to their activities of daily living without hesitation. FT moves away from traditional body building type exercises where the emphasis is on overloading one muscle group at a time. FT exercises use various muscles in the upper and lower body simultaneously, teaching them to work together. This full body approach puts an emphasis on core stability, which decreases strain on vulnerable joints like the lower back, hips, knees, and shoulders. Exercises using dumbbells, kettle bells and medicine balls are typically used because the exerciser is required to control and balance the weight while lifting and lowering it.

This movement training approach provides many benefits. By using multiple muscles and joints at the same time to simulate activities of daily living, FT can:

Improve overall muscle strength, flexibility, and endurance
Improve balance, stability, and coordination
Help in injury prevention and injury rehabilitation
Help improve posture
Provide a cardiovascular workout which can improve aerobic and anaerobic energy systems
Burn more calories due to greater muscle mass involvement
Improve functional outcome with less wear and tear on the body due to a more holistic approach to training.

There are 4 basic principles of FT. As previously mentioned, the most important concept is that multi-joint and multi-muscle exercises be integrated, so you are using your entire body. Instead of just using your knee on a leg extension machine, why not perform a squat that forces you to use your back, hips, knees, and ankles? Eventually you should incorporate upper body exercises with these lower body movements, like performing a squat with a bicep curl using weight. This motion mimics the action of lifting a laundry basket or a young child from the floor, as pictured below.

Keeping in mind that the body is 3 dimensional, incorporating multi-planar motion is the next important concept. The body is designed to move in all directions, forward and backward, side to side, and rotation. For example, multidirectional lunges prepare the body for common activities, such as VACUUMING, and YARDWORK. The illustration on the left demonstrates a forward lunge in figure A, a side lunge in figure B, and a backward lunge in figure C. The illustration on the right demonstrates a forward lunge while incorporating trunk rotation with a medicine ball.

Core training has been a buzzword in the area of strength training and general fitness over the last few years. The best way to incorporate core conditioning into FT is to include a component of balance and stability. Whether you perform an upper body exercise while standing on one foot or sitting on a stability ball while maintaining good posture, there are multiple ways you can achieve this goal. Having a strong core will improve functional movement, prevent back pain, help you lift with greater ease, and improve your posture.

Last but not least, the final principle of FT is Have Fun! Instead of sitting on a machine and doing 3 sets of 15 repetitions, grab a brightly colored medicine ball, band, stability ball, kettle bell or dumbbell. Functional training creates a playground type atmosphere that is sure to keep you motivated and excited throughout your entire workout.

How to get started with a Functional Training program? It is a good idea to start with exercises using only your body weight for resistance in order to focus on your form. As you become more comfortable and are ready for more of a challenge, add weight. In order to prevent injury, it is important that you have good mechanics when performing any complex movement patterns.

FT will challenge you mentally and physically, while providing an effective and fun full body workout. Remember train movements, not just muscles. When you use exciting functional training tools, the majority of your health and fitness goals can be achieved!

If you have any questions regarding these FT exercises, please do not hesitate to ask your physical therapist, or contact me at Nicole.Chaput@JointVenturesPT.com.

Is Kettlebell The Boost That Your Routine Needs?

Thu, 18 Apr 2013 17:57:00 GMT

Over the past few years, I have had several clients and patients ask me if they should use kettlebells as part of their fitness routine. I always say that kettlebells are yet another great training strategy that allow us to fully develop ourselves as athletes and to achieve our personal goals. While traditional workout programs can become stale after a while, kettlebells can be the shot in the arm that not only makes training interesting again, but that also increases overall muscular strength and endurance.

Top 5 Kettlebell Training Benefits

1. Intense Endurance Challenge

One of the biggest draws of kettlebell training is that it allows for multiple exercises to be performed in quick succession, without having to change weights or equipment. This allows for shorter, more intense workouts that can increase cardiovascular endurance, as well as resting metabolism. This benefits both endurance athletes and those looking for general fitness and weight loss.

2. Increased Strength and Power

While kettlebells can help you to increase endurance, they can also be used to gain strength and power. Kettlebells can be used with Olympic weightlifting exercises such as the clean-and-jerk and the snatch. Kettlebells can also be used with traditional powerlifting exercises, such as squats and dead lifts.

3. Versatility

Kettlebells also offer exercises that are specially designed for their unique shape, such as swings and figure eights. Kettlebells are designed with an offset center of mass. This means that a majority of the weight is in one end of the kettlebell, unlike traditional barbells or dumbbells. This allows the kettlebell to be used in a wide variety of exercises and because it is offset, it requires greater muscular control compared to other traditional training exercises.

4. Core Strength and Stabilization

Kettlebells allow numerous exercises to be performed while using a single arm. This makes the exercise more challenging for the core and small stabilizing muscles of the body. So, along with increased strength and speed, kettlebell training also improves stabilization while performing active movement.

5. Full Body Workout

The full body style of kettlebell training allows for a greater amount of muscle to be activated while needing very few pieces of equipment. This means that you get a large amount of muscle activation and an intense, well-rounded workout in a short amount of time.

A New Age for Kettlebell Training

As little as five years ago, it was difficult to find a gym that had kettlebells. Fast-forward to today, and the popularity of the kettlebell has grown immensely. Not only do a majority of gyms now provide them, but you can purchase a kettlebell yourself, not only from a specialty store, but also from stores like Target or even Marshalls.

Kettlebell Training at Joint Ventures

If you’d like to start kettlebell training, but don’t know where to start, Joint Ventures is here to help. This May we will be offering a 3-week ‘Introduction to Kettlebell’ class. The class will allow you to not only learn how to use a kettlebell with proper form and technique, but also how to get an intense, unique, and fun workout.

Chris Contois, a Joint Ventures physical therapist with more than five years of experience using kettlebells, will lead the class. He has incorporated kettlebell training into his own routine to achieve a variety of fitness goals, including finishing full and half marathons and winning powerlifting competitions.

If you would like to learn more about Chris or the Joint Ventures kettlebell class, please feel free to look at Chris’ bio and email him at Chris.Contois@JointVenturesPT.com to sign up for the class.

Kettlebell Class Dates:

Thursday, May 2, 7-8 pm

Monday, May 6, 7-8 pm

Thursday, May 9, 7-8 pm

Monday, May 13, 7-8 pm

Thursday, May 16, 7-8 pm

Monday, May 20, 7-8 pm

Kettlebell Class Cost: $100 paid in advance for the 6-class package. That’s less than $20 per class!

Tragedy on Marathon Monday

Wed, 17 Apr 2013 21:11:00 GMT

The Joint Ventures Physical Therapy family has unfortunately been affected by the tragic events that occurred on Marathon Monday.

One of our therapists, Lee Ann Yanni, and her husband Nick were 10 feet from the finish line when the bombs went off. They were cheering on a friend and Joint Ventures’ patient who had just finished the race.

Lee Ann sustained an open fibular fracture, shrapnel wounds and experienced some temporary loss of hearing. She will undergo surgery for a skin graft and will remain in the hospital for about a week. Her husband Nick ruptured his ear drum and was discharged from Tufts Medical Center Tuesday. Both know they are extremely lucky.

We have established a fundraiser to assist them with the medical expenses they will incur during recovery. Should you wish to donate please visithttp://www.giveforward.com/fundraiser/9t72/leeannlovers

Here is the details of their experience:http://on.today.com/113zUL7

We will continue to send our thoughts, prayers and positive energy to those affected. Boston is our home and united we stand!

Your Body's Response to Stress

Thu, 11 Apr 2013 15:13:00 GMT

Throughout the day we are all exposed to various amounts of stress. We’re not talking emotional stress here, but physical stress---the forces your body is subjected to with everything you do. There are external forces, such as gravity, friction, and ground reaction force (the force that travels up your body when your foot hits the ground as you walk, run, jump, etc). And there are also internal forces such as joint contact (bone and cartilage interactions), muscle contraction, and joint shearing (sliding and pivoting). I think when most of us hear the word “stress” we have a negative association because we think of emotional stress, like being busy, or being overloaded with work or relationship issues. Physical stress could be harmful if it is repetitive or excessive, but when applied at the correct amount, it can have a positive impact on your body. Furthermore, insufficient amounts of physical stress can be harmful. Without enough physical stress, you can develop things like osteoporosis (low bone density), muscle strains, muscle atrophy, and myofascial dysfunctions.

All human tissues have a certain capacity or amount of physical stress that they can tolerate. The trick is finding the balance of how much stress is appropriate to put on these tissues. The musculoskeletal system is exposed to physical stress with all of your daily activities. Sitting, using stairs, driving, picking up your kids, putting away the groceries, holding your cell phone---everything puts a certain amount of force on your muscles, tendons, ligaments, bones, and cartilage. When we lift weights or do cardiovascular exercise, we are intentionally putting forces on our bodies. The tissues in your body can adapt to new forces or changes in forces; however, their ability to do this largely depends on how much force and how often you apply it. For example, if you have been lifting weights on a regular basis for several weeks, picking up that 30 pound bag of dog food and carrying it into your house is no big deal. But if you sit at a desk all day, sit in your car on a long commute, and then sit on your couch watching television every night, that same 30 pound bag could hurt you because your tissues aren’t used to that much force on a regular basis. Human tissues need time to adapt to forces in order to avoid failure or injury. Typically, tissues respond better to a relative low force applied for a long duration. This would be like consistently jogging and slowly building up the time or distance you jog over several months, while also giving your body adequate time to rest in between jogs. Applying appropriate amounts of force over an appropriate amount of time allows the muscles, tendons, ligaments, cartilage, and bones to gain a healthy tolerance to stress, and in turn, can protect you when unexpected strain or force is applied to the body.

If you exceed the tissue’s capacity for force, or if you apply a small force too often, you get tissue injury. This is obvious with a traumatic incident such as a car accident, but it is also true with just sitting too long at your computer day after day. The latter is referred to as microtrauma, which can be just as damaging to tissues. Think of it this way, you can lift a 100 pound box the wrong way just one time and hurt your back by straining muscles and herniating a disc, but you can have the same effect if you pick up a 1 pound weight the wrong way one hundred times. That’s macrotrauma versus microtrauma, and both are a result of too much force to the tissues.

Now, don’t think that you can avoid injury by avoiding force. Although that’s true to an extent, you need to follow the “everything in moderation” rule. If you sit around and never do anything that applies physical stress to your body, you can become extremely weak and deconditioned. This will occur naturally in all of us simply by aging. Over the decades we lose strength, flexibility, and endurance. It’s going to happen, there’s no denying it, but the rate at which this happens is in your hands. It’s never too late to start. You can do something as simple as going for a walk every day, or you can go beyond that and do some sort of activity that works on your muscular strength and endurance. Doing something to stress the tissues in a healthy manner will allow for ease of daily tasks such as picking up and carrying the grocery bags or taking the stairs when the elevator breaks down. If you’re worried about where to start or fear you’ll injure yourself, consult a personal trainer or a physical therapist for some safe and healthy ideas. Or, you can email me at Erin.Futrell@JointVenturesPT.com.

Remember, stress can sometimes be a good thing.

Tabata your way to Strength and Cardiac Health!

Wed, 03 Apr 2013 04:00:00 GMT

Everyone should exercise and the American College of Sports Medicine (ACSM) recommends “150 minutes of Moderate Intensity exercise per week” for the average adult. Along with this cardiac workout, the ACSM also recommends flexibility and strength training 2-3 times per week for most adults. Many people claim they don’t have time to do cardio for 30 minutes, 5 times per week, in addition to weight training, and ask me which they should focus on.

You should do both!

“I don’t have that much time to exercise during the day!”

Enter Tabata – a form of circuit training (developed in Japan by Izumi Tabata) that builds strength/anaerobic capacity and cardio aerobic fitness at the same time.

Tabata is a type of High Intensity Interval Training (HIIT) that has been shown to result in the same or greater aerobic improvements as in subjects who completed 30-60 min aerobic workouts 6 times per week. Additionally, the Tabata/HIIT group showed a 28% improvement in anaerobic strength, while the traditional aerobic workouts did not improve strength at all. The best part is that a Tabata only takes 4 minutes to complete.

The way HIIT works is you perform exercises quickly (with good form) with little rest in between sets, therefore building the strength and anaerobic energy systems at the same that time you are improving your cardio or aerobic systems.

Tabata works by performing 20 seconds of 1 exercise and then taking 10 seconds rest and repeating that cycle for 8 rounds, for a total of 4 minutes.

It’s that easy.

A traditional Tabata may use the same exercise over all 8 rounds, but if that’s too challenging (4 minutes of push-ups can be tough, even with breaks), you can alternate between a lower body exercise and an upper body exercise and still get a good cardiac workout (alternating push-ups with backward lunges, as an example set).

If you have any underlying injuries or conditions, you should see a health professional to determine which exercises might be right for your Tabata.

And always, form is important!!

Good luck! Please feel free to contact me with any questions at Brent.Butler@JointVenturesPT.com.

Brent Butler, PT, DPT, OCS, CSCS

Poor Posture and the Diaphragm

Thu, 28 Mar 2013 18:37:00 GMT

Most people with poor posture have poor breathing habits. Many people don’t realize that a slouched sitting posture can wreak havoc on the function of the diaphragm. The diaphragm is a large dome shaped muscle at the base of the lungs, responsible for expanding the lungs so we can take in air to get oxygen. When this muscle isn’t working as well as it should, other muscles in the upper back and neck area can take over by expanding the rib cage and helping to fill the lungs. However, this compensation pattern can lead to more chronic back or neck pain. So if you find yourself sitting in a chair most of the day, or if you’re rehabbing from a neck, back or rib injury, you could probably benefit from some diaphragmatic breathing practice to wake up this underutilized muscle.

The following are just some of the benefits of diaphragmatic breathing:

Decreases the work of breathing by lowering your breathing rate
Decreases oxygen demand
Strengthens the diaphragm
It’s relaxing and can help relieve anxiety
Can help power your singing voice!

To reap the benefits of a healthy functioning diaphragm, use the following tips to activate it.

It may be easiest to practice diaphragmatic breathing laying down at first, in a quiet and comfortable environment. You can then practice in different positions and during different activities for even greater benefit.

Step 1: Loosen any tight clothing.

Step 2: Put one hand flat on your stomach, with a finger just above the navel. Put your other hand on your chest.

Step 3: Take a slow breath in, focusing on raising your stomach into your finger as you breathe in to engage the diaphragm. Make sure your chest does not rise, at least until the end of the breath.

Step 4: Take a short pause at the end of breathing in.

Step 5: Slowly breath out (as if you are blowing into a plastic tube), feeling to make sure that your stomach and hand lower back down.

That’s all there is to it. You can start practicing by taking just a few breaths at different times throughout the day. Or you could take about 5-10 minutes once a day to focus on diaphragmatic breathing and work your way up to 3-4 times a day.

If you have any questions about diaphragmatic breathing, please contact me at Dan.Bertrand@JointVenturesPT.com.

Overuse Injuries in Children

Wed, 20 Mar 2013 04:00:00 GMT

Osgood-Schatter disease and Sever's disease are common overuse injuries in children. They occur when a muscle repeatedly exerts high levels of tension on its attachment point. This often occurs during a growth-spurt, when the bones grow faster than muscles and tendons do, resulting in increased muscle tension and pulling on attachment points. It can also be the result of faulty body mechanics, when one muscle group isn't working as hard as it should, and another group takes over and becomes overused and tight. These conditions occur frequently in children who participate heavily in running and jumping sports such as volleyball and gymnastics.

Osgood-Schlatter disease occurs when the quadriceps muscle at the front of the thigh pulls repetitively at its attachment below the knee (on the shin bone). This can result in pain and swelling at the bony prominence just below the knee (the tibial tubercle). This can be very painful, especially with running, jumping and climbing stairs and is more common in boys.

Sever's disease occurs at the back of the heel when the calf muscles pull repetitively on the Achilles. This will result in pain and swelling at the back of the heel and can cause the growth of a bone spur up from the heel towards the Achilles. It is also worse with running and jumping activities and with walking downhill.

These conditions will sometimes settle with rest and icing but often physical therapy is needed to address the mechanical reasons for the increased tension. Immobilization is sometimes recommended, but is a last resort as this will result in muscle weakness and will definitely require rehabilitation. If you have any questions about overuse injury, please feel free to contact me at Jessica.Douglas@JointVenturesPT.com.

Juicing Experiment - Take 1

Wed, 13 Mar 2013 21:19:00 GMT

With the juicing craze sweeping the Nation, Joint Ventures decided to give it a go! Resident massage therapist, Ryan Holohan, put together a concoction of: collard greens, celery, cilantro, ginger, 1 whole jalapeno pepper, lemon juice and Sriracha hot chili sauce! Wowie!

Here is the outcome:

Pretty Right? Cheers to health, wellness and veggie juice!:

Down the hatch!

Verdict? Umm... Yum?

Maybe a little on the hot side! Clearly this recipe is not for the faint of heart!

Share your juicing stories, techniques and tips below!

See you next time!

Employee Spotlight: Tri-Twins Jess & Tricia!

Fri, 08 Mar 2013 17:16:00 GMT

This month, we are highlighting two of our employees who have a similar interest. Both Tricia Weston, Business Development Specialist, and Jessica Douglas, Director of Clinical Operations and Physical Therapist, participate in triathlons! Continue reading to hear their experiences, advice, and of course, a fun fact or two!

1. Both of you have competed in triathlons. How many have you done? What do you feel is your greatest accomplishment regarding these races?

Jessica: I started racing in 2006, and do 2-5 Triathlons/year, in addition to some running and cycling races. Last year I qualified and raced in the US Age Group Nationals and had a personal best for the distance (Olympic distance is 0.9 mile swim, 25 mile bike and 6.2 mile run), despite starting off with my slowest swim ever!

Tricia: I have competed in many triathlons – short course (Sprint), mid-distance (Olympic and 70.3-half Ironmans) and long course (I have done 4 Ironmans – 3 at Lake Placid, NY, 1 in Louisville Kentucky). The actual number completed escapes me but I can tell you given a race season (May through September) I typically compete in 3 mid-distance events (70.3) and I throw in a few Olympic distance races for training and race prep for the longer distance events. My greatest accomplishment through my triathlon career was qualifying for the World Championships for 70.3 in Clearwater, Florida. I qualified for the Worlds 3 consecutive years by placing top 3 in my age group at qualifying events – not an easy task and I always went into my races wanting to ‘win the ticket to Florida’ for my children and family – this is also the way my children referred to my accomplishment, ‘mommy, you won the ticket to Florida!’, for my children they knew this meant a week away in Florida for my family and a vacation for Mommy post race! Another major accomplishment was I won the Danskin Women’s Triathlon (1st place overall) in 1998. I raced as an elite athlete. It was the most AMAZING feeling to cross the finish line first out of over 2,000 participants – crossing the line and breaking the tape was an incredible feeling I will never forget – I worked my tail off and had to strategically race to win – hard to explain but strategy is critical in Sprint events as you do not have much time to perform and you need to know when to push the envelope, when to back off and when to put things into 5th gear without running out of gas and potentially losing the race – it was a true battle between myself and 2nd and 3rd place, I had some ‘left in the tank’ and I turned it on at the exact right time to take home the win. I also competed in NYC as an Elite athlete at the NYC Nautica Triathlon – I was granted Elite status due to my race resume. The Elite athletes were announced pre-race to the swim start podium/dock – it was a surreal moment being in NYC racing at that level. Also, placing top 3 in my age group if not walking away from races with 1st place Masters and 1st place age group was a feeling I got used to through the years.

2. What training advice do you have for those looking to participate for the first time?

J: Ask questions! Most triathletes love talking about triathlon, and are happy to give their opinion about races, gear, etc. That being said, don't be afraid to hire a coach and get a professional opinion. Sometimes, people think that they have to be "good" to warrant having a coach, but that's just not true. Having someone develop a plan based on your strengths and weaknesses is sometimes the most useful when you are not sure what you shold be working on!

T: Set an attainable goal – take baby steps, short course (a Sprint distance) to get a feel with the transition from swim to bike to run. Also, follow a program that best suits you incorporating all 3 activities with some strength training worked in as well.

3. Running, swimming, biking. Which leg do you enjoy the most?

J: I love to run. It really helps me clear my head. If I am frustrated about something, I go for a run and try to work it out in my head while I run. Most times, I come back ready to tackle the problem successfully!

T: I really enjoy the biking but this is something that developed for me after I got into the sport! I got into triathlons as a runner – I was running marathons and thought, ‘what’s next?’ Initially I enjoyed the run part of it as I was naturally accustomed to road races but overtime developed a passion for cycling.

4. If you were a type food, what would you be?

J: Some sort of spicy sauce/salsa that you can add to a lot of different types of foods! I have a lot of different interests.

T: A banana!

5. Who is your all time favorite band/musician?

J: Dave Matthews Band - I could listen to them all day (with a little of his duet work with Tim Reynolds thrown in too)

T: The Allman Brothers

6. What is one of your favorite quotes?

J: "Pain is Temporary, Pride is Permanent."

T: "Nothing will work unless you do."

7. If you could have any superpower, what would it be?

J: Teletransportation - I am not patient at all and hate waiting in traffic, or for the bus, or stop lights. I would be much happier if I could snap my fingers and arrive at my destination.

T: To be able to fly to any location around the world on any given day or time

8. Who would play the lead role as you in a movie about your life?

J: Jennifer Garner (She's a Red Sox fan too!)

T: Anne Hathaway

9. If you could have a drink with anyone, (fictional, alive, dead, famous, non-famous) who would it be?

J: My grandmother, back when she was in her 50's. She died of Alzheimer's a few years ago, so the last few years I knew her, the person she became was different from who she was earlier in her life. I would love to talk to her when she was younger, to see what she was like then. She raised 3 very strong and independent women, who have now raised their own independent daughters, and I would like to know more about how she did that in a time that did not encourage that type of behavior in women. Oh, and she would definitely have a glass of White Zinfindel!

T: Craig Alexander – Pro-Triathlete

10. List one fun fact about yourself that people don’t know.

J: When I was 10, I was an extra in the movie, "The Witches of Eastwick." I have never seen it, as it was rated R, but mom assured me that you couldn't actually see me in the crowd scene I was filmed in.

T: I LOVE to bake!